Public Health Code MCL Act 368 of 1978
Public Health Code MCL Act 368 of 1978
Public Health Code MCL Act 368 of 1978
AN ACT to protect and promote the public health; to codify, revise, consolidate, classify, and add to the
laws relating to public health; to provide for the prevention and control of diseases and disabilities; to provide
for the classification, administration, regulation, financing, and maintenance of personal, environmental, and
other health services and activities; to create or continue, and prescribe the powers and duties of, departments,
boards, commissions, councils, committees, task forces, and other agencies; to prescribe the powers and
duties of governmental entities and officials; to regulate occupations, facilities, and agencies affecting the
public health; to regulate health maintenance organizations and certain third party administrators and insurers;
to provide for the imposition of a regulatory fee; to provide for the levy of taxes against certain health
facilities or agencies; to promote the efficient and economical delivery of health care services, to provide for
the appropriate utilization of health care facilities and services, and to provide for the closure of hospitals or
consolidation of hospitals or services; to provide for the collection and use of data and information; to provide
for the transfer of property; to provide certain immunity from liability; to regulate and prohibit the sale and
offering for sale of drug paraphernalia under certain circumstances; to provide for the implementation of
federal law; to provide for penalties and remedies; to provide for sanctions for violations of this act and local
ordinances; to provide for an appropriation and supplements; to repeal certain acts and parts of acts; to repeal
certain parts of this act; and to repeal certain parts of this act on specific dates.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1985, Act 198, Eff. Mar. 31, 1986;Am. 1988, Act 60, Eff. Aug. 1, 1989;Am.
1988, Act 139, Imd. Eff. June 3, 1988;Am. 1993, Act 361, Eff. Sept. 1, 1994;Am. 1994, Act 170, Imd. Eff. June 17, 1994;Am.
1998, Act 332, Imd. Eff. Aug. 10, 1998;Am. 2002, Act 303, Imd. Eff. May 10, 2002;Am. 2003, Act 234, Imd. Eff. Dec. 29, 2003.
Compiler's note: For transfer of the Department of Insurance and Office of the Commissioner on Insurance from the Department of
Licensing and Regulation to the Department of Commerce, see E.R.O. No. 1991-9, compiled at MCL 338.3501 of the Michigan
Compiled Laws.
For transfer of powers and duties of certain health-related functions, boards, and commissions from the Department of Licensing and
Regulation to the Department of Commerce, see E.R.O. No. 1991-9, compiled at MCL 338.3501 of the Michigan Compiled Laws.
For transfer of powers and duties of licensing of substance abuse programs and certification of substance abuse workers in the
division of program standards, evaluation, and data services of the center for substance abuse services, from the department of public
health to the director of the department of commerce, see E.R.O. No. 1996-1, compiled at MCL 330.3101 of the Michigan Compiled
Laws.
Popular name: Act 368
ARTICLE 1
PRELIMINARY PROVISIONS
PART 11
SHORT TITLE, GENERAL DEFINITIONS, AND CONSTRUCTION
333.1101 Short title.
Sec. 1101. This act shall be known and may be cited as the public health code.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Compiler's note: For transfer of powers and duties of licensing of substance abuse programs and certification of substance abuse
workers in the division of program standards, evaluation, and data services of the center for substance abuse services, from the
department of public health to the director of the department of commerce, see E.R.O. No. 1996-1, compiled at MCL 330.3101 of the
Michigan Compiled Laws.
Popular name: Act 368
333.1104 Definitions; A to G.
Sec. 1104. (1) "Acknowledgment of parentage" means an acknowledgment executed as provided in the
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acknowledgment of parentage act, 1996 PA 305, MCL 722.1001 to 722.1013.
(2) "Administrative procedures act of 1969" means the administrative procedures act of 1969, 1969 PA
306, MCL 24.201 to 24.328, or a successor act.
(3) "Adult" means an individual 18 years of age or older.
(4) "Code" means this act.
(5) "Department", except as provided in articles 8, 15, and 17, means the department of health and human
services.
(6) "Director", except as provided in articles 8, 15, and 17, means the director of health and human
services.
(7) "Governmental entity" means a government, governmental subdivision or agency, or public
corporation.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1996, Act 307, Eff. June 1, 1997;Am. 2013, Act 268, Imd. Eff. Dec. 30, 2013;
Am. 2015, Act 155, Eff. Jan. 18, 2016.
Popular name: Act 368
333.1105 Definitions; I to M.
Sec. 1105. (1) Individual means a natural person.
(2) Local health department means:
(a) A county health department of a single county provided pursuant to section 2413 and its board of
health, if any.
(b) A district health department created pursuant to section 2415 and its board of health.
(c) A city health department created pursuant to section 2421 and its board of health, if any.
(d) Any other local agency approved by the department under part 24.
(3) Local health officer means the individual in charge of a local health department or his or her
authorized representative.
(4) Magistrate means a judge authorized to issue warrants by the laws of this state.
(5) Minor means an individual under 18 years of age.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.1106 Definitions.
Sec. 1106. (1) "Opioid antagonist" means naloxone hydrochloride or any other similarly acting and equally
safe drug approved by the federal food and drug administration for the treatment of drug overdose.
(2) "Opioid-related overdose" means a condition, including, but not limited to, extreme physical illness,
decreased level of consciousness, respiratory depression, coma, or death, that results from the consumption or
use of an opioid or another substance with which an opioid was combined or that a layperson would
reasonably believe to be an opioid-related overdose that requires medical assistance.
(3) "Parentage registry" means the department's compilation of data concerning children's parentage, which
data the department receives from any source, including, but not limited to, a copy of an order of filiation
from the circuit court or an acknowledgment of paternity or parentage under this act, under section 2114 of
the estates and protected individuals code, 1998 PA 386, MCL 700.2114, or under the acknowledgment of
parentage act, 1996 PA 305, MCL 722.1001 to 722.1013.
(4) "Person" means an individual, partnership, cooperative, association, private corporation, personal
representative, receiver, trustee, assignee, or other legal entity. Person does not include a governmental entity
unless specifically provided.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1996, Act 307, Imd. Eff. June 20, 1996;Am. 2000, Act 58, Eff. Apr. 1, 2000;
Am. 2014, Act 311, Imd. Eff. Oct. 14, 2014.
Popular name: Act 368
333.1108 Definitions; R, S.
Sec. 1108. (1) Rule means a rule promulgated pursuant to the administrative procedures act of 1969.
(2) State means a state, district, territory, commonwealth, or insular possession of the United States or
any area subject to the lawful authority of the United States.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
PART 12
GENERAL PROVISIONS
333.1201 Delaying promulgation of new rules.
Sec. 1201. When the department is directed to promulgate rules by this code and rules exist on the date the
requirement to promulgate takes effect, which rules the department believes adequately cover the matter, the
department may delay the promulgation of new rules until the department considers it advisable.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.1203 Approval of certain plans or issuance of certain permits pursuant to code; effect.
Sec. 1203. The approval of plans or the issuance of a permit pursuant to this code which involves the
construction, alteration, or renovation of a building, structure, or premises, the use of a site, or the installation
or alteration of equipment does not relieve the person receiving the approval or permit from complying with
all consistent applicable provisions of building and construction laws, zoning requirements, and other state
and local statutes, charters, ordinances, rules, regulations, and orders.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
ARTICLE 2
ADMINISTRATION
PART 22
STATE DEPARTMENT OF PUBLIC HEALTH
333.2201 Department of public health and office of director of public health continued.
Sec. 2201. The department of public health and the office of the director of public health created by
sections 425 and 426 of Act No. 380 of the Public Acts of 1965, being sections 16.525 and 16.526 of the
Michigan Compiled Laws, shall continue under this code.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Compiler's note: For transfer of powers and duties of the division of occupational health in the bureau of environmental and
occupational health, with the exception of dry cleaning unit, from the department of public health to the director of the department of
labor, see E.R.O. No. 1996-1, compiled at MCL 330.3101 of the Michigan Compiled Laws.
For transfer of certain powers and duties of the office of policy, planning and evaluation from the department of public health to the
director of the department of community health, see E.R.O. No. 1996-1, compiled at MCL 330.3101 of the Michigan Compiled Laws.
Popular name: Act 368
333.2202 Director of public health; appointment, term, and qualifications; designation and
responsibility of chief medical executive; administrative experience defined.
Sec. 2202. (1) The governor shall appoint the director of public health by the method and for a term
prescribed by section 508 of Act No. 380 of the Public Acts of 1965, being section 16.608 of the Michigan
Compiled Laws. The director shall be qualified in the general field of health administration. Qualification
may be demonstrated by either of the following:
(a) Not less than 8 years administrative experience of which not less than 5 years have been in the field of
health administration.
(b) A degree beyond the level of baccalaureate in a field related to public health or administration, and not
less than 5 years of administrative experience in the field of health administration.
(2) If the director is not a physician, the director shall designate a physician as chief medical executive of
the department. The chief medical executive shall be a full-time employee and shall be responsible to the
director for the medical content of policies and programs.
(3) As used in this section, administrative experience means service in a management or supervisory
capacity.
History: 1978, Act 368, Eff. Sept. 30, 1978.
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Compiler's note: For transfer of certain powers and duties of the chief medical executive from the department of public health to the
director of the department of community health, see E.R.O. No. 1996-1, compiled at MCL 330.3101 of the Michigan Compiled Laws.
Popular name: Act 368
333.2208 Public health advisory council; creation; appointment, qualifications, and terms of
members; removal; vacancy.
Sec. 2208. (1) The public health advisory council is created in the department. The public health advisory
council shall consist of 16 members. Initial members of the public health advisory council shall include those
individuals currently appointed to the advisory council created under section 506 of Act No. 380 of the Public
Acts of 1965, being section 16.606 of the Michigan Compiled Laws, who shall serve for the remainder of
their terms under that section.
(2) The advisory council shall represent consumers and providers of health care representative of the
population as to sex, race, and ethnicity and shall include representatives of a local governing entity as
defined in part 24 and a local health department. New members shall be appointed by the governor with the
advice and consent of the senate. Except for initial members, a member of the public health advisory council
shall serve for a term of 4 years or until a successor is appointed. After the effective date of this part, an
individual shall not serve more than 2 full terms and 1 partial term, consecutive or otherwise.
(3) The director may request the governor to remove a member from the public health advisory council at
any time for good cause.
(4) A vacancy shall be filled in the same manner as an original appointment for the balance of the
unexpired term.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Compiler's note: For transfer of powers and duties of the public health advisory council to the director of the department of
community health and abolishment of the council, see E.R.O. No. 1997-4, compiled at MCL 333.26324 of the Michigan Compiled Laws.
Popular name: Act 368
333.2209 Public health advisory council; election and terms of chairperson and
vice-chairperson; quorum; reimbursement; staff support.
Sec. 2209. (1) The public health advisory council shall elect a chairperson and vice-chairperson for terms
of 2 years and shall determine the number of voting members constituting a quorum for the transaction of
business.
(2) Public health advisory council members shall be reimbursed pursuant to section 1216.
(3) The department shall provide staff support to the public health advisory council.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Compiler's note: For transfer of powers and duties of the public health advisory council to the director of the department of
community health and abolishment of the council, see E.R.O. No. 1997-4, compiled at MCL 333.26324 of the Michigan Compiled Laws.
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Popular name: Act 368
333.2211 Coordination between local health departments and local health planning agencies;
review; annual assessment; information.
Sec. 2211. (1) In each of the 3 years immediately after the effective date of this part, the public health
advisory council shall review the coordination between local health departments and local health planning
agencies, and make annual assessments by January 1 of those years to the director including actions which
should be taken to improve coordination. The annual assessment shall be available to the governor,
legislature, county boards of commissioners, local health departments, health planning agencies, and other
interested persons.
(2) The department shall provide the public health advisory council with information necessary to carry out
its functions under this code.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Compiler's note: For transfer of powers and duties of the public health advisory council to the director of the department of
community health and abolishment of the council, see E.R.O. No. 1997-4, compiled at MCL 333.26324 of the Michigan Compiled Laws.
Popular name: Act 368
333.2221 Organized programs to prevent disease, prolong life, and promote public health;
duties of department.
Sec. 2221. (1) Pursuant to section 51 of article 4 of the state constitution of 1963, the department shall
continually and diligently endeavor to prevent disease, prolong life, and promote the public health through
organized programs, including prevention and control of environmental health hazards; prevention and
control of diseases; prevention and control of health problems of particularly vulnerable population groups;
development of health care facilities and agencies and health services delivery systems; and regulation of
health care facilities and agencies and health services delivery systems to the extent provided by law.
(2) The department shall:
(a) Have general supervision of the interests of the health and life of the people of this state.
(b) Implement and enforce laws for which responsibility is vested in the department.
(c) Collect and utilize vital and health statistics and provide for epidemiological and other research studies
for the purpose of protecting the public health.
(d) Make investigations and inquiries as to:
(i) The causes of disease and especially of epidemics.
(ii) The causes of morbidity and mortality.
(iii) The causes, prevention, and control of environmental health hazards, nuisances, and sources of illness.
(e) Plan, implement, and evaluate health education by the provision of expert technical assistance and
financial support.
(f) Take appropriate affirmative action to promote equal employment opportunity within the department
and local health departments and to promote equal access to governmental financed health services to all
individuals in the state in need of service.
(g) Have powers necessary or appropriate to perform the duties and exercise the powers given by law to
the department and which are not otherwise prohibited by law.
(h) Plan, implement, and evaluate nutrition services by the provision of expert technical assistance and
financial support.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.2223 Biennial plan for rural health; preparation; submission to standing committees.
Sec. 2223. The center for rural health created under section 2612, in consultation with the department and
professional associations representing health facilities and health professions, shall prepare a biennial plan for
rural health. The center for rural health, in consultation with the department, shall submit the plan to the
standing committees in the senate and house of representatives with jurisdiction over matters pertaining to
public health.
History: Add. 1990, Act 125, Imd. Eff. June 26, 1990.
Compiler's note: For transfer of certain powers and duties of the center for rural health from the department of public health to the
director of the department of community health, see E.R.O. No. 1996-1, compiled at MCL 330.3101 of the Michigan Compiled Laws.
For transfer of powers and duties of the center for rural health to the director of the department of community health and abolishment
of the center, see E.R.O. No. 1997-4, compiled at MCL 333.26324 of the Michigan Compiled Laws.
Popular name: Act 368
333.2224 Promotion of local health services; coordination and integration of public health
services.
Sec. 2224. Pursuant to this code, the department shall promote an adequate and appropriate system of local
health services throughout the state and shall endeavor to develop and establish arrangements and procedures
for the effective coordination and integration of all public health services including effective cooperation
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between public and nonpublic entities to provide a unified system of statewide health care.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.2233 Rules.
Sec. 2233. (1) The department may promulgate rules necessary or appropriate to implement and carry out
the duties or functions vested by law in the department.
(2) If the Michigan supreme court rules that sections 45 and 46 of the administrative procedures act of
1969, Act No. 306 of the Public Acts of 1969, being sections 24.245 and 24.246 of the Michigan Compiled
Laws, are unconstitutional, and a statute requiring legislative review of administrative rules is not enacted
within 90 days after the Michigan supreme court ruling, the department shall not promulgate rules under this
act.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1996, Act 67, Imd. Eff. Feb. 26, 1996.
Compiler's note: In separate opinions, the Michigan Supreme Court held that Section 45(8), (9), (10), and (12) and the second
sentence of Section 46(1) (An agency shall not file a rule ... until at least 10 days after the date of the certificate of approval by the
committee or after the legislature adopts a concurrent resolution approving the rule.) of the Administrative Procedures Act of 1969, in
providing for the Legislature's reservation of authority to approve or disapprove rules proposed by executive branch agencies, did not
comply with the enactment and presentment requirements of Const 1963, Art 4, and violated the separation of powers provision of Const
1963, Art 3, and, therefore, were unconstitutional. These specified portions were declared to be severable with the remaining portions
remaining effective. Blank v Department of Corrections, 462 Mich 103 (2000).
Popular name: Act 368
Administrative rules: R 287.1; R 287.451 et seq.; R 287.481 et seq.; R 325.60; R 325.151 et seq.; R 325.921 et seq.; R 325.951 et
seq.; R 325.1053 et seq.; R 325.1213 et seq.; R 325.1281 et seq.; R 325.1541 et seq.; R 325.2101 et seq.; R 325.2111 et seq.; R 325.2581;
R 325.3271 et seq.; R 325.3311 et seq.; R 325.3401 et seq.; R 325.3801 et seq.; R 325.5810 et seq.; R 325.9001 et seq.; R 325.13051 et
seq.; R 325.13091 et seq.; R 325.17101 et seq.; R 325.23101 et seq.; R 338.3801; and R 338.3821 et seq. of the Michigan Administrative
Code.
333.2253 Epidemic; emergency order and procedures; avian influenza; conditions requiring
assistance of department of agriculture.
Sec. 2253. (1) If the director determines that control of an epidemic is necessary to protect the public
health, the director by emergency order may prohibit the gathering of people for any purpose and may
establish procedures to be followed during the epidemic to insure continuation of essential public health
services and enforcement of health laws. Emergency procedures shall not be limited to this code.
(2) If an epidemic described in subsection (1) involves avian influenza or another virus or disease that is or
may be spread by contact with animals, the department of agriculture shall cooperate with and assist the
director in the director's response to the epidemic.
(3) Upon request from the director, the department of agriculture shall assist the department in any review
or update of the department's pandemic influenza plan under section 5112.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2006, Act 157, Imd. Eff. May 26, 2006.
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Popular name: Act 368
333.2262 Violation; rules adopting schedule of monetary civil penalties; issuance, contents,
and delivery of citation.
Sec. 2262. (1) The department may promulgate rules to adopt a schedule of monetary civil penalties, not to
exceed $1,000.00 for each violation or day that a violation continues, which may be assessed for a specified
violation of this code or a rule promulgated or an order issued under this code and which the department has
the authority and duty to enforce.
(2) If a department representative believes that a person has violated this code or a rule promulgated or an
order issued under this code which the department has the authority and duty to enforce, the representative
may issue a citation at that time or not later than 90 days after discovery of the alleged violation. The citation
shall be written and shall state with particularity the nature of the violation, including reference to the section,
rule, or order alleged to have been violated, the civil penalty established for the violation, if any, and the right
to appeal the citation pursuant to section 2263. The citation shall be delivered or sent by registered mail to the
alleged violator.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.2263 Citation; petition for administrative hearing; decision of hearings officer; review;
provisions governing hearings and appeals; civil penalty.
Sec. 2263. (1) Not later than 20 days after receipt of the citation, the alleged violator may petition the
department for an administrative hearing, which shall be held within 60 days after receipt of the petition by
the department. The administrative hearing may be conducted by a hearings officer who may affirm, dismiss,
or modify the citation. The decision of the hearings officer shall be final, unless within 30 days after the
decision the director grants a review of the citation. Upon review, the director may affirm, dismiss, or modify
the citation.
(2) Hearings and appeals under this section shall conform to the administrative procedures act of 1969.
(3) A civil penalty shall become final if a petition for an administrative hearing is not received within the
time specified in subsection (1). A civil penalty imposed shall be paid to the state treasury for deposit in the
general fund. A civil penalty may be recovered in a civil action brought in the county in which the violation
occurred or the defendant resides.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
PART 23
BASIC HEALTH SERVICES
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333.2301 Identification of priority health problems; preparation and basis of proposed list of
basic health services.
Sec. 2301. (1) The department, utilizing broad participation of, and providing ample opportunity for the
submission of recommendations by, the individuals and organizations described in section 2302, annually
shall identify the priority health problems of this state utilizing state health plans and an assessment procedure
based on data and statistics consistent with or provided for in sections 2616 and 2617i. Identification of
priority health problems related to mental health shall be made with the consultation and advice of the
department of mental health. From these priorities, the department annually shall prepare a proposed list of
basic preventive, personal, and environmental health services to be made available and accessible to all
residents in need of the services in this state without regard for place of residence, marital status, sex, age,
race, or inability to pay.
(2) The list of proposed basic health services shall be based upon the capabilities of the health related arts
and sciences and upon criteria related to health needs, resources, and performance and shall take into account
the services provided by private practitioners and private providers of health services. To the extent that the
proposed list of basic health services includes mental health services for which responsibility has been vested
in state or local mental health agencies by Act No. 258 of the Public Acts of 1974, as amended, being sections
330.1001 to 330.2106 of the Michigan Compiled Laws, or rules promulgated pursuant to that act, the
inclusion of those services in the proposed list shall be subject to the approval of the department of mental
health.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Compiler's note: For transfer of certain powers and duties of the bureau of child and family services, with the exception of the
women, infants, and children division, from the department of public health to the director of the department of community health, see
E.R.O. No. 1996-1, compiled at MCL 330.3101 of the Michigan Compiled Laws.
Popular name: Act 368
333.2302 Annual budget request to include proposed list of basic health services and
proposed program statement; review and comment.
Sec. 2302. The proposed list of basic health services, the methodology used to derive the list, and a
proposed program statement shall be included in the department's annual budget request and shall be made
available for review and comment to the legislature, health planning agencies, local health departments, local
governmental entities, health professional associations, and the public.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.2311 Proposed health services as basic health services; revision, publication, and
dissemination of list and program statement.
Sec. 2311. Those health services proposed under this part which are funded by appropriations to the
department or which are made available through other arrangements approved by the legislature in the
appropriations process are basic health services for purposes of this code. The department shall revise the
proposed list of basic health services and the program statement to reflect funds actually appropriated and
shall cause the list and program statement, as revised, to be published and widely disseminated.
History: 1978, Act 368, Eff. Sept. 30, 1978.
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Popular name: Act 368
333.2321 Availability and accessibility of basic health services; demonstration upon request;
basic health service as required service; notice of nonavailability or nonaccessibility;
investigation; notice to complainant.
Sec. 2321. (1) Upon request, the department shall demonstrate the availability and accessibility of the basic
health services in a manner consistent with the revised program statement and this code.
(2) A basic health service designated for delivery through a local health department is a required service
under part 24 for the local fiscal year covered by the appropriation.
(3) A person who believes that a basic health service described in the revised program statement is not
available or accessible may notify the department. The department shall investigate each written complaint
and shall notify the complainant of the availability and source of the service. If there are grounds to believe
that the service is not available or accessible, the complainant shall be given written notice, within a
reasonable time, of the action proposed to be taken.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
PART 24
LOCAL HEALTH DEPARTMENTS
333.2401 Meanings of words and phrases; general definitions and principles of construction.
Sec. 2401. (1) For purposes of this part, the words and phrases defined in sections 2403 to 2408 have the
meanings ascribed to them in those sections.
(2) In addition, article 1 contains general definitions and principles of construction applicable to all articles
in this code.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.2403 Definitions; A to D.
Sec. 2403. (1) Allowable service means a health service delivered in a city, county, district, or part
thereof, which is not a required service but which the department determines is eligible for cost
reimbursement pursuant to sections 2471 to 2498.
(2) County includes a unified county unless otherwise specified.
(3) District means a multi-county or city-county district served by a health department created under
section 2415.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.2406 Definitions; L.
Sec. 2406. Local governing entity means:
(a) In case of a single county health department, the county board of commissioners.
(b) In case of a district health department, the county boards of commissioners of the counties comprising
the district.
(c) In case of a district health department which includes a single city health department, the county boards
of commissioners of the counties comprising the district and the mayor and city council of the city.
(d) In case of a single city health department, the mayor and city council of the city.
(e) In the case of a local health department serving a county within which a single city health department
has been created pursuant to section 2422, the county board of commissioners elected from the districts
served by the county health department.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.2408 Definitions; R to U.
Sec. 2408. (1) Required service means a local health service specifically required pursuant to this part or
specifically required elsewhere in state law, except a service specifically excluded by this part or a rule
promulgated pursuant to this part.
(2) Unified county means a county having an optional unified form of county government under Act No.
139 of the Public Acts of 1973, as amended, being sections 45.551 to 45.573 of the Michigan Compiled Laws.
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History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.2417 Claim against district health department; audit; allowance of claim; report; appeal;
apportionment of allowed claims; formula; voucher.
Sec. 2417. A claim against a district health department shall be audited by the district board of health
which has the same power to allow the claim that a local governing entity has as to claims against a county or
city. If the district board of health meets less often than once a month, a claim may be allowed by the local
health officer and 1 member of the district board of health who shall report the action to the board at its next
regular meeting. The same right of appeal from the decision of the district board of health as to a claim exists
as from a similar decision of a local governing entity. The total amount of the allowed claims shall be
apportioned among the local governing entities of the district using a formula approved by the district health
board. The formula determined by the district health board shall be approved by the state department of
treasury. A voucher for an allowed claim shall be issued by the officers of each local governing entity for its
apportioned share.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.2423 Selection of option by city; failure to notify department; continuing local financial
support for affected services.
Sec. 2423. Failure to notify the department under section 2422 is considered an exercise of the option in
section 2422(c). Selection of the option in section 2422(a) or (b) does not preclude the selection of the option
in section 2422(c) and the implementation of section 2424 at a later time. During the transition period, a city
exercising the option in section 2422(c) shall continue local financial support for affected services at a level
considered by the department to be consistent with support previously provided by the city, or with the
requirements of the approved plan.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.2424 Selection of option by city; planning period; transition plan; responsibility for local
cost of required services; approval of developed plan; disposition of federal funds.
Sec. 2424. (1) A city selecting an option under section 2422 has a planning period of:
(a) One year after the selection of the option in section 2422(a).
(b) Eighteen months after the selection of the option in section 2422(b) or (c).
(2) During the planning period the affected local governing entities shall develop and adopt a plan setting
forth the arrangements, agreements, and contracts necessary to establish a local health department pursuant to
the exercised option and prescribing a timetable for the indicated transition. The transition plan shall provide
that a city shall assume full financial liability for the local cost of services or programs provided by the city or
transferred to the city by another local governing entity by virtue of the exercise of the option in section
2422(a). The plan shall include contracts providing that an employee transferred under the plan shall not lose
any benefit or right as a result of the transfer. Upon completion of the transition period, a city exercising that
option is solely responsible for the local cost of all required services under this part.
(3) By the end of the planning period, the developed plan shall be submitted to the department for
approval. If a plan is not submitted or approved, the department shall develop a transition plan during the 6
months after the end of the planning period and, upon completion, the plan shall be an approved plan under
this section.
(4) Subject to federal law and regulations, disposition of federal funds shall be made in accordance with
the approved plan and option exercised.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.2426 Real and personal property of village or township board or department of health;
title; use and administration.
Sec. 2426. The title to real and personal property of a village or township board or department of health,
including cemetery and trust property, shall vest in the village or township and be held in its name as of the
effective date of the repeal by this code of provisions authorizing the creation of boards or departments of
health. The property shall be used and administered by the village or township, or appropriate agency thereof,
as provided by law.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.2431 Local health department; requirements; report; reviewing plan for organization of
local health department; waiver.
Sec. 2431. (1) A local health department shall:
(a) Have a plan of organization approved by the department.
(b) Demonstrate ability to provide required services.
(c) Demonstrate ability to defend and indemnify employees for civil liability sustained in the performance
of official duties except for wanton and wilful misconduct.
(d) Meet the other requirements of this part.
(2) Each local health department shall report to the department at least annually on its activities, including
information required by the department.
(3) In reviewing a plan for organization of a local health department, the department shall consider the
fiscal capacity and public health effort of the applicant and shall encourage boundaries consistent with those
of planning agencies established pursuant to federal law.
(4) The department may waive a requirement of this section during the option period specified in section
2422 based on acceptable plan development during the planning period described in section 2424 and
thereafter based on acceptable progress toward implementation of the plan as determined by the department.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1985, Act 18, Imd. Eff. May 16, 1985.
Popular name: Act 368
333.2453 Epidemic; emergency order and procedures; involuntary detention and treatment.
Sec. 2453. (1) If a local health officer determines that control of an epidemic is necessary to protect the
public health, the local health officer may issue an emergency order to prohibit the gathering of people for any
purpose and may establish procedures to be followed by persons, including a local governmental entity,
during the epidemic to insure continuation of essential public health services and enforcement of health laws.
Emergency procedures shall not be limited to this code.
(2) A local health department or the department may provide for the involuntary detention and treatment of
individuals with hazardous communicable disease in the manner prescribed in sections 5201 to 5238.
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History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.2461 Violation; schedule of monetary civil penalties; issuance, contents, and delivery of
citation.
Sec. 2461. (1) In the manner prescribed in sections 2441 and 2442 a local governing entity may adopt a
schedule of monetary civil penalties of not more than $1,000.00 for each violation or day that the violation
continues which may be assessed for a specified violation of this code or a rule promulgated, regulation
adopted, or order issued which the local health department has the authority and duty to enforce.
(2) If a local health department representative believes that a person has violated this code or a rule
promulgated, regulation adopted, or order issued under this code which the local health department has the
authority and duty to enforce, the representative may issue a citation at that time or not later than 90 days after
discovery of the alleged violation. The citation shall be written and shall state with particularity the nature of
the violation, including reference to the section, rule, order, or regulation alleged to have been violated, the
civil penalty established for the violation, if any, and the right to appeal the citation pursuant to section 2462.
The citation shall be delivered or sent by registered mail to the alleged violator.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.2462 Citation; petition for administrative hearing; decision of local health officer; review;
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petition for judicial review; civil penalty.
Sec. 2462. (1) Not later than 20 days after receipt of the citation, the alleged violator may petition the local
health department for an administrative hearing which shall be held within 30 days after the receipt of the
petition. After the administrative hearing, the local health officer may affirm, dismiss, or modify the citation.
The decision of the local health officer shall be final, unless within 60 days of the decision the appropriate
local governing entity or committee thereof, or in the case of a district department, the district board of health
or committee thereof, grants review of the citation. After the review, the local governing entity, board of
health, or committee thereof may affirm, dismiss, or modify the citation.
(2) A person aggrieved by a decision of a local health officer, local governing entity, or board of health
under this section may petition the circuit court of the county in which the principal office of the local health
department is located for review. The petition shall be filed not later than 60 days following receipt of the
final decision.
(3) A civil penalty becomes final if a petition for an administrative hearing or review is not received within
the time specified in this section. A civil penalty imposed under this part is payable to the appropriate local
health department for deposit with the general funds of the local governing entity, or in case of a district, the
funds shall be divided according to the formula used to divide other district funds. A civil penalty may be
recovered in a civil action brought in the county in which the violation occurred or the defendant resides.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.2472 Services eligible for cost sharing; criteria and procedures for additional services;
minimum standards for delivery of services.
Sec. 2472. (1) Services which a local health department is required to provide under the program plan
described in part 23 are eligible for cost sharing under this part.
(2) The department shall prescribe criteria and procedures for designating additional services proposed by
a local health department as allowable services.
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(3) The department shall establish minimum standards of scope, quality, and administration for the
delivery of required and allowable services not inconsistent with sections 2471 to 2498.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.2477 Local governing entity not to receive less than received under prior provisions;
providing, designating, and reallocating funds; accountability.
Sec. 2477. (1) A local governing entity shall not receive less in any year under sections 2471 to 2498 than
it received under Act No. 306 of the Public Acts of 1927, as amended, being sections 327.201 to 327.208a of
the Michigan Compiled Laws, in the full state fiscal year immediately before the effective date of this part.
(2) Funds under this part shall be provided to the local governing entity which shall be accountable for
substantial conformance with agreements and standards as provided by section 2484. The funds shall be
designated for the local health department but may be reallocated through the local health department if
services are rendered by other local agencies.
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History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.2482 Minimum expenditure for health services; waiving maintenance of local funding;
certain services considered health services.
Sec. 2482. (1) The total local appropriations for a local health department expended for health services
shall be not less in any year than in the local health department's full fiscal year immediately before the
effective date of this part. However, the department may waive maintenance of local funding in extraordinary
circumstances.
(2) For purposes of this section, services for which funds under Act No. 306 of the Public Acts of 1927, as
amended, were being used on the effective date of this part are considered health services.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.2492 Status report; appropriation for development and implementation of evaluation and
related training.
Sec. 2492. (1) At the end of the second full state fiscal year after the effective date of this part, the
department shall report to the governor and legislature as to the status of required and allowable health
services in relation to standards, costs, and health needs of the people of this state.
(2) An amount equal to 1% of the estimated total expenditures for the required and allowable local health
services shall be appropriated to the department annually for the development and implementation of
evaluation and related training for local health departments and department staffs in the delivery of the
required and allowable health services authorized under sections 2471 to 2498.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.2498 Petition for administrative hearing; finality of order or compliance date; reaffirming,
modifying, or revoking order; modifying time for compliance; petition for writ of
mandamus.
Sec. 2498. (1) Within 60 working days after receipt of an administrative compliance order and proposed
compliance period, a local governing entity may petition the department for an administrative hearing. If the
local governing entity does not petition the department for a hearing within 60 days after the receipt of an
administrative compliance order, the order and proposed compliance date shall be final.
(2) After a hearing, the department may reaffirm, modify, or revoke the order or modify the time permitted
for compliance.
(3) If the local governing entity fails to correct a deficiency for which a final order has been issued within
the period permitted for compliance, the department may petition the appropriate circuit court for a writ of
mandamus to compel correction.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
PART 25.
HEALTH INFORMATION TECHNOLOGY
333.2501 Definitions.
Sec. 2501. As used in this part:
(a) "Commission" means the health information technology commission created under section 2503.
(b) "Department" means the department of community health.
History: Add. 2006, Act 137, Imd. Eff. May 12, 2006.
Popular name: Act 368
PART 26
DATA, INFORMATION, AND RESEARCH
333.2601 Applicability.
Sec. 2601. Unless otherwise provided, this part applies to all data made or received by the department.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Compiler's note: For transfer of certain powers and duties of the center for health promotion and chronic disease prevention and the
office of policy, planning and evaluation, from the department of public health to the director of community health, see E.R.O. No.
1996-1, compiled at MCL 330.3101 of the Michigan Compiled Laws.
Popular name: Act 368
333.2602 Meanings of words and phrases; general definitions and principles of construction.
Sec. 2602. (1) For purposes of this part, the words and phrases defined in sections 2603 to 2607 have the
meanings ascribed to them in those sections.
(2) In addition, article 1 contains general definitions and principles of construction applicable to all articles
in this code.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.2603 Definitions; D.
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Sec. 2603. (1) Data means items of information made or received by the department which pertain to a
condition, status, act, or omission, existing independently of the memory of an individual, whether the
information is retrievable by manual or other means and whether or not coded. It includes the normal and
computer art meanings of the word data.
(2) Data system means an interrelated grouping of data for use by the department.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.2607 Definitions; R, S.
Sec. 2607. (1) Record means a datum or a grouping of data about a person or an object under the
ownership or control of a person or governmental entity in which the person, object, or governmental entity is
identifiable by name, number, symbol, or other identifying particular.
(2) System of records means an interrelated grouping of records for use by the department.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.2618 Publications; annual report; summary report; statement of limitations of data used.
Sec. 2618. The department shall publish and make available periodically to agencies and individuals health
statistics publications of general interest, publications bringing health statistics into focus on priority
programmatic issues and health profiles. An annual report on the health information system shall be made
available to the governor and the legislature and to collaborating agencies. A summary report of each area
described in sections 2616 and 2617 shall be included in the annual report not less than once each 5 years.
The department shall include in the report a statement of the limitations of the data used in terms of their
quality, accuracy, and completeness.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.2621 Comprehensive policy for conduct and support of research and demonstration
activities; conducting and supporting demonstration projects and scientific evaluations.
Sec. 2621. (1) The department shall establish a comprehensive policy pursuant to and consistent with
section 2611(2) for the conduct and support of research and demonstration activities related to the
department's responsibility for the health care needs of the people of this state.
(2) The department shall conduct research and demonstration activities related to the department's
responsibility for the environmental, preventive, and personal health needs of the communities and people of
this state, including:
(a) The causes, effects, and methods of prevention of illness.
(b) The determinants of health, including behavior related to health.
(c) The accessibility, acceptability, availability, organization, distribution, utilization, quality, and
financing of health care, especially those services for the medically needy.
(3) The department may conduct and support demonstration projects to carry out subsection (2).
(4) The department shall conduct or support the conduct of scientific evaluations of the effectiveness,
efficiency, and relevance of programs conducted or supported by the department.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.2623 Publication and dissemination of results and information obtained under MCL
333.2621.
Sec. 2623. The department may:
(a) Publish, make available, and disseminate, promptly and on as broad a basis as practicable, the results of
health services research, demonstrations, and evaluations conducted and supported under section 2621.
(b) Provide indexing, abstracting, translation, publication, and other services leading to a more effective
and timely dissemination of information as to health services, research, demonstrations, and evaluations
conducted or supported under section 2621 to public and private entities and persons engaged in the
improvement of health and to the general public.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.2624 Grants and contracts to conduct or support research activities and scientific
evaluations.
Sec. 2624. The department may make grants to and contracts with persons and governmental entities to
conduct or support research activities and scientific evaluations authorized under sections 2621 and 2623.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.2639 Review of personal records upon request; procedures for reviewing request;
administrative hearing; records of requests.
Sec. 2639. (1) Upon written request, an individual shall be permitted to review his or her personal records
maintained or made under the authority of this part, in accordance with this section.
(2) The department shall establish procedures for reviewing a request from a person concerning access to
or the amendment of a record or data pertaining to the person, or from a researcher, other person, or
governmental entity requesting information or access to information possessed by the department, including a
method of making a determination on the request for access or amendment. A person or researcher aggrieved
by a decision under this section may request an administrative hearing.
(3) The department shall maintain records of requests for access to or amendments of data with the
accuracy, relevance, timeliness, and completeness necessary to assure fairness to the person making the
request.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.2640 Parentage registry; use and access by family independence agency; access to
child's medical records and information; immunity; exception.
Sec. 2640. (1) The department shall give prompt access to the parentage registry to the family
independence agency or its agent for the purpose of the family independence agency's duty to aid in the
establishment or enforcement of child support obligations. The family independence agency or its agent may
use or disclose the information from the parentage registry in carrying out that duty.
(2) Notwithstanding section 2637, if there is a compelling need for medical records or information to
determine whether child abuse or neglect has occurred or to take action to protect a child where there may be
a substantial risk of harm, the department shall give access to a family independence agency caseworker or
administrator directly involved in the investigation to the child's medical records and information that are
pertinent to the child abuse or neglect investigation. Medical records or information disclosed under this
section shall include the identity of the individual to whom the record or information pertains.
(3) The department shall provide the access described by subsection (2) only upon receipt of a written
request from a caseworker or administrator directly involved in the investigation and shall provide that access
within 14 calendar days after the record holder receives the written request. The department shall provide that
access regardless of the consent of the person from whom consent would otherwise be required.
(4) To the extent not protected by the immunity conferred by 1964 PA 170, MCL 691.1401 to 691.1415,
an individual who in good faith provides access to medical records or information under subsection (2) is
immune from civil or administrative liability arising from that conduct, unless the conduct was gross
negligence or willful and wanton misconduct.
(5) This section does not apply to a report, record, datum, or information whose confidentiality and
disclosure are governed by section 5131.
History: Add. 1996, Act 307, Imd. Eff. June 20, 1996;Am. 1998, Act 496, Eff. Mar. 1, 1999.
Popular name: Act 368
333.2651 Repealed. 2006, Act 301, Imd. Eff. July 20, 2006.
Compiler's note: The repealed section pertained to creation of the anatomy board.
Popular name: Act 368
333.2652 Receiving and allocating bodies or parts; purpose; records of receipt and
disposition; universities designated to perform duties and responsibilities; powers.
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Sec. 2652. (1) The department shall receive dead human bodies, or parts of dead human bodies, designated
for scientific uses and allocate the bodies or parts 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 in this state. The department shall keep permanent records of the receipt and disposition of
dead bodies and parts.
(2) The department may designate Michigan state university, Wayne state university, or the university of
Michigan to perform the duties and responsibilities of this section and sections 2653 to 2663.
(3) A university designated under subsection (2) may exercise all of the powers of the department
contained in this section and sections 2653 to 2663 as delegated by the department.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2006, Act 301, Imd. Eff. July 20, 2006.
Compiler's note: For transfer of powers and duties of the anatomy board to the director of the department community health and the
abolishment of the board, see E.R.O. No. 1997-4, compiled at MCL 333.26324 of the Michigan Compiled Laws.
Popular name: Act 368
333.2653 Unclaimed body defined; notice to persons with authority to control disposition
of unclaimed body; availability of unclaimed body to department; request for notification
concerning unclaimed body; time, manner, and contents of notice; release of body; notice
and surrender of body to benevolent association.
Sec. 2653. (1) As used in sections 2652 to 2663, "unclaimed body" means a dead human body for which
the deceased has not provided a disposition, for which an estate or assets to defray costs of burial do not exist,
and that is not claimed for burial by a person, relative, or court appointed fiduciary who has the right to
control disposition of the body.
(2) An official of a public institution or a state or local officer in charge or control of an unclaimed body
which would have to be buried at public expense shall use due diligence to notify the persons with authority
to control the interment or disposition of the unclaimed body under section 3206 of the estates and protected
individuals code, 1998 PA 386, MCL 700.3206. If there is no person under section 3206 of the estates and
protected individuals code, 1998 PA 386, MCL 700.3206, to direct the disposition of the unclaimed body in a
manner other than provided by this section and sections 2655 to 2659, the unclaimed body shall become
available to the department. Upon written request by the department for notification concerning unclaimed
bodies coming under his or her jurisdiction, the officer, for the definite period specified in the request of the
department, shall notify the department by telephone, facsimile, or electronic mail immediately following 72
hours after death, excluding Sundays and holidays, stating, when possible, the name, age, sex, religion, and
cause of death of the deceased, and shall release the body according to the regulations or instructions of the
department.
(3) If the deceased was a member of a religious faith maintaining a benevolent association that will provide
for the burial of the deceased in accordance with the tenets of the religion, the department shall notify the
benevolent association of the death of the deceased by telephone, facsimile, or electronic mail, and shall
surrender the body to the benevolent association upon request.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2006, Act 301, Imd. Eff. July 20, 2006.
Compiler's note: For transfer of powers and duties of the anatomy board to the director of the department community health and the
abolishment of the board, see E.R.O. No. 1997-4, compiled at MCL 333.26324 of the Michigan Compiled Laws.
Popular name: Act 368
333.2656 Receiving unclaimed body for educational purposes; expense; record; disposition.
Sec. 2656. A person receiving an unclaimed body for educational purposes shall bear all reasonable
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expense incurred in the preservation and transportation of the body and shall keep a permanent record of
bodies received, giving the identification number, name, age, religion, and sex, the place of last residence of
the deceased, and the source and disposition, with dates, of the body. A person receiving an unclaimed body,
or part thereof, for educational purposes shall dispose of the body in accordance with the standards adopted
under section 2678.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Compiler's note: For transfer of powers and duties of the anatomy board to the director of the department community health and the
abolishment of the board, see E.R.O. No. 1997-4, compiled at MCL 333.26324 of the Michigan Compiled Laws.
Popular name: Act 368
333.2661 Repealed. 2006, Act 301, Imd. Eff. July 20, 2006.
Compiler's note: The repealed section pertained to autopsy upon and disposition of an unclaimed body.
Popular name: Act 368
333.2671 Public health and welfare dependent on humane use of animals for certain
purposes.
Sec. 2671. The public health and welfare depend on the humane use of animals for the diagnosis and
treatment of human and animal diseases; the advancement of veterinary, dental, medical, and biological
sciences; and the testing, diagnosis, improvement, and standardization of laboratory specimens, biologic
products, pharmaceuticals, and drugs.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.2676 Registration for humane use of animals for experimental purposes; compliance
with standards; grounds for suspension or revocation of registration; findings of fact
conclusive; application for review of questions of law; orders.
Sec. 2676. A person shall not keep or use animals for experimental purposes unless registered to do so by
the department. The department shall grant registration for the humane use of animals for experimental
purposes upon compliance with board standards. The department may suspend or revoke a registration for
failure to comply with this part or board standards. Findings of fact by the department, in the absence of fraud
or arbitrariness, shall be conclusive, but the circuit court for the county in which the defendant resides or has
his or her principal place of business may review questions of law involved in a final decision or
determination of the department if the aggrieved party applies for the review not later than 30 days after the
determination. The circuit court has jurisdiction to make orders as justice requires.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Compiler's note: For transfer of powers and duties of the animal research advisory board to the director of the department of
community health and the abolishment of the board, see E.R.O. No. 1997-4, compiled at MCL 333.26324 of the Michigan Compiled
Laws.
Popular name: Act 368
333.2678 Rules.
Sec. 2678. The department shall promulgate rules to implement section 2637 and may promulgate rules to
implement this part including the establishment of fees, standards pertaining to unclaimed bodies, or parts
thereof, standards pertaining to the use of animals for experimental purposes, and the implementation of
sections 2616 and 2617.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Compiler's note: For transfer of powers and duties of the animal research advisory board to the director of the department of
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community health and the abolishment of the board, see E.R.O. No. 1997-4, compiled at MCL 333.26324 of the Michigan Compiled
Laws.
Popular name: Act 368
Administrative rules: R 325.921 et seq. and R 325.951 et seq. of the Michigan Administrative Code.
333.2681 Definitions.
Sec. 2681. As used in sections 2681 to 2683:
(a) "Cord blood unit" means the blood collected from a single placenta and umbilical cord.
(b) "Donor" means a mother who has delivered a baby and consents to donate the newborn's blood
remaining in the placenta and umbilical cord.
(c) "Donor bank" means a qualified cord blood stem cell bank that enters into a contract with the director
under section 2682.
(d) "Human cord blood stem cells" means hematopoietic stem cells and any other stem cells contained in
the neonatal blood collected immediately after the birth from the separated placenta and umbilical cord.
(e) "Network" means the statewide network of qualified cord blood stem cell banks established under
section 2682.
History: Add. 2006, Act 635, Imd. Eff. Jan. 4, 2007.
Popular name: Act 368
333.2683 Educational materials on uses and benefits of cord blood stem cells; development
and dissemination; availability.
Sec. 2683. (1) If funding is made available, the department shall promote public awareness and increase
knowledge about the statewide network of cord blood stem cell banks, cord blood banking options, and the
benefits of cord blood stem cells by developing and disseminating educational materials on the uses and
benefits of cord blood stem cells, the viability of cord blood stem cells, information on research results
utilizing cord blood stem cells, and any other related materials and information to enable the public to make
informed decisions about the utilization of cord blood stem cells. Information shall include, but is not limited
to, all of the following:
(a) An explanation of the differences between public and private cord blood banking.
(b) Information on the statewide network of cord blood stem cell banks.
(c) Cord blood options available.
(d) The medical process and risks involved in the collection of cord blood.
(e) Medically accepted uses and benefits of cord blood collection and transplantation.
(f) A statement that due to ongoing research and development there may be future uses and benefits of cord
blood collection and transplantation.
(g) An explanation of any costs to the donor associated with cord blood donation and storage.
(h) Information on how to request printed materials and how to access other information available on the
department's website.
(i) Options for ownership and future use of the donated material.
(j) An explanation of the storage, maintenance, and viability for transplantation of cord blood stem cells.
(2) The department, on its website, shall make the materials and information gathered and developed under
subsection (1) available in printable format to the public and to health care facilities and agencies, cord blood
banks, and health care professionals.
(3) The department shall encourage health care professionals and health care facilities and agencies,
including, but not limited to, physicians, nurse midwives, nurses, hospitals, birthing facilities, and local health
departments to disseminate information to a pregnant woman before her third trimester of pregnancy about
cord blood donation and the options for cord blood banking.
History: Add. 2006, Act 638, Imd. Eff. Jan. 4, 2007.
Popular name: Act 368
333.2683a Statewide network of cord blood stem cell banks; public awareness efforts; report
on expenditure of funds.
Sec. 2683a. On or before April 1, 2007 and annually thereafter, the department shall submit to the house
and senate appropriations subcommittees on community health, the house and senate standing committees on
public health, the house and senate fiscal agencies, and the state budget director a report detailing the
expenditure of funds related to both of the following:
(a) The statewide network of cord blood stem cell banks established under section 2682.
(b) The public awareness efforts required in this section.
History: Add. 2006, Act 636, Imd. Eff. Jan. 4, 2007.
Popular name: Act 368
333.2685 Use of live human embryo, fetus, or neonate for nontherapeutic research;
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prohibitions; presumption.
Sec. 2685. (1) A person shall not use a live human embryo, fetus, or neonate for nontherapeutic research if,
in the best judgment of the person conducting the research, based upon the available knowledge or
information at the approximate time of the research, the research substantially jeopardizes the life or health of
the embryo, fetus, or neonate. Nontherapeutic research shall not in any case be performed on an embryo or
fetus known by the person conducting the research to be the subject of a planned abortion being performed for
any purpose other than to protect the life of the mother.
(2) For purposes of subsection (1) the embryo or fetus shall be conclusively presumed not to be the subject
of a planned abortion if the mother signed a written statement at the time of the research, that she was not
planning an abortion.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
***** 333.2690 THIS SECTION IS AMENDED EFFECTIVE MARCH 29, 2017: See 333.2690.amended
*****
333.2690 Sale, transfer, distribution, or giving away of embryo, fetus, or neonate.
Sec. 2690. A person shall not knowingly sell, transfer, distribute, or give away an embryo, fetus, or
neonate for a use which is in violation of sections 2685 to 2689.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
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***** 333.2690.amended THIS AMENDED SECTION IS EFFECTIVE MARCH 29, 2017 *****
333.2690.amended Selling, collecting fee for, transferring, distributing, or giving away
embryo, fetus, or neonate; financial benefit or compensation prohibited; exception;
definitions.
Sec. 2690. (1) A person shall not knowingly sell, collect any fee for, transfer, distribute, or give away an
embryo, fetus, or neonate for a use that is in violation of sections 2685 to 2689.
(2) Except as otherwise provided in subsection (3), a physician, or a person associated with the physician,
who, as a result of the physician's performing an elective abortion, possesses a dead embryo, fetus, or neonate
shall not knowingly financially benefit from or receive any type of compensation for either of the following:
(a) Allowing a person that was not involved in the performance of the elective abortion to have access to
the embryo, fetus, or neonate for the purpose of the person taking possession and control of the embryo, fetus,
or neonate, including the organs, tissues, or cells of the embryo, fetus, or neonate.
(b) Transferring possession and control of the embryo, fetus, or neonate, including the organs, tissues, or
cells of the embryo, fetus, or neonate, to a person that was not involved in the performance of the elective
abortion.
(3) Subsection (2) does not apply to any of the following:
(a) A hospital.
(b) A person that is performing an activity as part of that person's employment with a hospital or a contract
with a hospital.
(c) A person that performs an activity under section 2688 or 2836.
(4) As used in this section:
(a) "Elective abortion" means the intentional use of an instrument, drug, or other substance or device to
terminate a woman's pregnancy for a purpose other than to increase the probability of a live birth, to preserve
the life or health of the child after live birth, or to remove a fetus that has died as a result of natural causes,
accidental trauma, or a criminal assault on the pregnant woman. Elective abortion does not include any of the
following:
(i) The use or prescription of a drug or device intended as a contraceptive.
(ii) The intentional use of an instrument, drug, or other substance or device by a physician to terminate a
woman's pregnancy if the woman's physical condition, in the physician's reasonable medical judgment,
necessitates the termination of the woman's pregnancy to avert her death.
(iii) Treatment on a pregnant woman who is experiencing a miscarriage or has been diagnosed with an
ectopic pregnancy.
(b) "Hospital" means a hospital licensed under article 17.
(c) "Person associated with the physician" means any of the following:
(i) An employee of the physician or other individual who assists the physician in performing an elective
abortion.
(ii) A private physician practice, professional corporation, or freestanding surgical outpatient facility
licensed under article 17, that is owned or operated by the physician and in which an elective abortion is
performed.
(iii) A private physician practice, professional corporation, or freestanding surgical outpatient facility
licensed under article 17, that employs or contracts with the physician to perform an elective abortion.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2016, Act 386, Eff. Mar. 29, 2017.
Popular name: Act 368
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PART 27
MICHIGAN ESSENTIAL HEALTH PROVIDER RECRUITMENT STRATEGY
333.2701 Definitions.
Sec. 2701. As used in this part:
(a) "Board certified" means certified to practice in a particular medical speciality by a national board
recognized by the American board of medical specialties or the American osteopathic association.
(b) "Certified nurse midwife" means an individual licensed as a registered professional nurse under part
172 who has been issued a specialty certification in the practice of nurse midwifery by the board of nursing
under section 17210.
(c) "Certified nurse practitioner" means an individual licensed as a registered professional nurse under part
172 who has been issued a specialty certification as a nurse practitioner by the board of nursing under section
17210.
(d) "Dental school" means an accredited program for the training of individuals to become dentists.
(e) "Dentist" means an individual licensed to engage in the practice of dentistry under part 166.
(f) "Designated nurse" means a certified nurse midwife or certified nurse practitioner.
(g) "Designated physician" means a physician qualified in 1 of the physician specialty areas identified in
section 2711.
(h) "Designated professional" means a designated physician, designated nurse, dentist, or physician's
assistant.
(i) "Health resource shortage area" means a geographic area, population group, or health facility designated
by the department under section 2717.
(j) "Medicaid" means benefits under the program of medical assistance established under title XIX of the
social security act, 42 USC 1396 to 1396w-5, and administered by the department of human services under
the social welfare act, 1939 PA 280, MCL 400.1 to 400.119b.
(k) "Medical school" means an accredited program for the training of individuals to become physicians.
(l) "Medicare" means benefits under the federal medicare program established under title XVIII of the
social security act, 42 USC 1395 to 1395kkk-1.
(m) "National health service corps" means the agency established under 42 USC 254d.
(n) "Nurse" means an individual licensed to engage in the practice of nursing under part 172.
(o) "Nursing program" means an accredited program for the training of individuals to become nurses.
(p) "Physician" means an individual licensed as a physician under part 170 or an osteopathic physician
under part 175.
(q) "Physician's assistant" means an individual licensed as a physician's assistant under part 170 or part
175.
(r) "Physician's assistant program" means an accredited program for the training of individuals to become
physician's assistants.
(s) "Service obligation" means the contractual obligation undertaken by an individual under section 2705
or section 2707 to provide health care services for a determinable time period at a site designated by the
department.
History: Add. 1990, Act 16, Eff. Oct. 1, 1990;Am. 2014, Act 172, Imd. Eff. June 17, 2014.
Compiler's note: For transfer of certain powers and duties of the bureau of child and family services, with the exception of the
women, infants, and children division, and the division of managed care the bureau of health systems, from the department of public
health to the director of the department of community health, see E.R.O. No. 1996-1, compiled at MCL 330.3101 of the Michigan
Compiled Laws.
Popular name: Act 368
333.2703 Michigan essential health provider recruitment strategy; creation; purpose; duties
of department.
Sec. 2703. (1) The Michigan essential health provider recruitment strategy is created in the department to
facilitate the placement and retention of designated professionals in health resource shortage areas.
(2) In operating the Michigan essential health provider recruitment strategy, the department shall do all of
the following:
(a) Recruit and place designated professionals in health resource shortage areas, as provided in this part.
(b) Coordinate with the national health service corps activities in this state.
(c) Provide consultation to communities and health resource shortage areas in securing, placing, and
retaining designated professionals.
(d) Perform other duties as set forth in this part.
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(e) Engage in other activities appropriate to the purposes of the program.
History: Add. 1990, Act 16, Eff. Oct. 1, 1990.
Popular name: Act 368
333.2707 Grant program for minority students; administration; eligibility; condition for award
of grant; priority; determination of appropriate grant; failure to fulfill service obligation or
complete training program; repayment; disposition of amounts repaid; service obligation
considered fulfilled; source of funds; distribution of funds; definition.
Sec. 2707. (1) The department shall administer a grant program for minority students enrolled in medical
schools, dental schools, nursing programs, or physician's assistant programs. Only minority students who
meet the financial resources eligibility standards for federal student loan programs under title IV of the higher
education act of 1965, Public Law 89-329, are eligible to receive a grant under this section.
(2) The department may award a grant to a minority student enrolled in a medical school who is training to
become a designated physician, to a minority student enrolled in a dental school who is training to become a
dentist, or to a minority student enrolled in a nursing program or physician's assistant program. As a condition
for the award of the grant, the recipient of the grant shall enter into a written contract with the department that
requires the recipient to provide, upon completion of training, full-time health care services in a health
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resource shortage area to which he or she is assigned by the department for a period equal to the number of
years for which a grant is accepted. In awarding grants, the department shall give priority to students who are
residents of this state and enrolled in a medical school, dental school, nursing program, or physician's
assistant program in this state.
(3) The department shall determine an appropriate grant amount for each academic year for each health
care profession.
(4) An individual who incurs a service obligation under subsection (2) and who completes the training
program for which the grant was awarded but fails to fulfill the service obligation shall repay to the
department an amount equal to 2 times the amount of all grants the individual accepted under this section plus
interest. The interest shall be at a rate determined by the state treasurer to reflect the cumulative annual
percentage change in the Detroit consumer price index. An individual who incurs a service obligation under
subsection (2) and who fails to complete the training program for which the grant was awarded shall repay to
the department an amount equal to the actual amount of all grants the individual accepted under this section.
Repayment to the department under this subsection shall be made within 3 years after the repayment
obligation is incurred. Amounts repaid under this subsection shall be deposited with the state treasurer and
credited to the minority health profession grant fund created in section 2721.
(5) An obligated individual shall be considered to have fulfilled the service obligation incurred under
subsection (2) if any of the following occur:
(a) Service has been rendered for the obligated period.
(b) The obligated individual dies.
(c) The obligated individual is unable, by reason of permanent disability, to render the service.
(d) The obligated individual fails to satisfy the academic requirements for completion of the training
program in which he or she is enrolled after having made a good faith effort.
(e) The obligated individual fails to satisfy the requirements for licensure, certification, or other form of
authorization to practice the profession for which he or she has been trained.
(f) Other circumstances occur that are considered by the department to constitute a compelling reason to
consider the service obligation fulfilled.
(6) The department may accept funds for the operation of the grant program from any source and distribute
those funds in a manner consistent with this section.
(7) As used in this section, "Detroit consumer price index" means the most comprehensive index of
consumer prices available for the Detroit area from the bureau of labor statistics of the United States
department of labor.
History: Add. 1990, Act 16, Eff. Oct. 1, 1990;Am. 2014, Act 173, Imd. Eff. June 17, 2014.
Popular name: Act 368
333.2711 Recruitment for programs created in MCL 333.2705 and 333.2707; designated
physician specialty areas; preference; "qualified" defined.
Sec. 2711. (1) For the programs created in sections 2705 and 2707, the department shall only recruit
physicians who are qualified or students who are training to become qualified in 1 or more of the following
designated physician specialty areas:
(a) General practice.
(b) Family practice.
(c) Obstetrics.
(d) Pediatrics.
(e) Emergency medicine.
(f) Internal medicine.
(g) Preventive medicine.
(h) Psychiatry.
(2) When enrolling individuals to participate in the programs created in sections 2705 and 2707, the
department may give preference to an individual who is qualified or studying in 1 or more of the specific
designated physician specialty areas of general practice, family practice, obstetrics, pediatrics, or internal
medicine over an individual qualified or studying in another designated physician specialty area described in
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subsection (1).
(3) As used in this section, "qualified" means board certified or eligible for board certification.
History: Add. 1990, Act 16, Eff. Oct. 1, 1990;Am. 2014, Act 172, Imd. Eff. June 17, 2014.
Popular name: Act 368
333.2717 Health resource shortage area; criteria for identification and designation.
Sec. 2717. (1) The department shall develop criteria for the identification and designation of a geographic
area, population group, or health facility as a health resource shortage area. In developing the criteria, the
department shall consider the needs of rural areas. The criteria may include, but are not limited to, all of the
following:
(a) Infant mortality rate.
(b) Percentage of population below 100% of the poverty line.
(c) Percentage of population age 65 and over.
(d) Appropriate physician to population ratio.
(e) Percentage of population eligible for medicaid.
(f) Aggregate unemployment rate.
(g) Percentage of practicing physicians who accept medicare or medicaid assignment.
(h) Geographic proximity of physicians to the resident population.
(i) Average time the resident population must travel to obtain physician services from physicians in a
designated physician specialty area.
(2) On the basis of the criteria set forth in subsection (1), the department shall identify and designate
geographic areas, population groups, and health facilities in Michigan as health resource shortage areas for 1
or more designated professionals.
(3) Each of the following shall be considered a health resource shortage area:
(a) A health manpower shortage area, as designated under section 332 of title III of the public health
service act, 42 U.S.C. 254e, that is located in this state.
(b) A population of an urban or rural area designated as an area with a shortage of personal health services,
as designated under section 330(b)(3) of title III of the public health service act, 42 U.S.C. 254c, that is
located within this state.
(c) A population group designated as having a shortage of personal health services, as designated under
section 330(b)(3) of title III of the public health service act, 42 U.S.C. 254c, that is located within this state.
History: Add. 1990, Act 16, Eff. Oct. 1, 1990.
Popular name: Act 368
333.2721 Minority health profession grant fund; creation; funding; use; investments;
crediting earnings to fund.
Sec. 2721. (1) There is created the minority health profession grant fund as a separate fund in the state
treasury, to be administered by the department. The department shall deposit amounts repaid under section
2707 with the state treasurer, who shall credit the amounts to the fund. The fund shall be used to fund grants
made under section 2707.
(2) The state treasurer shall direct the investment of the fund money and shall credit earnings to the fund.
History: Add. 1990, Act 16, Eff. Oct. 1, 1990.
Popular name: Act 368
PART 28
VITAL RECORDS
333.2801 Meanings of words and phrases; general definitions and principles of construction.
Sec. 2801. (1) For purposes of this part, the words and phrases defined in sections 2803 to 2805 have the
meanings ascribed to them in those sections.
(2) In addition, article 1 contains general definitions and principles of construction applicable to all articles
in this code.
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History: 1978, Act 368, Eff. Sept. 30, 1978.
Compiler's note: For transfer of certain powers and duties of the office of policy, planning and evaluation from the department of
public health to the director of the department of community health, see E.R.O. No. 1996-1, compiled MCL 330.3101 of the Michigan
Compiled Laws.
Popular name: Act 368
333.2803 Definitions; A to F.
Sec. 2803. (1) "Abortion" means that term as defined in section 17015.
(2) "Dead body" means a human body or fetus, or a part of a dead human body or fetus, in a condition
from which it may reasonably be concluded that death has occurred.
(3) "Fetal death" means the death of a fetus that has completed at least 20 weeks of gestation or weighs at
least 400 grams. Fetal death includes a stillbirth. The definition shall conform in all other respects as closely
as possible to the definition recommended by the federal agency responsible for vital statistics.
(4) "Fetal remains" means a dead fetus or part of a dead fetus that has completed at least 10 weeks of
gestation or has reached the stage of development that, upon visual inspection of the fetus or part of the fetus,
the head, torso, or extremities appear to be supported by skeletal or cartilaginous structures. Fetal remains do
not include the umbilical cord or placenta.
(5) "File" means to present a certificate, report, or other record to the local registrar for registration by the
state registrar.
(6) "Final disposition" means the burial, cremation, interment, or other legal disposition of a dead body or
fetal remains.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2002, Act 562, Imd. Eff. Oct. 1, 2002;Am. 2012, Act 499, Eff. Mar. 31, 2013.
Popular name: Act 368
333.2804 Definitions; I to R.
Sec. 2804. (1) "Institution" means a public or private establishment that provides inpatient medical,
surgical, or diagnostic care or treatment or nursing, custodial, or domiciliary care to 2 or more unrelated
individuals, including an establishment to which individuals are committed by law.
(2) "Law enforcement agency" means a police agency of a city, village, or township; a sheriff's
department; the department of state police; and any other governmental law enforcement agency.
(3) "Live birth" means that term as defined in section 1 of the born alive infant protection act, 2002 PA
687, MCL 333.1071.
(4) "Local registrar" means the county clerk or the clerk's deputy, or in the case of a city having a
population of 40,000 or more, the city clerk or city department designated by the governing body of the city;
or a registrar appointed pursuant to section 2814. Population shall be determined according to the latest
federal decennial census.
(5) "Miscarriage" means the spontaneous expulsion of a nonviable fetus that has completed less than 20
weeks of gestation.
(6) "Registration" means the acceptance by the state registrar and the incorporation of certificates provided
for in this part into the official vital records.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1985, Act 20, Imd. Eff. May 16, 1985;Am. 1990, Act 149, Imd. Eff. June 27,
1990;Am. 2012, Act 499, Eff. Mar. 31, 2013.
Popular name: Act 368
333.2805 Definitions; S to V.
Sec. 2805. (1) State registrar means the official appointed under section 2813 or his or her authorized
representative.
(2) System of vital statistics means the collection, certification, compilation, amendment, coordination,
and preservation of vital records, including the tabulation, analysis, and publication of vital statistics.
(3) Vital record means a certificate or registration of birth, death, marriage, or divorce; an
acknowledgment of parentage; or related data.
(4) Vital statistics means data derived from vital records and related reports.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1996, Act 307, Eff. June 1, 1997.
Popular name: Act 368
333.2821 Birth registration required; filing record of birth; time of registration; transmission
to childhood immunization registry.
Sec. 2821. (1) Birth registration is required for each individual born in this state.
(2) A record of birth for each live birth that occurs in this state shall be filed at the office of the local
registrar not more than 5 days after the birth. The birth shall be registered when the filing is completed.
(3) Upon receipt of a vital record consisting of a birth registration transmitted by a local registrar pursuant
to section 2815(2), the state registrar shall transmit the information contained in the birth registration to the
childhood immunization registry created in section 9207 .
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1996, Act 540, Imd. Eff. Jan. 15, 1997.
Popular name: Act 368
333.2822 Persons required to report live birth occurring in state; abortion defined.
Sec. 2822. (1) The following individuals shall report a live birth that occurs in this state:
(a) If a live birth occurs in an institution or enroute to an institution, the individual in charge of the
institution or his or her designated representative shall obtain the personal data, prepare the certificate of birth,
secure the signatures required by the certificate of birth, and file the certificate of birth with the local registrar
or as otherwise directed by the state registrar within 5 days after the birth. The physician or other individual in
attendance shall provide the medical information required by the certificate of birth and certify to the facts of
birth not later than 72 hours after the birth. If the physician or other individual does not certify to the facts of
birth within 72 hours, the individual in charge of the institution or his or her authorized representative shall
complete and certify the facts of birth.
(b) If a live birth occurs outside an institution, the record shall be prepared, certified, and filed with the
local registrar by 1 of the following individuals in the following order of priority:
(i) The physician in attendance at or immediately after the live birth.
(ii) Any other individual in attendance at or immediately after the live birth.
(iii) The father, the mother, or, in the absence of the father and the inability of the mother, the individual in
charge of the premises where the live birth occurs.
(c) If a live birth occurs during an attempted abortion and the mother of the newborn has expressed a desire
not to assume custody and responsibility for the newborn by refusing to authorize necessary life-sustaining
medical treatment, the live birth shall be reported as follows:
(i) If the attempted abortion took place in an institution, the live birth shall be reported in the same manner
as provided in subdivision (a), except that the parents shall be listed as unknown and the newborn shall be
listed as Baby Doe.
(ii) If the attempted abortion took place outside an institution, the live birth shall be reported in the same
manner as provided in subdivision (b), except that the parents shall be listed as unknown and the newborn
shall be listed as Baby Doe.
(2) As used in this section, abortion means that term as defined in section 17015.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2002, Act 691, Eff. Mar. 31, 2003.
Popular name: Act 368
333.2825 Assuming custody of live born child of unknown parentage; form, contents, and
filing of report; place of birth; report as birth registration; sealing and opening of report.
Sec. 2825. (1) A person who assumes custody of a live born child of unknown parentage shall report on a
form and in a manner prescribed by the state registrar the following information:
(a) The date and place of finding the child.
(b) The sex and approximate birth date of the child.
(c) The name and address of the person or institution with whom the child is placed for care.
(d) The name given to the child by the custodian of the child.
(e) Other data required by the state registrar.
(2) The report shall be filed in the manner prescribed by the state registrar not later than 5 days after the
person assumes custody.
(3) The place where the child is found shall be entered as the place of birth.
(4) A report made under this section constitutes the birth registration for the child.
(5) If the child is identified and a birth registration is found or obtained, a report registered under this
section shall be sealed and may be opened only by order of a court of competent jurisdiction or as provided by
rule.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.2827 Failure to register birth within time prescribed; filing certificate of birth; registration
of birth subject to evidentiary requirements; marking certificate delayed and showing
date of delayed registration; endorsing summary statement of evidence on certificate;
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failure to register due to conflict of information.
Sec. 2827. (1) When the birth of an individual born in this state has not been registered within the time
period prescribed in section 2821, a certificate of birth may be filed in accordance with procedures established
pursuant to section 2896 or as otherwise provided under subsection (4). The certificate shall be registered
subject to evidentiary requirements the department prescribes to substantiate the alleged facts of birth.
(2) Except as otherwise provided under subsection (4), a certificate of birth registered 1 year or more after
the date of birth shall be marked "delayed" and show on its face the date of the delayed registration.
(3) A summary statement of the evidence submitted in support of the delayed registration shall be endorsed
on the certificate.
(4) A certificate of birth that was not originally registered due to a conflict of information provided
pursuant to section 2824(1) shall be registered upon the resolution of that conflict or upon the child who is the
subject of the certificate of birth reaching the age of 18. A certificate of birth registered pursuant to this
subsection is considered to have been filed and registered on the date the department originally received the
birth information and shall not be marked "delayed".
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2006, Act 567, Imd. Eff. Jan. 3, 2007.
Popular name: Act 368
333.2829 Report of adoption; form; contents; report when adoption order amended,
annulled, or rescinded; duty of probate register or clerk; requirements of birth certificate
issued to adopted individual.
Sec. 2829. (1) For each adoption ordered by the probate court in this state, the court shall prepare a report
of adoption on a form prescribed and furnished by the state registrar. The report shall:
(a) Include the facts necessary to locate and identify the certificate of live birth of the individual adopted.
(b) Provide information necessary to establish a new certificate of live birth of the individual adopted.
(c) Identify the adoption order.
(d) Be certified by the probate register or clerk.
(2) When an adoption order is amended, annulled, or rescinded, the court shall prepare a report which shall
include the facts necessary to identify the original adoption report and the facts amended in the adoption order
necessary to properly amend the birth record. The report of a rescission of adoption shall include the current
names and addresses of the petitioners.
(3) Not later than the tenth day of the calendar month, the probate register or clerk shall forward:
(a) To the state registrar, reports of adoption orders, and amendments, annulments, and rescissions of the
orders, entered during the preceding month for individuals born in this state.
(b) To the appropriate registration authority in another state, the United States department of state, or the
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United States immigration and naturalization service, reports of adoption orders, and amendments,
annulments, and rescissions of the orders, entered during the preceding month for individuals born outside
this state.
(4) A birth certificate issued to an adopted individual shall conform to the requirements of sections 67 and
68 of chapter X of Act No. 288 of the Public Acts of 1939, as amended, being sections 710.67 and 710.68 of
the Michigan Compiled Laws.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1979, Act 208, Eff. May 14, 1980;Am. 1992, Act 248, Imd. Eff. Nov. 19, 1992.
Popular name: Act 368
333.2830 Adoption of child born outside United States, territory of United States, or Canada;
filing, form, and contents of delayed registration of birth; petition for issuance of delayed
registration of birth; entering change of name.
Sec. 2830. (1) If a child whose birth occurred outside the United States, a territory of the United States, or
Canada is adopted by a resident of this state under the laws of this state or under the laws of a foreign country,
the probate court, on motion of the adopting parent, may file a delayed registration of birth on a form
provided by the department. The delayed registration shall contain the date and place of birth and other facts
specified by the department.
(2) If the date and place of birth of a child described in subsection (1) cannot be documented from foreign
records or a medical assessment of the development of the child indicates that the date of birth as stated in the
immigration records is not correct, the court shall determine the facts and establish a date and place of birth
and may file a delayed registration of birth as provided in subsection (1).
(3) Upon the petition of a child adopted in this state whose birth occurred outside the United States, a
territory of the United States, or Canada, or a petition of the child's adoptive parents, the court that issued an
order of adoption for that child before the effective date of this section may issue a delayed registration of
birth for the adopted child as provided in subsection (1).
(4) A probate court may, at the request of the adopting parent when filing a delayed registration of birth
under subsection (1), enter a new name for the child on the delayed registration of birth. After the filing of a
delayed registration of birth that includes a change of name, the new name shall be the legal name of the
adopted child.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1994, Act 242, Eff. July 5, 1994;Am. 2005, Act 22, Imd. Eff. May 19, 2005.
Popular name: Act 368
333.2832 New certificate of birth; actual place and date of birth to be shown; substitution for
original certificate; inspection; restoration of original certificate upon notice of annulment
or rescission of adoption; preparing new certificate on delayed birth certificate form;
sealing or forwarding original certificate.
Sec. 2832. (1) When a new certificate of live birth is established, the actual place and date of birth shall be
shown. The new certificate shall be substituted for the original certificate of live birth. Thereafter, the original
certificate and the evidence of adoption or sex designation are not subject to inspection except as otherwise
provided in section 2882(2) or (3) or upon a court order. Evidence in support of other birth record changes is
subject to inspection as provided in sections 2882 and 2883.
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(2) Upon receipt of notice of annulment of adoption or a copy of an order of rescission, the original
certificate of live birth shall be restored to its place in the files. The certificate created under subsection (1) is
not subject to inspection except upon a court order.
(3) If a certificate of live birth is not on file for the individual for whom a new live birth certificate is to be
established under section 2831, a new live birth certificate may be prepared on the delayed birth certificate
form in use at the time of adoption, legitimation, or paternity determination.
(4) When a new certificate of live birth is established by the state registrar, all copies of the original
certificate of birth in the custody of a custodian of permanent records in this state shall be sealed from
inspection or forwarded to the state registrar, as the state registrar directs.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1992, Act 248, Imd. Eff. Nov. 19, 1992;Am. 1994, Act 206, Eff. Jan. 1, 1995;
Am. 1996, Act 307, Eff. June 1, 1997.
Popular name: Act 368
333.2834 Report of fetal death; time, form, and manner; prohibited information; report if dead
fetus delivered in or outside institution; notice to medical examiner; investigation and
report; use and disposition of confidential statistical reports; disclosure identifying
biological parents prohibited; incorporation of records into system of vital statistics;
certificate of stillbirth.
Sec. 2834. (1) A fetal death occurring in this state shall be reported to the state registrar within 5 days after
delivery. The state registrar shall prescribe the form and manner for reporting fetal deaths.
(2) The fetal death reporting form shall not contain the name of the biological parents, common identifiers
such as social security or drivers license numbers, or other information identifiers that would make it possible
to identify in any manner or in any circumstances the biological parents of the fetus. A state agency shall not
compare data in an information system file with data in another computer system that would result in
identifying in any way a woman or father involved in a fetal death. Statistical information that may reveal the
identity of the biological parents involved in a fetal death shall not be maintained. This subsection does not
apply after June 1, 2003.
(3) If a dead fetus that has completed at least 20 weeks of gestation or weighs at least 400 grams is
delivered in an institution, the individual in charge of the institution or his or her authorized representative
shall prepare and file the fetal death report and shall follow the protocols in place for the institution in the
event of a death that occurs after a live birth but before being discharged from the institution.
(4) If a dead fetus that has completed at least 20 weeks of gestation or weighs at least 400 grams is
delivered outside an institution, the physician in attendance shall prepare and file the fetal death report.
(5) If a fetal death occurs without medical attendance at or after the delivery or if inquiry is required by the
medical examiner, the attendant, mother, or other person having knowledge of the fetal death shall notify the
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medical examiner who shall investigate the cause and prepare and file the fetal death report.
(6) The fetal death reports required under this section and filed before June 1, 2003 are confidential
statistical reports to be used only for medical and health purposes and shall not be incorporated into the
permanent official records of the system of vital statistics. A schedule for the disposition of these reports shall
be provided for by the department. The department or any employee of the department shall not disclose to
any person outside the department the reports or the contents of the reports required by this section and filed
before June 1, 2003 in a way that permits the person to whom the report is disclosed to identify the biological
parents.
(7) The fetal death reports required under this section and filed on or after June 1, 2003 are permanent vital
records documents and shall be incorporated into the system of vital statistics. Access to a fetal death report or
information contained on a fetal death report is the same as a live birth record under sections 2882, 2883, and
2888.
(8) With information provided to the department under subsection (7), the department shall create a
certificate of stillbirth that conforms as nearly as possible to recognized national standardized forms and
includes, but is not limited to, the following information:
(a) The name of the fetus, if it was given a name by the parent or parents.
(b) The number of weeks of gestation completed.
(c) The date of delivery and weight at the time of delivery.
(d) The name of the parent or parents.
(e) The name of the institution in which the fetus was delivered or the name of the health professional in
attendance if the delivery was outside an institution.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2002, Act 562, Imd. Eff. Oct. 1, 2002;Am. 2012, Act 499, Eff. Mar. 31, 2013.
Popular name: Act 368
333.2835 "Physical complication" defined; report of abortion; form, transmittal, and contents
of report; prohibited information; destruction of reports; annual statistical report; use of
statistical reports; prohibited disclosures; violation; penalty; release of reports or
contents to department of licensing and regulatory affairs.
Sec. 2835. (1) As used in this section and section 2837, "physical complication" means a physical
condition occurring during or after an abortion that, under generally accepted standards of medical practice,
requires medical attention. Physical complication includes, but is not limited to, infection, hemorrhage,
cervical laceration, or perforation of the uterus.
(2) A physician who performs an abortion shall report the performance of that procedure to the department
on forms prescribed and provided by the department. A physician shall transmit a report required under this
subsection to the director within 7 days after the performance of the abortion.
(3) Each report of an abortion required under subsection (2) shall contain only the following information
and no other information:
(a) The age of the individual at the time of the abortion.
(b) The marital status of the individual at the time of the abortion.
(c) The race and, if applicable, Hispanic ethnicity of the individual.
(d) The city or township, county, and state in which the individual resided at the time of the abortion.
(e) The name and address of the facility and the type of facility in which the abortion was performed.
(f) The source of referral to the physician performing the abortion.
(g) The number of previous pregnancies carried to term.
(h) The number of previous pregnancies ending in spontaneous abortion.
(i) The number of previous pregnancies terminated by abortion.
(j) The method used before the abortion to confirm the pregnancy, the period of gestation in weeks of the
present pregnancy, and the first day of the last menstrual period.
(k) The method used to perform the abortion.
(l) The weight of the embryo or fetus, if determinable.
(m) Whether the fetus showed evidence of life when separated, expelled, or removed from the individual.
(n) The date of performance of the abortion.
(o) The method and source of payment for the abortion.
(p) A physical complication or death resulting from the abortion and observed by the physician or reported
to the physician or his or her agent before the report required under subsection (2) is transmitted to the
director.
(q) The physician's signature and his or her state license number.
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(4) The report required under subsection (2) shall not contain the name of the individual, common
identifiers such as her social security number or motor vehicle operator's license number or other information
or identifiers that would make it possible to identify in any manner or under any circumstances an individual
who has obtained or seeks to obtain an abortion. A state agency shall not compare data in an electronic or
other information system file with data in another electronic or other information system that would result in
identifying in any manner or under any circumstances an individual obtaining or seeking to obtain an
abortion. Statistical information that may reveal the identity of an individual obtaining or seeking to obtain an
abortion shall not be maintained.
(5) The department shall destroy each individual report required by this section and each copy of the report
after retaining the report for 5 years after the date the report is received.
(6) The department shall make available annually in aggregate a statistical report summarizing the
information submitted in each individual report required by this section. The department shall specifically
summarize aggregate data regarding all of the following in the annual statistical report:
(a) The period of gestation in 4-week intervals from 5 weeks through 28 weeks.
(b) Abortions performed on individuals aged 17 and under.
(c) Physical complications reported under subsection (3)(p) and section 2837.
(7) The reports required under this section are statistical reports to be used only for medical and health
purposes and shall not be incorporated into the permanent official records of the system of vital statistics.
(8) Except as otherwise provided in subsection (10), the department or an employee of the department shall
not disclose to a person or entity outside the department the reports or the contents of the reports required by
this section in a manner or fashion so as to permit the person or entity to whom the report is disclosed to
identify in any way the individual who is the subject of the report, the identity of the physician who
performed the abortion, or the name or address of a facility in which an abortion was performed.
(9) A person who discloses confidential identifying information in violation of this section, section
2834(6), or section 2837 is guilty of a felony punishable by imprisonment for not more than 3 years or a fine
of not more than $5,000.00, or both.
(10) The department may release the reports or the contents of the reports required by this section to the
department of licensing and regulatory affairs for regulatory purposes only. The department of licensing and
regulatory affairs or an employee of the department of licensing or regulatory affairs shall not disclose to a
person or entity outside of the department of licensing and regulatory affairs the reports or the contents of the
reports required by this section in a manner or fashion so as to permit the person or entity to whom the report
is disclosed to identify in any way the individual who is the subject of the report, the identity of the physician
who performed the abortion, or the name or address of a facility in which an abortion was performed.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1999, Act 207, Eff. Mar. 10, 2000;Am. 2002, Act 562, Imd. Eff. Oct. 1, 2002;
Am. 2010, Act 117, Eff. Jan. 1, 2011;Am. 2012, Act 499, Eff. Mar. 31, 2013.
Popular name: Act 368
333.2841 Death registration required; place of death; failure to report death to law
enforcement agency, funeral home, or 9-1-1 operator; violation; penalty.
Sec. 2841. (1) Death registration is required for each individual who dies in this state. If the place of death
is unknown, but the body is found in this state, the death registration shall show this fact and shall be
completed and filed in accordance with this section and section 2842. The place where the body is found shall
be shown as the place of death.
(2) Except as otherwise provided under this part, an individual who discovers the body of an individual he
or she knows or has reason to know is dead and fails to inform a law enforcement agency, a funeral home, or
a 9-1-1 operator of the discovery is guilty of a misdemeanor punishable by imprisonment for not more than 1
year or a fine of not more than $1,000.00, or both. This subsection does not apply to an individual who knows
or has reason to know that a law enforcement agency, a funeral home, or a 9-1-1 operator has been informed
of the discovery of the body.
(3) A person who violates subsection (2) with the purpose of concealing the fact or cause of death of the
individual is guilty of a felony punishable by imprisonment for not more than 5 years or a fine of not more
than $5,000.00, or both.
(4) A sentence imposed for a violation of this section may be imposed to run consecutively to any other
sentence imposed for a conviction that arises out of the same transaction.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2012, Act 538, Eff. Apr. 1, 2013.
Popular name: Act 368
333.2843 Report of death by funeral director; dead body defined; personal data; medical
certification; neglecting or refusing to sign death certificate as misdemeanor; penalty;
certification and filing of death record; deceased infant; information.
Sec. 2843. (1) A funeral director who first assumes custody of a dead body, either personally or through
his or her authorized agent, shall report the death. For purposes of this subsection, "dead body" includes, but
is not limited to, the body of an infant who survived an attempted abortion as described in the born alive
infant protection act and who later died. The funeral director or the authorized agent shall obtain the necessary
personal data from the next of kin or the best qualified individual or source available and shall obtain medical
certification as follows:
(a) If the death occurred outside an institution, the medical certification portion of the death record shall be
completed and certified not later than 48 hours after death by the attending physician; or in the absence of the
attending physician, by a physician acting as the attending physician's authorized representative; or in the
absence of an authorized representative, by the county medical examiner; or in the absence of the county
medical examiner, by the county health officer or the deputy county medical examiner. If the death occurred
in an institution, the medical certification shall be completed and signed not later than 48 hours after death by
the attending physician; or in the absence of the attending physician, by a physician acting as the attending
physician's authorized representative; or in the absence of an authorized representative, by the chief medical
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officer of the institution in which death occurred, after reviewing pertinent records and making other
investigation as considered necessary, or by a pathologist.
(b) A physician described in subdivision (a), who for himself or herself or as an agent or employee of
another individual neglects or refuses to certify a death record properly presented to him or her for
certification by a funeral director or who refuses or neglects to furnish information in his or her possession, is
guilty of a misdemeanor punishable by imprisonment for not more than 60 days, or a fine of not less than
$25.00 nor more than $100.00, or both.
(2) A physician described in subsection (1)(a) shall provide the medical certification described in
subsection (1)(a) within 48 hours after the death.
(3) A death record shall be certified by a funeral director who is licensed under article 18 of the
occupational code, 1980 PA 299, MCL 339.1801 to 339.1812, or by an individual who holds a courtesy
license under section 1806a of that act, MCL 339.1806a, and shall be filed with the local registrar of the
district where the death occurred within 72 hours after the death.
(4) Except as otherwise provided in this subsection, the death of an infant who was born alive following an
attempted abortion and was surrendered to an emergency service provider under the safe delivery of newborns
law, sections 1 to 20 of chapter XII of the probate code of 1939, 1939 PA 288, MCL 712.1 to 712.20, and
then died shall be reported in the same manner as for any death. However, the deceased infant shall be listed
as "Baby Doe" and no information that would directly identify the deceased infant or the deceased infant's
parents shall be reported, including, but not limited to, the following information:
(a) The name of the mother or father.
(b) The address of the mother or father.
(c) The name of the informant.
(d) The address of the informant.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2002, Act 691, Eff. Mar. 31, 2003;Am. 2013, Act 79, Eff. Sept. 26, 2013.
Popular name: Act 368
333.2844 Referral of case to county medical examiner; determining and certifying cause of
death; investigation; completing and signing medical certification; notice to funeral
director; final disposition.
Sec. 2844. (1) When death occurs more than 10 days after the deceased was last seen by a physician, if the
cause of death appears to be other than the illness or condition for which the deceased was being treated, or if
the attending physician cannot accurately determine the cause of death, the case shall be referred to the county
medical examiner for investigation to determine and certify the cause of death. If the county medical
examiner determines that the case does not fall within his or her jurisdiction, the county medical examiner
shall refer the case back to the deceased's physician within 24 hours for completion of the medical
certification.
(2) When an investigation is required under Act No. 181 of the Public Acts of 1953, as amended, being
sections 52.201 to 52.216 of the Michigan Compiled Laws, the county medical examiner shall determine the
cause of death and shall complete and sign the medical certification within 48 hours after taking charge of the
case.
(3) If the cause of death cannot be determined within 48 hours after death, the medical certification may be
completed as provided by the department. The attending physician or county medical examiner shall give the
funeral director in custody of the body notice of the reason for the delay, and final disposition shall not be
made until authorized by the attending physician or medical examiner.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.2844a Dental examination of dead body; forwarding records to law enforcement agency;
entering information into national crime information center; cancellation of information.
Sec. 2844a. (1) In deaths investigated by the county medical examiner or deputy county medical examiner
where he or she is not able to establish and verify, as required under section 5 of 1953 PA 181, MCL 52.205,
the identity of the dead body by visual means, fingerprints, DNA, or other definitive identification procedures,
the county medical examiner or deputy county medical examiner may have a qualified dentist, as determined
by the county medical examiner or deputy county medical examiner, carry out a dental examination of the
dead body. If the county medical examiner or deputy county medical examiner, with the aid of the dental
examination and other identifying findings, is still not able to establish the identity of the dead body, the
county medical examiner or deputy county medical examiner shall forward the dental examination records to
the appropriate law enforcement agency. The law enforcement agency shall enter the information from the
dental examination records into the national crime information center pursuant to section 8 of 1968 PA 319,
MCL 28.258.
(2) If a person reported missing has not been found within 30 days, the law enforcement agency
conducting the investigation for the missing person shall request the family or next of kin of the missing
person to give them written consent to contact and request from the dentist of the missing person the person's
dental records. The information from the dental records of the missing person shall be entered into the
national crime information center by the law enforcement agency pursuant to section 8 of 1968 PA 319, MCL
28.258.
(3) If a person reported missing has been found, the law enforcement agency that entered the information
under subsection (2) shall cancel the information.
History: Add. 1980, Act 418, Imd. Eff. Jan. 13, 1981;Am. 1990, Act 149, Imd. Eff. June 27, 1990;Am. 2006, Act 570, Imd. Eff.
Jan. 3, 2007.
Popular name: Act 368
333.2845 Inability to locate body; registration of death upon receipt of findings of probate
court; marking death registration; extension of time periods.
Sec. 2845. (1) When a death is presumed to have occurred in this state but the body cannot be located, the
state registrar may register the death upon receipt of the findings of the probate court, including the personal
and medical data required to complete the death registration. The death registration shall be marked
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presumptive and shall show on its face the date of registration and identify the court and the date of decree.
(2) The state registrar may provide for the extension of time periods prescribed for the filing of death
registrations in cases where compliance would result in undue hardship.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.2846 Failure to register death within prescribed time period; filing, registering, and
marking certificate; evidentiary requirements.
Sec. 2846. (1) When a death occurring in this state is not registered within the time period prescribed by
section 2843, a certificate may be filed in accordance with department procedures. The certificate shall be
registered subject to evidentiary requirements the department prescribes to substantiate the alleged facts of
death.
(2) A certificate of death registered 1 year or more after the date of death shall be marked delayed and
shall show on its face the date of the delayed registration.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.2848 Authorization for final disposition of dead body or fetus; time; form; retention of
permit; religious service or ceremony not required; cremation; moving body; permit
issued by other state.
Sec. 2848. (1) Except as otherwise provided in sections 2844 and 2845, a funeral director or person acting
as a funeral director, who first assumes custody of a dead body, not later than 72 hours after death or the
finding of a dead body and before final disposition of the body, shall obtain authorization for the final
disposition. The authorization for final disposition of a dead body shall be issued on a form prescribed by the
state registrar and signed by the local registrar or the state registrar.
(2) Except as otherwise provided in section 2836, or unless the mother has provided written consent for
research on the dead fetus under section 2688, before final disposition of a dead fetus, irrespective of the
duration of pregnancy, the funeral director or person assuming responsibility for the final disposition of the
fetus or fetal remains shall obtain from the parents, or parent if the mother is unmarried, an authorization for
final disposition on a form prescribed and furnished or approved by the state registrar. The authorization may
allow final disposition to be by a funeral director, the individual in charge of the institution where the fetus
was delivered or miscarried, or an institution or agency authorized to accept donated bodies, fetuses, or fetal
remains under this act. The parents, or parent if the mother is unmarried, may direct the final disposition to be
interment or cremation as those terms are defined in section 2 of the cemetery regulation act, 1968 PA 251,
MCL 456.522, or incineration. After final disposition, the funeral director, the individual in charge of the
institution, or other person making the final disposition shall retain the permit for not less than 7 years. This
section as amended by the amendatory act that added this sentence does not require a religious service or
ceremony as part of the final disposition of fetal remains.
(3) If final disposition is by cremation, the medical examiner of the county in which death occurred shall
sign the authorization for final disposition.
(4) A body may be moved from the place of death to be prepared for final disposition with the consent of
the physician or county medical examiner who certifies the cause of death.
(5) A permit for disposition issued under the law of another state that accompanies a dead body or dead
fetus brought into this state is authorization for final disposition of the dead body or dead fetus in this state.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2002, Act 562, Imd. Eff. Oct. 1, 2002;Am. 2012, Act 499, Eff. Mar. 31, 2013.
Popular name: Act 368
333.2850 Interment or other disposition of dead body or fetus; duty of individual in charge of
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premises; record of final disposition.
Sec. 2850. An individual in charge of premises in which interments or other disposition of dead bodies is
made shall not inter or allow interment or other disposition of a dead body or fetus unless it is accompanied
by an authorization for final disposition. An individual in charge of a place for final disposition shall keep a
record of a final disposition made in the premises under his or her charge. The record shall state the name of
the deceased, date and place of death, date of final disposition, and the name and address of the funeral
director or person acting as a funeral director.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.2852 Weather conditions requiring storage of dead body; authorization for delayed
interment; disinterment and reinterment permit not required.
Sec. 2852. When weather conditions prevent an immediate interment of a dead body and storage is
necessary, the individual in charge of a cemetery shall obtain written authorization for delayed interment
signed by the next of kin or authorized agent. The authorization shall specify the approximate hour and date
of interment and place of temporary storage. This storage is not considered interment and a disinterment and
reinterment permit is not required.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.2853 Permit for disinterment and reinterment required; issuance; forms for permits and
applications; retention of application; copy of permit as permanent record; petition for
disinterment order.
Sec. 2853. (1) A permit for disinterment and reinterment is required before disinterment of a dead body.
The local health department in whose jurisdiction the body is interred shall issue the permit upon proper
application by a licensed funeral director or person acting as a funeral director in accordance with rules
promulgated by the department.
(2) A person shall not disinter or permit the disinterment of a dead body in a cemetery and the body's
reinterment in a cemetery or removal from the cemetery unless a disinterment and reinterment permit is
issued by the local health department in the jurisdiction in which the cemetery is located.
(3) The department shall prepare and furnish to local health departments the forms for permits and
applications therefor, which shall be used in the procedures prescribed by this section and section 2852.
(4) The local health department shall retain an application for a disinterment and reinterment permit for not
less than 5 years. A duplicate copy of the permit shall be maintained in permanent records of the cemetery
from which the body was disinterred.
(5) If a required consent cannot be obtained, a person may petition the circuit court of the county in which
the cemetery is located for a disinterment order.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
Administrative rules: R 325.8051 et seq. of the Michigan Administrative Code.
333.2854 Failure to comply with provisions of MCL 333.2836 or 333.2848; violation; state civil
infraction; civil fine.
Sec. 2854. A person who violates this part by failing to dispose of fetal remains resulting from an abortion
as prescribed in section 2836 or by failing to obtain the proper authorization for final disposition of a dead
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body as provided under section 2848 is responsible for a state civil infraction as provided under chapter 88 of
the revised judicature act of 1961, 1961 PA 236, MCL 600.8801 to 600.8835, and may be ordered to pay a
civil fine of not more than $1,000.00 per violation.
History: Add. 2012, Act 499, Eff. Mar. 31, 2013.
Popular name: Act 368
333.2873 Conditions precluding amendment of vital record; reason for refusal; appeal;
reporting amendment; preservation of original information.
Sec. 2873. (1) If an applicant does not submit the minimum documentation required by the department for
amending a vital record or if the state registrar has reasonable cause to question the validity or adequacy of
the applicant's sworn statement or the documentary evidence, and if the deficiencies are not corrected, the
state registrar shall not amend the vital record and shall advise the applicant of the reason for the refusal. The
applicant shall have the right to appeal to a circuit court.
(2) When a certificate is amended under this section or section 2871 or 2872, the state registrar shall report
the amendment to the appropriate custodian of permanent local records who shall amend the record
accordingly.
(3) The original information contained in a vital record which is amended shall be preserved by the state
registrar in accordance with section 2876.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.2881 Procedures applicable to system of vital statistics; request and fee for verification
of facts; request and fee for name and location of court which finalized adoption.
Sec. 2881. (1) The procedures established by the department pursuant to part 26 to protect the
confidentiality of records and to regulate the disclosure of data contained in a departmental data system or
system of records are applicable to the system of vital statistics.
(2) Except as otherwise provided in section 2890, upon written request and payment of the prescribed fee,
the state registrar or local registrar shall verify for any person the following facts:
(a) The name or names of the individual to whom the vital record pertains.
(b) The nature of the event.
(c) The date of the event.
(d) The place of the event.
(e) The date of filing.
(3) Upon written request of an adult person who has been adopted, and payment of a fee as prescribed in
section 2891, the department shall inform the requester of the name and location of the court which finalized
the adoption.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1979, Act 208, Eff. May 14, 1980;Am. 1987, Act 83, Imd. Eff. June 29, 1987.
Popular name: Act 368
333.2882 Issuance of certain certified copies; request; fee; request of adopted adult or
confidential intermediary; phrase to be marked on certificate provided under subsection
(2) or (3).
Sec. 2882. (1) Except as otherwise provided in section 2890, upon written request and payment of the
prescribed fee, the state registrar or local registrar shall issue the appropriate 1 of the following:
(a) A certified copy of a live birth record, an affidavit of parentage filed after June 1, 1997, or a record of
stillbirth filed after June 1, 2003 to 1 of the following:
(i) The individual who is the subject of the record.
(ii) A parent named in the record.
(iii) An heir, a legal representative, or a legal guardian of the individual who is the subject of the record.
(iv) A court of competent jurisdiction.
(b) If the live birth record is 100 or more years old, a certified copy of the live birth record to any
applicant.
(c) A certified copy of a death record, including the cause of death, to any applicant.
(d) A certified copy of a marriage or divorce record to any applicant, except as provided by rule.
(e) A certified copy of a fetal death record that was filed before September 30, 1978, to any applicant.
(2) Upon written request of an adult who has been adopted and payment of the prescribed fee, the state
registrar shall issue to that individual a copy of his or her original certificate of live birth, if the written request
identifies the name of the adult adoptee and is accompanied by a copy of a central adoption registry clearance
reply form that was completed by the family independence agency and delivered to that individual as required
by section 68(9) of the Michigan adoption code, chapter X of the probate code of 1939, 1939 PA 288, MCL
710.68.
(3) Upon written request of a confidential intermediary appointed under section 68b of the Michigan
adoption code, chapter X of the probate code of 1939, 1939 PA 288, MCL 710.68b, presentation of a certified
copy of the order of appointment, identification of the name of the adult adoptee, and payment of the required
fee, the state registrar shall issue to the confidential intermediary a copy of the original certificate of live birth
of the adult adoptee on whose behalf the intermediary was appointed.
(4) A copy of the original certificate of live birth provided under subsection (2) or (3) shall have the
following phrase marked on the face of the copy: This document is a copy of a sealed record and is not the
active birth certificate of the individual whose name appears on this document.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1987, Act 83, Imd. Eff. June 29, 1987;Am. 1994, Act 186, Imd. Eff. June 20,
1994;Am. 1994, Act 206, Eff. Jan. 1, 1995;Am. 1996, Act 307, Eff. June 1, 1997;Am. 1997, Act 54, Imd. Eff. July 1, 1997;Am.
2002, Act 544, Imd. Eff. July 26, 2002;Am. 2002, Act 691, Eff. Mar. 31, 2003.
Popular name: Act 368
333.2882a Heirloom birth certificate; issuance; administration; fee; design; seal; signature of
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governor; marketing and promotion; certificate not official record; section to be referred to
as "Pam Posthumus law."
Sec. 2882a. (1) In addition to the birth record copies and certificates issued under section 2882 and subject
to the limitations of section 2882(1)(a) and (b), the state registrar shall issue, upon request and payment of the
fee prescribed in subsection (2), an heirloom birth certificate representing the birth of the individual named on
the original birth record or certificate. The state registrar may establish procedures for the administration of an
heirloom birth certificate. The state registrar shall establish procedures to allow the purchase of a gift card or
certificate that can be redeemed by a person eligible to purchase an heirloom birth certificate under this
section.
(2) The fee for each heirloom certificate of birth is $40.00. The state registrar shall transmit $20.00 of each
fee collected under this section to the state treasurer for deposit as a gift or donation into the children's trust
fund created in 1982 PA 249, MCL 21.171 to 21.172.
(3) The department shall design each heirloom birth certificate available for issue under subsection (1)
consistent with the form and content prescribed under section 2811 and so that it is suitable for display. An
heirloom birth certificate may bear the seal of the state and may be signed by the governor.
(4) The department shall market and promote heirloom birth certificates available under this section.
(5) An heirloom birth certificate issued under this section is not an official record of birth and is not the
active birth certificate of the individual whose name appears on the document.
(6) This section may be referred to as the "Pam Posthumus law".
History: Add. 2011, Act 28, Imd. Eff. May 16, 2011;Am. 2012, Act 127, Imd. Eff. May 8, 2012.
Popular name: Act 368
333.2883 Furnishing copies or data from system of vital statistics; requirements; availability
of copies of certificates or reports.
Sec. 2883. (1) The department may furnish copies or data from the system of vital statistics to the federal
agency responsible for national vital statistics if the federal agency shares in the cost of collecting, processing,
and transmitting the data, and if the data is not used for other than statistical purposes by the federal agency
unless authorized by the state registrar.
(2) The department may furnish copies or data from the system of vital statistics to federal, state, local, and
other public or private agencies for statistical or administrative purposes upon terms or conditions prescribed
by the department if the copies or data are used only for the purpose for which requested unless otherwise
authorized by the state registrar.
(3) The department may make available copies of certificates or reports required under this part or data
derived from the certificates or reports that the department determines are necessary to local health agencies
for local health planning and program activities.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.2884 Transmitting transcripts of records and other reports to offices of vital statistics
outside state; agreement; return of transcripts; transcripts received from other
jurisdictions.
Sec. 2884. The state registrar, by agreement, may transmit transcripts of records and other reports required
by this part to offices of vital statistics outside this state when the records or other reports relate to residents of
those jurisdictions or individuals born in those jurisdictions. The agreement shall require that the transcripts
be used for statistical and administrative purposes only as specified in the agreement. The transcripts shall be
returned by the other jurisdiction not later than 2 years after the date of the event or after the statistical
tabulations have been accomplished, whichever is sooner. Transcripts received from other jurisdictions by the
department in this state shall be handled in the same manner.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.2889 Tagging birth certificate of missing child; notifying state police of request for copy
of certificate; matching LEIN entry and certificate; tagging by local registrar; removal of
tag.
Sec. 2889. (1) Upon notification pursuant to section 8 of Act No. 319 of the Public Acts of 1968, being
section 28.258 of the Michigan Compiled Laws, that a person less than 17 years of age who was born in this
state is missing, the state registrar shall immediately tag the birth certificate of that person in a manner that
will alert the registrar to the fact that the birth certificate is that of a missing child. The state registrar shall
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immediately notify the appropriate local registrars to similarly tag the birth certificate or appropriate
document of the missing child. The state registrar shall check to see if a request for a copy of the missing
child's birth certificate was received within 14 days preceding the tagging of the birth certificate. If a request
had been received, the state registrar shall immediately notify the state police of the request.
(2) The state registrar may access the law enforcement information network to obtain from the law
enforcement agency reporting the missing person information necessary to provide a positive match between
the missing person's LEIN entry and the missing person's birth certificate.
(3) Upon notification by the state registrar pursuant to subsection (1), the local registrar shall immediately
tag the birth certificate or appropriate document of a missing child in a manner that will alert the registrar to
the fact that the birth certificate is that of a missing child.
(4) Upon notification pursuant to section 8 of Act No. 319 of the Public Acts of 1968 that the information
entered into the law enforcement information network regarding a missing child has been canceled, the state
registrar shall remove the tag from the child's birth certificate not later than 7 days after receiving the notice.
(5) Upon removal of a tag by the state registrar pursuant to subsection (4), the state registrar shall
immediately notify the local registrar who shall remove the tag from the missing child's birth certificate or
appropriate document not later than 7 days after receiving the notice from the state registrar.
History: Add. 1987, Act 83, Imd. Eff. June 29, 1987.
Popular name: Act 368
333.2891 Search for vital record; request; fee; official statement if record not located;
verification of identity; fees for search, establishment, or registration; furnishing copies
without charge; fees for creation of new vital records and corrections of vital records;
additional fees; disposition of fees; system of fees for local registrars; vital records fund.
Sec. 2891. (1) The state registrar or a local registrar shall, upon receipt of a written request and payment of
the prescribed fee, conduct a search for a vital record for an individual who purports to be eligible under
section 2882 or for an agency under section 2883(2) to receive a certified copy, administrative use copy, or a
statistical use copy of the requested vital record.
(2) If a search for a vital record is conducted by the state registrar and the vital record cannot be located,
the state registrar shall issue an official statement that the vital record could not be located instead of a
certified copy or an administrative use copy of the vital record. If a search for a vital record is conducted by a
local registrar and the vital record cannot be located, the local registrar is not required to issue an official
statement as described in this subsection, and the local registrar may waive the prescribed fee.
(3) The state registrar or a local registrar may require an applicant who requests a certified copy, an
administrative use copy, or a statistical use copy of a vital record to provide verification of his or her identity
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before releasing the vital record if eligibility for the vital record is restricted under section 2882.
(4) Subject to subsection (8), the fees for a search for a vital record are as follows:
(a) A search including 1 certified copy,
1 administrative use copy, or 1 statistical use
copy of a vital record or an official statement
issued by the state registrar that a vital record
could not be located.................................. $ 34.00
(b) Additional identical copies ordered at
the same time......................................... $ 16.00
per copy
(c) Additional years searched.................... $ 12.00
per year
(d) An authenticated copy........................ $ 42.00
(e) Additional authenticated copies ordered
at the same time...................................... $ 26.00
per copy
(f) Verification of facts delineated in
section 2881(2)....................................... $ 18.00
(g) Except as otherwise provided in
subdivision (h), a request for an expedited
search for a vital record under this
subsection............................................ $ 12.00
(h) A request for an expedited search
for an authenticated copy of a vital
record under subdivision (d).......................... $ 25.00
(5) The fees for establishment or registration of a vital record are as follows:
(a) Application for establishment of a
delayed certificate of birth or death that
includes 1 certified copy or an official
denial of the application............................. $ 50.00
(b) Registration of a delayed certificate
of birth for a foreign born adopted child that
includes 1 certified copy............................. $ 50.00
(6) Upon formal application of a soldier; sailor; marine; member of the coast guard; nurse; member of a
women's auxiliary; or other person who is entitled to a bonus, a pension, or other compensation under a law of
this state, the United States, or another state or territory of the United States or a service auxiliary for a vital
record for the purpose of obtaining the bonus, pension, or compensation, the state registrar shall furnish 1
certified copy of the vital record requested without charge. If the person entitled to the vital record is deceased
or mentally incompetent, the state registrar may furnish the copy to an heir, guardian, or legal representative
of the person. The state registrar shall label a certified copy furnished under this subsection with the following
statement: "for veteran's benefits only, not for personal use".
(7) Upon formal application, the state registrar or a local registrar shall furnish a certified copy of a vital
record without charge to a licensed child placing agency representing a child for adoption purposes. The state
registrar or local registrar shall label a certified copy provided under this subsection with the following
statement: "for adoption purposes only, not for personal use".
(8) Upon formal application, the state registrar shall charge a person 65 years of age or older a fee of
$14.00 for a search for and 1 certified copy of his or her birth record.
(9) The state registrar shall charge the following fees for the creation of new vital records and corrections
of vital records:
(a) Application to create a new certificate
of birth following an adoption; legal change of
name for minors; acknowledgment of paternity; sex
change; legitimation; order of filiation; or a
request to replace a court filed certificate of
adoption.............................................. $ 50.00
(b) Subject to subsection (10),
application received within 1 year of the date
of the event to create a new certificate of birth
or death to correct obvious minor errors and
omissions............................................. $ 50.00
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(c) An application with a request for an
expedited creation of a new certificate under
this subsection....................................... $ 25.00
(10) The errors and omissions that may be corrected under subsection (9)(b) are limited to the following:
(a) The addition of a given first or middle name if a name was not recorded at the time of filing.
(b) A change to a social security number.
(c) The addition of information originally specified as unknown or that was omitted by error.
(d) A minor spelling change.
(11) The state registrar shall charge a fee of $50.00 for an application to amend birth and death records
more than 1 year after the date of the event for the purpose of adding information or correcting an error in
information recorded on the document. The state registrar shall charge a fee of $25.00 for an application with
a request for an expedited amendment to a birth or death record under this subsection.
(12) The state registrar shall not charge a fee for any of the following:
(a) Changing a vital record to correct an error made within the office of a local registrar or the state
registrar.
(b) Correcting an error if the correction is initiated by the state registrar.
(c) Correcting a vital record if the correction is requested by a county medical examiner for a case within
his or her jurisdiction.
(d) Correcting a record if the correction is ordered by a court of competent jurisdiction following denial by
the department of an application to make the correction.
(e) Correcting a vital record if the correction is requested by a public agency that is the guardian of the
individual to whom the vital record pertains.
(13) The state registrar shall charge a fee of $50.00 for an application to amend a birth record regarding a
documented legal change of name for an adult. The state registrar shall charge a fee of $25.00 for an
application with a request for an expedited amendment to a birth record under this subsection.
(14) The state registrar or a local registrar with approval of the state registrar may charge a reasonable fee
to cover the costs of special services performed pursuant to section 2883, 2884, or 2888.
(15) A local registrar shall deposit fees collected under this section as the governing body of the city or
county directs. The state registrar shall transmit fees collected under this section to the state treasurer for
deposit into the vital records fund created in section 2892.
(16) The state registrar shall charge a fee of $12.00 for an application for a copy or a certified copy of a
vital records-related document, including, but not limited to, a completed application submitted under this
section or a document submitted under this section to support a requested change to a vital record.
(17) The state registrar or a local registrar shall not charge a fee other than a fee prescribed in this section.
However, a local governmental unit may adopt a system of fees for local registrars under the jurisdiction of
the local governmental unit for a search that provides for fees less than those set forth in this section, and a
charter county with a population of more than 2,000,000 may adopt a system of fees for a local registrar under
the jurisdiction of that charter county that provides for fees more than those set forth in this section. However,
a charter county shall not impose a fee that is greater than the cost of the service for which the fee is charged.
(18) For searches under subsection (4), a local registrar shall charge fees according to the following:
(a) The governing body of a local governmental unit that has jurisdiction over a local registrar may adopt a
system of fees for the local registrar that provides for fees less than or equal to the fees set forth in subsection
(4). These fees shall be used for the maintenance and sustenance of the vital records fees program only. The
fees shall alleviate any burden to the taxpayers to provide this worthwhile program. A charter county with a
population of more than 2,000,000 may adopt a system of fees for a local registrar under the jurisdiction of
that charter county that provides for fees that are more than the fees set forth in subsection (4). A charter
county shall not impose a fee that is greater than the cost of the service for which the fee is charged. A system
of fees adopted under this subdivision shall be used by all local registrars under the jurisdiction of the local
governmental unit and shall be reasonably related to the cost incurred by the local registrar in making the
search.
(b) If a system of fees is not adopted by a local registrar's local governmental unit under subdivision (a),
the local registrar shall not charge a fee other than a fee prescribed in subsection (4).
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1980, Act 522, Imd. Eff. Jan. 26, 1981;Am. 1981, Act 63, Imd. Eff. June 8,
1981;Am. 1984, Act 296, Imd. Eff. Dec. 20, 1984;Am. 1992, Act 78, Imd. Eff. June 2, 1992;Am. 2001, Act 31, Imd. Eff. June 29,
2001;Am. 2004, Act 467, Imd. Eff. Dec. 28, 2004;Am. 2013, Act 136, Imd. Eff. Oct. 15, 2013.
Compiler's note: Enacting section 1 of Act 136 of 2013 provides:
"Enacting section 1. This amendatory act takes effect October 1, 2013."
Popular name: Act 368
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333.2892 Vital records fund creation; duties of state treasurer; disposition of fund;
administrator of fund; expenditures; limitation.
Sec. 2892. (1) The vital records fund is created within the state treasury. The state treasurer may receive
money or other assets from any source for deposit into the vital records fund. The state treasurer shall direct
the investment of money or other assets in the vital records fund. The state treasurer shall credit to the vital
records fund interest and earnings from the investment of money or other assets in the vital records fund.
Money in the vital records fund at the close of the fiscal year shall remain in the vital records fund and shall
not lapse to the general fund.
(2) The department of technology, management, and budget is the administrator of the fund for auditing
purposes. The department of technology, management, and budget shall expend money from the fund, upon
appropriation, only for the maintenance and sustainability of the system of vital statistics in this state.
History: Add. 2013, Act 136, Imd. Eff. Oct. 15, 2013.
Compiler's note: Enacting section 1 of Act 136 of 2013 provides:
"Enacting section 1. This amendatory act takes effect October 1, 2013."
Popular name: Act 368
PART 32
EMERGENCY MEDICAL SERVICES SYSTEM
333.3201-333.3249 Repealed. 1981, Act 79, Imd. Eff. June 30, 1981.
Popular name: Act 368
PART 36
NUTRITION SERVICES SYSTEM
333.3601-333.3625 Expired. 1978, Act 368, Eff. Oct. 1, 1980.
Popular name: Act 368
ARTICLE 5
PREVENTION AND CONTROL OF DISEASES AND DISABILITIES
PART 51
GENERAL PROVISIONS
333.5101 Definitions and principles of construction.
Sec. 5101. (1) As used in this article:
(a) "Care" includes treatment, control, transportation, confinement, and isolation in a facility or other
location.
(b) "Communicable disease" means an illness due to a specific infectious agent or its toxic products that
results from transmission of that infectious agent or its products from a reservoir to a susceptible host, directly
as from an infected individual or animal, or indirectly through the agency of an intermediate plant or animal
host, vector, or the inanimate environment.
(c) "HIV" means human immunodeficiency virus.
(d) "HIV infection" or "HIV infected" means the status of an individual who has tested positive for HIV, as
evidenced by either a double positive enzyme-linked immunosorbent assay test, combined with a positive
western blot assay test, or a positive result under an HIV test that is considered reliable by the federal Centers
for Disease Control and Prevention and is approved by the department.
(e) "Immunization" means the process of increasing an individual's immunity to a disease by use of a
vaccine, antibody preparation, or other substance.
(f) "Infection" means the invasion of the body with microorganisms or parasites, whether or not the
invasion results in detectable pathologic effects.
(g) "Serious communicable disease or infection" means a communicable disease or infection that is
designated as serious by the department pursuant to this part. Serious communicable disease or infection
includes, but is not limited to, HIV infection, acquired immunodeficiency syndrome, sexually transmitted
infection, and tuberculosis.
(h) "Sexually transmitted infection" means syphilis, gonorrhea, chancroid, lymphogranuloma venereum,
granuloma inguinale, and other sexually transmitted infections that the department may designate and require
to be reported under section 5111.
(2) In addition, article 1 contains general definitions and principles of construction applicable to all articles
in this code.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1988, Act 491, Eff. Mar. 30, 1989;Am. 1994, Act 200, Imd. Eff. June 21, 1994;
Am. 2010, Act 119, Imd. Eff. July 13, 2010;Am. 2016, Act 63, Eff. July 4, 2016.
Compiler's note: For transfer of certain powers and duties of the bureau of infectious disease control from the department of public
health to the director of the department of community health, see E.R.O. No. 1996-1, compiled at MCL 330.3101 of the Michigan
Compiled Laws.
Popular name: Act 368
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333.5110 Expedited partner therapy.
Sec. 5110. (1) To protect and promote the public health of individuals in this state, expedited partner
therapy is authorized as provided in this section. Expedited partner therapy is authorized to protect individuals
in this state from the spread of sexually transmitted infections, which can cause infertility and ectopic
pregnancies. The department may promulgate rules under the administrative procedures act of 1969 that it
determines necessary to implement and administer this section. In addition to the requirements of section
5111, the department shall include in the list of reportable diseases, infections, and disabilities a separate list
of sexually transmitted infections for which expedited partner therapy as authorized in this section is
appropriate. In developing the list, the department shall consult with the federal centers for disease control
and prevention and health professionals in this state.
(2) In addition to treating his or her patient, a health professional may provide expedited partner therapy if
all of the following requirements are met:
(a) The patient has a laboratory-confirmed or suspected clinical diagnosis of a sexually transmitted
infection.
(b) The patient indicates that he or she has a partner with whom the patient has engaged in sexual activity
within the 60-day period immediately before the diagnosis of a sexually transmitted infection.
(c) The patient indicates that his or her partner is unable or is unlikely to seek clinical services in a timely
manner.
(3) A health professional who provides expedited partner therapy as authorized in this section shall do all
of the following:
(a) Dispense or prescribe the therapy in the name of the partner, if known, without the physical
examination of the partner by the health professional. Notwithstanding any provision of this act or rules to the
contrary, if the name of the partner is not known, the health professional shall dispense or prescribe the
therapy in the name of "expedited partner therapy".
(b) Convey to the patient that it is important to notify his or her partner of his or her diagnosis and that it is
important for the partner to obtain medical care for a complete evaluation, testing for sexually transmitted
infections, counseling, and treatment.
(c) Distribute to the patient the information sheet developed under subsection (4).
(4) The department shall develop and distribute to local health departments and, upon request, distribute to
health professionals subject to this section an information sheet that includes all of the following information:
(a) A description of expedited partner therapy and its purpose.
(b) A statement that a common therapy for certain sexually transmitted infections is antibiotic therapy and
that, if the expedited partner therapy dispensed or prescribed for the reader includes antibiotic therapy, the
information sheet contains important warnings and information of which the reader should be aware.
(c) A warning that identifies contraindications for expedited partner therapy.
(d) A warning about the dangers of administering certain antibiotic therapies to a pregnant individual.
(e) Information about antibiotics dispensed or prescribed in antibiotic therapy and dosages of those
antibiotics dispensed or prescribed.
(f) A warning about the risk of allergies to and drug interactions with antibiotics described in subdivision
(e).
(g) Information about sexually transmitted infections, the treatment of diagnosed sexually transmitted
infections, and the prevention of sexually transmitted infections.
(h) A notice that the partner should be tested for sexually transmitted infections.
(i) A notice of the risk to the patient, his or her partner, and others, including the public health, if a sexually
transmitted infection is not completely treated.
(j) A notice of the responsibility of the patient to notify his or her sexual partners of the risk of sexually
transmitted infections and the importance of examination and treatment for sexually transmitted infections.
(k) A statement advising any individual who has any questions regarding anything in the information sheet
to contact his or her health professional or local health department.
(l) A statement that the cost of drugs dispensed pursuant to a prescription issued in the name of expedited
partner therapy must be paid by the individual filling the prescription if that individual does not have
prescription drug coverage under a health benefit plan or third-party reimbursement arrangement.
(5) This section does not require a health benefit plan or third-party reimbursement arrangement to pay for
or provide reimbursement for expedited partner therapy authorized under this section unless the partner who
receives the therapy is listed as a member, subscriber, contract holder, or beneficiary under the health benefit
plan or third-party reimbursement arrangement.
(6) Except as otherwise provided in this subsection, a health professional who provides expedited partner
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therapy as authorized in this section is not liable for damages in a civil action or subject to administrative
action under sections 16221 and 16226 for personal injury, death, or other consequences arising from or
related in any way to the provision of expedited partner therapy by the health professional. This subsection
does not apply if the action of the health professional in providing expedited partner therapy is gross
negligence.
(7) As used in this section:
(a) "Expedited partner therapy" is the indirect treatment of a partner of a patient who has been diagnosed as
having a sexually transmitted infection through the dispensing or prescribing of antibiotic drug or other
treatment that is the standard of care for sexually transmitted infections in accordance with guidelines
established by the federal centers for disease control and prevention for the treatment of the partner without
the physical examination of the partner by a health professional.
(b) "Health professional" means any of the following:
(i) An individual licensed or otherwise authorized to engage in a health profession under article 15 and
whose scope of practice includes the diagnosis and treatment of sexually transmitted infections.
(ii) For the purpose of dispensing therapy under this section, a pharmacist who is licensed or otherwise
authorized to engage in the practice of pharmacy under article 15.
(c) "Sexual activity" includes sexual contact and sexual penetration as those terms are defined in section
5129.
(d) "Sexually transmitted infection" means 1 of the following:
(i) Until the department establishes a separate list under subsection (1), a sexually transmitted infection for
which the federal centers for disease control and prevention recommends the use of expedited partner therapy.
(ii) On and after the date the department establishes a separate list under subsection (1), a sexually
transmitted infection included in that list.
History: Add. 2014, Act 525, Imd. Eff. Jan. 14, 2015.
Popular name: Act 368
333.5112 Pandemic influenza plan; establishment and maintenance; annual review and
update; availability to public; report.
Sec. 5112. (1) The department shall establish and maintain a pandemic influenza plan. The department
shall consult with the United States department of health and human services and the federal centers for
disease control and prevention to ensure that the pandemic influenza plan established by this state is
consistent with the national preparedness efforts. The department, in consultation with the department of
agriculture and the local health departments in this state, shall review and update the pandemic influenza plan
at least annually. The department shall make the pandemic influenza plan and any updates to that plan
available to the public through its website.
(2) Beginning 1 year after the effective date of this section and annually thereafter, the department shall
prepare a report regarding the pandemic influenza plan established under subsection (1), including an
assessment of the plan's effectiveness and this state's preparedness for an influenza outbreak, and present that
report to the appropriate standing committees and appropriations subcommittees of the senate and house of
representatives of the legislature that primarily address public health issues.
History: Add. 2006, Act 163, Imd. Eff. May 26, 2006.
Popular name: Act 368
333.5114 HIV infected test subject; report; form; encoded individual case files.
Sec. 5114. (1) Except as otherwise provided in this section, a person or governmental entity that obtains
from a test subject a test result that indicates that the test subject is HIV infected or from a test subject who
has already been diagnosed as HIV infected a test result ordered to evaluate immune system status, to
quantify HIV levels, or to diagnose acquired immunodeficiency syndrome shall, within 7 days after obtaining
a diagnostic test result or, for a nondiagnostic test result, within a time frame as determined by the
department, report to the appropriate local health department or, if requested by the local health department,
to the department on a form provided by the department or through electronic methods approved by the
department all of the following information, if available:
(a) The name and address of the person or governmental entity that submits the report.
(b) The name, address, and telephone number of the health care provider who diagnosed the test subject or
who ordered the test.
(c) The name, date of birth, race, sex, address, and telephone number of the test subject.
(d) The date on which the specimen was collected for testing.
(e) The type of test performed.
(f) The test result.
(g) If known, whether or not the test subject has tested positive for the presence of HIV or an antibody to
HIV on a previous occasion.
(h) The probable method of transmission.
(i) The purpose of the test.
(j) Any other medical or epidemiological information considered necessary by the department for the
surveillance, control, and prevention of HIV infections. Information added by the department under this
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subdivision shall be promulgated as rules.
(2) An individual who undergoes a test for HIV or an antibody to HIV in a physician's private practice
office or the office of a physician employed by or under contract to a health maintenance organization or who
submits a specimen for either of those tests to that physician may request that the report made by the
physician under this section not include the name, address, and telephone number of the test subject. Except
as otherwise provided in section 5114a, if such a request is made under this subsection, the physician shall
comply with the request and submit the specimen to the laboratory without the name, address, or telephone
number of the test subject.
(3) A local health department shall not maintain a roster of names obtained under this section, but shall
maintain individual case files that are encoded to protect the identities of the individual test subjects.
History: Add. 1988, Act 489, Eff. Mar. 30, 1989;Am. 2004, Act 514, Eff. Apr. 1, 2005.
Popular name: Act 368
333.5117 Individual with serious communicable disease or infection; order authorizing care;
report; authority not restricted; financial liability for care.
Sec. 5117. (1) A local health department that knows that an individual who has a serious communicable
disease or infection, including, but not limited to, tuberculosis or sexually transmitted infection, but not
including HIV infection and acquired immunodeficiency syndrome, regardless of the individual's domicile, is
in the local health department's jurisdiction and requires care, immediately shall furnish the necessary care in
accordance with requirements established by the department under section 5111(2)(g). The local health
department shall issue an order authorizing the care.
(2) The local health department promptly shall report the action taken under this section to the county
department of human services of the individual's probable place of domicile.
(3) This section does not restrict the authority of the local health department in furnishing care to the
individual, pending determination by the local health department or, upon its request, by the county
department of human services of the probable place of domicile of the individual.
(4) Financial liability for care rendered under this section shall be determined in accordance with part 53.
History: Add. 1988, Act 491, Eff. Mar. 30, 1989;Am. 1994, Act 200, Imd. Eff. June 21, 1994;Am. 2010, Act 119, Imd. Eff. July
13, 2010;Am. 2016, Act 65, Eff. July 4, 2016.
Popular name: Act 368
333.5119 Individual applying for marriage license; availability of tests for sexually
transmitted infection and HIV infection; educational materials; informing HIV infected
applicants of test results; definitions.
Sec. 5119. (1) An individual applying for a marriage license shall be advised through the distribution of
written educational materials by the county clerk regarding prenatal care and the transmission and prevention
of sexually transmitted infection and HIV infection. The written educational materials shall describe the
availability to the applicant of tests for both sexually transmitted infection and HIV infection. The information
shall include a list of locations where HIV counseling and testing services funded by the department are
available. The written educational materials shall be approved or prepared by the department.
(2) A county clerk shall not issue a marriage license to an applicant who fails to sign and file with the
county clerk an application for a marriage license that includes a statement with a check-off box indicating
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that the applicant has received the educational materials regarding the transmission and prevention of both
sexually transmitted infection and HIV infection and has been advised of testing for both sexually transmitted
infection and HIV infection, pursuant to subsection (1).
(3) If either applicant for a marriage license undergoes a test for HIV or an antibody to HIV, and if the test
results indicate that an applicant is HIV infected, the physician or a designee of the physician, the physician's
assistant, the certified nurse midwife, the certified nurse practitioner, or the local health officer or a designee
of the local health officer administering the test immediately shall inform both applicants of the test results
and shall counsel both applicants regarding the modes of HIV transmission, the potential for HIV
transmission to a fetus, and protective measures.
(4) As used in this section:
(a) "Certified nurse midwife" means an individual licensed as a registered professional nurse under part
172 who has been issued a specialty certification in the practice of nurse midwifery by the board of nursing
under section 17210.
(b) "Certified nurse practitioner" means an individual licensed as a registered professional nurse under part
172 who has been issued a specialty certification as a nurse practitioner by the board of nursing under section
17210.
(c) "Physician" means an individual licensed as a physician under part 170 or an osteopathic physician
under part 175.
(d) "Physician's assistant" means an individual licensed as a physician's assistant under part 170 or part
175.
History: Add. 1988, Act 491, Eff. Mar. 30, 1989;Am. 1990, Act 46, Imd. Eff. Mar. 30, 1990;Am. 1994, Act 75, Imd. Eff. Apr.
11, 1994;Am. 2000, Act 209, Eff. Jan. 1, 2001;Am. 2016, Act 66, Eff. July 4, 2016.
Popular name: Act 368
333.5123 Initial examination of pregnant woman or woman recently delivering infant; test
specimens required; exceptions; record; availability of test results and records.
Sec. 5123. (1) A physician or an individual otherwise authorized by law to provide medical treatment to a
pregnant woman shall take or cause to be taken, at the time of the woman's initial examination, test specimens
of the woman and shall submit the specimens to a clinical laboratory approved by the department for the
purpose of performing tests approved by the department for sexually transmitted infection, HIV or an
antibody to HIV, and hepatitis B. If, when a woman appears at a health care facility to deliver an infant or for
care in the immediate postpartum period having recently delivered an infant outside a health care facility, no
record of results from the tests required under this subsection is readily available to the physician or
individual otherwise authorized to provide care in such a setting, then the physician or individual otherwise
authorized to provide care shall take or cause to be taken specimens of the woman and shall submit the
specimens to a clinical laboratory approved by the department for the purpose of performing department
approved tests for sexually transmitted infection, HIV or an antibody to HIV, and hepatitis B. This subsection
does not apply if, in the professional opinion of the physician or other person, the tests are medically
inadvisable or the woman does not consent to be tested.
(2) The physician or other individual described in subsection (1) shall make and retain a record showing
the date the tests required under subsection (1) were ordered and the results of the tests. If the tests were not
ordered by the physician or other person, the record shall contain an explanation of why the tests were not
ordered.
(3) The test results and the records required under subsection (2) are not public records, but shall be
available to a local health department and to a physician who provides medical treatment to the woman or her
offspring.
History: Add. 1988, Act 491, Eff. Mar. 30, 1989;Am. 1994, Act 200, Imd. Eff. June 21, 1994;Am. 2016, Act 68, Eff. July 4,
2016.
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Popular name: Act 368
333.5127 Minor infected with sexually transmitted infection or HIV; consent to treatment;
informing spouse, parent, guardian, or person in loco parentis; financial responsibility.
Sec. 5127. (1) Subject to section 5133, the consent to the provision of medical or surgical care, treatment,
or services by a hospital, clinic, or physician that is executed by a minor who is or professes to be infected
with a sexually transmitted infection or HIV is valid and binding as if the minor had achieved the age of
majority. The consent is not subject to later disaffirmance by reason of minority. The consent of any other
person, including a spouse, parent, or guardian, or person in loco parentis, is not necessary to authorize the
services described in this subsection to be provided to a minor.
(2) For medical reasons a treating physician, and on the advice and direction of the treating physician, a
physician, a member of the medical staff of a hospital or clinic, or other health professional, may inform the
spouse, parent, guardian, or person in loco parentis as to the treatment given or needed. The information may
be given to or withheld from these persons without consent of the minor and notwithstanding the express
refusal of the minor to the providing of the information.
(3) A spouse, parent, guardian, or person in loco parentis of a minor is not financially responsible for
surgical care, treatment, or services provided under this section.
History: Add. 1988, Act 491, Eff. Mar. 30, 1989;Am. 2016, Act 69, Eff. July 4, 2016.
Popular name: Act 368
333.5129 Individuals arrested and charged, bound over, or convicted of certain crimes;
examination or testing for certain diseases; partner notification; expedited examination or
testing; information and counseling; providing name, address, and telephone number of
victim or individual; providing test results to victim or individual; transmitting test results
and other medical information; confidentiality; referral of individual for appropriate
medical care; financial responsibility; applicability of subsections (2), (3), and (4) to certain
individuals; costs; definitions.
Sec. 5129. (1) An individual arrested and charged with violating section 448, 449, 449a, 450, 452, or 455
of the Michigan penal code, 1931 PA 328, MCL 750.448, 750.449, 750.449a, 750.450, 750.452, and 750.455,
or a local ordinance prohibiting prostitution or engaging or offering to engage the services of a prostitute may,
upon order of the court, be examined or tested to determine whether the individual has sexually transmitted
infection, hepatitis B infection, hepatitis C infection, HIV infection, or acquired immunodeficiency syndrome.
Examination or test results that indicate the presence of sexually transmitted infection, hepatitis B infection,
hepatitis C infection, HIV infection, or acquired immunodeficiency syndrome must be reported to the
defendant and, pursuant to sections 5114 and 5114a, to the department and the appropriate local health
department for partner notification.
(2) Except as otherwise provided in this section, if an individual is arrested and charged with violating
section 145a, 338, 338a, 338b, 448, 449, 449a, 450, 452, 455, 520b, 520c, 520d, 520e, or 520g of the
Michigan penal code, 1931 PA 328, MCL 750.145a, 750.338, 750.338a, 750.338b, 750.448, 750.449,
750.449a, 750.450, 750.452, 750.455, 750.520b, 750.520c, 750.520d, 750.520e, and 750.520g, or section
7404 by intravenously using a controlled substance, or a local ordinance prohibiting prostitution, solicitation,
gross indecency, or the intravenous use of a controlled substance, the judge or magistrate responsible for
setting the individual's conditions of release pending trial shall distribute to the individual the information on
sexually transmitted infection and HIV infection required to be distributed by county clerks under section
5119(1) and shall recommend that the individual obtain additional information and counseling at a local
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health department testing and counseling center regarding sexually transmitted infection, hepatitis B infection,
hepatitis C infection, HIV infection, and acquired immunodeficiency syndrome. Counseling under this
subsection is voluntary on the part of the individual.
(3) If a defendant is bound over to circuit court for violating section 145a, 338, 338a, 338b, 450, 452, 455,
520b, 520c, 520d, 520e, or 520g of the Michigan penal code, 1931 PA 328, MCL 750.145a, 750.338,
750.338a, 750.338b, 750.450, 750.452, 750.455, 750.520b, 750.520c, 750.520d, 750.520e, and 750.520g, and
the district court determines there is reason to believe the violation involved sexual penetration or exposure to
a body fluid of the defendant, the district court shall order the defendant to be examined or tested for sexually
transmitted infection, hepatitis B infection, and hepatitis C infection and for the presence of HIV or an
antibody to HIV. The circuit court shall order the examination or testing if the defendant is brought before it
by way of indictment for any of the violations described in this subsection. If a defendant is bound over to or
brought before the circuit court for violating section 520b, 520c, 520d, 520e, or 520g of the Michigan penal
code, 1931 PA 328, MCL 750.520b, 750.520c, 750.520d, 750.520e, and 750.520g, the court shall, upon the
victim's request, order the examination or testing to be done not later than 48 hours after the date that the
information or indictment is presented and the defendant is in custody or has been served with the information
or indictment. The court shall include in its order for expedited examination or testing at the victim's request
under this subsection a provision that requires follow-up examination or testing that is considered medically
appropriate based on the results of the initial examination or testing. Except as provided in subsection (5), (6),
or (7), or as otherwise provided by law, the examinations and tests must be confidentially administered by a
licensed physician, the department, or a local health department. The court also shall order the defendant to
receive counseling regarding sexually transmitted infection, hepatitis B infection, hepatitis C infection, HIV
infection, and acquired immunodeficiency syndrome, including, at a minimum, information regarding
treatment, transmission, and protective measures.
(4) Except as otherwise provided in this section, upon conviction of a defendant or the issuance by the
probate court of an order adjudicating a child to be within the provisions of section 2(a)(1) of chapter XIIA of
the probate code of 1939, 1939 PA 288, MCL 712A.2, for violating section 145a, 338, 338a, 338b, 448, 449,
449a, 450, 452, 455, 520b, 520c, 520d, 520e, or 520g of the Michigan penal code, 1931 PA 328, MCL
750.145a, 750.338, 750.338a, 750.338b, 750.448, 750.449, 750.449a, 750.450, 750.452, 750.455, 750.520b,
750.520c, 750.520d, 750.520e, and 750.520g, or section 7404 by intravenously using a controlled substance,
or a local ordinance prohibiting prostitution, solicitation, gross indecency, or the intravenous use of a
controlled substance, the court that has jurisdiction of the criminal prosecution or juvenile hearing shall order
the defendant or child to be examined or tested for sexually transmitted infection, hepatitis B infection, and
hepatitis C infection and for the presence of HIV or an antibody to HIV. Except as provided in subsection (5),
(6), or (7), or as otherwise provided by law, the examinations and tests must be confidentially administered by
a licensed physician, the department, or a local health department. The court also shall order the defendant or
child to receive counseling regarding sexually transmitted infection, hepatitis B infection, hepatitis C
infection, HIV infection, and acquired immunodeficiency syndrome, including, at a minimum, information
regarding treatment, transmission, and protective measures.
(5) If the victim or individual with whom the defendant or child found to be within the provisions of
section 2(a)(1) of chapter XIIA of the probate code of 1939, 1939 PA 288, MCL 712A.2, engaged in sexual
penetration or sexual contact or who was exposed to a body fluid during the course of the crime consents, the
court or probate court shall provide the person or agency conducting the examinations or administering the
tests under subsection (3) or (4) with the name, address, and telephone number of the victim or individual
with whom the defendant or child engaged in sexual penetration or sexual contact or who was exposed to a
body fluid of the defendant during the course of the crime. If the victim or individual with whom the
defendant or child engaged in sexual penetration during the course of the crime is a minor or otherwise
incapacitated, the victim's or individual's parent, guardian, or person in loco parentis may give consent for
purposes of this subsection. After the defendant or child is examined or tested as to the presence of sexually
transmitted infection, hepatitis B infection, hepatitis C infection, or HIV or an antibody to HIV, or if the
defendant or child receives appropriate follow-up testing for the presence of HIV, the person or agency
conducting the examinations or administering the tests shall immediately provide the examination or test
results to the victim or individual with whom the defendant or child found to be within the provisions of
section 2(a)(1) of chapter XIIA of the probate code of 1939, 1939 PA 288, MCL 712A.2, engaged in sexual
penetration or sexual contact or who was exposed to a body fluid during the course of the crime and shall
refer the victim or other individual for appropriate counseling.
(6) The examination or test results and any other medical information obtained from the defendant or child
found to be within the provisions of section 2(a)(1) of chapter XIIA of the probate code of 1939, 1939 PA
288, MCL 712A.2, by the person or agency conducting the examinations or administering the tests under
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subsection (3) or (4) must be transmitted to the court or probate court and, after the defendant or child is
sentenced or an order of disposition is entered, made part of the court record. The examination or test results
and any other medical information described in this subsection are confidential and may be disclosed only to
1 or more of the following:
(a) The defendant or child.
(b) The local health department.
(c) The department.
(d) The victim or other individual required to be informed of the results under this subsection or subsection
(5) or, if the victim or other individual is a minor or otherwise incapacitated, to the victim's or other
individual's parent, guardian, or person in loco parentis.
(e) Upon written authorization of the defendant or child found to be within the provisions of section 2(a)(1)
of chapter XIIA of the probate code of 1939, 1939 PA 288, MCL 712A.2, or the child's parent, guardian, or
person in loco parentis.
(f) As otherwise provided by law.
(7) If the defendant is placed in the custody of the department of corrections, the court shall transmit a
copy of the defendant's examination and test results and other medical information to the department of
corrections. If the child found to be within the provisions of section 2(a)(1) of chapter XIIA of the probate
code of 1939, 1939 PA 288, MCL 712A.2, is placed by the probate court in the custody of an individual
related to the child or a public or private agency, institution, or facility, the probate court shall transmit a copy
of the child's examination or test results to the individual related to the child or the director of the agency,
institution, or facility. A person or agency that discloses information in compliance with this subsection or
subsection (6) is not civilly or criminally liable for making the disclosure. A person or agency that receives
test results or other medical information pertaining to HIV infection or acquired immunodeficiency syndrome
under this subsection or subsection (6) is subject to section 5131 and shall not disclose the test results or other
medical information except as specifically permitted under that section.
(8) If an individual receives counseling or is examined or tested under this section and is found to be
infected with sexually transmitted infection, hepatitis B, or hepatitis C or to be HIV infected, the individual
must be referred by the agency providing the counseling or testing for appropriate medical care. The
department, the local health department, or any other agency providing counseling or testing under this
section is not financially responsible for medical care received by an individual as a result of a referral made
under this subsection.
(9) The requirements for the distribution of information concerning sexually transmitted infection,
counseling concerning sexually transmitted infection, and examining or testing for sexually transmitted
infection under subsections (2), (3), and (4) do not apply to an individual charged with or convicted of
violating section 7404 by intravenously using a controlled substance or violating a local ordinance prohibiting
the intravenous use of a controlled substance.
(10) The court may, upon conviction or the issuance by the probate court of an order adjudicating a child to
be within the provisions of section 2(a)(1) of chapter XIIA of the probate code of 1939, 1939 PA 288, MCL
712A.2, order an individual who is examined or tested under this section to pay the actual and reasonable
costs of that examination or test incurred by the licensed physician or local health department that
administered the examination or test.
(11) An individual who is ordered to pay the costs of an examination or test under subsection (10) shall
pay those costs within 30 days after the order is issued or as otherwise provided by the court. The amount
ordered to be paid under subsection (10) must be paid to the clerk of the court, who shall transmit the
appropriate amount to the physician or local health department named in the order. If an individual is ordered
to pay a combination of fines, costs, restitution, assessments, probation or parole supervision fees, or other
payments upon conviction in addition to the costs ordered under subsection (10), the payments must be
allocated as provided under the probate code of 1939, 1939 PA 288, MCL 710.21 to 712B.41, the code of
criminal procedure, 1927 PA 175, MCL 760.1 to 777.69, and the William Van Regenmorter crime victim's
rights act, 1985 PA 87, MCL 780.751 to 780.834. An individual who fails to pay the costs within the 30-day
period or as otherwise ordered by the court is guilty of a misdemeanor punishable by imprisonment for not
more than 90 days or a fine of not more than $100.00, or both.
(12) As used in this section:
(a) "Sexual contact" means that term as defined in section 520a of the Michigan penal code, 1931 PA 328,
MCL 750.520a.
(b) "Sexual penetration" means that term as defined in section 520a of the Michigan penal code, 1931 PA
328, MCL 750.520a.
(c) "Victim" includes, but is not limited to, a victim as that term is defined in section 520a of the Michigan
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penal code, 1931 PA 328, MCL 750.520a.
History: Add. 1988, Act 471, Eff. Mar. 30, 1989;Am. 1994, Act 1, Imd. Eff. Feb. 16, 1994;Am. 1994, Act 72, Imd. Eff. Apr. 11,
1994;Am. 1994, Act 200, Imd. Eff. June 21, 1994;Am. 1995, Act 253, Imd. Eff. Jan. 5, 1996;Am. 2004, Act 98, Imd. Eff. May
13, 2004;Am. 2014, Act 321, Eff. Jan. 12, 2015;Am. 2016, Act 70, Eff. July 4, 2016.
Popular name: Act 368
PART 52
HAZARDOUS COMMUNICABLE DISEASES
333.5201 Definitions and principles of construction.
Sec. 5201. (1) As used in this part:
(a) Carrier means an individual who serves as a potential source of infection and who harbors or who the
department reasonably believes to harbor a specific infectious agent or a serious communicable disease or
infection, whether or not there is present discernible disease.
(b) Health threat to others means that an individual who is a carrier has demonstrated an inability or
unwillingness to conduct himself or herself in such a manner as to not place others at risk of exposure to a
serious communicable disease or infection. Health threat to others includes, but is not limited to, 1 or more of
the following:
(i) Behavior by the carrier that has been demonstrated epidemiologically to transmit, or that evidences a
careless disregard for transmission of, a serious communicable disease or infection to others.
(ii) A substantial likelihood that the carrier will transmit a serious communicable disease or infection to
others, as evidenced by the carrier's past behavior or statements made by the carrier that are credible
indicators of the carrier's intention to do so.
(iii) Affirmative misrepresentation by the carrier of his or her status as a carrier before engaging in
behavior that has been demonstrated epidemiologically to transmit the serious communicable disease or
infection.
(2) In addition, article 1 contains general definitions and principles of construction applicable to all articles
in this code and part 51 contains definitions applicable to this part.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1988, Act 490, Eff. Mar. 30, 1989.
Compiler's note: For transfer of certain powers and duties of the bureau of infectious disease control from the department of public
health to the director of the department of community health, see E.R.O. No. 1996-1, compiled at MCL 330.3101 of the Michigan
Compiled Laws.
Popular name: Act 368
333.5204 Request for testing made by officer, employee, or individual making lawful arrest;
procedures; rules; definitions.
Sec. 5204. (1) A police officer, a fire fighter, a local correctional officer or other county employee, a court
employee, or an individual making a lawful arrest may proceed under this section if he or she has received
training in the transmission of bloodborne diseases under the rules governing exposure to bloodborne diseases
in the workplace promulgated by the occupational health standards commission or incorporated by reference
under the Michigan occupational safety and health act, 1974 PA 154, MCL 408.1001 to 408.1094.
(2) A police officer, a fire fighter, a local correctional officer or other county employee, a court employee,
or an individual making a lawful arrest who has received the training described in subsection (1) and who,
while performing his or her official duties or otherwise performing the duties of his or her employment,
determines that he or she has sustained a percutaneous, mucous membrane, or open wound exposure to the
blood or body fluids of an arrestee, correctional facility inmate, parolee, or probationer may request that the
arrestee, correctional facility inmate, parolee, or probationer be tested for HIV infection, HBV infection, HCV
infection, or all 3 infections, pursuant to this section.
(3) An officer or employee or an individual making a lawful arrest who desires to make a request described
in subsection (2) shall make the request to his or her employer in writing on a form provided by the
department as soon as possible, but not later than 72 hours, after the exposure occurs. The request form shall
be dated and shall contain, at a minimum, the name and address of the officer, employee, or individual
making a lawful arrest making the request and a description of his or her exposure to the blood or other body
fluids of the arrestee, correctional facility inmate, parolee, or probationer. The request form shall also contain
a statement that the requester is subject to the confidentiality requirements of subsection (7) and section 5131.
The request form shall not contain information that would identify the arrestee, correctional facility inmate,
parolee, or probationer by name, except if necessary to identify the individual for purposes of testing under
this section.
(4) The employer of an individual making a request under subsections (2) and (3) shall accept as fact the
requester's description of his or her exposure to blood or other body fluids as described in subsection (2). The
requester's employer shall have the test for HIV infection, HBV infection, HCV infection, or all 3 infections
performed by the local health department or by a health care provider designated by the local health
department. If the test subject consents to the performance of the test or tests named in the request, the
requester's employer shall transport the test subject to the local health department or designated health care
provider for testing, or a representative of the local health department or designated health care provider shall
come to where the test subject is held or housed to take a blood or other body fluid sample for testing, as soon
as practicable after the local health department receives the request for testing from the requester's employer.
If the test subject refuses to undergo 1 or more tests specified in the request, the requester's employer may
proceed with a petition to the family division of the circuit court in the manner provided in section 5205 or
5207, as appropriate.
(5) A local health department or a health care provider designated by the local health department that
performs 1 or more tests under this section may charge the officer or employee or arresting individual
requesting the test for the reasonable and customary charges of each test. The officer or employee or arresting
individual requesting the test is responsible for the payment of the charges if the charges are not payable by
the officer's or employee's or arresting individual's employer, pursuant to an agreement between the officer or
employee or arresting individual and the employer, or by the officer's or employee's or arresting individual's
health care payment or benefits plan. A local health department or a health care provider designated by the
local health department to perform an HIV test under this section is not required to provide HIV counseling
pursuant to section 5133(1) to an officer or employee or arresting individual who requests that an arrestee,
correctional facility inmate, parolee, or probationer be tested for HIV under this section, unless the local
health department or designated health care provider tests the officer or employee or arresting individual for
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HIV.
(6) A local health department or a health care provider designated by the local health department to
perform a test under this section shall, on a form provided by the department, notify the requesting officer or
employee or arresting individual of the HIV test, HBV test, or HCV test results, as applicable, whether
positive or negative, within 2 days after the test results are obtained by the local health department or
designated health care provider. The notification shall be transmitted directly to the requesting officer or
employee or arresting individual or, upon request of the requesting officer or employee or arresting
individual, to his or her primary care physician or to another health professional designated by the officer or
employee or arresting individual. The notification required under this subsection shall include an explanation
of the confidentiality requirements of subsection (7). The notification required under this subsection shall also
contain a statement recommending that the requesting officer, employee, or arresting individual undergo an
HIV test, an HBV test, or an HCV test, or all 3 tests.
(7) The notice required under subsection (6) shall not contain information that would identify the arrestee,
correctional facility inmate, parolee, or probationer who tested positive or negative for HIV, HBV, or HCV.
The information contained in the notice is confidential and is subject to this section, the rules promulgated
under section 5111, and section 5131. A person who receives confidential information under this section shall
disclose the information to others only to the extent consistent with the authorized purpose for which the
information was obtained.
(8) The department may promulgate rules to administer this section. The department shall develop and
distribute the forms required under this section.
(9) In addition to the penalties prescribed in the rules promulgated under section 5111 and in section 5131,
a person who discloses information in violation of subsection (7) is guilty of a misdemeanor.
(10) A local health department or designated health care provider shall report to the department each test
result obtained under this section that indicates that an individual is HIV infected, in compliance with section
5114.
(11) A person or governmental entity that makes a good faith effort to comply with subsections (1) to (6) is
immune from civil liability or criminal penalty based on compliance with, or the failure to comply with, those
subsections.
(12) As used in this section and section 5205:
(a) "Correctional facility" means a municipal or county jail, work camp, lockup, holding center, halfway
house, community corrections center, or any other facility maintained by a municipality or county that houses
adult prisoners. Correctional facility does not include a facility owned or operated by the department of
corrections.
(b) "Employee" means a county employee or a court employee.
(c) "HBV" means hepatitis B virus.
(d) "HBV infected" or "HBV infection" means the status of an individual who is tested as HBsAg-positive.
(e) "HCV" means hepatitis C virus.
(f) "HCV infected" or "HCV infection" means the status of an individual who has tested positive for the
presence of HCV antibodies or has tested positive for HBV using an RNA test.
(g) "HIV" means human immunodeficiency virus.
(h) "HIV infected" means that term as defined in section 5101.
(i) "Individual making a lawful arrest" or "arresting individual" means 1 of the following:
(i) A private security police officer authorized to make an arrest without a warrant under section 30 of the
private security business and security alarm act, 1968 PA 330, MCL 338.1080, and section 15 of the code of
criminal procedure, 1927 PA 175, MCL 764.15.
(ii) A merchant, agent of a merchant, employee of a merchant, or independent contractor providing
security for a merchant authorized to make an arrest in the merchant's store and in the course of his or her
employment as prescribed by section 16(d) of the code of criminal procedure, 1927 PA 175, MCL 764.16.
Individual making a lawful arrest or arresting individual does not include a private person authorized to make
an arrest under section 16(a) and (b) of the code of criminal procedure, 1927 PA 175, MCL 764.16.
(j) "Local correctional officer" means an individual employed by a local governmental unit in a
correctional facility as a corrections officer.
(k) "Officer" means a law enforcement officer, motor carrier officer, or property security officer employed
by the state, a law enforcement officer employed by a local governmental unit, a fire fighter employed by or
volunteering for a local governmental unit, or a local correctional officer.
History: Add. 1997, Act 57, Eff. Jan. 1, 1998;Am. 2010, Act 119, Imd. Eff. July 13, 2010.
Popular name: Act 368
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333.5205 Failure or refusal to comply with warning notice; petition; hearing; notice; waiver;
orders; recommendation and duties of commitment review panel and circuit court; appeal
to circuit court; termination or continuation of commitment; cost of implementing order;
right to counsel; appeal to court of appeals; leaving facility or refusal to undergo testing
for certain infections as contempt.
Sec. 5205. (1) If a department representative or a local health officer knows or has reasonable grounds to
believe that an individual has failed or refused to comply with a warning notice issued under section 5203, the
department or local health department may petition the circuit court for the county of Ingham or for the
county served by the local health department for an order as described in subsection (6).
(2) A petition filed under subsection (1) shall state all of the following:
(a) The grounds and underlying facts that demonstrate that the individual is a health threat to others and,
unless an emergency order is sought under section 5207, has failed or refused to comply with a warning
notice issued under section 5203.
(b) The petitioner's effort to alleviate the health threat to others before the issuance of the warning notice,
unless an emergency order is sought under section 5207.
(c) The type of relief sought.
(d) A request for a court hearing on the allegations set forth in the petition.
(3) If a test subject refuses to undergo a test requested by an officer or employee or an arresting individual
under section 5204, the officer's or employee's or arresting individual's employer may petition the circuit
court for the county in which the employer is located or the appropriate district court for an order as described
in subsection (7).
(4) A petition filed under subsection (3) shall state all of the following:
(a) Substantially the same information contained in the request made to an officer's or employee's or
arresting individual's employer under section 5204(2) and (3), except that the petition shall contain the name
of the arrestee, correctional facility inmate, parolee, or probationer who is the proposed test subject.
(b) The reasons for the officer's or employee's or arresting individual's determination that the exposure
described in the request made under section 5204(2) and (3) could have transmitted HIV, HBV, or HCV, or
all or a combination of those viruses, along with the date and place the officer or employee or arresting
individual received the training in the transmission of bloodborne diseases required under section 5204(1).
(c) The fact that the arrestee, correctional facility inmate, parolee, or probationer has refused to undergo
the test or tests requested under section 5204(2) and (3).
(d) The type of relief sought.
(e) A request for a court hearing on the allegations set forth in the petition.
(5) Upon receipt of a petition filed under subsection (1), the circuit court shall fix a date for hearing that
shall be as soon as possible, but not later than 14 days after the date the petition is filed. Notice of the petition
and the time and place of the hearing shall be served personally on the individual and on the petitioner not
less than 3 days before the date of the hearing. Notice of the hearing shall include notice of the individual's
right to appear at the hearing, the right to present and cross-examine witnesses, and the right to counsel as
provided in subsection (12). The individual and the petitioner may waive notice of hearing, and upon filing of
the waiver in writing, the circuit court may hear the petition immediately. Upon receipt of a petition filed
under subsection (3), the circuit court or the district court shall fix a date for hearing that shall be as soon as
possible, but not later than 24 hours after the time and date the petition is filed. Notice of the petition and the
time and place of the hearing shall be served personally on both the proposed test subject under section 5204
and the petitioner within a time period that is reasonable under the circumstances. Notice of the hearing shall
include notice of the proposed test subject's right to appear at the hearing, the right to present and
cross-examine witnesses, and the right to counsel as provided in subsection (12). The proposed test subject
and the petitioner may waive notice of the hearing, and upon filing of the waiver in writing, the circuit court
or the district court may hear the petition filed under subsection (3) immediately.
(6) Upon a finding by the circuit court that the department or local health department has proven the
allegations set forth in a petition filed under subsection (1) by clear and convincing evidence, the circuit court
may issue 1 or more of the following orders:
(a) An order that the individual participate in a designated education program.
(b) An order that the individual participate in a designated counseling program.
(c) An order that the individual participate in a designated treatment program.
(d) An order that the individual undergo medically accepted tests to verify the individual's status as a
carrier or for diagnosis.
(e) An order that the individual notify or appear before designated health officials for verification of status,
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testing, or other purposes consistent with monitoring.
(f) An order that the individual cease and desist conduct that constitutes a health threat to others.
(g) An order that the individual live part-time or full-time in a supervised setting for the period and under
the conditions set by the circuit court.
(h) Subject to subsection (8), an order that the individual be committed to an appropriate facility for the
period and under the conditions set by the circuit court. A commitment ordered under this subdivision shall
not be for more than 6 months, unless the director of the facility, upon motion, shows good cause for
continued commitment.
(i) Any other order considered just by the circuit court.
(7) Upon a finding by the circuit court or the district court that the officer's or employee's or arresting
individual's employer has proven the allegations set forth in a petition filed under subsection (3), including,
but not limited to, the requesting officer's or employee's or arresting individual's description of his or her
exposure to the blood or body fluids of the proposed test subject, the circuit court or the district court may
issue an order requiring the proposed test subject to undergo a test for HIV infection, HBV infection, or HCV
infection, or all or a combination of the 3 infections.
(8) The circuit court shall not issue an order authorized under subsection (6)(h) unless the court first
considers the recommendation of a commitment review panel appointed by the court under this subsection to
review the need for commitment of the individual to a health facility. The commitment review panel shall
consist of 3 physicians appointed by the court from a list of physicians submitted by the department. Not less
than 2 of the physicians shall have training and experience in the diagnosis and treatment of serious
communicable diseases and infections. However, upon the motion of the individual who is the subject of the
order, the court shall appoint as 1 member of the commitment review panel a physician who is selected by the
individual. The commitment review panel shall do all of the following:
(a) Review the record of the proceeding.
(b) Interview the individual, or document the reasons why the individual was not interviewed.
(c) Recommend either commitment or an alternative or alternatives to commitment, and document the
reasons for the recommendation.
(9) An individual committed to a facility under subsection (6)(h) may appeal to the circuit court for a
commitment review panel recommendation as to whether or not the patient's commitment should be
terminated. Upon the filing of a claim of appeal under this subsection, the court shall reconvene the
commitment review panel appointed under subsection (5) as soon as practicable, but not more than 14 days
after the filing of the claim of appeal. Upon reconvening, the commitment review panel shall do all of the
following:
(a) Review the appeal and any other information considered relevant by the commitment review panel.
(b) Interview the individual, or document the reasons why the individual was not interviewed.
(c) Recommend to the court either termination or continuation of the commitment, and document the
reasons for the recommendation.
(10) Upon receipt of the recommendation of the commitment review panel under subsection (9), the circuit
court may terminate or continue the commitment.
(11) The cost of implementing an order issued under subsection (6) shall be borne by the individual who is
the subject of the order, unless the individual is unable to pay all or a part of the cost, as determined by the
circuit court. If the court determines that the individual is unable to pay all or a part of the cost of
implementing the order, then the state shall pay all of the cost or that part of the cost that the individual is
unable to pay, upon the certification of the department. The cost of implementing an order issued under
subsection (7) shall be borne by the arrestee, correctional facility inmate, parolee, or probationer who is tested
under the order.
(12) An individual who is the subject of a petition filed under this section or an affidavit filed under section
5207 has the right to counsel at all stages of the proceedings. If the individual is unable to pay the cost of
counsel, the circuit court shall appoint counsel for the individual.
(13) An order issued by the circuit court under subsection (6) may be appealed to the court of appeals. The
court of appeals shall hear the appeal within 30 days after the date the claim of appeal is filed with the court
of appeals. However, an order issued by the circuit court under subsection (6) shall not be stayed pending
appeal, unless ordered by the court of appeals on motion for good cause. An order issued by the circuit court
under subsection (7) may be appealed to the court of appeals. The court of appeals shall hear the appeal
within 15 days after the date the claim of appeal is filed with the court of appeals. However, an order issued
by the circuit court under subsection (7) shall not be stayed pending appeal, unless ordered by the court of
appeals on motion for good cause. An order issued by a district court under subsection (7) may be appealed to
the circuit court for the county in which the district court is located. The circuit court shall hear the appeal
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within 15 days after the date the claim of appeal is filed with the circuit court. However, an order issued by a
district court under subsection (7) shall not be stayed pending appeal, unless ordered by the circuit court on
motion for good cause.
(14) An individual committed to a facility under this section who leaves the facility before the date
designated in the commitment order without the permission of the circuit court or who refuses to undergo a
test for HIV infection, HBV infection, HCV infection, or all or a combination of the 3 infections is guilty of
contempt.
History: Add. 1988, Act 490, Eff. Mar. 30, 1989;Am. 1997, Act 57, Eff. Jan. 1, 1998;Am. 2000, Act 37, Imd. Eff. Mar. 17,
2000.
Popular name: Act 368
333.5207 Protection of public health in emergency; affidavit; court order; taking individual
into custody; transporting individual to emergency care or treatment facility; temporary
detention; notice of hearing; continued temporary detention; petition.
Sec. 5207. (1) To protect the public health in an emergency, upon the filing of an affidavit by a department
representative or a local health officer, the circuit court may order the department representative, local health
officer, or a peace officer to take an individual whom the court has reasonable cause to believe is a carrier and
is a health threat to others into custody and transport the individual to an appropriate emergency care or
treatment facility for observation, examination, testing, diagnosis, or treatment and, if determined necessary
by the court, temporary detention. If the individual is already institutionalized in a facility, the court may
order the facility to temporarily detain the individual. An order issued under this subsection may be issued in
an ex parte proceeding upon an affidavit of a department representative or a local health officer. The court
shall issue an order under this subsection upon a determination that reasonable cause exists to believe that
there is a substantial likelihood that the individual is a carrier and a health threat to others. An order under this
subsection may be executed on any day and at any time, and shall be served upon the individual who is the
subject of the order immediately upon apprehension or detention.
(2) An affidavit filed by a department representative or a local health officer under subsection (1) shall set
forth the specific facts upon which the order is sought including, but not limited to, the reasons why an
emergency order is sought.
(3) An individual temporarily detained under subsection (1) shall not be detained longer than 72 hours,
excluding Saturdays, Sundays, and legal holidays, without a court hearing to determine if the temporary
detention should continue.
(4) Notice of a hearing under subsection (3) shall be served upon the individual not less than 24 hours
before the hearing is held. The notice shall contain all of the following information:
(a) The time, date, and place of the hearing.
(b) The grounds and underlying facts upon which continued detention is sought.
(c) The individual's right to appear at the hearing.
(d) The individual's right to present and cross-examine witnesses.
(e) The individual's right to counsel, including the right to counsel designated by the circuit court, as
described in section 5205(13).
(5) The circuit court may order that the individual continue to be temporarily detained if the court finds, by
a preponderance of the evidence, that the individual would pose a health threat to others if released. An order
under this subsection to continued temporary detention shall not continue longer than 5 days, unless a petition
is filed under section 5205. If a petition is filed under section 5205, the temporary detention shall continue
until a hearing on the petition is held under section 5205.
History: Add. 1988, Act 490, Eff. Mar. 30, 1989;Am. 1997, Act 57, Eff. Jan. 1, 1998.
Popular name: Act 368
PART 53
EXPENSE OF CARE
333.5301 County chargeable with expense of care; reimbursement by state; individuals with
tuberculosis or honorable discharges considered domiciled in state at large; expense of
care paid by state on certification of department; reasonableness of claims and accounts;
appeal.
Sec. 5301. (1) The county in which an individual receiving care under section 5117 has a domicile is
chargeable with the expense of the care, and this state shall reimburse that county for all or a portion of the
expense in the amounts the legislature appropriates for that purpose. An individual who has tuberculosis and
has not acquired a legal settlement in this state in accordance with the social welfare act, Act No. 280 of the
Public Acts of 1939, being sections 400.1 to 400.121 of the Michigan Compiled Laws, or an individual who
was honorably discharged from a branch of the military services of the United States and not otherwise
hospitalized for the purpose of this part shall be considered to be domiciled in this state at large, and the
expense of that individual's care, while the care continues with the approval of the department, shall be paid
by the state on certification of the department. The reasonableness and propriety of all claims and accounts
under this subsection shall be passed upon and determined by the department, subject to appeal to the circuit
court for the county of Ingham as to questions of law.
(2) An individual committed to an inpatient facility for tuberculosis pursuant to a probate court order under
section 5205 and not otherwise hospitalized for the purpose of part 51 or 52 shall be considered to be
domiciled in this state at large, and the expense of that individual's care, while the care continues with the
approval of the department, shall be paid by the state on certification of the department. The reasonableness
and propriety of all claims and accounts under this subsection shall be passed upon and determined by the
department, subject to appeal to the circuit court for the county of Ingham as to questions of law.
History: Add. 1988, Act 491, Eff. Mar. 30, 1989.
Compiler's note: For transfer of certain powers and duties of the bureau of infectious disease control from the department of public
health to the director of the department of community health, see E.R.O. No. 1996-1, compiled at MCL 330.3101 of the Michigan
Compiled Laws.
Popular name: Act 368
333.5303 Care provided where individual found at expense of county where individual
domiciled; notice; return of individual to county of domicile; disputed or contested claim
arising between 2 or more counties; decision.
Sec. 5303. (1) Upon determination by the county department of social services that the place of domicile of
an individual receiving care under section 5117 is in another county in this state, care shall be provided where
the individual is found at the expense of the county where the individual is domiciled. The county department
of social services, not later than 1 month after the commencement of care, shall mail written notice that the
care is being provided to the local department of social services of the individual's county of domicile. The
local health department of the county of domicile may provide for the return of the individual to, and care in,
that county.
(2) If the domicile of the individual is not acknowledged by the alleged county of domicile within 1 month
after mailing the notice under subsection (1), the question of domicile may be submitted for decision to the
state department of social services. If a disputed or contested claim arises between 2 or more counties as to
the county of domicile, the director of social services shall determine the county of domicile when so
requested or on his or her own motion. The decision of the director of social services is final. However,
pending determination, the county in which the individual is found shall provide the necessary care.
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History: Add. 1988, Act 491, Eff. Mar. 30, 1989.
Popular name: Act 368
333.5305 Determination that county where individual found not county of domicile;
reimbursement.
Sec. 5305. Upon determination by the director of social services that the county where the individual is
found is not the county of domicile, the county of domicile, as determined by the director of social services,
shall reimburse the county where the individual is found for all expenses incurred, less any reimbursements
from the state or other source for the care.
History: Add. 1988, Act 491, Eff. Mar. 30, 1989.
Popular name: Act 368
333.5307 Expenditure under MCL 333.5117 considered expenditure for protection of public
health, not welfare or relief; reimbursement; notice and hearing; finding; order;
distribution of receipts.
Sec. 5307. An expenditure of public funds under section 5117 for the care of an individual is considered an
expenditure for the protection of the public health, and not money advanced as welfare or relief. An individual
is not legally obligated to reimburse the expense incurred, unless the department and the county of domicile,
after reasonable notice and upon a hearing, find that the individual hospitalized or treated, or the persons
legally liable for the individual's support, are possessed of sufficient income or estate to enable them to make
the reimbursement in whole or in part without materially affecting their reasonable economic security or
support, in view of their respective resources, obligations, and responsibilities to dependents and order
reimbursement. The order shall not be made retroactive unless the department and the county of domicile find
that the person to be charged is guilty of misrepresenting or withholding knowledge of facts material to the
issue. Receipts under the order, and money voluntarily paid as reimbursement, shall be distributed pro rata to
the funds out of which the expenditure was made.
History: Add. 1988, Act 491, Eff. Mar. 30, 1989.
Popular name: Act 368
PART 54
CHRONIC DISEASES
333.5401 Chronic disease defined; general definitions and principles of construction.
Sec. 5401. (1) As used in this part, chronic disease includes an impairment or deviation from normal
having 1 or more of the following characteristics:
(a) It is permanent.
(b) It leaves residual disability.
(c) It is caused by nonreversible pathological alterations.
(d) It requires special training of the patient for rehabilitation.
(e) It may be expected to require a long period of supervision, observation, or care.
(2) In addition, article 1 contains general definitions and principles of construction applicable to all articles
in this code and part 51 contains definitions applicable to this part.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Compiler's note: For transfer of certain powers and duties of the center for health promotion and chronic disease prevention from the
department of public health to the director of the department community health, see E.R.O. No. 1996-1, compiled at MCL 330.3101 of
the Michigan Compiled Laws.
Popular name: Act 368
333.5411 Chronic disease prevention and control program; statewide program as to mental
disabilities; establishment; scope; programs continued.
Sec. 5411. (1) The department shall establish a chronic disease prevention and control program which shall
include arthritis, cancer, dental disease, diabetes, genetic disease, heart disease, hypertension, renal disease,
and any other disease the department designates as chronic pursuant to section 5439. The department shall
cooperate with the department of mental health in establishment of a statewide program for genetic screening
and counseling in the area of mental disabilities.
(2) Programs established under this part shall continue, at a minimum, the programs established pursuant
to Act No. 96 of the Public Acts of 1975, being sections 329.551 to 329.557 of the Michigan Compiled Laws,
and Act No. 335 of the Public Acts of 1974, being sections 325.531 to 325.533 of the Michigan Compiled
Laws.
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History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
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333.5429 Terminated. 1978, Act 368, Eff. Sept. 30, 1980.
Compiler's note: Subsection (2) of this section provided :
(2) This section shall terminate when the renal disease subcommittee of the committee is appointed or 2 years after the effective date
of this part, whichever occurs first.
The date the renal disease subcommittee was appointed is not determinable.
Popular name: Act 368
333.5431 Testing newborn infant for certain conditions; reporting positive test results to
parents, guardian, or person in loco parentis; compliance; fee; Detroit consumer price
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index defined; violation as misdemeanor; hardship waiver; conduct of department
regarding blood specimens; pamphlet; additional blood specimen for future identification.
Sec. 5431. (1) A health professional in charge of the care of a newborn infant or, if none, the health
professional in charge at the birth of an infant shall administer or cause to be administered to the infant a test
for each of the following:
(a) Phenylketonuria.
(b) Galactosemia.
(c) Hypothyroidism.
(d) Maple syrup urine disease.
(e) Biotinidase deficiency.
(f) Sickle cell anemia.
(g) Congenital adrenal hyperplasia.
(h) Medium-chain acyl-coenzyme A dehydrogenase deficiency.
(i) Other treatable but otherwise disabling conditions as designated by the department.
(2) The informed consent requirements of sections 17020 and 17520 do not apply to the tests required
under subsection (1). The tests required under subsection (1) shall be administered and reported within a time
and under conditions prescribed by the department. The department may require that the tests be performed
by the department.
(3) If the results of a test administered under subsection (1) are positive, the results shall be reported to the
infant's parents, guardian, or person in loco parentis. A person is in compliance with this subsection if the
person makes a good faith effort to report the positive test results to the infant's parents, guardian, or person in
loco parentis.
(4) Subject to the annual adjustment required under this subsection and subject to subsection (6), if the
department performs 1 or more of the tests required under subsection (1), the department may charge a fee for
the tests of not more than $53.71. The department shall adjust the amount prescribed by this subsection
annually by an amount determined by the state treasurer to reflect the cumulative annual percentage change in
the Detroit consumer price index. As used in this subsection, Detroit consumer price index means the most
comprehensive index of consumer prices available for the Detroit area from the bureau of labor statistics of
the United States department of labor.
(5) A person who violates this section or a rule promulgated under this part is guilty of a misdemeanor.
(6) The department shall provide for a hardship waiver of the fee authorized under subsection (4) under
circumstances found appropriate by the department.
(7) The department shall do all of the following in regard to the blood specimens taken for purposes of
conducting the tests required under subsection (1):
(a) By April 1, 2000, develop a schedule for the retention and disposal of the blood specimens used for the
tests after the tests are completed. The schedule shall meet at least all of the following requirements:
(i) Be consistent with nationally recognized standards for laboratory accreditation and federal law.
(ii) Require that the disposal be conducted in compliance with section 13811.
(iii) Require that the disposal be conducted in the presence of a witness. For purposes of this subparagraph,
the witness may be an individual involved in the disposal or any other individual.
(iv) Require that a written record of the disposal be made and kept, and that the witness required under
subparagraph (iii) signs the record.
(b) Allow the blood specimens to be used for medical research during the retention period established
under subdivision (a), as long as the medical research is conducted in a manner that preserves the
confidentiality of the test subjects and is consistent to protect human subjects from research risks under
subpart A of part 46 of subchapter A of title 45 of the code of federal regulations.
(8) The department shall rewrite its pamphlet explaining the requirements of this section when the supply
of pamphlets in existence on March 15, 2000 is exhausted. When the department rewrites the explanatory
pamphlet, it shall include at least all of the following information in the pamphlet:
(a) The nature and purpose of the testing program required under this section, including, but not limited to,
a brief description of each condition or disorder listed in subsection (1).
(b) The purpose and value of the infant's parent, guardian, or person in loco parentis retaining a blood
specimen obtained under subsection (9) in a safe place.
(c) The department's schedule for retaining and disposing of blood specimens developed under subsection
(7)(a).
(d) That the blood specimens taken for purposes of conducting the tests required under subsection (1) may
be used for medical research pursuant to subsection (7)(b).
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(9) In addition to the requirements of subsection (1), the health professional described in subsection (1) or
the hospital or other facility in which the birth of an infant takes place, or both, may offer to draw an
additional blood specimen from the infant. If such an offer is made, it shall be made to the infant's parent,
guardian, or person in loco parentis at the time the blood specimens are drawn for purposes of subsection (1).
If the infant's parent, guardian, or person in loco parentis accepts the offer of an additional blood specimen,
the blood specimen shall be preserved in a manner that does not require special storage conditions or
techniques, including, but not limited to, lamination. The health professional or hospital or other facility
employee making the offer shall explain to the parent, guardian, or person in loco parentis at the time the offer
is made that the additional blood specimen can be used for future identification purposes and should be kept
in a safe place. The health professional or hospital or other facility making the offer may charge a fee that is
not more than the actual cost of obtaining and preserving the additional blood specimen.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1986, Act 300, Eff. Mar. 31, 1987;Am. 1987, Act 14, Imd. Eff. Apr. 14, 1987;
Am. 1988, Act 264, Imd. Eff. July 15, 1988;Am. 1992, Act 81, Imd. Eff. June 2, 1992;Am. 1998, Act 88, Imd. Eff. May 13, 1998;
Am. 1999, Act 138, Imd. Eff. Oct. 5, 1999;Am. 2000, Act 33, Imd. Eff. Mar. 15, 2000;Am. 2002, Act 691, Eff. Apr. 1, 2003.
Popular name: Act 368
Administrative rules: R 325.1471 et seq. of the Michigan Administrative Code.
333.5439 Rules.
Sec. 5439. The department may promulgate rules to implement this part including rules designating
additional chronic diseases and the time and conditions under which tests required by section 5431 shall be
administered.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
Administrative rules: R 325.1471 et seq. of the Michigan Administrative Code.
PART 54A
LEAD ABATEMENT
333.5451 Short title of part.
Sec. 5451. This part shall be known and may be cited as the lead abatement act.
History: Add. 1998, Act 219, Imd. Eff. July 1, 1998.
Popular name: Act 368
333.5453 Definitions; A.
Sec. 5453. (1) "Abatement", except as otherwise provided in subsection (2), means a measure or set of
measures designed to permanently eliminate lead-based paint hazards. Abatement includes all of the
following:
(a) The removal of lead-based paint and dust lead hazards, the permanent enclosure or encapsulation of
lead-based paint, the replacement of lead-painted surfaces or fixtures, the removal or covering of soil lead
hazards, and all preparation, cleanup, disposal, and postabatement clearance testing activities associated with
such measures.
(b) A project for which there is a written contract or other documentation that provides that a person will
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be conducting activities in or to a residential dwelling or child occupied facility that will result in the
permanent elimination of lead-based paint hazards or that are designed to permanently eliminate lead-based
paint hazards.
(c) A project resulting in the permanent elimination of lead-based paint hazards, conducted by a person
certified under this part, except a project that is exempt from this part.
(d) A project resulting in the permanent elimination of lead-based paint hazards, conducted by a person
who, through their company name or promotional literature, represents, advertises, or holds themselves out to
be in the business of performing lead-based paint activities except a project that is exempt from this part.
(e) A project resulting in the permanent elimination of lead-based paint hazards that is conducted in
response to a state or local government abatement order.
(2) Abatement does not include any of the following:
(a) Renovation, remodeling, landscaping, or other activity, if the activity is not designed to permanently
eliminate lead-based paint hazards, but is instead designed to repair, restore, or remodel a structure, target
housing, or dwelling even though the activity may incidentally result in a reduction or elimination of a
lead-based paint hazard.
(b) An interim control, operation, and maintenance activity, or other measure or activity designed to
temporarily, but not permanently, reduce a lead-based paint hazard.
(c) Any lead-based paint activity performed by the owner of an owner-occupied residential dwelling or an
owner-occupied multifamily dwelling containing 4 or fewer units if the activity is performed only in that
owner-occupied unit of the multifamily dwelling.
(d) The scraping or removal of paint, painting over paint, or other similar activity that may incidentally
result in a reduction or elimination of a lead-based paint hazard, if the activity meets all of the following:
(i) The activity is performed only on residential or multifamily dwellings containing 4 or fewer units.
(ii) The activity is coordinated by a nonprofit charitable or volunteer organization that meets all of the
following:
(A) Is in compliance with the procedures established under subpart J of part 35 of title 24 of the code of
federal regulations, 24 CFR 35.900 to 35.940.
(B) Has written guidelines in place to ensure safe work practices to protect residents and volunteers from
hazards including, but not limited to, lead exposure and asbestos exposure.
(C) In writing, discloses to the owner of the residential or multifamily dwelling all of the following:
(I) The presence of any known lead-based paint and lead-based paint hazards.
(II) Information regarding the lead safe housing registry maintained by the department under section
5474b.
(III) Information regarding the owner's obligations under the federal lead-based paint or lead-based paint
hazard disclosure rule under subpart F of part 745 of title 40 of the code of federal regulations, 40 CFR
745.100 to 745.119.
(D) Notifies the department that the residential or multifamily dwelling may be required to be on the lead
safe housing registry maintained by the department.
(iii) The activity is performed only by unpaid volunteers and the organization receives no remuneration
directly from the owner or occupant of the residential dwelling or multifamily dwelling.
(iv) The activity does not involve the use of a lead-based paint encapsulating product that requires
certification from the department.
(v) The activity does not involve the use of high-pressure water or compressed air cleaning equipment on,
the dry sanding of, or the scraping of, asbestos siding prior to painting.
(3) "Accredited training program" means a training program that has been accredited by the department
under this part to provide training for individuals engaged in lead-based paint activities.
(4) "Adequate quality control" means a plan or design that ensures the authenticity, integrity, and accuracy
of a sample including, but not limited to, a dust sample, a soil or paint chip sample, or a paint film sample.
Adequate quality control also includes a provision in a plan or design described in this subsection for
representative sampling.
History: Add. 1998, Act 220, Imd. Eff. July 1, 1998;Am. 2002, Act 644, Imd. Eff. Dec. 23, 2002;Am. 2008, Act 45, Imd. Eff.
Mar. 27, 2008.
Popular name: Act 368
333.5454 Definitions; C.
Sec. 5454. (1) Certified abatement worker means an individual who has been trained to perform
abatements by an accredited training program and who is certified by the department under this part to
perform abatement.
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(2) Certified clearance technician means an individual who has completed an approved training course
and been certified by the department under this part to conduct clearance testing following interim controls.
(3) Certified firm means a person that performs a lead-based paint activity for which the department has
issued a certificate of approval under this part.
(4) Certified inspector means an individual who has been trained by an accredited training program and
certified by the department under this part to conduct inspections and take samples for the presence of lead in
paint, dust, and soil for the purposes of abatement clearance testing.
(5) Certified project designer means an individual who has been trained by an accredited training
program and certified by the department under this part to prepare abatement project designs, occupant
protection plans, and abatement reports.
(6) Certified risk assessor means an individual who has been trained by an accredited training program
and certified by the department under this part to conduct inspections and risk assessments and to take
samples for the presence of lead in paint, dust, and soil for the purposes of abatement clearance testing.
(7) Certified supervisor means an individual who has been trained by an accredited training program and
certified by the department under this part to supervise and conduct abatements and to prepare occupant
protection plans and abatement reports.
(8) Child occupied facility means a building or portion of a building constructed before 1978 that is
visited regularly by a child who is 6 years of age or less, on at least 2 different days within a given week, if
each day's visit is at least 3 hours and the combined weekly visit is at least 6 hours in length, and the
combined annual visits are at least 60 hours in length. Child occupied facility includes, but is not limited to, a
day-care center, a preschool, and a kindergarten classroom.
History: Add. 1998, Act 220, Imd. Eff. July 1, 1998;Am. 2002, Act 644, Imd. Eff. Dec. 23, 2002.
Popular name: Act 368
333.5455 Definitions; C.
Sec. 5455. (1) Clearance levels means the values that indicate the maximum amount of lead permitted in
dust on a surface following completion of an abatement as listed in rules promulgated by the department.
(2) Clearance professional means 1 or more of the following individuals when performing clearance
testing:
(a) A certified inspector.
(b) A certified risk assessor.
(c) A certified clearance technician.
(3) Common area means a portion of a building that is generally accessible to all occupants of the
building. Common area includes, but is not limited to, a hallway, a stairway, a laundry and recreational room,
a playground, a community center, a garage, and a boundary fence.
(4) Component or building component means a specific design or structural element or fixture of a
building, residential dwelling, or child occupied facility that is distinguished by its form, function, and
location. Component or building component, includes but is not limited to, a specific interior or exterior
design or structural element or fixture.
(5) Containment means a process to protect workers and the environment by controlling exposure to a
dust lead hazard and debris created during an abatement.
(6) Course agenda means an outline of the key topics to be covered during an accredited training
program, including the time allotted to teach each topic.
(7) Course test means an evaluation of the overall effectiveness of the accredited training program by
testing a trainee's knowledge and retention of the topics covered during the accredited training program.
(8) Course test blueprint means written documentation identifying the proportion of course test questions
devoted to each major topic in the accredited training program curriculum.
History: Add. 1998, Act 220, Imd. Eff. July 1, 1998;Am. 2002, Act 644, Imd. Eff. Dec. 23, 2002.
Popular name: Act 368
333.5456 Definitions; D, E.
Sec. 5456. (1) Department means the department of community health.
(2) Deteriorated paint means paint or other surface coating that is cracking, flaking, chipping, peeling, or
otherwise damaged or separating from the substrate of a building component.
(3) Discipline means 1 of the specific types or categories of lead-based paint activities identified in this
part for which an individual may receive training from an accredited training program and become certified
by the department.
(4) Distinct painting history means the application history, as indicated by its visual appearance or a
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record of application, over time of paint or other surface coatings to a component or room.
(5) Documented methodology means a method or protocol used to do either or both of the following:
(a) Sample and test for the presence of lead in paint, dust, and soil.
(b) Perform related work practices as described in rules promulgated under this part.
(6) Dust lead hazard means surface dust in a residential dwelling or child occupied facility that contains
a concentration of lead at or in excess of levels identified by the EPA pursuant to section 403 of title IV of the
toxic substances control act, Public Law 94-469, 15 U.S.C. 2683, or as otherwise defined by rule.
(7) Elevated blood level or EBL means for purposes of lead abatement an excessive absorption of lead
that is a confirmed concentration of lead in whole blood of 20 ug/dl, micrograms of lead per deciliter of whole
blood, for a single venous test or of 15-19 ug/dl in 2 consecutive tests taken 3 to 4 months apart. For purposes
of case management of children 6 years of age or less, elevated blood level means an excessive absorption of
lead that is a confirmed concentration of lead in whole blood of 10 ug/dl.
(8) Encapsulant means a substance that forms a barrier between lead-based paint and the environment
using a liquid-applied coating, with or without reinforcement materials, or an adhesively bonded covering
material.
(9) Encapsulation means the application of an encapsulant.
(10) Enclosure means the use of rigid, durable construction materials that are mechanically fastened to
the substrate in order to act as a barrier between lead-based paint and the environment.
(11) EPA means the United States environmental protection agency.
History: Add. 1998, Act 220, Imd. Eff. July 1, 1998;Am. 2002, Act 644, Imd. Eff. Dec. 23, 2002.
Popular name: Act 368
333.5457 Definitions; G to I.
Sec. 5457. (1) Guest instructor means an individual designated by the manager or principal instructor of
an accredited training program to provide instruction specific to the lecture, hands-on activities, or work
practice components of a course in the accredited training program.
(2) Hands-on skills assessment means an evaluation that tests a trainee's ability to satisfactorily perform
the work practices, work procedures, or any other skill taught in an accredited training program.
(3) Hazardous waste means waste as defined in 40 C.F.R. 261.3.
(4) Inspection means a surface-by-surface investigation in target housing or a child occupied facility to
determine the presence of lead-based paint and the provision of a report explaining the results of the
investigation.
(5) Interim controls means a set of measures designed to temporarily reduce human exposure or likely
exposure to lead-based paint hazards including, but not limited to, specialized cleaning, repairs, maintenance,
painting, temporary containment, ongoing monitoring of lead-based paint hazards or potential hazards, and
the establishment and operation of management and resident education programs.
History: Add. 1998, Act 219, Imd. Eff. July 1, 1998;Am. 2002, Act 644, Imd. Eff. Dec. 23, 2002.
Popular name: Act 368
333.5458 Definitions; L.
Sec. 5458. (1) Lead-based paint means paint or other surface coatings that contain lead equal to or in
excess of 1.0 milligrams per square centimeter or more than 0.5% by weight.
(2) Lead-based paint activity means inspection, risk assessment, and abatement in target housing and
child occupied facilities or in any part thereof.
(3) Lead-based paint hazard means any of the following conditions:
(a) Any lead-based paint on a friction surface that is subject to abrasion and where the lead dust levels on
the nearest horizontal surface are equal to or greater than the dust lead hazard levels identified in rules
promulgated under this part.
(b) Any damaged or otherwise deteriorated lead-based paint on an impact surface that is caused by impact
from a related building component.
(c) Any chewable lead-based painted surface on which there is evidence of teeth marks.
(d) Any other deterioriated lead-based paint in or on any residential building or child occupied facility.
(e) Surface dust in a residential dwelling or child occupied facility that contains lead in a mass-per-area
concentration equal to or exceeding the levels established by rules promulgated under this part.
(f) Bare soil on residential real property or property of a child occupied facility that contains lead equal to
or exceeding levels established by rules promulgated under this part.
(4) Lead-based paint investigation means an activity designed to determine the presence of lead-based
paint or lead-based paint hazards in target housing and child occupied facilities.
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(5) Living area means an area of a residential dwelling used by 1 or more children age 6 and under
including, but not limited to, a living room, kitchen area, den, playroom, and a children's bedroom.
History: Add. 1998, Act 219, Imd. Eff. July 1, 1998;Am. 2002, Act 644, Imd. Eff. Dec. 23, 2002.
Popular name: Act 368
333.5459 Definitions; M to S.
Sec. 5459. (1) Multifamily dwelling means a structure that contains more than 1 separate residential
dwelling unit and that is used or occupied, or intended to be used or occupied, in whole or in part, as the home
or residence of 1 or more persons.
(2) Paint in poor condition means 1 or more of the following:
(a) More than 10 square feet of deteriorated paint on an exterior component with a large surface area.
(b) More than 2 square feet of deteriorated paint on an interior component with large surface areas.
(c) More than 10% of the total surface area of the component is deteriorated on an interior or exterior
component with a small surface area.
(3) Permanently covered soil means soil that has been separated from human contact by the placement of
a barrier consisting of solid, relatively impermeable materials including, but not limited to, pavement or
concrete but not including grass, mulch, or other landscaping materials.
(4) Person means that term as defined in section 1106 but including the state and a political subdivision
of the state.
(5) Principal instructor means the individual who has the primary responsibility for organizing and
teaching a particular course in an accredited training program.
(6) Recognized laboratory means an environmental laboratory recognized by the EPA pursuant to
section 405 of title IV of the toxic substances control act, Public Law 94-469, 15 U.S.C. 2685, as being
capable of performing an analysis for lead compounds in paint, soil, and dust.
(7) Reduction means a measure designed to reduce or eliminate human exposure to a lead-based paint
hazard through methods including, but not limited to, interim controls and abatement.
(8) Residential dwelling means either of the following:
(a) A detached single family dwelling unit, including, but not limited to, attached structures such as
porches and stoops and accessory structures such as garages, fences, and nonagricultural or noncommercial
outbuildings.
(b) A building structure that contains more than 1 separate residential dwelling unit that is used or
occupied, in whole or in part, as the home or residence of 1 or more persons.
(9) Risk assessment means both of the following:
(a) An on-site investigation in target housing or a child occupied facility to determine the existence, nature,
severity, and location of a lead-based paint hazard.
(b) The provision of a report by the person conducting the risk assessment explaining the results of the
investigation and options for reducing the lead-based paint hazard.
(10) Soil lead hazard means bare soil on a residential dwelling or on the property of a child occupied
facility that contains lead at or in excess of levels identified by the EPA pursuant to section 403 of title IV of
the toxic substances control act, Public Law 94-469, 15 U.S.C. 2683, or as otherwise defined by rule.
History: Add. 1998, Act 219, Imd. Eff. July 1, 1998;Am. 2002, Act 644, Imd. Eff. Dec. 23, 2002.
Popular name: Act 368
333.5460 Definitions; T to V.
Sec. 5460. (1) Target housing means housing constructed before 1978, except any of the following:
(a) Housing for the elderly or persons with disabilities, unless any 1 or more children age 6 years or less
resides or is expected to reside in that housing.
(b) A 0-bedroom dwelling.
(c) An unoccupied dwelling unit pending demolition, provided the dwelling unit remains unoccupied until
demolition.
(2) Third party examination means the examination for certification under this part in the disciplines of
clearance technician, inspector, risk assessor, worker, and supervisor offered and administered by a party
other than an accredited training program.
(3) Training curriculum means an established set of course topics for instruction in an accredited training
program for a particular discipline designed to provide specialized knowledge and skills.
(4) Training hour means not less than 50 minutes of actual learning, including, but not limited to, time
devoted to lecture, learning activities, small group activities, demonstrations, evaluations, or hands-on
experience or a combination of those activities.
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(5) Training manager means the individual responsible for administering an accredited training program
and monitoring the performance of principal instructors and guest instructors.
(6) Visual inspection for clearance testing means the visual examination of a residential dwelling or a
child occupied facility following an abatement designed to determine whether the abatement has been
successfully completed.
(7) Visual inspection for risk assessment means the visual examination of a residential dwelling or a
child occupied facility to determine the existence of deteriorated paint or other potential sources of lead-based
paint hazards.
History: Add. 1998, Act 219, Imd. Eff. July 1, 1998;Am. 2002, Act 644, Imd. Eff. Dec. 23, 2002.
Popular name: Act 368
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Popular name: Act 368
Administrative rules: R 325.9901 et seq. of the Michigan Administrative Code.
PART 54B.
LEAD-BEARING SUBSTANCES
333.5481 Definitions.
Sec. 5481. As used in this part:
(a) "Children" means individuals who are 7 years old or younger.
(b) "Consumer" means that term as used in the consumer product safety act, 15 USC 2051 to 2085.
(c) "Children's jewelry" means jewelry that is made for, marketed for use by, or marketed to children,
including, but not limited to, the following:
(i) Jewelry represented in its packaging, display, or advertising as appropriate for use by children.
(ii) Jewelry sold in conjunction with, attached to, or packaged together with other products that are
packaged, displayed, or advertised as appropriate for use by children.
(iii) Jewelry sized for children and not intended for use by adults.
(iv) Jewelry sold in a vending machine.
(v) Jewelry sold in a retail store, catalog, or online website in which a person exclusively offers for sale
products that are packaged, displayed, or advertised as appropriate for use by children.
(vi) Jewelry sold in a discrete portion of a retail store, catalog, or online website in which a person offers
for sale products that are packaged, displayed, or advertised as appropriate for use by children.
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(d) "Lead-bearing substance" means an item or substance that contains lead, or a coating on an item that
contains lead, so that the lead content is more than 0.06% of the total weight. Lead-bearing substance does not
include glass or crystal decorative components.
(e) "Person" means an individual, partnership, corporation, association, governmental entity, or other legal
entity.
History: Add. 2007, Act 161, Eff. Mar. 20, 2008.
Popular name: Act 368
333.5483 Children's jewelry containing lead-bearing substance; sale, offer for sale, or
transfer prohibited.
Sec. 5483. A person shall not sell, offer for sale, or transfer to any person any children's jewelry in this
state that contains a lead-bearing substance.
History: Add. 2007, Act 161, Eff. Mar. 20, 2008.
Popular name: Act 368
333.5485 Lunch box containing lead-bearing substance; exception; "lunch box" defined.
Sec. 5485. (1) A person shall not sell or offer for sale in this state or for use in this state a lunch box that
contains a lead-bearing substance.
(2) This section does not apply to the sale of a collectible lunch box or any other lunch box no longer
intended to be used to carry food or drink for human consumption.
(3) As used in this section, "lunch box" means a fabricated container marketed or intended to be used to
carry packaged or unpackaged food or drink for human consumption.
History: Add. 2007, Act 160, Eff. Mar. 20, 2008.
Popular name: Act 368
PART 54C.
TOXIC SUBSTANCES IN CHILDREN'S PRODUCTS
333.5491 Definitions.
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Sec. 5491. As used in this part:
(a) "Child care article" means a product designed or intended by the manufacturer to facilitate the sleep,
relaxation, or feeding of children or to help children with sucking or teething.
(b) "Children" means individuals who are 7 years old or younger.
(c) "Consumer" means that term as used in the consumer product safety act, 15 USC 2051 to 2085.
(d) "Person" means an individual, partnership, corporation, association, governmental entity, or other legal
entity.
(e) "Toxic substance" means a substance that contains lead, or a coating on an item that contains lead, so
that the lead content is more than 0.06% of the total weight. Toxic substance does not include glass or crystal
decorative components.
(f) "Toy" means an article designed and made for the amusement of a minor or for the minor's use in play.
History: Add. 2007, Act 159, Eff. Mar. 20, 2008.
Popular name: Act 368
333.5492 Toxic substance in toy or child care article; prohibited conduct; exception.
Sec. 5492. (1) A person shall not use or apply a toxic substance in or on any toy or child care article in this
state.
(2) A person shall not sell, offer for sale, or transfer a toy or child care article in this state that contains a
toxic substance.
(3) This section does not apply to the sale of a collectible toy that is not marketed to or intended to be used
by a minor.
History: Add. 2007, Act 159, Eff. Mar. 20, 2008.
Popular name: Act 368
PART 55
333.5501 Repealed. 1988, Act 442, Eff. Dec. 27, 1991.
Compiler's note: The repealed section pertained to reports and records on Alzheimer's disease and related disorders.
Popular name: Act 368
333.5511 Alzheimer's disease or related disorder; state plan for network of regional,
multidisciplinary diagnostic and assessment centers; submission to governor and
legislature.
Sec. 5511. (1) The department shall develop, in consultation with the department of social services, the
department of mental health, the office of services to the aging, and the office of health and medical affairs, a
state plan for a network of regional, multidisciplinary diagnostic and assessment centers for individuals
diagnosed or identified as having Alzheimer's disease or a related disorder. In developing the state plan,
consideration shall be given to all of the following:
(a) A center shall be located so as to minimize transportation problems for patients and their families.
(b) A center shall be operated in conjunction with existing related services and programs.
(c) A center shall have the capacity to be reimbursed for the diagnostic and assessment process by
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third-party payers, including, but not limited to, medicare and the state medical assistance program.
(d) Payment for services provided to individuals without sufficient health insurance coverage who have a
limited income, but who are not eligible for the state medical assistance program.
(2) The state plan shall be completed and submitted to the governor and the legislature within 1 year after
the effective date of this section.
History: Add. 1988, Act 443, Imd. Eff. Dec. 27, 1988.
Popular name: Act 368
333.5523 Identification of Alzheimer's disease and related disorders autopsy network; tasks.
Sec. 5523. The director shall identify an Alzheimer's disease and related disorders autopsy network. The
network shall include individuals qualified to perform all of the following tasks:
(a) Provide information to, and obtain consent from, an affected individual or his or her family as provided
in section 5529.
(b) Extract the necessary tissue.
(c) Preserve the tissue, prepare it for transport, and arrange for it to be transported.
(d) Examine the tissue and prepare a report on the results of the tissue examination.
(e) Provide the department and the family representative of the deceased with the results of the tissue
examination.
History: Add. 1988, Act 441, Imd. Eff. Dec. 27, 1988.
Popular name: Act 368
PART 55A
EYE CARE CONSUMER PROTECTION
333.5551 Eye care consumer protection law; meanings of words and phrases.
Sec. 5551. (1) This part may be referred to as the "eye care consumer protection law".
(2) As used in this part, the words and phrases defined in sections 5553 to 5557 have the meanings
ascribed to them in those sections.
(3) In addition, article 1 contains general definitions and principles of construction applicable to all articles
in this code.
History: Add. 2014, Act 269, Eff. Sept. 30, 2014.
333.5553 Definitions; C to E.
Sec. 5553. (1) "Contact lens" means a lens placed directly on the surface of the eye, regardless of whether
it is intended to correct a visual defect. Contact lens includes, but is not limited to, a cosmetic, therapeutic, or
corrective lens.
(2) "Department" means the department of licensing and regulatory affairs.
(3) "Diagnostic contact lens" means a contact lens used to determine a proper contact lens fit.
(4) "Examination and evaluation", for the purpose of writing a valid prescription, means an assessment of
the ocular health and visual status of a patient that does not consist solely of objective refractive data or
information generated by an automated refracting device or other automated testing device.
History: Add. 2014, Act 269, Eff. Sept. 30, 2014.
333.5555 Definitions; L to S.
Sec. 5555. (1) "Licensee" means any of the following:
(a) A physician who is licensed or otherwise authorized to engage in the practice of medicine under part
170 and who specializes in eye care.
(b) A physician who is licensed or otherwise authorized to engage in the practice of osteopathic medicine
and surgery under part 175 and who specializes in eye care.
(c) An optometrist who is licensed or otherwise authorized to engage in the practice of optometry under
part 174.
(2) "Spectacles" means an optical instrument or device worn or used by an individual that has 1 or more
lenses designed to correct or enhance vision to address the visual needs of the individual wearer and
commonly known as glasses, including spectacles that may be adjusted by the wearer to achieve different
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types or levels of visual correction or enhancement.
History: Add. 2014, Act 269, Eff. Sept. 30, 2014.
333.5557 Definitions; V.
Sec. 5557. "Valid prescription" means 1 of the following, as applicable:
(a) For a contact lens, a written or electronic order by a licensee who has conducted an examination and
evaluation of a patient and has determined a satisfactory fit for the contact lens based on an analysis of the
physiological compatibility of the lens on the cornea and the physical fit and refractive functionality of the
lens on the patient's eye. To be a valid prescription under this subdivision, it must include at least all of the
following information:
(i) A statement that the prescription is for a contact lens.
(ii) The contact lens type or brand name, or for a private label contact lens, the name of the manufacturer,
trade name of the private label brand, and, if applicable, trade name of the equivalent or similar brand.
(iii) All specifications necessary to order and fabricate the contact lens, including power, material, base
curve or appropriate designation, and diameter, if applicable.
(iv) The quantity of contact lenses to be dispensed.
(v) The number of refills.
(vi) Specific wearing instructions and contact lens disposal parameters, if any.
(vii) The patient's name.
(viii) The date of the examination and evaluation.
(ix) The date the prescription is originated.
(x) The prescribing licensee's name, address, and telephone number.
(xi) The prescribing licensee's written or electronic signature, or other form of authentication.
(xii) An expiration date of not less than 1 year from the date of the examination and evaluation or a
statement of the reasons why a shorter time is appropriate based on the medical needs of the patient.
(b) For spectacles, a written or electronic order by a licensee who has examined and evaluated a patient. To
be a valid prescription under this subdivision, it must include at least all of the following information:
(i) A statement that the prescription is for spectacles.
(ii) As applicable and as specified for each eye, the lens power including the spherical power, cylindrical
power including axis, prism, and power of the multifocal addition.
(iii) Any special requirements, the omission of which would, in the opinion of the prescribing licensee,
adversely affect the vision or ocular health of the patient. As used in this subparagraph, "special requirements"
includes, but is not limited to, type of lens design, lens material, tint, or lens treatments.
(iv) The patient's name.
(v) The date of the examination and evaluation.
(vi) The date the prescription is originated.
(vii) The prescribing licensee's name, address, and telephone number.
(viii) The prescribing licensee's written or electronic signature, or other form of authentication.
(ix) An expiration date of not less than 1 year from the date of the examination and evaluation or a
statement of the reasons why a shorter time is appropriate based on the medical needs of the patient.
History: Add. 2014, Act 269, Eff. Sept. 30, 2014.
333.5567 Order to cease and desist; hearing; costs; referral of case for further enforcement;
action under MCL 333.5569 or 333.5571.
Sec. 5567. (1) After a determination as described in section 5565(4), the department may order a person to
cease and desist from a violation of this part or a rule promulgated under this part.
(2) A person ordered to cease and desist under this section is entitled to a hearing before the department if
a written request for a hearing is filed within 30 days after the effective date of the order.
(3) The department may assess costs related to the investigation of a violation of this part or rules
promulgated under this part. The department may issue an order for costs assessed under this subsection after
a hearing held in compliance with the administrative procedures act of 1969.
(4) The department may refer a case for further enforcement action under section 5569 or 5571 against a
person that fails to comply with a cease and desist order that is not contested or that is upheld following a
hearing.
(5) The department is not required to issue a cease and desist order before taking action under section 5569
or 5571.
History: Add. 2014, Act 269, Eff. Sept. 30, 2014.
333.5569 Civil action; filing; injunction or other relief; civil fine; costs; attorney fees.
Sec. 5569. (1) The department may file a civil action in a court of competent jurisdiction seeking an
injunction or other appropriate relief to enforce this part or a rule promulgated under this part.
(2) In an action under subsection (1), the court may impose on a person that violates or attempts to violate
this part or a rule promulgated under this part a civil fine of not less than $5,000.00 for each violation or
attempted violation. The court may also award costs of an investigation and attorney fees from a person that
violates or attempts to violate this part or a rule promulgated under this part.
History: Add. 2014, Act 269, Eff. Sept. 30, 2014.
333.5571 Violation of part, rule, or order as misdemeanor; fine; costs; attorney fees.
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Sec. 5571. A person that violates this part or a rule promulgated under this part or violates a cease and
desist order issued under this part is guilty of a misdemeanor punishable by imprisonment for not more than 1
year or a fine of not less than $5,000.00 or more than $25,000.00, or both. If successful in obtaining a
conviction, the agency prosecuting the case is entitled to actual costs and attorney fees from the defendant.
History: Add. 2014, Act 269, Eff. Sept. 30, 2014.
PART 56
OCCUPATIONAL DISEASES
333.5601 Occupational disease defined; general definitions and principles of construction.
Sec. 5601. (1) As used in this part, occupational disease means an illness of the human body arising out
of and in the course of an individual's employment and having 1 or more of the following characteristics:
(a) It is caused by a frequently repeated or continuous exposure to a hazardous substance or agent or to a
specific industrial practice which is hazardous and which has continued over an extended period of time.
(b) It is caused by an acute exposure to a hazardous substance or agent.
(c) It presents symptoms characteristic of an occupational disease known to have resulted in other cases
from the same type of specific exposure.
(2) In addition, article 1 contains general definitions and principles of construction applicable to all articles
in this code and part 51 contains definitions applicable to this part.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Compiler's note: For transfer of powers and duties of the division of occupational health in the bureau of environmental and
occupational health, with the exception of dry cleaning unit, from the department of public health to the director of the department of
labor, see E.R.O. No. 1996-1, compiled at MCL 330.3101 of the Michigan Compiled Laws.
Popular name: Act 368
333.5621 Reports not public records; exemption from disclosure; access to record.
Sec. 5621. (1) Reports submitted to the department under section 5611 are not public records and are
exempt from disclosure pursuant to section 13(1)(d) of Act No. 442 of the Public Acts of 1976.
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(2) The bureau of worker's disability compensation and the compensation appeal board in the department
of labor shall have access to the record of an actual case of occupational disease in a compensation case
before it.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
PART 56A
TERMINAL ILLNESS
333.5651 Short title of part.
Sec. 5651. This part shall be known and may be cited as the Michigan dignified death act.
History: Add. 1996, Act 594, Eff. Mar. 31, 1997.
Popular name: Act 368
333.5653 Definitions.
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Sec. 5653. (1) As used in this part:
(a) "Advanced illness", except as otherwise provided in this subdivision, 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, the time course of
which may or may not be determinable through reasonable medical prognostication. For purposes of section
5655(b) only, "advanced illness" has the same general meaning as "terminal illness" has in the medical
community.
(b) "Health facility" means a health facility or agency licensed under article 17.
(c) "Hospice" means that term as defined in section 20106.
(d) "Medical treatment" means a treatment including, but not limited to, palliative care treatment, or a
procedure, medication, surgery, a diagnostic test, or a hospice plan of care that may be ordered, provided, or
withheld or withdrawn by a health professional or a health facility under generally accepted standards of
medical practice and that is not prohibited by law.
(e) "Patient" means an individual who is under the care of a physician.
(f) "Patient advocate" means that term as described and used in sections 5506 to 5515 of the estates and
protected individuals code, 1998 PA 386, MCL 700.5506 to 700.5515.
(g) "Patient surrogate" means the parent or legal guardian of a patient who is a minor or a member of the
immediate family, the next of kin, or the legal guardian of a patient who has a condition other than minority
that prevents the patient from giving consent to medical treatment.
(h) "Physician" means that term as defined in section 17001 or 17501.
(2) Article 1 contains general definitions and principles of construction applicable to all articles in this
code.
History: Add. 1996, Act 594, Eff. Mar. 31, 1997;Am. 2000, Act 58, Eff. Apr. 1, 2000;Am. 2001, Act 239, Imd. Eff. Jan. 8, 2002
;Am. 2004, Act 551, Imd. Eff. Jan. 3, 2005.
Popular name: Act 368
333.5654 Recommended medical treatment for advanced illness; duty of physician to inform
orally; limitation or modification of disclosed information.
Sec. 5654. (1) A physician who has diagnosed a patient as having a reduced life expectancy due to an
advanced illness and is recommending medical treatment for the patient shall do all of the following:
(a) Orally inform the patient, the patient's patient surrogate, or, if the patient has designated a patient
advocate and is unable to participate in medical treatment decisions, the patient advocate acting on behalf of
the patient in accordance with sections 5506 to 5515 of the estates and protected individuals code, 1998 PA
386, MCL 700.5506 to 700.5515, about the recommended medical treatment and about alternatives to the
recommended medical treatment.
(b) Orally inform the patient, patient surrogate, or patient advocate about the advantages, disadvantages,
and risks of the recommended medical treatment and of each alternative medical treatment described in
subdivision (a) and about the procedures involved.
(2) A physician's duty to inform a patient, patient surrogate, or patient advocate under subsection (1) does
not require the disclosure of information beyond that required by the applicable standard of practice.
(3) Subsection (1) does not limit or modify the information required to be disclosed under sections 5133(2)
and 17013(1).
History: Add. 1996, Act 594, Eff. Mar. 31, 1997;Am. 2000, Act 58, Eff. Apr. 1, 2000;Am. 2001, Act 239, Eff. Oct. 1, 2002;
Am. 2004, Act 551, Imd. Eff. Jan. 3, 2005.
Popular name: Act 368
333.5655 Recommended medical treatment for advanced illness; duty of physician to inform
orally and in writing; requirements.
Sec. 5655. In addition to the requirements of section 5654, a physician who has diagnosed a patient as
having a reduced life expectancy due to an advanced illness and is recommending medical treatment for the
patient shall, both orally and in writing, inform the patient, the patient's patient surrogate, or, if the patient has
designated a patient advocate and is unable to participate in medical treatment decisions, the patient advocate,
of all of the following:
(a) If the patient has not designated a patient advocate, that the patient has the option of designating a
patient advocate to make medical treatment decisions for the patient in the event the patient is not able to
participate in his or her medical treatment decisions because of his or her medical condition.
(b) That the patient, or the patient's patient surrogate or patient advocate, acting on behalf of the patient,
has the right to make an informed decision regarding receiving, continuing, discontinuing, and refusing
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medical treatment for the patient's reduced life expectancy due to advanced illness.
(c) That the patient, or the patient's patient surrogate or patient advocate, acting on behalf of the patient,
may choose palliative care treatment including, but not limited to, hospice care and pain management.
(d) That the patient or the patient's surrogate or patient advocate acting on behalf of the patient may choose
adequate and appropriate pain and symptom management as a basic and essential element of medical
treatment.
History: Add. 1996, Act 594, Eff. Mar. 31, 1997;Am. 2001, Act 239, Eff. Oct. 1, 2002.
Compiler's note: Enacting section 3 of Act 239 of 2001 provides:
Enacting section 3. The 2001 amendatory act that amended section 5655 of the public health code, 1978 PA 368, MCL 333.5655,
shall not be construed as creating a new mandated benefit for any coverages issued under the insurance code of 1956, 1956 PA 218, MCL
500.100 to 500.8302, the nonprofit health care corporation reform act, 1980 PA 350, MCL 550.1101 to 550.1704, or any other health care
payment or benefits plan.
Popular name: Act 368
333.5659 Life insurer, health insurer, or health care payment or benefits plan; prohibited
acts.
Sec. 5659. A life insurer, a health insurer, or a health care payment or benefits plan shall not do 1 or more
of the following because a patient with reduced life expectancy due to advanced illness, the patient's patient
surrogate, or the patient advocate has made a decision to refuse or discontinue a medical treatment as a result
of information received as required under this part:
(a) Refuse to provide or continue coverage or benefits to the patient within the scope and level of coverage
or benefits of an existing policy, certificate, or contract.
(b) Limit the amount of coverage or benefits available to the patient within the scope and level of coverage
or benefits of an existing policy, certificate, or contract.
(c) Charge the patient a different rate for coverage or benefits under an existing policy, certificate, or
contract.
(d) Consider the terms of an existing policy, certificate, or contract to have been breached or modified.
(e) Invoke a suicide or intentional death exemption or exclusion in a policy, certificate, or contract
covering the patient.
History: Add. 1996, Act 594, Eff. Mar. 31, 1997;Am. 2001, Act 237, Eff. Jan. 8, 2002.
Popular name: Act 368
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PART 57
EXPOSURE TO CHEMICAL HERBICIDES
333.5701 Definitions.
Sec. 5701. (1) As used in this part:
(a) "Agent orange" means the chemical herbicide made from chemicals known as
2,4-Dichlorophenoxyacetic acid and its esters, or 2,4-D, and Trichlorophenoxyacetic acid and its esters, or
2,4,5-T.
(b) "Chemical agent" means a chemical herbicide or defoliant other than agent orange, or a chemical
weapon, which chemical herbicide, defoliant, or weapon is of the type used by the armed forces of the United
States.
(c) "Commission" means the agent orange commission created in section 5731.
(d) "Department" means the department of health and human services in cooperation with the veterans'
service offices.
(e) "Dioxin" means the chemicals known as 2,3,7,8-Tetrachlorodibenzo-p-dioxin, or 2,3,7,8-TCDD.
(f) "Hospital" means a hospital licensed pursuant to article 17.
(g) "Information resource center" means the agent orange information resource center created in section
5745.
(h) "Physician" means a physician licensed pursuant to article 15.
(i) "Veteran" means that term as defined in section 1 of 1965 PA 190, MCL 35.61.
(j) "Vietnam-era veteran" means a veteran who served in the armed forces of the United States between
12:01 a.m., January 1, 1961, and 12:01 a.m., September 1, 1973, and who meets either of the following
criteria:
(i) Has been a resident of this state continuously since June 11, 1987.
(ii) Is a resident of this state at the time he or she begins participating in testing or other activities under
this part, and was a resident of this state at the time of induction into the armed forces of the United States.
(2) In addition, article 1 contains general definitions and principles of construction applicable to all articles
in this code.
History: Add. 1987, Act 48, Imd. Eff. June 11, 1987;Am. 2016, Act 206, Eff. Sept. 20, 2016.
Popular name: Act 368
333.5747 Rules.
Sec. 5747. The department shall promulgate rules to implement this part.
History: Add. 1987, Act 49, Imd. Eff. June 11, 1987.
Popular name: Act 368
PART 58
CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS
333.5801 Child or youth with special health care needs or child defined; general
definitions and principles of construction.
Sec. 5801. (1) As used in this part, "child or youth with special health care needs" or "child" means a single
or married individual under 21 years of age whose activity is or may become so restricted by disease or
specified medical condition as to reduce the individual's normal capacity for education and self-support.
(2) In addition, article 1 contains general definitions and principles of construction applicable to all articles
in this code and part 51 contains definitions applicable to this part.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2015, Act 91, Imd. Eff. June 25, 2015.
Compiler's note: For transfer of certain powers and duties of the bureau of child and family services, with the exception of the
women, infants, and children division, from the department of public health to the director of the department of community health, see
E.R.O. No. 1996-1, compiled at MCL 330.3101 of the Michigan Compiled Laws.
Popular name: Act 368
333.5811 Repealed. 2015, Act 91, Imd. Eff. June 25, 2015.
Compiler's note: The repealed section pertained to crippled children's advisory committee.
Popular name: Act 368
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History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2015, Act 91, Imd. Eff. June 25, 2015.
Popular name: Act 368
333.5841 Charges for medical care and treatment; agreement for payment; information;
account; disposition of parent participation payments; modification or cancellation of
agreement.
Sec. 5841. (1) All or part of the charges for the medical care and treatment of a child or youth with special
health care needs must be paid to the department of treasury by the child, parent, or spouse, if that individual
has the ability to pay. The payment must be in the amount and at a rate determined by agreement between the
individual and the department. Upon treatment of the child or youth with special health care needs, the
department shall furnish the department of treasury information required to keep a correct account of the
money due this state from the child, parent, or spouse. The department of treasury shall credit the parent
participation payments to the parent participation fund.
(2) The department may modify or cancel an agreement made under this section based on economic or
other factors and shall report that action to the department of treasury.
(3) The department of treasury may accept and issue a receipt for an amount due under an agreement or
modification to an agreement under this section.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2015, Act 91, Imd. Eff. June 25, 2015.
Popular name: Act 368
333.5847 Payments not considered social services aid; individual not considered indigent.
Sec. 5847. Payments made by this state under this part are not considered social services aid, and an
individual is not considered an indigent because of his or her inability to pay for the care and treatment of a
child or youth with special health care needs.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2015, Act 91, Imd. Eff. June 25, 2015.
Popular name: Act 368
333.5861 Receiving and holding title to property; property as trust fund; disposition of
property.
Sec. 5861. The department may receive and hold title to real and personal property by gift, devise, bequest,
and conveyance to be used for the purpose of carrying out this part. The property accepted shall be held and
used as a trust fund for the purposes for which received. The department of public health promptly shall send
the money, securities, or like personal property received to the department of treasury to be credited to the
fund of this state designated by the donor or the department. The income from securities shall be sent
promptly to the department of treasury to be credited to the fund designated and shall be likewise disbursed.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.5871 Entering home or taking charge of child or youth with special health care needs;
power to accept or refuse services.
Sec. 5871. (1) A department official, agent, or representative shall not enter a home or take charge of a
child or youth with special health care needs over the objection of a parent, a guardian, a person in loco
parentis, or the person that has custody of the child.
(2) This part does not limit the power of a parent, guardian, or person in loco parentis of the child to accept
or refuse the services offered under this part for a child or youth with special health care needs or by an
agency employed for that purpose.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2015, Act 91, Imd. Eff. June 25, 2015.
Popular name: Act 368
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History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2015, Act 91, Imd. Eff. June 25, 2015.
Popular name: Act 368
PART 58A
INFANT DEATH DUE TO UNSAFE SLEEP EDUCATION AND PREVENTION
333.5881 "Infant safe sleep act"; meanings of words and phrases; general definitions and
principles of construction.
Sec. 5881. (1) This part may be referred to as the "infant safe sleep act".
(2) For purposes of this part, the words and phrases defined in sections 5883 to 5884 have the meanings
ascribed to them in those sections unless the context requires otherwise.
(3) In addition, article 1 contains general definitions and principles of construction applicable to all articles
in this act.
History: Add. 2014, Act 122, Eff. Aug. 12, 2014.
Popular name: Act 368
333.5883 Definitions; H, I.
Sec. 5883. (1) "Health professional" means an individual licensed, registered, certified, or otherwise
authorized to engage in a health profession under article 15.
(2) "Hospital" means a hospital licensed under article 17 that provides clinically related health services for
obstetrical and infant care and includes a hospital operated by this state, a local governmental unit, or an
agency. Hospital does not include an office used primarily for private or group practice by health
professionals in which no reviewable, clinically related health services are offered.
(3) "Infant" means a child who is 12 months old or younger.
(4) "Infant death due to unsafe sleep" means infant death by suffocation, asphyxiation, or strangulation in a
sleep environment.
History: Add. 2014, Act 122, Eff. Aug. 12, 2014.
Popular name: Act 368
333.5884 Definitions; P.
Sec. 5884. (1) "Parent" means a natural parent, stepparent, adoptive parent, legal guardian, or legal
custodian of an infant.
(2) "Parent acknowledgment statement" means the statement of a parent on a form described in section
5885(2).
History: Add. 2014, Act 122, Eff. Aug. 12, 2014.
Compiler's note: Act 368
333.5885 Infant safe sleep practices; information and materials to be provided by hospital;
parent acknowledgment statement; form; birth occurring in setting other than hospital;
use of materials consistent with or provided by department.
Sec. 5885. (1) A hospital shall provide to parents readily understandable information and educational and
instructional materials regarding infant safe sleep practices. The materials described in this subsection must
explain the risk factors associated with infant death due to unsafe sleep practices and emphasize infant safe
sleep practices.
(2) A hospital shall prescribe the form of a parent acknowledgment statement. The form must include a
place for a parent to sign, acknowledging that the parent has received the educational and instructional
materials provided on the risk factors associated with infant death due to unsafe sleep practices and infant safe
sleep practices.
(3) For a birth that occurs in a setting other than a hospital, the health professional in charge at the birth of
an infant, or if none the health professional in charge of the care of an infant, shall provide the materials
described in subsection (1) to a parent after the birth of an infant.
(4) To comply with this section, a hospital or health professional subject to this section may use
educational and instructional materials provided by the department under subsection (5) or may use
educational and instructional materials of its choice that are consistent with the materials provided by the
department under subsection (5).
(5) Upon the request of a hospital or health professional subject to this section, the department shall
provide, at no cost, to the hospital or health professional, educational and instructional materials described in
section 5887(c).
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History: Add. 2014, Act 122, Eff. Aug. 12, 2014.
Popular name: Act 368
PART 59
MICHIGAN HEALTH INITIATIVE PROGRAM
333.5901 Definitions.
Sec. 5901. As used in this part:
(a) "AIDS" means acquired immunodeficiency syndrome.
(b) "Advisory task force" means the task force created in section 5906.
(c) "Fund" means the Michigan health initiative fund created in section 5911.
(d) "HCV" means hepatitis C virus.
(e) "HIV" means human immunodeficiency virus.
(f) "Institute of higher education" means a public or private college or university. Institute of higher
education includes a community college.
(g) "Risk reduction" means the process of identifying and reducing or eliminating behaviors or conditions,
or both, that are harmful to physical or mental health, or both.
History: Add. 1987, Act 258, Eff. July 1, 1988;Am. 2006, Act 238, Imd. Eff. June 26, 2006.
Compiler's note: For transfer of certain powers and duties of the center for health promotion and chronic disease prevention from the
department of public health to the director of the department community health, see E.R.O. No. 1996-1, compiled at MCL 330.3101 of
the Michigan Compiled Laws.
For transfer of certain powers and duties of the bureau of infectious disease control from the department of public health to the
director of the department of community health, see E.R.O. No. 1996-1, compiled at MCL 330.3101 of the Michigan Compiled Laws.
Popular name: Act 368
333.5903 Repealed. 2006, Act 238, Imd. Eff. June 26, 2006.
Compiler's note: The repealed section pertained to creation of risk reduction and AIDS policy commission.
Popular name: Act 368
333.5905 Repealed. 2006, Act 238, Imd. Eff. June 26, 2006.
Compiler's note: The repealed section pertained to membership of risk reduction and AIDS policy commission.
Popular name: Act 368
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333.5906 Hepatitis C advisory task force; creation; membership; terms; chairperson and
officers; compensation and expenses; business conducted at public meeting; writings;
duties; abolishment of task force on June 30, 2010.
Sec. 5906. (1) The hepatitis C advisory task force is created in the department. The task force shall be
appointed by the governor. The task force shall consist of 11 members including the director and his or her
designee as an ex officio member, 1 member from an association representing local public health, and 9
members appointed from the following categories:
(a) Business and industry.
(b) Labor.
(c) Health care providers.
(d) The legal community.
(e) Religious organizations.
(f) State and local government.
(g) The education community.
(2) A health care provider member appointed pursuant to subsection (1) shall not be an employee of a state
executive department or local health department, nor represent a facility or agency which is owned or
operated by a state executive department or a local health department. To the extent practicable, the members
appointed pursuant to subsection (1), except the director, shall be representative of the demographic
composition and geographic regions of this state.
(3) The term of each member, other than the director, shall be 3 years, except that of the members first
appointed, 4 shall serve for 3 years, 3 shall serve for 2 years, and 3 shall serve for 1 year. A member shall not
serve more than 2 consecutive terms, whether partial or full. A vacancy on the task force shall be filled for the
balance of the unexpired term in the same manner as the original appointment. The task force biannually shall
elect a chairperson and other officers and committees as considered appropriate by the task force. The actual
and necessary per diem compensation and the schedule for reimbursement of expenses for the public
members of the task force shall be the same as is established annually by the legislature for similar
commissions or task forces that are reimbursed from the general fund.
(4) The business which the task force performs shall be conducted at a public meeting of the task force
held in compliance with the open meetings act, 1976 PA 267, MCL 15.261 to 15.275. Public notice of the
time, date, and place of the meeting shall be given in the manner required by the open meetings act, 1976 PA
267, MCL 15.261 to 15.275. A writing prepared, owned, used, in the possession of, or retained by the task
force in the performance of an official function shall be made available to the public in compliance with the
freedom of information act, 1976 PA 442, MCL 15.231 to 15.246.
(5) The task force shall do all of the following:
(a) Meet not less than quarterly at the call of the chairperson.
(b) Advise the governor and the legislature on policies regarding hepatitis C and risk reduction.
(c) Annually report to the governor and the legislature on major risk factors and preventable diseases or
conditions including, but not limited to, hepatitis C.
(d) Make recommendations to the department regarding the allocation of money, if available, from the
Michigan health initiative fund or any other source, including, but not limited to, the level of funding for
grants under section 5925.
(e) Review and comment to the department on topics determined by the task force to be appropriate for the
media campaign conducted under this part.
(f) Review and identify potential additional funding mechanisms and sources to cover the costs of
outreach, awareness, available treatment options, and testing, for HCV.
(g) Make recommendations to the department regarding information to be utilized and incorporated into
the HCV information package, including, but not limited to, information regarding the status of HCV in this
state, state-supported testing and counseling programs, and research findings.
(6) The hepatitis C advisory task force created under this section is abolished effective June 30, 2010.
History: Add. 2006, Act 238, Imd. Eff. June 26, 2006.
Popular name: Act 368
333.5907 Repealed. 2006, Act 238, Imd. Eff. June 26, 2006.
Compiler's note: The repealed section pertained to business conducted at meeting of risk reduction and AIDS policy commission.
Popular name: Act 368
333.5909 Repealed. 2006, Act 238, Imd. Eff. June 26, 2006.
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Compiler's note: The repealed section pertained to duties of risk reduction and AIDS policy commission.
Popular name: Act 368
333.5919 Risk reduction, HCV information package, and AIDS information package.
Sec. 5919. The department shall utilize the fund to develop, in cooperation with institutions of higher
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education, a risk reduction, HCV information package, and AIDS information package that shall include, but
not be limited to, information regarding testing, counseling, transmission, prevention, and treatment.
History: Add. 1987, Act 258, Eff. July 1, 1988;Am. 2006, Act 238, Imd. Eff. June 26, 2006.
Popular name: Act 368
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333.5927 Educational programs for health care workers; availability of educational materials
to individuals at high risk for hepatitis C virus.
Sec. 5927. (1) The department shall utilize the fund to develop educational programs for health care
workers, whether licensed or not, regarding the delivery of quality care and protection against exposure to
disease in the workplace.
(2) The department shall utilize the fund to make available to health care workers, veterans, public safety
officers, parolees, and other individuals at high risk for the hepatitis C virus educational materials, in written
and electronic forms, on the diagnosis, treatment, and prevention of the hepatitis C virus. The educational
materials shall include the recommendations of the federal centers for disease control and prevention
regarding prevention and control of the hepatitis C virus. As used in this subsection, "public safety officer"
means any individual serving a public agency in an official capacity, with or without compensation, as a law
enforcement officer, firefighter, or emergency medical services personnel.
History: Add. 1987, Act 258, Eff. July 1, 1988;Am. 2006, Act 239, Imd. Eff. June 26, 2006.
Popular name: Act 368
PART 59A
HEALTHY MICHIGAN FUND
333.5951 Fund defined.
Sec. 5951. As used in this part, fund means the healthy Michigan fund created in section 5953.
History: Add. 1995, Act 121, Imd. Eff. June 30, 1995.
Popular name: Act 368
ARTICLE 6
SUBSTANCE ABUSE
PART 61
GENERAL PROVISIONS (Repealed by 2012 PA 500)
333.6101-333.6141 Repealed. 2012, Act 500, Imd. Eff. Dec. 28, 2012.
Popular name: Act 368
PART 62
SUBSTANCE ABUSE SERVICES
333.6201 Repealed. 2012, Act 500, Imd. Eff. Dec. 28, 2012.
Compiler's note: The repealed section pertained to creation of office of substance abuse services.
Popular name: Act 368
333.6203 Repealed. 2012, Act 500, Imd. Eff. Dec. 28, 2012.
Compiler's note: The repealed section pertained to duties of office of substance abuse services.
Popular name: Act 368
333.6205 Repealed. 2012, Act 500, Imd. Eff. Dec. 28, 2012.
Compiler's note: The repealed section pertained to additional duties of office of substance abuse services.
Popular name: Act 368
333.6207 Repealed. 2012, Act 500, Imd. Eff. Dec. 28, 2012.
Compiler's note: The repealed section pertained to additional duties of office of substance abuse services.
Popular name: Act 368
333.6209 Repealed. 2012, Act 500, Imd. Eff. Dec. 28, 2012.
Compiler's note: The repealed section pertained to review of office of substance abuse services.
Popular name: Act 368
333.6211 Repealed. 2012, Act 500, Imd. Eff. Dec. 28, 2012.
Compiler's note: The repealed section pertained to formula recommendation for distribution of funds.
Popular name: Act 368
333.6213 Repealed. 2012, Act 500, Imd. Eff. Dec. 28, 2012.
Compiler's note: The repealed section pertained to powers of administrator.
Popular name: Act 368
333.6215 Repealed. 2012, Act 500, Imd. Eff. Dec. 28, 2012.
Compiler's note: The repealed section pertained to creation of state interdepartmental substance abuse services coordinating
commission.
Popular name: Act 368
333.6217 Repealed. 2012, Act 500, Imd. Eff. Dec. 28, 2012.
Compiler's note: The repealed section pertained to duties of state interdepartmental substance abuse services coordinating
commission.
Popular name: Act 368
333.6221 Repealed. 2012, Act 500, Imd. Eff. Dec. 28, 2012.
Compiler's note: The repealed section pertained to creation of advisory commission on substance abuse services.
Popular name: Act 368
333.6222 Repealed. 2012, Act 500, Imd. Eff. Dec. 28, 2012.
Compiler's note: The repealed section pertained to officers, meetings, and report of advisory commission on substance abuse
services.
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Popular name: Act 368
333.6223 Repealed. 2012, Act 500, Imd. Eff. Dec. 28, 2012.
Compiler's note: The repealed section pertained to duties of advisory commission on substance abuse services.
Popular name: Act 368
333.6226 Repealed. 2012, Act 500, Imd. Eff. Dec. 28, 2012.
Compiler's note: The repealed section pertained to city, county, or regional coordinating agency.
Popular name: Act 368
333.6228 Repealed. 2012, Act 500, Imd. Eff. Dec. 28, 2012.
Compiler's note: The repealed section pertained to duties of city, county, or regional coordinating agency.
Popular name: Act 368
333.6230 Definitions.
Sec. 6230. As used in this part:
(a) "Department" means the department of licensing and regulatory affairs.
(b) "Director" means the director of the department or his or her designee.
(c) "Substance use disorder services" means substance use disorder prevention services or substance use
disorder treatment and rehabilitation services, or both, as those terms are defined in section 100d of the mental
health code, 1974 PA 258, MCL 330.1100d.
History: Add. 2012, Act 501, Eff. Jan. 1, 2013.
Popular name: Act 368
333.6231 Repealed. 2012, Act 500, Imd. Eff. Dec. 28, 2012.
Popular name: Act 368
Compiler's note: The repealed section pertained to promulgation of administrative rules.
333.6232 Repealed. 2012, Act 500, Imd. Eff. Dec. 28, 2012.
Compiler's note: The repealed section pertained to waiting list for services.
Popular name: Act 368
333.6234 Rules.
Sec. 6234. The department may promulgate rules under the administrative procedures act of 1969 for the
administration of this part and the licensing of substance use disorder services programs under this part. Rules
promulgated under former section 6231 relating to the licensing of substance use disorder services programs
remain effective and applicable on and after the effective date of this section until rules are promulgated by
the department under this section.
History: Add. 2012, Act 501, Eff. Jan. 1, 2013.
Popular name: Act 368
333.6241 Premises of applicant; inspection; compliance; facility visit; health and sanitation
matters; other matters; conduct.
Sec. 6241. The director or the personnel of another department or agency acting at the request of the
director may enter the premises of an applicant for a license or a licensee at any reasonable time to make an
inspection to determine whether the applicant or licensee is complying with this part and rules promulgated
under this part. A local health department may visit a facility at the request of the director to advise as to
matters affecting health and the sanitation of the buildings used or other matters designated by the director.
The inspections shall be conducted in accordance with standards established in rules.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2012, Act 501, Eff. Jan. 1, 2013.
Compiler's note: For transfer of powers and duties of the Office of Substance Abuse Services as an autonomous entity within the
Department of Public Health to the Department of Public Health, see E.R.O. No. 1991-3, as amended, compiled at MCL 333.26321 of the
Michigan Compiled Laws.
Popular name: Act 368
333.6243 License; denial, suspension, revocation, or refusal to renew; violation; hearing and
appeal.
Sec. 6243. The department may deny, suspend, revoke, or refuse to renew a license of an applicant or
licensee who is in violation of this part or rules promulgated under this part after opportunity for a hearing. A
hearing and an appeal in a contested case shall be conducted by the director pursuant to the administrative
procedures act of 1969.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2012, Act 501, Eff. Jan. 1, 2013.
Compiler's note: For transfer of powers and duties of the Office of Substance Abuse Services as an autonomous entity within the
Department of Public Health to the Department of Public Health, see E.R.O. No. 1991-3, as amended, compiled at MCL 333.26321 of the
Michigan Compiled Laws.
Popular name: Act 368
PART 65
INCAPACITATED PERSONS (Repealed by 2012 PA 500)
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333.6501-333.6523 Repealed. 2012, Act 500, Imd. Eff. Dec. 28, 2012.
Popular name: Act 368
ARTICLE 7
CONTROLLED SUBSTANCES
PART 71
GENERAL PROVISIONS
333.7101 Meanings of words and phrases; general definitions and principles of construction.
Sec. 7101. (1) Except as otherwise provided in section 7341, for purposes of this article, the words and
phrases defined in sections 7103 to 7109 have the meanings ascribed to them in those sections.
(2) In addition, article 1 contains general definitions and principles of construction applicable to all articles
in this code.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1984, Act 347, Eff. Mar. 29, 1985.
Compiler's note: For transfer of powers and duties of certain health-related functions, boards, and commissions from the Department
of Licensing and Regulation to the Department of Commerce, see E.R.O. No. 1991-9, compiled at MCL 338.3501 of the Michigan
Compiled Laws.
For transfer of powers and duties of the bureau of health services from the department of consumer and industry services to the
director of the department of community health by Type II transfer, see E.R.O. No. 2003-1, compiled at MCL 445.2011.
Popular name: Act 368
333.7103 Definitions; A.
Sec. 7103. (1) Administer means the direct application of a controlled substance, whether by injection,
inhalation, ingestion, or other means, to the body of a patient or research subject by a practitioner, or in the
practitioner's presence by his or her authorized agent, or the patient or research subject at the direction and in
the presence of the practitioner.
(2) Administrator means the Michigan board of pharmacy or its designated or established authority.
(3) Agent means an authorized person who acts on behalf of or at the direction of a manufacturer,
distributor, dispenser, or prescriber. It does not include a common or contract carrier, public warehouseman,
or employee of the carrier or warehouseman.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1988, Act 60, Eff. Aug. 1, 1989.
Popular name: Act 368
333.7104 Definitions; B to E.
Sec. 7104. (1) Bureau means the drug enforcement administration, United States department of justice,
or its successor agency.
(2) Controlled substance means a drug, substance, or immediate precursor included in schedules 1 to 5 of
part 72.
(3) Controlled substance analogue means a substance the chemical structure of which is substantially
similar to that of a controlled substance in schedule 1 or 2 and that has a narcotic, stimulant, depressant, or
hallucinogenic effect on the central nervous system substantially similar to or greater than the narcotic,
stimulant, depressant, or hallucinogenic effect on the central nervous system of a controlled substance
included in schedule 1 or 2 or, with respect to a particular individual, that the individual represents or intends
to have a narcotic, stimulant, depressant, or hallucinogenic effect on the central nervous system substantially
similar to or greater than the narcotic, stimulant, depressant, or hallucinogenic effect on the central nervous
system of a controlled substance included in schedule 1 or 2. Controlled substance analogue does not include
1 or more of the following:
(a) A controlled substance.
(b) A substance for which there is an approved new drug application.
(c) A substance with respect to which an exemption is in effect for investigational use by a particular
person under section 505 of the federal food, drug and cosmetic act, chapter 675, 52 Stat. 1052, 21 U.S.C.
355, to the extent conduct with respect to the substance is pursuant to the exemption.
(d) Any substance to the extent not intended for human consumption before an exemption takes effect with
respect to the substance.
(4) Counterfeit prescription form means a printed form that is the same or similar to a prescription form
and that was manufactured, printed, duplicated, forged, electronically transmitted, or altered without the
knowledge or permission of a prescriber.
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(5) Counterfeit substance means a controlled substance that, or the container or labeling of which,
without authorization, bears the trademark, trade name or other identifying mark, imprint, number, or device,
or any likeness thereof, of a manufacturer, distributor, or dispenser other than the person who in fact
manufactured, distributed, or dispensed the substance.
(6) Deleterious drug means a drug, other than a proprietary medicine, likely to be destructive to adult
human life in quantities of 3.88 grams or less.
(7) Electronic signature means an electronic sound, symbol, or process attached to or logically associated
with a record and executed or adopted by a person with the intent to sign the record.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1978, Act 625, Imd. Eff. Jan. 6, 1979;Am. 1988, Act 60, Eff. Aug. 1, 1989;
Am. 1993, Act 80, Eff. April 1, 1994;Am. 1994, Act 38, Eff. June 1, 1994;Am. 2001, Act 233, Eff. Jan. 6, 2003.
Compiler's note: Enacting section 1 of Act 233 of 2001 provides:
Enacting section 1. Sections 7104, 7107, and 7109 of the public health code, 1978 PA 368, MCL 333.7104, 333.7107, and 333.7109,
as amended by this amendatory act, take effect upon the promulgation of the rules required under section 7333a of the public health code,
1978 PA 368, MCL 333.7333a, and receipt by the secretary of state of written notice from the director of the department of consumer and
industry services that the electronic monitoring system required by section 7333a of the public health code, 1978 PA 368, MCL
333.7333a, is operational. The notice to the secretary of state shall include a statement that the department of consumer and industry
services is able to receive data from at least 80% of those required to report under section 7333a of the public health code, 1978 PA 368,
MCL 333.7333a, and is able to respond to requests for data from persons authorized to make such requests and to review and utilize the
data.
The rules required under section 7333a of the public health code, 1978 PA 368, MCL 333.7333a, pertaining to the operation of the
electronic monitoring system, were promulgated on December 30, 2002. In addition, a written notice from the director of the department
of consumer and industry services that the electronic monitoring system required by section 7333a of the public health code is operational
was filed with, and received by, the secretary of state on January 6, 2003.
Popular name: Act 368
333.7106 Definitions; I to M.
Sec. 7106. (1) "Immediate precursor" means a substance that the administrator has found to be and by rule
designates as being the principal compound commonly used or produced primarily for use and that is an
immediate chemical intermediary used or likely to be used in the manufacture of a controlled substance, the
control of which is necessary to prevent, curtail, or limit manufacture.
(2) "Industrial hemp" means the plant Cannabis sativa L. and any part of the plant, whether growing or not,
with a delta-9-tetrahydrocannibinol concentration of not more than 0.3% on a dry weight basis.
(3) "Manufacture" means the production, preparation, propagation, compounding, conversion, or
processing of a controlled substance, directly or indirectly by extraction from substances of natural origin, or
independently by means of chemical synthesis, or by a combination of extraction and chemical synthesis. It
includes the packaging or repackaging of the substance or labeling or relabeling of its container, except that it
does not include either of the following:
(a) The preparation or compounding of a controlled substance by an individual for his or her own use.
(b) The preparation, compounding packaging, or labeling of a controlled substance by either of the
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following:
(i) A practitioner as an incident to the practitioner's administering or dispensing of a controlled substance
in the course of his or her professional practice.
(ii) A practitioner, or by the practitioner's authorized agent under his or her supervision, for the purpose of,
or as an incident to, research, teaching, or chemical analysis, and not for sale.
(4) "Marihuana" means all parts of the plant Cannabis sativa L., growing or not; the seeds of that plant; the
resin extracted from any part of the plant; and every compound, manufacture, salt, derivative, mixture, or
preparation of the plant or its seeds or resin. Marihuana does not include the mature stalks of the plant, fiber
produced from the stalks, oil or cake made from the seeds of the plant, any other compound, manufacture,
salt, derivative, mixture, or preparation of the mature stalks, except the resin extracted from those stalks, fiber,
oil, or cake, or any sterilized seed of the plant that is incapable of germination. Marihuana does not include
industrial hemp grown or cultivated, or both, for research purposes under the industrial hemp research act.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2014, Act 548, Imd. Eff. Jan. 15, 2015.
Popular name: Act 368
Compiler's note: In subsection (2), the word delta-9-tetrahydrocannibinol should evidently read delta-9-tetrahydrocannabinol.
333.7107 Definitions; N.
Sec. 7107. Narcotic drug means 1 or more of the following, whether produced directly or indirectly by
extraction from substances of vegetable origin, or independently by means of chemical synthesis, or by a
combination of extraction and chemical synthesis:
(a) Opium and opiate, and any salt, compound, derivative, or preparation of opium or opiate.
(b) Any salt, compound, isomer, derivative, or preparation thereof which is chemically equivalent or
identical with any of the substances referred to in subdivision (a), but not including the isoquinoline alkaloids
of opium.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1988, Act 60, Eff. Aug. 1, 1989;Am. 1993, Act 80, Eff. Apr. 1, 1994;Am.
2001, Act 233, Eff. Jan. 6, 2003.
Compiler's note: Enacting section 1 of Act 233 of 2001 provides:
Enacting section 1. Sections 7104, 7107, and 7109 of the public health code, 1978 PA 368, MCL 333.7104, 333.7107, and 333.7109,
as amended by this amendatory act, take effect upon the promulgation of the rules required under section 7333a of the public health code,
1978 PA 368, MCL 333.7333a, and receipt by the secretary of state of written notice from the director of the department of consumer and
industry services that the electronic monitoring system required by section 7333a of the public health code, 1978 PA 368, MCL
333.7333a, is operational. The notice to the secretary of state shall include a statement that the department of consumer and industry
services is able to receive data from at least 80% of those required to report under section 7333a of the public health code, 1978 PA 368,
MCL 333.7333a, and is able to respond to requests for data from persons authorized to make such requests and to review and utilize the
data.
The rules required under section 7333a of the public health code, 1978 PA 368, MCL 333.7333a, pertaining to the operation of the
electronic monitoring system, were promulgated on December 30, 2002. In addition, a written notice from the director of the department
of consumer and industry services that the electronic monitoring system required by section 7333a of the public health code is operational
was filed with, and received by, the secretary of state on January 6, 2003.
Popular name: Act 368
333.7108 Definitions; O.
Sec. 7108. (1) Opiate means a substance having an addiction-forming or addiction-sustaining liability
similar to morphine or being capable of conversion into a drug having addiction-forming or
addiction-sustaining liability. It does not include, unless specifically designated as controlled under section
7212, the dextrorotatory isomer of 3-methoxy-n-methyl-morphinan and its salts (dextromethorphan). It does
include its racemic and levorotatory forms.
(2) Opium poppy means the plant of the species Papaver somniferum L., except its seeds.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
***** 333.7109 THIS SECTION IS AMENDED EFFECTIVE MARCH 28, 2017: See 333.7109.amended
*****
333.7109 Definitions; P to U.
Sec. 7109. (1) Person means a person as defined in section 1106 or a governmental entity.
(2) Poppy straw means all parts, except the seeds, of the opium poppy, after mowing.
(3) Practitioner means:
(a) A prescriber or pharmacist, a scientific investigator as defined by rule of the administrator, or other
person licensed, registered, or otherwise permitted to distribute, dispense, conduct research with respect to, or
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administer a controlled substance in the course of professional practice or research in this state, including an
individual in charge of a dog pound or animal shelter licensed or registered by the department of agriculture
pursuant to 1969 PA 287, MCL 287.331 to 287.340, or a class B dealer licensed by the United States
department of agriculture pursuant to the animal welfare act, Public Law 89-544, 7 U.S.C. 2131 to 2147,
2149, and 2151 to 2159 and the department of agriculture pursuant to 1969 PA 224, MCL 287.381 to
287.395, for the limited purpose of buying, possessing, and administering a commercially prepared, premixed
solution of sodium pentobarbital to practice euthanasia on animals.
(b) A pharmacy, hospital, or other institution or place of professional practice licensed, registered, or
otherwise permitted to distribute, prescribe, dispense, conduct research with respect to, or administer a
controlled substance in the course of professional practice or research in this state.
(4) Prescriber means that term as defined in section 17708.
(5) Prescription form means a printed form, that is authorized and intended for use by a prescribing
practitioner to prescribe controlled substances or other prescription drugs and that meets the requirements of
rules promulgated by the administrator, and all of the following requirements:
(a) Bears the preprinted, stamped, typed, or manually printed name, address, and telephone number or
pager number of the prescribing practitioner.
(b) Includes the manually printed name of the patient, the address of the patient, the prescribing
practitioner's signature, and the prescribing practitioner's drug enforcement administration registration
number.
(c) The quantity of the prescription drug prescribed, in both written and numerical terms.
(d) Includes the date the prescription drug was prescribed.
(e) Any rules promulgated by the department pursuant to section 7333a(7).
(6) Production means the manufacture, planting, cultivation, growing, or harvesting of a controlled
substance.
(7) Sign means to affix one's signature manually to a document or to use an electronic signature.
(8) Ultimate user means an individual who lawfully possesses a controlled substance for personal use or
for the use of a member of the individual's household, or for administering to an animal owned by the
individual or by a member of the individual's household.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1980, Act 414, Imd. Eff. Jan. 11, 1981;Am. 1986, Act 174, Imd. Eff. July 7,
1986;Am. 1988, Act 60, Eff. Aug. 1, 1989;Am. 1993, Act 80, Eff. Apr. 1, 1994;Am. 2001, Act 233, Eff. Jan. 6, 2003.
Compiler's note: Section 3 of Act 174 of 1986 provides: This amendatory act shall only apply to contested cases filed on or after
July 1, 1986.
Enacting section 1 of Act 233 of 2001 provides:
Enacting section 1. Sections 7104, 7107, and 7109 of the public health code, 1978 PA 368, MCL 333.7104, 333.7107, and 333.7109,
as amended by this amendatory act, take effect upon the promulgation of the rules required under section 7333a of the public health code,
1978 PA 368, MCL 333.7333a, and receipt by the secretary of state of written notice from the director of the department of consumer and
industry services that the electronic monitoring system required by section 7333a of the public health code, 1978 PA 368, MCL
333.7333a, is operational. The notice to the secretary of state shall include a statement that the department of consumer and industry
services is able to receive data from at least 80% of those required to report under section 7333a of the public health code, 1978 PA 368,
MCL 333.7333a, and is able to respond to requests for data from persons authorized to make such requests and to review and utilize the
data.
The rules required under section 7333a of the public health code, 1978 PA 368, MCL 333.7333a, pertaining to the operation of the
electronic monitoring system, were promulgated on December 30, 2002. In addition, a written notice from the director of the department
of consumer and industry services that the electronic monitoring system required by section 7333a of the public health code is operational
was filed with, and received by, the secretary of state on January 6, 2003.
Popular name: Act 368
Administrative rules: R 338.471 et seq. and R 338.3101 et seq. of the Michigan Administrative Code.
***** 333.7109.amended THIS AMENDED SECTION IS EFFECTIVE MARCH 28, 2017 *****
333.7109.amended Definitions; P to U.
Sec. 7109. (1) "Person" means a person as defined in section 1106 or a governmental entity.
(2) "Poppy straw" means all parts, except the seeds, of the opium poppy, after mowing.
(3) "Practitioner" means any of the following:
(a) A prescriber or pharmacist, a scientific investigator as defined by rule of the administrator, or other
person licensed, registered, or otherwise permitted to distribute, dispense, conduct research with respect to, or
administer a controlled substance in the course of professional practice or research in this state, including an
individual in charge of a dog pound or animal shelter licensed or registered by the department of agriculture
and rural development under 1969 PA 287, MCL 287.331 to 287.340, or a class B dealer licensed by the
United States Department of Agriculture under the animal welfare act, Public Law 89-544, 7 USC 2131 to
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2147, 2149, and 2151 to 2159 and the department of agriculture and rural development under 1969 PA 224,
MCL 287.381 to 287.395, for the limited purpose of buying, possessing, and administering a commercially
prepared, premixed solution of sodium pentobarbital to practice euthanasia on animals.
(b) A pharmacy, hospital, or other institution or place of professional practice licensed, registered, or
otherwise permitted to distribute, prescribe, dispense, conduct research with respect to, or administer a
controlled substance in the course of professional practice or research in this state.
(4) "Prescriber" means that term as defined in section 17708.
(5) "Prescription form" means a printed form, that is authorized and intended for use by a prescribing
practitioner to prescribe controlled substances or other prescription drugs and that meets the requirements of
rules promulgated by the administrator, and all of the following requirements:
(a) Bears the preprinted, stamped, typed, or manually printed name, address, and telephone number or
pager number of the prescribing practitioner.
(b) Includes the manually printed name of the patient, the address of the patient, the prescribing
practitioner's signature, and the prescribing practitioner's drug enforcement administration registration
number.
(c) Includes the quantity of the prescription drug prescribed, in both written and numerical terms.
(d) Includes the date the prescription drug was prescribed.
(e) Complies with any rules promulgated by the department under section 7333a(6).
(6) "Production" means the manufacture, planting, cultivation, growing, or harvesting of a controlled
substance.
(7) "Sign" means to affix one's signature manually to a document or to use an electronic signature.
(8) "Ultimate user" means an individual who lawfully possesses a controlled substance for personal use or
for the use of a member of the individual's household, or for administering to an animal owned by the
individual or by a member of the individual's household.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1980, Act 414, Imd. Eff. Jan. 11, 1981;Am. 1986, Act 174, Imd. Eff. July 7,
1986;Am. 1988, Act 60, Eff. Aug. 1, 1989;Am. 1993, Act 80, Eff. Apr. 1, 1994;Am. 2001, Act 233, Eff. Jan. 6, 2003;Am.
2016, Act 383, Eff. Mar. 28, 2017.
Compiler's note: Section 3 of Act 174 of 1986 provides: This amendatory act shall only apply to contested cases filed on or after
July 1, 1986.
Enacting section 1 of Act 233 of 2001 provides:
Enacting section 1. Sections 7104, 7107, and 7109 of the public health code, 1978 PA 368, MCL 333.7104, 333.7107, and 333.7109,
as amended by this amendatory act, take effect upon the promulgation of the rules required under section 7333a of the public health code,
1978 PA 368, MCL 333.7333a, and receipt by the secretary of state of written notice from the director of the department of consumer and
industry services that the electronic monitoring system required by section 7333a of the public health code, 1978 PA 368, MCL
333.7333a, is operational. The notice to the secretary of state shall include a statement that the department of consumer and industry
services is able to receive data from at least 80% of those required to report under section 7333a of the public health code, 1978 PA 368,
MCL 333.7333a, and is able to respond to requests for data from persons authorized to make such requests and to review and utilize the
data.
The rules required under section 7333a of the public health code, 1978 PA 368, MCL 333.7333a, pertaining to the operation of the
electronic monitoring system, were promulgated on December 30, 2002. In addition, a written notice from the director of the department
of consumer and industry services that the electronic monitoring system required by section 7333a of the public health code is operational
was filed with, and received by, the secretary of state on January 6, 2003.
Popular name: Act 368
Administrative rules: R 338.471 et seq. and R 338.3101 et seq. of the Michigan Administrative Code.
PART 72
STANDARDS AND SCHEDULES
333.7201 Administration of article; adding, deleting, or rescheduling substances.
Sec. 7201. The administrator shall administer this article and may add substances to, or delete or
reschedule all substances enumerated in the schedules in sections 7212, 7214, 7216, 7218, and 7220 in
compliance with the administrative procedures act of 1969.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2012, Act 182, Imd. Eff. June 19, 2012.
Constitutionality: The Legislature's delegation to the Board of Pharmacy of the authority to schedule controlled substances in
accordance with detailed criteria is not an unlawful delegation of power. People v Turmon, 417 Mich 638; 340 NW2d 620 (1983).
Compiler's note: For transfer of powers and duties of certain health-related functions, boards, and commissions from the Department
of Licensing and Regulation to the Department of Commerce, see E.R.O. No. 1991-9, compiled at MCL 338.3501 of the Michigan
Compiled Laws.
Popular name: Act 368
Administrative rules: R 338.3101 et seq. of the Michigan Administrative Code.
PART 73
MANUFACTURE, DISTRIBUTION, AND DISPENSING
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333.7301 Rules.
Sec. 7301. The administrator may promulgate rules relating to the licensure and control of the
manufacture, distribution, prescribing of controlled substances included in schedule 2, and dispensing of
controlled substances in this state.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1986, Act 174, Imd. Eff. July 7, 1986;Am. 1988, Act 60, Eff. Aug. 1, 1989;
Am. 1993, Act 80, Eff. Apr. 1, 1994.
Compiler's note: Section 3 of Act 174 of 1986 provides: This amendatory act shall only apply to contested cases filed on or after
July 1, 1986.
For transfer of powers and duties of certain health-related functions, boards, and commissions from the Department of Licensing and
Regulation to the Department of Commerce, see E.R.O. No. 1991-9, compiled at MCL 338.3501 of the Michigan Compiled Laws.
Popular name: Act 368
Administrative rules: R 338.471 et seq. and R 338.3101 et seq. of the Michigan Administrative Code.
***** 333.7303a THIS SECTION IS AMENDED EFFECTIVE AUGUST 1, 2017: See 333.7303a.amended
*****
333.7303a Licensed prescriber; administering or dispensing controlled substance without
separate license; use of other controlled substances; recording response; records
required to be maintained; waiver of requirement under MCL 333.7303.
Sec. 7303a. (1) A prescriber who holds a controlled substances license may administer or dispense a
controlled substance listed in schedules 2 to 5 without a separate controlled substances license for those
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activities.
(2) Before prescribing or dispensing a controlled substance to a patient, a licensed prescriber shall ask the
patient about other controlled substances the patient may be using. The prescriber shall record the patient's
response in the patient's medical or clinical record.
(3) A licensed prescriber who dispenses controlled substances shall maintain all of the following records
separately from other prescription records:
(a) All invoices and other acquisition records for each controlled substance acquired by the prescriber for
not less than 5 years after the date the prescriber acquires the controlled substance.
(b) A log of all controlled substances dispensed by the prescriber for not less than 5 years after the date the
controlled substance is dispensed.
(c) Records of all other dispositions of controlled substances under the licensee's control for not less than 5
years after the date of the disposition.
(4) The requirement under section 7303 for a license is waived in the following circumstances:
(a) When a controlled substance listed in schedules 2 to 5 is administered on the order of a licensed
prescriber by an individual who is licensed under article 15 as a practical nurse, a registered professional
nurse, or a physician's assistant.
(b) When methadone or a methadone congener is dispensed on the order of a licensed prescriber in a
methadone treatment program licensed under article 6 or when a controlled substance listed in schedules 2 to
5 is dispensed on the order of a licensed prescriber in a hospice rendering emergency care services in a
patient's home as described in section 17746 by a registered professional nurse or a physician's assistant
licensed under article 15.
History: Add. 1993, Act 305, Imd. Eff. Dec. 28, 1993.
Popular name: Act 368
333.7305 Permitting certain persons to apply for license; application upon expiration of
existing license.
Sec. 7305. The administrator shall initially permit a person who owns, or operates an establishment
engaged in the manufacture, distribution, prescription, or dispensing of a controlled substance before
September 30, 1978 and who is licensed by this state to apply for a license pursuant to this article. However, a
person who is licensed under existing state law with the administrator or department of commerce is not
required to apply for a license pursuant to this article until the expiration of the person's existing license.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1993, Act 80, Eff. Apr. 1, 1994.
Popular name: Act 368
***** 333.7321 THIS SECTION IS AMENDED EFFECTIVE MARCH 28, 2017: See 333.7321.amended
*****
333.7321 Records; inventories; annual report; violation; civil fine.
Sec. 7321. (1) Subject to subsection (2), a person licensed to manufacture, distribute, prescribe, or dispense
controlled substances under this article shall keep records and maintain inventories in conformance with the
record-keeping and inventory requirements of federal law and with any additional rules the administrator
promulgates, unless exempted by those rules.
(2) Beginning May 1, 1989, and annually thereafter, each person licensed under this article to manufacture,
distribute, prescribe, or dispense controlled substances shall inventory and report to the administrator all
schedule 2 to 5 controlled substances possessed by the person at the time of the inventory. The annual report
required under this subsection may be conducted and submitted to the administrator not more than 30 days
before May 1, but shall be conducted and submitted to the administrator not later than 60 days after May 1. A
person who violates this subsection may be punished by a civil fine of not more than $25,000.00 in a
proceeding in the circuit court.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1988, Act 245, Eff. Sept. 1, 1988.
Popular name: Act 368
Administrative rules: R 338.471 et seq. and R 338.3101 et seq. of the Michigan Administrative Code.
***** 333.7321.amended THIS AMENDED SECTION IS EFFECTIVE MARCH 28, 2017 *****
333.7321.amended Records; inventories; annual inventory; retention.
Sec. 7321. (1) Subject to subsection (2), a person licensed to manufacture, distribute, prescribe, or dispense
controlled substances under this article shall keep records and maintain inventories in conformance with the
record-keeping and inventory requirements of federal law and with any additional rules the administrator
promulgates, unless exempted by those rules.
(2) Beginning May 1, 1989, and annually thereafter, each person licensed under this article to manufacture,
distribute, prescribe, or dispense controlled substances shall inventory all schedule 2 to 5 controlled
substances possessed by the person at the time of the inventory. A person described in this subsection may
conduct the annual inventory required under this subsection not more than 30 days before May 1, but shall
conduct the inventory not later than 60 days after May 1. A person described in this subsection shall retain the
inventory required under this subsection for not less than 2 years after the date of the inventory's creation and
shall make the inventory available for inspection by the department at the request of the department.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1988, Act 245, Eff. Sept. 1, 1988;Am. 2016, Act 383, Eff. Mar. 28, 2017.
Popular name: Act 368
Administrative rules: R 338.471 et seq. and R 338.3101 et seq. of the Michigan Administrative Code.
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Popular name: Act 368
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Am. 1988, Act 60, Eff. Aug. 1, 1988;Am. 1988, Act 240, Imd. Eff. July 11, 1988;Am. 1989, Act 143, Imd. Eff. June 29, 1989;
Am. 1990, Act 30, Eff. Mar. 28, 1991;Am. 1991, Act 186, Imd. Eff. Dec. 27, 1991;Am. 1993, Act 80, Eff. Apr. 1, 1994;Am.
1993, Act 138, Imd. Eff. Aug. 2, 1993;Am. 2001, Act 231, Eff. Jan. 6, 2003;Am. 2006, Act 451, Imd. Eff. Dec. 14, 2006;Am.
2010, Act 3, Imd. Eff. Feb. 4, 2010.
Compiler's note: Enacting section 2 of Act 231 of 2001 provides:
Enacting section 2. Section 7333 of the public health code, 1978 PA 368, MCL 333.7333, as amended by this amendatory act, takes
effect upon promulgation of the rules required under section 7333a(1) of the public health code, 1978 PA 368, MCL 333.7333a, as added
by this amendatory act, and receipt by the secretary of state of written notice from the director of the department of consumer and
industry services that the electronic monitoring system required by section 7333a of the public health code, 1978 PA 368, MCL
333.7333a, as added by this amendatory act, is operational. The notice to the secretary of state shall include a statement that the
department of consumer and industry services is able to receive data from at least 80% of those required to report under section 7333a of
the public health code, 1978 PA 368, MCL 333.7333a, as added by this amendatory act, and is able to respond to requests for data from
persons authorized to make such requests and to review and utilize the data."
The rules required under section 7333a of the public health code, 1978 PA 368, MCL 333.7333a, pertaining to the operation of the
electronic monitoring system, were promulgated on December 30, 2002. In addition, a written notice from the director of the department
of consumer and industry services that the electronic monitoring system required by section 7333a of the public health code is operational
was filed with, and received by, the secretary of state on January 6, 2003.
Popular name: Act 368
Administrative rules: R 338.471 et seq. and R 338.3101 et seq. of the Michigan Administrative Code.
***** 333.7333a THIS SECTION IS AMENDED EFFECTIVE MARCH 28, 2017: See 333.7333a.amended
*****
333.7333a Electronic monitoring system.
Sec. 7333a. (1) The department shall establish, by rule, an electronic system for monitoring schedule 2, 3,
4, and 5 controlled substances dispensed in this state by veterinarians, and by pharmacists and dispensing
prescribers licensed under part 177 or dispensed to an address in this state by a pharmacy licensed in this
state. The rules shall provide an appropriate electronic format for the reporting of data including, but not
limited to, patient identifiers, the name of the controlled substance dispensed, date of dispensing, quantity
dispensed, prescriber, and dispenser. The department shall require a veterinarian, pharmacist, or dispensing
prescriber to utilize the electronic data transmittal process developed by the department or the department's
contractor. A veterinarian, pharmacist, or dispensing prescriber shall not be required to pay a new fee
dedicated to the operation of the electronic monitoring system and shall not incur any additional costs solely
related to the transmission of data to the department. The rules promulgated under this subsection shall
exempt both of the following circumstances from the reporting requirements:
(a) The administration of a controlled substance directly to a patient.
(b) The dispensing from a health facility or agency licensed under article 17 of a controlled substance by a
dispensing prescriber in a quantity adequate to treat a patient for not more than 48 hours.
(2) Notwithstanding any practitioner-patient privilege, the director of the department may provide data
obtained under this section to all of the following:
(a) A designated representative of a board responsible for the licensure, regulation, or discipline of a
practitioner, pharmacist, or other person who is authorized to prescribe, administer, or dispense controlled
substances.
(b) An employee or agent of the department.
(c) A state, federal, or municipal employee or agent whose duty is to enforce the laws of this state or the
United States relating to drugs.
(d) A state-operated medicaid program.
(e) A state, federal, or municipal employee who is the holder of a search warrant or subpoena properly
issued for the records.
(f) A practitioner or pharmacist who requests information and certifies that the requested information is for
the purpose of providing medical or pharmaceutical treatment to a bona fide current patient.
(g) An individual with whom the department has contracted under subsection (8).
(h) A practitioner or other person who is authorized to prescribe controlled substances for the purpose of
determining if prescriptions written by that practitioner or other person have been dispensed.
(i) Until December 31, 2016, the health care payment or benefit provider for the purposes of ensuring
patient safety and investigating fraud and abuse.
(3) Except as otherwise provided in this part, information submitted under this section shall be used only
for bona fide drug-related criminal investigatory or evidentiary purposes or for the investigatory or
evidentiary purposes in connection with the functions of a disciplinary subcommittee or 1 or more of the
licensing or registration boards created in article 15.
(4) A person who receives data or any report under subsection (2) containing any patient identifiers of the
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system from the department shall not provide it to any other person or entity except by order of a court of
competent jurisdiction.
(5) Except as otherwise provided in this subsection, reporting under subsection (1) is mandatory for a
veterinarian, pharmacist, and dispensing prescriber. However, the department may issue a written waiver of
the electronic reporting requirement to a veterinarian, pharmacist, or dispensing prescriber who establishes
grounds that he or she is unable to use the electronic monitoring system. The department shall require the
applicant for the waiver to report the required information in a manner approved by the department.
(6) In addition to the information required to be reported annually under section 7112(3), the controlled
substances advisory commission shall include in the report information on the implementation and
effectiveness of the electronic monitoring system.
(7) The department, in consultation with the controlled substances advisory commission, the Michigan
board of pharmacy, the Michigan board of medicine, the Michigan board of osteopathic medicine and
surgery, the Michigan state police, and appropriate medical professional associations, shall examine the need
for and may promulgate rules for the production of a prescription form on paper that minimizes the potential
for forgery. The rules shall not include any requirement that sequential numbers, bar codes, or symbols be
affixed, printed, or written on a prescription form or that the prescription form be a state produced
prescription form. In examining the need for rules for the production of a prescription form on paper that
minimizes the potential for forgery, the department shall consider and identify the following:
(a) Cost, benefits, and barriers.
(b) Overall cost-benefit analysis.
(c) Compatibility with the electronic monitoring system required under this section.
(8) The department may enter into 1 or more contractual agreements for the administration of this section.
(9) The department, all law enforcement officers, all officers of the court, and all regulatory agencies and
officers, in using the data for investigative or prosecution purposes, shall consider the nature of the
prescriber's and dispenser's practice and the condition for which the patient is being treated.
(10) The data and any report containing any patient identifiers obtained from the data are not public
records and are not subject to the freedom of information act, 1976 PA 442, MCL 15.231 to 15.246.
(11) Beginning February 1, 2013 and through February 1, 2016, the department may issue a written request
to a health care payment or benefit provider to determine if the provider has accessed the electronic system as
provided in subsection (2)(i) in the previous calendar year and, if so, to determine the number of inquiries the
provider made in the previous calendar year and any other information the department requests in relation to
the provider's access to the electronic system. A health care payment or benefit provider shall respond to the
written request on or before the March 31 following the request. The department shall collaborate with health
care payment or benefit providers to develop a reasonable request and reporting form for use under this
subsection.
(12) As used in this section:
(a) "Department" means the department of licensing and regulatory affairs.
(b) "Health care payment or benefit provider" means a person that provides health benefits, coverage, or
insurance in this state, including a health insurance company, a nonprofit health care corporation, a health
maintenance organization, a multiple employer welfare arrangement, a medicaid contracted health plan, or
any other person providing a plan of health benefits, coverage, or insurance subject to state insurance
regulation.
History: Add. 2001, Act 231, Imd. Eff. Jan. 3, 2002;Am. 2011, Act 108, Imd. Eff. July 20, 2011;Am. 2012, Act 44, Imd. Eff.
Mar. 7, 2012.
Popular name: Act 368
Administrative rules: R 338.3101 et seq. of the Michigan Administrative Code.
***** 333.7333a.amended THIS AMENDED SECTION IS EFFECTIVE MARCH 28, 2017 *****
333.7333a.amended Electronic monitoring system; definitions.
Sec. 7333a. (1) The department shall establish, by rule, an electronic system for monitoring schedule 2, 3,
4, and 5 controlled substances dispensed in this state by veterinarians, and by pharmacists and dispensing
prescribers licensed under part 177 or dispensed to an address in this state by a pharmacy licensed in this
state. The rules must provide an appropriate electronic format for the reporting of data including, but not
limited to, patient identifiers, and the name of the controlled substance dispensed, the date of dispensing, the
quantity dispensed, the prescriber, and the dispenser. The department shall require a veterinarian, pharmacist,
or dispensing prescriber to utilize the electronic data transmittal process developed by the department or the
department's contractor. The department shall not require a veterinarian, pharmacist, or dispensing prescriber
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to pay a new fee dedicated to the operation of the electronic monitoring system or to incur any additional
costs solely related to the transmission of data to the department. The rules promulgated under this subsection
must exempt both of the following circumstances from the reporting requirements:
(a) The administration of a controlled substance directly to a patient.
(b) The dispensing from a health facility or agency licensed under article 17 of a controlled substance by a
dispensing prescriber in a quantity adequate to treat a patient for not more than 48 hours.
(2) Notwithstanding any practitioner-patient privilege, the director of the department may provide data
obtained under this section to all of the following:
(a) A designated representative of a board responsible for the licensure, regulation, or discipline of a
practitioner, pharmacist, or other person that is authorized to prescribe, administer, or dispense controlled
substances.
(b) An employee or agent of the department.
(c) A state, federal, or municipal employee or agent whose duty is to enforce the laws of this state or the
United States relating to drugs.
(d) A state-operated Medicaid program.
(e) A state, federal, or municipal employee who is the holder of a search warrant or subpoena properly
issued for the records.
(f) A practitioner or pharmacist who requests information and certifies that the requested information is for
the purpose of providing medical or pharmaceutical treatment to a bona fide current patient.
(g) An individual with whom the department has contracted under subsection (7).
(h) A practitioner or other person that is authorized to prescribe controlled substances for the purpose of
determining if prescriptions written by that practitioner or other person have been dispensed.
(i) The health care payment or benefit provider for the purposes of ensuring patient safety and investigating
fraud and abuse.
(3) Except as otherwise provided in this part, a person shall use information submitted under this section
only for bona fide drug-related criminal investigatory or evidentiary purposes or for the investigatory or
evidentiary purposes in connection with the functions of a disciplinary subcommittee or 1 or more of the
licensing or registration boards created in article 15.
(4) A person that receives data or any report under subsection (2) containing any patient identifiers of the
system from the department shall not provide it to any other person except by order of a court of competent
jurisdiction.
(5) Except as otherwise provided in this subsection, reporting under subsection (1) is mandatory for a
veterinarian, pharmacist, and dispensing prescriber. However, the department may issue a written waiver of
the electronic reporting requirement to a veterinarian, pharmacist, or dispensing prescriber who establishes
grounds that he or she is unable to use the electronic monitoring system. The department shall require the
applicant for the waiver to report the required information in a manner approved by the department.
(6) The department, in consultation with the Michigan board of pharmacy, the Michigan board of
medicine, the Michigan board of osteopathic medicine and surgery, the department of state police, and
appropriate medical professional associations, shall examine the need for and may promulgate rules for the
production of a prescription form on paper that minimizes the potential for forgery. The rules must not
include any requirement that sequential numbers, bar codes, or symbols be affixed, printed, or written on a
prescription form or that the prescription form be a state produced prescription form. In examining the need
for rules for the production of a prescription form on paper that minimizes the potential for forgery, the
department shall consider and identify the following:
(a) Cost, benefits, and barriers.
(b) Overall cost-benefit analysis.
(c) Compatibility with the electronic monitoring system required under this section.
(7) The department may enter into 1 or more contractual agreements for the administration of this section.
(8) The department, all law enforcement officers, all officers of the court, and all regulatory agencies and
officers, in using the data for investigative or prosecution purposes, shall consider the nature of the
prescriber's and dispenser's practice and the condition for which the patient is being treated.
(9) The data and any report containing any patient identifiers obtained from the data are not public records
and are not subject to the freedom of information act, 1976 PA 442, MCL 15.231 to 15.246.
(10) The department may issue a written request to a health care payment or benefit provider to determine
if the provider has accessed the electronic monitoring system as provided in subsection (2)(i) in the previous
calendar year and, if so, to determine the number of inquiries the provider made in the previous calendar year
and any other information the department requests in relation to the provider's access to the electronic
monitoring system. A health care payment or benefit provider shall respond to the written request on or before
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the March 31 following the request. The department shall collaborate with health care payment or benefit
providers to develop a reasonable request and reporting form for use under this subsection.
(11) As used in this section:
(a) "Department" means the department of licensing and regulatory affairs.
(b) "Health care payment or benefit provider" means a person that provides health benefits, coverage, or
insurance in this state, including a health insurance company, a nonprofit health care corporation, a health
maintenance organization, a multiple employer welfare arrangement, a Medicaid contracted health plan, or
any other person providing a plan of health benefits, coverage, or insurance subject to state insurance
regulation.
History: Add. 2001, Act 231, Imd. Eff. Jan. 3, 2002;Am. 2011, Act 108, Imd. Eff. July 20, 2011;Am. 2012, Act 44, Imd. Eff.
Mar. 7, 2012;Am. 2016, Act 383, Eff. Mar. 28, 2017.
Popular name: Act 368
Administrative rules: R 338.3101 et seq. of the Michigan Administrative Code.
333.7335 Repealed. 2013, Act 268, Imd. Eff. Dec. 30, 2013.
Compiler's note: Former MCL 333.7335, pertaining to marihuana controlled substances therapeutic research program, expired
November 1, 1982, pursuant to Act 125 of 1979.
The repealed section pertained to marihuana controlled substances therapeutic research program.
Popular name: Act 368
333.7336 Repealed. 2013, Act 268, Imd. Eff. Dec. 30, 2013.
Compiler's note: Former MCL 333.7336, pertaining to patient qualification review board and certification of designated pharmacies
for participation in marihuana distribution, expired November 1, 1982, pursuant to Act 125 of 1979.
The repealed section pertained to patient qualification review board.
Popular name: Act 368
333.7339 Dispensing, selling, or giving product to individual less than 18 years of age;
violation as misdemeanor; penalty.
Sec. 7339. (1) A person shall not dispense, sell, or otherwise give a product described in section
7220(1)(c)(ii) to an individual less than 18 years of age. This section does not apply to a physician or
pharmacist who prescribes, dispenses, administers, or delivers a product described in section 7220(1)(c)(ii) to
an individual less than 18 years of age, to a parent or guardian of an individual less than 18 years of age who
delivers the product to the individual, or to a person authorized by the individual's parent or legal guardian
who dispenses or delivers the product to the individual.
(2) In the course of selling, offering for sale, or otherwise distributing a product described in section
7220(1)(c)(ii), a person shall not advertise or represent in any manner that the product causes euphoria,
ecstasy, a buzz or high, or an altered mental state, heightens sexual performance, or, because it contains
ephedrine alkaloids, increases muscle mass.
(3) A person who violates this section is guilty of a misdemeanor punishable by imprisonment for not more
than 93 days or a fine of not more than $100.00, or both.
History: Add. 1999, Act 144, Eff. Jan. 21, 2000.
Popular name: Act 368
PART 74
OFFENSES AND PENALTIES
333.7401 Manufacturing, creating, delivering, or possessing with intent to manufacture,
create, or deliver controlled substance, prescription form, or counterfeit prescription form;
dispensing, prescribing, or administering controlled substance; violations; penalties;
consecutive terms; discharge from lifetime probation; plant defined.
Sec. 7401. (1) Except as authorized by this article, a person shall not manufacture, create, deliver, or
possess with intent to manufacture, create, or deliver a controlled substance, a prescription form, or a
counterfeit prescription form. A practitioner licensed by the administrator under this article shall not dispense,
prescribe, or administer a controlled substance for other than legitimate and professionally recognized
therapeutic or scientific purposes or outside the scope of practice of the practitioner, licensee, or applicant.
(2) A person who violates this section as to:
(a) A controlled substance classified in schedule 1 or 2 that is a narcotic drug or a drug described in section
7214(a)(iv) and:
(i) Which is in an amount of 1,000 grams or more of any mixture containing that substance is guilty of a
felony punishable by imprisonment for life or any term of years or a fine of not more than $1,000,000.00, or
both.
(ii) Which is in an amount of 450 grams or more, but less than 1,000 grams, of any mixture containing that
substance is guilty of a felony and punishable by imprisonment for not more than 30 years or a fine of not
more than $500,000.00, or both.
(iii) Which is in an amount of 50 grams or more, but less than 450 grams, of any mixture containing that
substance is guilty of a felony punishable by imprisonment for not more than 20 years or a fine of not more
than $250,000.00, or both.
(iv) Which is in an amount less than 50 grams, of any mixture containing that substance is guilty of a
felony punishable by imprisonment for not more than 20 years or a fine of not more than $25,000.00, or both.
(b) Either of the following:
(i) A substance described in section 7212(1)(h) or 7214(c)(ii) is guilty of a felony punishable by
imprisonment for not more than 20 years or a fine of not more than $25,000.00, or both.
(ii) Any other controlled substance classified in schedule 1, 2, or 3, except marihuana is guilty of a felony
punishable by imprisonment for not more than 7 years or a fine of not more than $10,000.00, or both.
(c) A substance classified in schedule 4 is guilty of a felony punishable by imprisonment for not more than
4 years or a fine of not more than $2,000.00, or both.
(d) Marihuana or a mixture containing marihuana is guilty of a felony punishable as follows:
(i) If the amount is 45 kilograms or more, or 200 plants or more, by imprisonment for not more than 15
years or a fine of not more than $10,000,000.00, or both.
(ii) If the amount is 5 kilograms or more but less than 45 kilograms, or 20 plants or more but fewer than
200 plants, by imprisonment for not more than 7 years or a fine of not more than $500,000.00, or both.
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(iii) If the amount is less than 5 kilograms or fewer than 20 plants, by imprisonment for not more than 4
years or a fine of not more than $20,000.00, or both.
(e) A substance classified in schedule 5 is guilty of a felony punishable by imprisonment for not more than
2 years or a fine of not more than $2,000.00, or both.
(f) A prescription form or a counterfeit prescription form is guilty of a felony punishable by imprisonment
for not more than 7 years or a fine of not more than $5,000.00, or both.
(3) A term of imprisonment imposed under subsection (2)(a) may be imposed to run consecutively with
any term of imprisonment imposed for the commission of another felony.
(4) If an individual was sentenced to lifetime probation under subsection (2)(a)(iv) as it existed before
March 1, 2003 and the individual has served 5 or more years of that probationary period, the probation officer
for that individual may recommend to the court that the court discharge the individual from probation. If an
individual's probation officer does not recommend discharge as provided in this subsection, with notice to the
prosecutor, the individual may petition the court seeking resentencing under the court rules. The court may
discharge an individual from probation as provided in this subsection. An individual may file more than 1
motion seeking resentencing under this subsection.
(5) As used in this section, "plant" means a marihuana plant that has produced cotyledons or a cutting of a
marihuana plant that has produced cotyledons.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1987, Act 275, Eff. Mar. 30, 1988;Am. 1988, Act 60, Eff. Aug. 1, 1989;Am.
1989, Act 143, Eff. Sept. 28, 1989;Am. 1994, Act 38, Eff. June 1, 1994;Am. 1994, Act 221, Eff. Mar. 30, 1995;Am. 1996, Act
249, Eff. Jan. 1, 1997;Am. 1998, Act 319, Eff. Oct. 1, 1998;Am. 2000, Act 314, Eff. Jan. 1, 2001;Am. 2001, Act 236, Eff. Jan. 6,
2003;Am. 2002, Act 665, Eff. Mar. 1, 2003;Am. 2002, Act 710, Eff. Apr. 1, 2003;Am. 2010, Act 352, Imd. Eff. Dec. 22, 2010;
Am. 2012, Act 183, Eff. July 1, 2012.
Compiler's note: For transfer of powers and duties of certain health-related functions, boards, and commissions from the Department
of Licensing and Regulation to the Department of Commerce, see E.R.O. No. 1991-9, compiled at MCL 338.3501 of the Michigan
Compiled Laws.
Enacting section 2 of Act 236 of 2001 provides:
Enacting section 2. Sections 7401, 7403, 7407, and 7521 of the public health code, 1978 PA 368, MCL 333.7401, 333.7403,
333.7407, and 333.7521, as amended by this amendatory act, take effect upon promulgation of the rules required under section 7333a of
the public health code, 1978 PA 368, MCL 333.7333a, and receipt by the secretary of state of written notice from the director of the
department of consumer and industry services that the electronic monitoring system required by section 7333a of the public health code,
1978 PA 368, MCL 333.7333a, is operational. The notice to the secretary of state shall include a statement that the department of
consumer and industry services is able to receive data from at least 80% of those required to report under section 7333a of the public
health code, 1978 PA 368, MCL 333.7333a, and is able to respond to requests for data from persons authorized to make such requests
and to review and utilize the data.
The rules required under section 7333a of the public health code, 1978 PA 368, MCL 333.7333a, pertaining to the operation of the
electronic monitoring system, were promulgated on December 30, 2002. In addition, a written notice from the director of the department
of consumer and industry services that the electronic monitoring system required by section 7333a of the public health code is operational
was filed with, and received by, the secretary of state on January 6, 2003.
Popular name: Act 368
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333.7408 Penalty cumulative.
Sec. 7408. A penalty imposed for violation of this article is in addition to, and not in lieu of, a civil or
administrative penalty or sanction otherwise authorized by law.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.7409 Conviction or acquittal under federal law or law of other state as bar to
prosecution.
Sec. 7409. If a violation of this article is a violation of a federal law or the law of another state, a
conviction or acquittal under federal law or the law of another state for the same act is a bar to prosecution in
this state.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.7410 Violations by individual 18 years of age or over who violates MCL 333.7401;
distribution of marihuana; penalties; definitions.
Sec. 7410. (1) Except as otherwise provided in subsections (2) and (3), an individual 18 years of age or
over who violates section 7401(2)(a)(iv) by delivering or distributing a controlled substance listed in schedule
1 or 2 that is either a narcotic drug or described in section 7214(a)(iv) to an individual under 18 years of age
who is at least 3 years the deliverer's or distributor's junior may be punished by the fine authorized by section
7401(2)(a)(iv) or by a term of imprisonment of not less than 1 year nor more than twice that authorized by
section 7401(2)(a)(iv), or both. An individual 18 years of age or over who violates section 7401 or 7401b by
delivering or distributing any other controlled substance listed in schedules 1 to 5 or gamma-butyrolactone to
an individual under 18 years of age who is at least 3 years the distributor's junior may be punished by the fine
authorized by section 7401(2)(b), (c), or (d) or 7401b, or by a term of imprisonment not more than twice that
authorized by section 7401(2)(b), (c), or (d) or 7401b, or both.
(2) An individual 18 years of age or over who violates section 7401(2)(a)(iv) by delivering a controlled
substance described in schedule 1 or 2 that is either a narcotic drug or described in section 7214(a)(iv) to
another person on or within 1,000 feet of school property or a library shall be punished, subject to subsection
(5), by a term of imprisonment of not less than 2 years or more than 3 times that authorized by section
7401(2)(a)(iv) and, in addition, may be punished by a fine of not more than 3 times that authorized by section
7401(2)(a)(iv).
(3) An individual 18 years of age or over who violates section 7401(2)(a)(iv) by possessing with intent to
deliver to another person on or within 1,000 feet of school property or a library a controlled substance
described in schedule 1 or 2 that is either a narcotic drug or described in section 7214(a)(iv) shall be punished,
subject to subsection (5), by a term of imprisonment of not less than 2 years or more than twice that
authorized by section 7401(2)(a)(iv) and, in addition, may be punished by a fine of not more than 3 times that
authorized by section 7401(2)(a)(iv).
(4) An individual 18 years of age or over who violates section 7401b or 7403(2)(a)(v), (b), (c), or (d) by
possessing gamma-butyrolactone or a controlled substance on or within 1,000 feet of school property or a
library shall be punished by a term of imprisonment or a fine, or both, of not more than twice that authorized
by section 7401b or 7403(2)(a)(v), (b), (c), or (d).
(5) The court may depart from the minimum term of imprisonment authorized under subsection (2) or (3)
if the court finds on the record that there are substantial and compelling reasons to do so.
(6) An individual 18 years of age or over who violates section 7401 by manufacturing methamphetamine
as that term is described in section 7214(c)(ii) on or within 1,000 feet of school property or a library shall be
punished by a term of imprisonment or a fine, or both, of not more than twice that authorized by section
7401(2)(b)(i).
(7) A person who distributes marihuana without remuneration and not to further commercial distribution
and who does not violate subsection (1) is guilty of a misdemeanor punishable by imprisonment for not more
than 1 year or a fine of not more than $1,000.00, or both, unless the distribution is in accordance with the
federal law or the law of this state.
(8) As used in this section:
(a) "Library" means a library that is established by the state; a county, city, township, village, school
district, or other local unit of government or authority or combination of local units of government and
authorities; a community college district; a college or university; or any private library open to the public.
(b) "School property" means a building, playing field, or property used for school purposes to impart
instruction to children in grades kindergarten through 12, when provided by a public, private, denominational,
or parochial school, except those buildings used primarily for adult education or college extension courses.
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History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1988, Act 12, Eff. June 1, 1988;Am. 1994, Act 174, Eff. Sept. 1, 1994;Am.
1999, Act 188, Imd. Eff. Nov. 24, 1999;Am. 2000, Act 302, Eff. Jan. 1, 2001;Am. 2006, Act 216, Imd. Eff. June 26, 2006;Am.
2006, Act 552, Eff. Mar. 30, 2007;Am. 2016, Act 128, Eff. Aug. 23, 2016.
Popular name: Act 368
333.7415 Dismissal of case; reduction of charge; plea of guilty, guilty but mentally ill, or nolo
contendere.
Sec. 7415. (1) After the arraignment of a defendant on a warrant charging the defendant with the
commission of any of the offenses specified in section 7401(2)(a)(i) or (ii) or 7403(2)(a)(i) or (ii), or with
conspiracy to commit an offense specified in section 7401(2)(a)(i) or (ii) or 7403(2)(a)(i) or (ii), the
examining magistrate shall not dismiss the case upon motion of the prosecuting attorney unless the dismissal
is with prejudice, nor shall the examining magistrate permit the prosecuting attorney to reduce the charge if it
appears to the examining magistrate at the conclusion of the preliminary examination that 1 or more of the
offenses set forth in this subsection was committed and that there is probable cause for charging the defendant
with a violation of 1 or more of the offenses.
(2) At or after the arraignment of a defendant on an indictment or information charging the defendant with
the commission of any of the offenses specified in section 7401(2)(a)(i) or (ii) or 7403(2)(a)(i) or (ii), or with
conspiracy to commit an offense specified in section 7401(2)(a)(i) or (ii) or 7403(2)(a)(i) or (ii), the court in
which the indictment or information is filed shall not dismiss the case upon motion of the prosecuting attorney
unless the dismissal is with prejudice, and the court shall not accept a plea of guilty, guilty but mentally ill, or
nolo contendere unless, with the consent of the prosecuting attorney on the record, the defendant enters a plea
of guilty, guilty but mentally ill, or nolo contendere to not less than 1 of the following felonies:
(a) An offense described in section 7401(2)(a)(i), (ii), (iii), or (iv).
(b) An offense described in section 7403(2)(a)(i), (ii), (iii), or (iv).
(c) Conspiracy to commit an offense described in subdivision (a) or (b).
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1988, Act 144, Imd. Eff. June 6, 1988.
Popular name: Act 368
333.7417 Product producing same or similar effect as scheduled ingredient; sale or offer to
sell prohibited; violation; penalty; "named product" defined.
Sec. 7417. (1) A person who knows that a named product contains or previously contained an ingredient
that was designated to be a schedule 1 controlled substance shall not sell or offer to sell any other product
while representing that it contains an ingredient that produces the same or a substantially similar physiological
or psychological effect as that scheduled ingredient. This subsection does not apply to a product approved by
the federal food and drug administration.
(2) A person who violates this section is guilty of a felony punishable by imprisonment for not more than 4
years or a fine of not more than $20,000.00, or both.
(3) As used in this section, "named product" means either of the following:
(a) A product having a designated brand name.
(b) A product having a street or common name with application sufficient to identify the product as a
specific product within this state or within a local unit of government.
History: Add. 2012, Act 183, Eff. July 1, 2012.
Popular name: Act 368
***** 333.7422 THIS SECTION IS AMENDED EFFECTIVE MARCH 28, 2017: See 333.7422.amended
*****
333.7422 Compliance with MCL 333.17744b; prescribing, dispensing, possessing, or
administering opioid-antagonist; person not in violation of article.
Sec. 7422. A person that complies with section 17744b is not in violation of this article with regard to the
prescribing, dispensing, possessing, or administering an opioid antagonist as authorized in that section.
History: Add. 2014, Act 313, Imd. Eff. Oct. 14, 2014.
Popular name: Act 368
***** 333.7422.amended THIS AMENDED SECTION IS EFFECTIVE MARCH 28, 2017 *****
333.7422.amended Compliance with MCL 333.17744b or MCL 333.17744e; prescribing,
dispensing, possessing, or administering opioid antagonist; person not in violation of
article.
Sec. 7422. A person that complies with section 17744b or 17744e is not in violation of this article with
regard to the prescribing, dispensing, possessing, or administering an opioid antagonist as authorized in either
of those sections.
History: Add. 2014, Act 313, Imd. Eff. Oct. 14, 2014;Am. 2016, Act 383, Eff. Mar. 28, 2017.
Popular name: Act 368
PART 75
ENFORCEMENT AND ADMINISTRATION
333.7501 Arrest without warrant.
Sec. 7501. A sheriff, deputy sheriff, or local or state police officer who has reasonable cause to believe that
a violation of this article punishable by imprisonment for 1 year or more has taken place or is taking place and
reasonable cause to believe that an individual has committed or is committing the violation, may arrest that
individual without a warrant for that violation whether or not the violation was committed in the law
enforcement officer's presence.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Compiler's note: For transfer of powers and duties of certain health-related functions, boards, and commissions from the Department
of Licensing and Regulation to the Department of Commerce, see E.R.O. No. 1991-9, compiled at MCL 338.3501 of the Michigan
Compiled Laws.
Popular name: Act 368
333.7505 Contents, execution, and return of warrant; copy of warrant and receipt for
property seized; inventory of property taken; delivering copy of inventory; filing warrant
with copy of return and papers returnable.
Sec. 7505. (1) The warrant shall:
(a) State the grounds for its issuance and the name of each person whose affidavit has been taken in
support thereof.
(b) Be directed to a person described in section 7502.
(c) Command the person to whom it is directed to inspect the area, premises, building, or conveyance
identified for the purpose specified and, if appropriate, direct the seizure of the property specified.
(d) Identify the item or types of property to be seized, if any.
(e) Designate the magistrate to whom it shall be returned.
(2) A warrant issued pursuant to this section shall be executed and returned within 10 days after its date
unless, upon a showing of a need for additional time, the court orders otherwise. If property is seized pursuant
to a warrant, a copy shall be given to the person from whom or from whose premises the property is taken,
together with a receipt for the property taken. The return of the warrant shall be made promptly, accompanied
by a written inventory of any property taken. The inventory shall be made in the presence of the person
executing the warrant and of the person from whose possession or premises the property was taken, if present,
or in the presence of at least 1 credible person other than the person executing the warrant. A copy of the
inventory shall be delivered to the person from whom or from whose premises the property was taken and to
the applicant for the warrant.
(3) The magistrate who issues a warrant shall attach thereto a copy of the return and all papers returnable
in connection therewith and file them with the clerk of the magistrate's court in which the inspection was
made.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.7515 Cooperation with federal and other state agencies; relying and acting upon results,
information, and evidence.
Sec. 7515. (1) The administrator may cooperate with federal and other state agencies in discharging its
responsibilities as to traffic in controlled substances and in suppressing the abuse of controlled substances. To
this end, the administrator may:
(a) Arrange for the exchange of information among governmental officials as to the use and abuse of
controlled substances.
(b) Coordinate and cooperate in training programs as to controlled substance law enforcement at local and
state levels.
(c) Cooperate with the bureau by establishing a centralized unit to accept, catalogue, file, and collect
statistics, including records of drug dependent individuals and other controlled substance law offenders in this
state, and make the information available for federal, state, and local law enforcement purposes. The
administrator shall not furnish the name or identity of a patient or research subject whose identity could not be
obtained under section 7516.
(d) Conduct programs of eradication aimed at destroying wild or illicit growth of plant species from which
controlled substances may be extracted.
(2) Results, information, and evidence received from the bureau relating to the regulatory functions of this
article, including results of inspections conducted by it, may be relied and acted upon by the disciplinary
subcommittee in the exercise of its regulatory functions under this article.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1993, Act 80, Eff. Apr. 1, 1994.
Popular name: Act 368
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333.7516 Name or identity of patient, research, or individual.
Sec. 7516. A practitioner engaged in professional practice or research is not required or compelled to
furnish the name or identity of a patient or research subject to the practitioner's licensing agency, and may not
be compelled in any state or local civil, criminal, administrative, legislative, or other proceeding to furnish the
name or identity of an individual that the practitioner is obligated to keep confidential.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.7524 Disposition of forfeited property; donation of lights and scales for education
purposes; appointment, compensation, and authority of receiver to dispose of forfeited
real property; expenses of forfeiture proceedings; court order.
Sec. 7524. (1) When property is forfeited under this article, the local unit of government that seized the
property may do any of the following, or if the property is seized by or in the custody of the state, the state
may do any of the following, subject to section 7523(1)(d):
(a) Retain it for official use.
(b) Sell that which is not required to be destroyed by law and which is not harmful to the public. The
proceeds and any money, negotiable instruments, securities, or any other thing of value as described in section
7521(1)(f) that are forfeited under this article shall be deposited with the treasurer of the entity having
budgetary authority over the seizing agency and applied as follows:
(i) For the payment of proper expenses of the proceedings for forfeiture and sale, including expenses
incurred during the seizure process, maintenance of custody, advertising, and court costs, except as otherwise
provided in subsection (4).
(ii) The balance remaining after the payment of expenses shall be distributed by the court having
jurisdiction over the forfeiture proceedings to the treasurer of the entity having budgetary authority over the
seizing agency. If more than 1 agency was substantially involved in effecting the forfeiture, the court having
jurisdiction over the forfeiture proceeding shall equitably distribute the money among the treasurers of the
entities having budgetary authority over the seizing agencies. A seizing agency may direct that the funds or a
portion of the funds it would otherwise have received under this subsection be paid to nonprofit organizations
whose primary activity is to assist law enforcement agencies with drug-related criminal investigations and
obtaining information for solving crimes. The money received by a seizing agency under this subparagraph
and all interest and other earnings on money received by the seizing agency under this subparagraph shall be
used only for law enforcement purposes, as appropriated by the entity having budgetary authority over the
seizing agency. A distribution made under this subparagraph shall serve as a supplement to, and not a
replacement for, funds otherwise budgeted for law enforcement purposes.
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(c) Require the administrator to take custody of the property and remove it for disposition in accordance
with law.
(d) Forward it to the bureau for disposition.
(2) Notwithstanding subsection (1), this state or local units of government may donate lights for plant
growth or scales forfeited under this article to elementary or secondary schools or institutions of higher
education that request in writing to receive those lights or scales pursuant to this subsection, for educational
purposes. This state or local units of government shall donate lights and scales under this subsection to
elementary or secondary schools or institutions of higher education in the order in which the written requests
are received. This state or local units of government may limit the number of lights and scales available to
each requestor.
(3) In the course of selling real property under subsection (1)(b), the court that has entered an order of
forfeiture may, on motion of the agency to whom the property has been forfeited, appoint a receiver to
dispose of the real property forfeited. The receiver shall be entitled to reasonable compensation. The receiver
shall have authority to do all of the following:
(a) List the forfeited real property for sale.
(b) Make whatever arrangements are necessary for the maintenance and preservation of the forfeited real
property.
(c) Accept offers to purchase the forfeited real property.
(d) Execute instruments transferring title to the forfeited real property.
(4) If a court enters an order of forfeiture, the court may order a person who claimed an interest in the
forfeited property under section 7523(1)(c) to pay the expenses of the proceedings of forfeiture to the entity
having budgetary authority over the seizing agency.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1982, Act 251, Imd. Eff. Sept. 29, 1982;Am. 1985, Act 135, Imd. Eff. Sept. 30,
1985;Am. 1988, Act 7, Imd. Eff. Feb. 8, 1988;Am. 1990, Act 30, Eff. Mar. 28, 1991;Am. 1990, Act 336, Eff. Apr. 1, 1991;Am.
1994, Act 8, Imd. Eff. Feb. 24, 1994;Am. 2006, Act 558, Imd. Eff. Dec. 29, 2006;Am. 2011, Act 161, Imd. Eff. Oct. 4, 2011.
Popular name: Act 368
333.7524b Report by agency of seizure and forfeiture activities under uniform forfeiture
reporting act.
Sec. 7524b. (1) Beginning February 1, 2016, each reporting agency shall report all seizure and forfeiture
activities under this article to the department of state police as required under the uniform forfeiture reporting
act.
(2) Beginning February 1, 2016, each reporting agency is subject to audit as required under the uniform
forfeiture reporting act.
(3) As used in this section, "reporting agency" means that term as defined in section 7 of the uniform
forfeiture reporting act.
History: Add. 2015, Act 151, Eff. Feb. 1, 2016.
Popular name: Act 368
333.7525 Controlled substance as contraband; seizure and summary forfeiture; seizure and
forfeiture of species of plants.
Sec. 7525. (1) A controlled substance listed in schedule 1 that is possessed, transferred, sold, or offered for
sale in violation of this article is contraband and shall be seized and summarily forfeited to this state. A
controlled substance listed in schedule 1 which is seized or comes into the possession of this state, the owner
of which is unknown, is contraband and shall be summarily forfeited to this state.
(2) Species of plants from which controlled substances in schedules 1 and 2 may be derived which have
been planted or cultivated in violation of this article, or of which the owner or cultivator is unknown, or which
are wild growths, may be seized and summarily forfeited to this state.
(3) The failure, upon demand by the administrator or its authorized agent, of the person in occupancy or in
control of land or premises upon which the species of plants are growing or being stored to produce an
appropriate license or proof that he or she is the holder thereof, constitutes authority for the seizure and
forfeiture of the plants.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
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333.7527 Destruction of controlled substance seized as evidence.
Sec. 7527. (1) Prior to trial the prosecuting attorney may move in writing for an order permitting the
destruction of all or part of a controlled substance, controlled substance analogue, counterfeit substance, or
imitation controlled substance seized as evidence in connection with a violation of this article. The motion
shall specify the reasons supporting the destruction. The prosecuting attorney shall serve a copy of the
motion, and any supporting materials, on the defendant or his or her attorney.
(2) If the defendant objects, the defendant or his or her attorney shall file specific objections within 21 days
after receiving the motion described in subsection (1). Failing to comply with this time limit waives any
objection to the destruction of the evidence.
(3) Before any hearing on the motion, the defendant or his or her attorney shall have an adequate
opportunity to inspect or test, or both, the evidence sought to be destroyed, subject to reasonable supervision
by laboratory or law enforcement personnel.
(4) Following a hearing, the court may order destruction of all or part of the controlled substance,
controlled substance analogue, counterfeit substance, or imitation controlled substance if the court determines
on the record that the destruction is warranted. The court shall specify the evidence to be destroyed and may
include further provisions in the order as the interests of justice require.
(5) The law enforcement agency having custody of the evidence shall destroy the controlled substance,
controlled substance analogue, counterfeit substance, or imitation controlled substance in accordance with an
order entered under subsection (4). Before destroying the evidence, the law enforcement agency shall make an
accurate photographic record of the controlled substance, controlled substance analogue, counterfeit
substance, or imitation controlled substance. The court may order that further records be made before the
evidence is destroyed.
History: Add. 1993, Act 289, Eff. Apr. 1, 1994.
Popular name: Act 368
ARTICLE 8
PHARMACEUTICAL-GRADE CANNABIS
PART 81
GENERAL PROVISIONS
333.8101 Meanings of words and phrases.
Sec. 8101. (1) For purposes of this article, the words and phrases defined in sections 8103 to 8107 have the
meanings ascribed to them in those sections.
(2) In addition, article 1 contains general definitions and principles of construction applicable to all articles
in this act.
History: Add. 2013, Act 268, Imd. Eff. Dec. 30, 2013.
Popular name: Act 368
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333.8103 Definitions; A to G.
Sec. 8103. (1) "Applicant" means the person submitting an application for a new license or license renewal
under part 82 and includes each individual identified in the application as an owner, operator, officer, director,
partner, member, or manager of the applicant.
(2) "CBD" and "CBD acid" mean cannabidiol and cannabidiol acid.
(3) "Department" means the department of licensing and regulatory affairs.
(4) "Director" means the director of the department.
(5) "Eligible patient" means an individual who meets the requirements of part 84 and has been issued an
enhanced pharmaceutical-grade cannabis registration card.
(6) "Enhanced pharmaceutical-grade cannabis registration card" or "registration card" means the
registration card issued to an eligible patient under part 84.
(7) "Good moral character" means that term as defined in section 1 of 1974 PA 381, MCL 338.41.
History: Add. 2013, Act 268, Imd. Eff. Dec. 30, 2013.
Popular name: Act 368
333.8105 Definitions; M to P.
Sec. 8105. (1) "Marihuana" means that term as defined in section 7106 and includes pharmaceutical-grade
cannabis.
(2) "Medical use" means the purchase, sale, possession, use, internal possession, delivery, transfer, or
transportation of pharmaceutical-grade cannabis or paraphernalia relating to the administration of
pharmaceutical-grade cannabis to treat or alleviate an eligible patient's debilitating medical condition.
(3) "Michigan medical marihuana act" means the Michigan medical marihuana act, 2008 IL 1, MCL
333.26421 to 333.26430.
(4) "Pharmaceutical-grade cannabis" means a grade of cannabis that is cultivated for the purposes of this
article; that is free of chemical residues such as fungicides and insecticides and is tested by validated methods
to determine its cannabinoid levels, specifically, THC and THC acid levels and CBD and CBD acid levels and
complies with the standards set forth in section 8303(6) for its microbial, mycotoxin, and metal contents,
including heavy metals; and that meets any other necessary requirements to be considered in compliance with
good manufacturing practices as prescribed in rules promulgated by the department under this article.
(5) "Pharmaceutical-grade cannabis fund" or "fund" means the pharmaceutical-grade cannabis fund created
in section 8113.
(6) "Pharmaceutical-grade cannabis licensed facility" or "licensed facility" means any secure entity,
operation, or facility at or through which pharmaceutical-grade cannabis is manufactured, cultivated, and
tested in this state for lawful medical use as provided for in this article and the Michigan medical marihuana
act. Pharmaceutical-grade cannabis licensed facility does not include a qualifying patient or primary caregiver
who possesses or cultivates marihuana in the manner prescribed in the Michigan medical marihuana act or an
eligible patient who possesses pharmaceutical-grade cannabis in the manner prescribed in this article.
History: Add. 2013, Act 268, Imd. Eff. Dec. 30, 2013.
Popular name: Act 368
333.8107 Definitions; Q to T.
Sec. 8107. (1) "Qualifying patient" means an individual who has been issued a registry identification card
as a qualifying patient under the Michigan medical marihuana act.
(2) "THC" means delta-9-tetrahydrocannabinol and tetrahydrocannabinol acid.
History: Add. 2013, Act 268, Imd. Eff. Dec. 30, 2013.
Popular name: Act 368
333.8111 Fees.
Sec. 8111. (1) Beginning on the effective date of this article, the director may charge a reasonable fee for
licensing, registration, inspection, testing, investigation, or other activity or service provided by the
department under this article. The fee authorized under this subsection is in addition to any fee authorized
under article 7. All fees permitted under this section shall be delivered to the state treasurer on a monthly
basis for deposit in the pharmaceutical-grade cannabis fund.
(2) Before collecting a fee under this article, the department shall develop and publish a comprehensive
schedule of fees. The schedule shall include a description of each activity or service and the maximum fee
charged for that activity or service. The department shall include a statement of the rationale used in
determining the fees contained in the schedule. The department shall revise the fee schedule from time to time
so that the amount of fees collected under this article does not exceed the amount necessary to fund the duties
of the department under this article.
History: Add. 2013, Act 268, Imd. Eff. Dec. 30, 2013.
Popular name: Act 368
333.8115 Rules.
Sec. 8115. (1) Subject to subsection (2), the department shall promulgate rules necessary to carry out this
article. The rules shall address, but are not required to be limited to addressing, all of the following subjects:
(a) If not specifically provided for in this article, activities necessary for the compliance with or
enforcement of or activities that constitute a violation of this article, including, but not limited to, procedures
and grounds for denying, suspending, or revoking a license or registration card under this article.
(b) Instructions for access by local health departments and law enforcement officers.
(c) All forms necessary or convenient for the implementation, administration, and enforcement of this
article.
(d) Activities that constitute or result in misrepresentation or unfair, deceptive practices.
(e) Procedures and forms for issuing enhanced pharmaceutical-grade cannabis registration cards.
(f) Regulating the manufacturing, inventory, storage, disposal, and sale of pharmaceutical-grade cannabis
and specifying legitimate sources for obtaining seed to cultivate pharmaceutical-grade cannabis.
(g) The quarterly reporting by licensed facilities of their inventory, which shall include the number of
plants under cultivation, the amount of dried plant material, the amount of destroyed plants, and all sales.
(h) Compliance with federal regulatory requirements.
(i) Health and sanitary requirements for licensed facilities.
(j) Record keeping, record retention, record storage, and record security requirements for
pharmaceutical-grade cannabis licensed facilities.
(k) Audit requirements for licensed facilities, which shall include self reporting of inventory on a monthly
basis, subject to inspection by designated state and federal authorities.
(l) Physical security requirements for pharmaceutical-grade cannabis that at a minimum include lighting
and alarms.
(m) The reporting and transmittal of monthly sales and income tax payments for licensed facilities.
(n) Authorization for the department of treasury to have access to licensing information to ensure sales and
income tax payments for licensed facilities.
(o) Activities that constitute lawful and unlawful financial arrangements between licensed facilities.
(p) The quantity of pharmaceutical-grade cannabis plants and dried plant material that a licensed facility
may possess in its inventory at any time.
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(q) Other matters necessary for the fair, impartial, stringent, and comprehensive implementation,
administration, and enforcement of this article to protect the health, safety, and welfare of the residents of this
state.
(2) The department of licensing and regulatory affairs may begin promulgation of the rules required under
this article at the time marihuana, including pharmaceutical-grade cannabis, is rescheduled by federal
authority. However, implementation and enforcement of this article shall not occur sooner than 180 days after
that federal authority reschedules marihuana.
History: Add. 2013, Act 268, Imd. Eff. Dec. 30, 2013.
Popular name: At 368
PART 81A
PRESCRIBING AND DISPENSING PHARMACEUTICAL-GRADE CANNABIS
333.8151 Recommendation by physician.
Sec. 8151. A physician who determines that his or her patient is likely to receive therapeutic or palliative
benefit from the use of pharmaceutical-grade cannabis to treat or alleviate the patient's debilitating medical
condition or symptoms of the patient's debilitating medical condition may recommend the issuance of an
enhanced pharmaceutical-grade cannabis registration card to that patient as an eligible patient.
History: Add. 2013, Act 268, Imd. Eff. Dec. 30, 2013.
Popular name: Act 368
PART 82
FACILITY LICENSING
333.8201 Licensing; purpose.
Sec. 8201. To protect the health, safety, and welfare of residents of this state, the department shall license
facilities under this article to cultivate, manufacture, and test pharmaceutical-grade cannabis in this state. The
department shall implement, administer, and enforce this article to ensure that a safe, pure, dosage-consistent
grade of pharmaceutical-grade cannabis is available to eligible patients who are residents of this state.
History: Add. 2013, Act 268, Imd. Eff. Dec. 30, 2013.
Popular name: Act 368
PART 83
PHARMACEUTICAL-GRADE CANNABIS LICENSED FACILITY OPERATIONS
333.8301 Physical location.
Sec. 8301. A pharmaceutical-grade cannabis licensed facility shall establish legal control of its physical
location. The physical location shall meet all applicable state and local zoning laws.
History: Add. 2013, Act 268, Imd. Eff. Dec. 30, 2013.
Popular name: Act 368
333.8307 Operation.
Sec. 8307. A pharmaceutical-grade cannabis licensed facility may operate on any calendar days of the
week, but shall do all of the following:
(a) Prohibit smoking or consumption of marihuana on its premises.
(b) Maintain all records required under this article on its premises.
(c) Make the licensed premises available for inspection and search by the department, by law enforcement
officers, and by any other state, federal, or local governmental agency authorized by law or department rule to
inspect the premises of the licensed facility under this act, during regular business hours and when the
licensed premises are occupied by the licensee or a clerk, servant, agent, or employee of the licensee.
Evidence of a violation of this act or rules promulgated under this act discovered under this subsection may be
seized and used in an administrative or court proceeding.
History: Add. 2013, Act 268, Imd. Eff. Dec. 30, 2013.
Popular name: Act 368
333.8309 Liability.
Sec. 8309. In addition to the provisions of section 2946 of the revised judicature act of 1961, 1961 PA 236,
MCL 600.2946, in a product liability action against a pharmaceutical-grade cannabis licensed facility,
pharmaceutical-grade cannabis is not defective or unreasonably dangerous, and the pharmaceutical-grade
cannabis licensed facility is not liable, if the product sold was tested and determined to meet the standards for
pharmaceutical-grade cannabis under this article.
History: Add. 2013, Act 268, Imd. Eff. Dec. 30, 2013.
Popular name: Act 368
PART 84
SALE AND DISTRIBUTION OF PHARMACEUTICAL-GRADE CANNABIS
333.8401 Sale or distribution; requirements; report.
Sec. 8401. (1) A pharmaceutical-grade cannabis licensed facility shall not sell or otherwise distribute
pharmaceutical-grade cannabis except as provided in this section.
(2) A pharmaceutical-grade cannabis licensed facility shall not sell or otherwise distribute
pharmaceutical-grade cannabis directly to the public.
(3) A pharmaceutical-grade cannabis licensed facility shall sell pharmaceutical-grade cannabis only to
pharmacies licensed in this state to be dispensed only to eligible patients and to other pharmaceutical-grade
cannabis licensed facilities for purposes provided for under this article. Pharmaceutical-grade cannabis
dispensed by a pharmacist or retail pharmacy licensed in this state shall have affixed upon each package and
container in which the cannabis is contained a label showing in legible English the name and address of the
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manufacturer, the date the prescription is filled, the dosage, including the total percentage of THC and total
percentage of CBD, the name of the patient, and the name and address of the dispensing pharmacy.
(4) A pharmaceutical-grade cannabis licensed facility may sell or otherwise distribute
pharmaceutical-grade cannabis to pharmacies for sale or distribution only to eligible patients as provided in
this article.
(5) A pharmaceutical-grade cannabis licensed facility shall report to the department on a quarterly basis all
quantities of pharmaceutical-grade cannabis sold to licensed pharmacists, retail pharmacies, and other
pharmaceutical-grade cannabis licensed facilities. The report shall be in writing and shall include the name
and address of each pharmacist, retail pharmacy, and pharmaceutical-grade cannabis licensed facility to which
the pharmaceutical-grade cannabis is sold. A report under this sub-section may be transmitted electronically,
if the transmission is ultimately reduced to writing.
History: Add. 2013, Act 268, Imd. Eff. Dec. 30, 2013.
Popular name: Act 368
PART 85
ENFORCEMENT
333.8501 Enforcement; inspection; finding of emergency; suspension of license; order.
Sec. 8501. (1) The department shall enforce this article and the applicable provisions of article 7 and shall
conduct at least 1 inspection of each pharmaceutical-grade cannabis licensed facility during the term of its
license to ensure compliance with the requirements of this article and article 7.
(2) Upon a finding that an emergency exists requiring immediate action to protect the public health, safety,
and welfare, the department may issue an order to suspend the license of a pharmaceutical-grade cannabis
licensed facility without notice or hearing. The order shall recite the existence of the emergency and the facts
supporting a determination of the need to protect public health, safety, and welfare. Notwithstanding this act
or the administrative procedures act of 1969, the order shall be effective immediately. A person to whom the
order is directed shall comply immediately but, on application to the department, shall be afforded a hearing
within 15 days. On the basis of the hearing, the order of summary suspension shall be continued, modified, or
dissolved not later than 30 days after the hearing.
History: Add. 2013, Act 268, Imd. Eff. Dec. 30, 2013.
Popular name: Act 368
333.8503 Suspension or revocation of facility license; oaths and subpoenas; notice; fees;
summary suspension.
Sec. 8503. (1) In addition to any other penalties prescribed or remedies provided in this article, article 7,
and article 15, the department may, on its own motion or on receipt of a complaint, and after an investigation
and a hearing before an administrative law judge at which the pharmaceutical-grade cannabis licensed facility
licensee is afforded an opportunity to be heard, suspend or revoke a facility license issued under this article.
The department may suspend or revoke a license for any violation by the licensee, a board member, an agent,
or an employee of the licensed facility or of any of the terms, conditions, or provisions of the license issued
by the department. The department may administer oaths and issue subpoenas to require the presence of
persons and the production of papers, books, and records necessary to the determination of any hearing that
the department is authorized to conduct.
(2) The department shall provide notice of suspension or revocation, as well as any required notice of a
hearing, by mailing the same in writing to the licensed facility at the address contained in the license. If a
license is suspended or revoked, no part of the fees paid for the license under this article or under article 7
shall be returned to the licensee. The department may summarily suspend a license without notice pending
any prosecution, investigation, or public hearing.
History: Add. 2013, Act 268, Imd. Eff. Dec. 30, 2013.
Popular name: Act 368
ARTICLE 9
SUPPORTIVE PERSONAL HEALTH SERVICES
PART 91
GENERAL PROVISIONS
333.9101 Plan for health services for pupils in elementary and secondary schools;
establishment; contents; cooperation in developing plan; consistency with program of
school nursing services; employment of certified school nurses; excusing pupils from
health instructions and class attendance.
Sec. 9101. (1) The department shall establish a plan for health services for pupils in the elementary and
secondary schools of this state. The plan shall include a definition of school health services and standards for
the implementation of the plan. The department shall cooperate with the department of education and the state
health planning and development agency in developing the plan to ensure coordination among those agencies.
(2) The plan may include the provision of health services by and through intermediate and local school
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districts.
(3) The plan shall be consistent with the program of school nursing services adopted pursuant to section
1252 of Act No. 451 of the Public Acts of 1976, being section 380.1252 of the Michigan Compiled Laws, and
shall encourage employment of individuals certified by the department of education as school nurses pursuant
to that section.
(4) The plan shall not require health instructions for a pupil whose parent or guardian objects in writing
and specifically requests that the pupil be excused. The plan shall not require a pupil to attend a class for
which the pupil is excused pursuant to Act No. 451 of the Public Acts of 1976, as amended, being sections
380.1 to 380.1853 of the Michigan Compiled Laws.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Compiler's note: For transfer of certain powers and duties of the bureau of child and family services, with the exception of the
women, infants, and children division, from the department of public health to the director of the department of community health, see
E.R.O. No. 1996-1, compiled at MCL 330.3101 of the Michigan Compiled Laws.
Popular name: Act 368
333.9111 Pharmaceutical, biologic, and diagnostic products and by-products for human,
veterinary, or agricultural use; developing, producing, purchasing, and receiving by gift;
research; distribution; costs.
Sec. 9111. (1) The department may develop, produce, purchase, and receive by gift pharmaceutical,
biologic, and diagnostic products and by-products for human, veterinary, or agricultural use. The department,
when necessary, may engage in research to improve these products or develop new products. The department
may distribute the products and by-products within this state and recover the actual costs associated with the
products and by-products. The department shall provide and distribute these products and by-products at no
cost upon request of local health departments, hospitals, or physicians for use within this state if considered
necessary by the department to protect the public health.
(2) The department may develop and produce pharmaceutical, biologic, and diagnostic products and
by-products for human, veterinary, or agricultural use for distribution or sale outside this state for both public
and private use, if the distribution or sale will not impair any program in this state. Compensation for these
products and by-products distributed or sold under this subsection shall cover the actual costs associated with
the products and by-products. Distribution outside this state may be made without cost if approved by the
governor in emergency situations and if the products and by-products are available and are not required for
immediate needs in this state.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1986, Act 204, Imd. Eff. July 25, 1986.
Popular name: Act 368
333.9121 Blood, blood plasma, blood products, blood derivatives, and human and artificial
tissues; standards regulating procurement, processing, distribution, and use; rendition of
service; warranty; liability.
Sec. 9121. (1) The department shall establish standards pursuant to section 9133 to regulate the
procurement, processing, distribution, and use of blood, blood plasma, blood products, blood derivatives, and
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human and artificial tissues.
(2) The procurement, processing, distribution, and use of whole blood, blood plasma, blood products,
blood derivatives, and human and artificial tissues including, but not limited to, corneas, bones, organs, or
parts of organs for the purpose of injecting, transfusing, or transplanting into a human body, is for all purposes
the rendition of a service by a person participating therein and, whether or not remuneration is paid to the
person, is not a sale for any purpose.
(3) An express, implied, or other warranty does not attach to services described in subsection (2). A person
involved in the rendition of the service is not liable as a result thereof, except for the person's own negligence
or willful misconduct.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1984, Act 390, Eff. Mar. 29, 1985;Am. 1988, Act 63, Imd. Eff. Mar. 24, 1988.
Popular name: Act 368
333.9123 Testing of donor, sample, specimen, or organ for presence of HIV or antibody to
HIV; applicability of subsection (1); effect of positive test results; inability to perform test;
written consent to use blood, tissue, organ, or other human specimen; donation of blood
exclusively for own use; use of self-replicating body fluids; informing donor of positive
test result; violation; liability; definitions.
Sec. 9123. (1) Except as otherwise provided in subsection (2), a person, including, but not limited to, a
licensee under article 15 or article 17 who procures or collects blood or human tissues, organs, or other
specimens for purposes of transplantation, transfusion, introduction, or injection into a human body shall test
or provide for the testing of each potential donor or each sample or specimen of blood or tissue, or each organ
or other human specimen for the presence in the donor, sample, specimen, or organ of HIV or an antibody to
HIV.
(2) Subsection (1) does not apply if a test for HIV or an antibody to HIV cannot be performed in the time
during which the blood, tissue, organ, or other human specimen is viable for purposes of transplantation,
transfusion, introduction, or injection into a human body, due to emergency or other exigent circumstances.
(3) Except as otherwise provided in subsection (4), if the results of a test performed under subsection (1)
are positive, the blood, tissue, organ, or other human specimen shall not be used for purposes of
transplantation, transfusion, introduction, or injection into a human body. If a test for HIV or an antibody to
HIV cannot be performed in the time during which the blood, tissue, organ, or other human specimen is viable
for purposes of transplantation, transfusion, introduction, or injection into a human body, due to emergency or
other exigent circumstances, then the blood, tissue, organ, or other human specimen may be used for purposes
of transplantation, transfusion, introduction, or injection into a human body if the person responsible for the
transplantation, transfusion, introduction, or injection and the person who intends to receive the blood, tissue,
organ, or other human specimen have been informed that there was insufficient time to perform a test for HIV
or an antibody to HIV, and have agreed in writing to the use of the blood, tissue, organ, or other human
specimen. If the person who intends to receive the blood, tissue, organ, or other human specimen is a minor,
then the parent, legal guardian, or person in loco parentis of the minor shall have been informed that there was
insufficient time to perform a test for HIV or an antibody to HIV and shall have agreed in writing to the use of
the blood, tissue, organ, or other human specimen. If the person who intends to receive the blood, tissue,
organ, or other human specimen is otherwise unable to give informed consent, then any of the following
persons, in order of priority stated, when persons in prior classes are not available at the time the
transplantation, transfusion, introduction, or injection is to be performed, shall have been informed that there
was insufficient time to perform a test for HIV or an antibody to HIV and shall have agreed in writing to the
use of the blood, tissue, organ, or other human specimen:
(i) The spouse.
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(ii) An adult son or daughter.
(iii) Either parent.
(iv) An adult brother or sister.
(v) A guardian of the person at the time the transplantation, transfusion, introduction, or injection is to be
performed.
(4) If a person donates blood exclusively for his or her own transfusion needs, and if the results of a test
performed under subsection (1) are positive, the person may use the blood for that purpose if both the person
responsible for the transfusion and the person who intends to receive the blood have been informed of the
positive test result and have consented in writing to the use of the blood.
(5) A person, including, but not limited to, a licensee under article 15 or article 17, who procures or
collects self-replicating body fluids for purposes of introduction into a human body shall test each potential
donor, and, if the donor donates on a regular basis, not less than every 3 months, for the presence in the donor
of HIV or an antibody to HIV. If at any time the test results are positive, the self-replicating body fluids of the
donor shall not be used for introduction into a human body.
(6) A person, including, but not limited to, a licensee under article 15 or article 17 who orders or performs,
or both, a test for HIV or an antibody to HIV under this section shall, if the test result is positive, inform the
donor of the positive test result. For purposes of this subsection, a positive test result is a double positive
enzyme-linked immunosorbent assay test, combined with a positive western blot assay test, or a positive
result under an HIV test that is considered reliable by the federal centers for disease control and is approved
by the department.
(7) A person who violates this section shall be liable in a civil action for damages for the loss or damage
resulting from the violation.
(8) As used in this section:
(a) Blood includes whole blood, blood plasma, blood products, and blood derivatives.
(b) HIV means human immunodeficiency virus.
(c) Self-replicating body fluids means bodily fluids that are reproduced by the body including, but not
limited to, breast milk. Self-replicating body fluids does not include blood or sperm.
History: Add. 1988, Act 487, Eff. July 1, 1989.
Popular name: Act 368
333.9132 Consent of minor to provision of health care; notice; permission to contact parents
for additional medical information; giving or withholding information without consent of
minor; health care defined.
Sec. 9132. (1) If a minor consents to the provision of prenatal and pregnancy related health care or to the
provision of health care for a child of the minor by a health facility or agency licensed under article 17 or a
health professional licensed under article 15, the consent shall be valid and binding as if the minor had
achieved the age of majority. The consent is not subject to later disaffirmance by reason of minority. The
consent of any other person, including the putative father of the child or a spouse, parent, guardian, or person
in loco parentis, is not necessary to authorize the provision of health care to a minor or to a child of a minor.
(2) Before providing health care to a minor pursuant to this section, a health facility or agency or a health
professional shall inform the minor that the putative father of the child or the minor's spouse, parent, guardian,
or person in loco parentis may be notified pursuant to subsection (4).
(3) At the initial visit to the health facility or health professional, permission shall be requested of the
minor to contact the minor's parents for any additional medical information which may be necessary or
helpful to the provision of proper health care.
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(4) For medical reasons, the treating physician, and on the advice and direction of the treating physician, a
member of the medical staff of a health facility or agency or other health professional may, but is not
obligated to, inform the putative father of the child or the spouse, parent, guardian, or person in loco parentis
as to the health care given or needed. The information may be given to or withheld from these persons
without consent of the minor and notwithstanding the express refusal of the minor to the providing of the
information.
(5) As used in this section, health care means only treatment or services intended to maintain the life and
improve the health of both the minor and the minor's child or fetus.
History: Add. 1984, Act 153, Imd. Eff. June 25, 1984.
Popular name: Act 368
333.9133 Rules.
Sec. 9133. The department may promulgate rules to implement this part which shall include rules to
establish the plan developed under section 9101 and to implement sections 9121 and 9131.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
Administrative rules: R 325.2941 et seq. of the Michigan Administrative Code.
333.9152 Screening pupils for scoliosis and other spinal disorders; guidelines; participation;
written statement; short title of section.
Sec. 9152. (1) The department, in cooperation with the department of education, shall develop guidelines
for the screening of pupils in the schools of this state for scoliosis and other spinal disorders, including grades
to be screened annually, reporting forms to be used, procedures for rescreening, and procedures for referral of
children who fail the rescreening, and shall provide technical, educational, and other assistance to local public
health departments for the implementation of scoliosis and other spinal disorder detection programs. In
developing the guidelines, the department shall consult with public and private agencies and organizations
involved in similar screening programs. The guidelines shall be distributed to all local health departments and
school districts within this state.
(2) A pupil shall not be required to participate in a scoliosis or other spinal disorder screening program if a
parent, guardian, or person in loco parentis of the pupil presents a written statement to the administrator of the
pupil's school stating that participation in a spinal disorder screening program violates the personal religious
beliefs of the pupil, parent, guardian, or person in loco parentis.
(3) This section shall be known and may be cited as the Ogonowski scoliosis screening act.
History: Add. 1981, Act 105, Eff. Mar. 31, 1982.
Popular name: Act 368
PART 92
IMMUNIZATION
333.9201 Definitions; principles of construction.
Sec. 9201. (1) As used in this part:
(a) "Camping" means attendance at a residential, day, troop, or travel camp conducted for more than 4
school-age children, apart from their parents, guardians, or persons in loco parentis for 5 or more days or parts
of days in a 14-day period.
(b) "Immunizing agent" means a vaccine, antibody preparation, or other substance used to increase an
individual's immunity to a disease or infectious agent.
(c) "Infectious agent" means that term as defined in R 325.9031 of the Michigan administrative code.
(d) "Registry" means the childhood immunization registry or Michigan care improvement registry
established under section 9207.
(2) In addition, article 1 contains general definitions and principles of construction applicable to all articles
in this code.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1996, Act 540, Imd. Eff. Jan. 15, 1997;Am. 2006, Act 91, Imd. Eff. Apr. 4,
2006.
Compiler's note: For transfer of certain powers and duties of the bureau of child and family services, with the exception of the
women, infants, and children division, from the department of public health to the director of the department of community health, see
E.R.O. No. 1996-1, compiled at MCL 330.3101 of the Michigan Compiled Laws.
Popular name: Act 368
333.9203 Free immunization treatments; free periodic immunization clinics for children;
publicity; mass immunization programs; liability.
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Sec. 9203. (1) A local health department shall offer free immunization treatments to the public for
protection in case of an epidemic or threatened epidemic of a disease as ordered by the director.
(2) A local health department shall conduct free periodic immunization clinics for children residing in its
jurisdiction. The local health department shall publicize the free immunization service and the time and place
of the clinics.
(3) When the department approves a mass immunization program to be administered in this state, health
personnel employed by a governmental entity who are required to participate in the program, or any other
individual authorized by the director or a local health officer to participate in the program without
compensation, is not liable to any person for civil damages as a result of an act or omission causing illness,
reaction, or adverse effect from the use of a drug or vaccine in the program, except for gross negligence or
wilful and wanton misconduct. This subsection does not exempt a drug manufacturer from liability for a drug
or vaccine used in the program.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.9209 Immunization status of kindergarten and first grade students; minimum percentage
levels of immunization; raising immunization level; report of additional immunizations;
form of report; exclusion of child from school attendance.
Sec. 9209. (1) Before November 1 of each year, the principal or administrator of each school shall deliver
to the state and local health departments a list of the immunization status at the time of school entry of new
entering kindergarten and first grade students.
(2) The department shall prescribe minimum percentage levels of immunization for children in a school.
(3) As a result of the information collected pursuant to subsection (1), the local health officer shall take
appropriate action, including immunization clinics, to raise the immunization level of children entering school
to the levels established pursuant to subsection (2).
(4) Before the following February 1, the principal or administrator of each school shall update the list to
show the additional immunizations received by each child since entering the school. The reports shall be
made on forms provided or approved by the department. A child who enters school in September and who has
not completed the immunizations required under section 9227 and has not filed an exemption under section
9215 before February 1 shall be excluded from school attendance. A child who enters school at any other time
of the school year and who has not completed the immunizations required under section 9227 and has not
filed an exemption under section 9215 within 4 months after entrance shall be excluded from school
attendance.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.9211 Preschool aged child registered in program of group residence, care, or camping;
certificate of immunization or statement of exemption; minimum dose of immunizing
agent; updated certificate; report of immunization status.
Sec. 9211. (1) A parent, guardian, or person in loco parentis applying to have a preschool aged child
registered in a program of group residence, care, or camping shall present to the operator of the program at the
time of registration or not later than the first day of the program a certificate of immunization or a statement
of exemption under section 9215. The operator of the group program shall not permit a child to attend the
group activity unless a minimum of 1 dose of an immunizing agent against each of the diseases specified by
the department has been received and certified to by a health professional or local health department. A
parent, guardian, or person in loco parentis of a child registered with only these minimum doses of an
immunizing agent and continuing enrollment in the group program shall present an updated certificate of
immunization within 4 months after initial attendance showing that the immunizations have been completed
as prescribed by the department, if the child remains in the program.
(2) Upon request by the department or local health department, a program operator shall report to the state
and local health departments the immunization status of each child accepted.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.9215 Exemptions.
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Sec. 9215. (1) A child is exempt from the requirements of this part as to a specific immunization for any
period of time as to which a physician certifies that a specific immunization is or may be detrimental to the
child's health or is not appropriate.
(2) A child is exempt from this part if a parent, guardian, or person in loco parentis of the child presents a
written statement to the administrator of the child's school or operator of the group program to the effect that
the requirements of this part cannot be met because of religious convictions or other objection to
immunization.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.9227 Rules.
Sec. 9227. (1) The department shall promulgate rules to implement this part, including, but not limited to,
rules governing all of the following:
(a) Age periods for immunizations.
(b) The minimum ages at which immunization may be commenced.
(c) The minimum number of doses required during a specified time period.
(d) Minimum levels of immunization for children in school.
(e) Reporting under section 9206(3).
(f) The acquisition, maintenance, and dissemination of information contained in the registry established
under section 9207.
(2) The department shall promulgate rules to implement the expansion of the registry to include the
reporting and recording of additional information such as lead screening performed on children.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1996, Act 540, Imd. Eff. Jan. 15, 1997;Am. 2006, Act 91, Imd. Eff. Apr. 4,
2006.
Popular name: Act 368
Administrative rules: R 325.171 et seq. and R 325.3501 et seq. of the Michigan Administrative Code.
PART 93
HEARING AND VISION
333.9301 Free hearing and vision testing and screening programs; publicity.
Sec. 9301. A local health department shall conduct periodic hearing and vision testing and screening
programs without charge for children residing in its jurisdiction. The local health department shall publicize
the free testing and screening service and the time and place of the clinics.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Compiler's note: For transfer of certain powers and duties of the bureau of child and family services, with the exception of the
women, infants, and children division, from the department of public health to the director of the department of community health, see
E.R.O. No. 1996-1, compiled at MCL 330.3101 of the Michigan Compiled Laws.
Popular name: Act 368
333.9302 Duty of parent, guardian, or person in loco parentis; time and frequency of testing
and screening.
Sec. 9302. A parent, guardian, or person in loco parentis of a child shall provide for the child's hearing and
vision testing and screening by an agency designated by the local health department. The testing and
screening shall be given during an age period and at a frequency specified by the department.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
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333.9303 Program to assist local health departments; establishment and administration.
Sec. 9303. (1) The department shall establish and administer a program to assist local health departments
in developing and maintaining periodic hearing and vision testing and screening programs for children.
(2) The department may establish and administer a program to assist local health departments in
developing and maintaining periodic hearing and vision testing and screening programs for adults.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.9307 Registration of child for kindergarten or first grade; certificate of hearing and vision
testing or screening or statement of exemption required; summary of hearing or vision
reports; forms; records.
Sec. 9307. (1) A parent, guardian, or person in loco parentis applying to have a child registered for the first
time in a kindergarten or first grade in a school in this state shall present to school officials, at the time of
registration or not later than the first day of school, a certificate of hearing and vision testing or screening or
statement of exemption under section 9311.
(2) Before November 1 of each year, the principal or administrator of each school shall give the state and
local health departments a summary of the hearing and vision reports at the time of school entry of new
entering kindergarten and first grade students. The reports shall be made on forms provided or approved by
the department.
(3) Records of testing and screening administered and conducted shall be made and preserved as provided
by the department. The records shall be available to health agencies and other persons to assist in obtaining
proper and necessary health and educational care, attention, and treatment as permitted by the department.
Individual testing and screening records shall be confidential as required by section 2637.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.9311 Exemption.
Sec. 9311. A child is exempt from this part if a parent, guardian, or person in loco parentis of the child
presents a written statement to the administrator of the child's school stating that the requirement violates the
personal religious beliefs of the parent, guardian, or person in loco parentis.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.9321 Rules.
Sec. 9321. The department may promulgate rules to implement this part, including the age and frequency
for testing and screening under section 9302 and the maintenance and disclosure of records under section
9307.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
Administrative rules: R 325.3271 et seq. and R 325.13091 et seq. of the Michigan Administrative Code.
PART 95
BREAST CANCER PROGRAM
333.9501 Breast cancer mortality reduction program; creation; scope.
Sec. 9501. The breast cancer mortality reduction program is created in the department. The program shall
include, but is not limited to, all of the following:
(a) Professional education programs for health professionals to develop state-of-the-art skills in cancer
screening, diagnosis, referral, treatment, and rehabilitation.
(b) Public education programs to assist the public in understanding all of the following:
(i) The benefits of regular breast cancer screening.
(ii) How to make the best use of the medical care system for cancer screening, diagnosis, referral,
treatment, and rehabilitation.
(iii) The available options for treatment of cancer.
(c) An applied research and community demonstration grant program that provides grants to local
communities to demonstrate and evaluate 1 or more of the following:
(i) Methods to reduce cancer morbidity and mortality.
(ii) Economical and effective methods of providing access to breast cancer screening, diagnosis, referral,
treatment, and rehabilitation services for populations with higher than expected rates of breast cancer
morbidity or mortality.
History: Add. 1989, Act 56, Imd. Eff. June 16, 1989.
Compiler's note: For transfer of certain powers and duties of the center for health promotion and chronic disease prevention from the
department of public health to the director of the department community health, see E.R.O. No. 1996-1, compiled at MCL 330.3101 of
the Michigan Compiled Laws.
Popular name: Act 368
333.9503 Report.
Sec. 9503. The department shall biennially submit a report to the senate and house committees with
jurisdiction over matters pertaining to public health. The report shall evaluate the effectiveness of the breast
cancer mortality reduction program. The report shall include, but is not limited to, data describing the rate of
breast cancer morbidity and mortality in this state and the extent of participation in breast cancer screening.
History: Add. 1989, Act 56, Imd. Eff. June 16, 1989.
Popular name: Act 368
PART 96
STATE LABORATORIES
333.9601 Laboratories; establishment, operation, and maintenance; services; continuation of
existing laboratories; location; agreements and contracts; fees; development and
publication of comprehensive schedule of testing services and fees; report.
Sec. 9601. (1) The department shall maintain and operate laboratories for the protection of the public
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health by developing or otherwise providing for adequate laboratory services to support public health
programs and to fulfill the requirements of law. The director shall determine the services to be offered by the
laboratories. Laboratories established by law on the effective date of this part shall be continued until
otherwise provided by law. Other laboratories shall be located at places designated by the department.
(2) The state, counties, and cities may enter into agreements and contracts necessary or appropriate to the
establishment, operation, and maintenance of the laboratories required under subsection (1).
(3) Beginning October 1, 1991, the director may charge a reasonable fee for a testing service provided by a
laboratory maintained and operated by the department under subsection (1). For fiscal year 1991-92 and
subsequent fiscal years, the director shall not charge a fee under this subsection that is greater than the fees
established under Executive Order No. 1991-17. Before collecting a fee under this subsection, the department
shall develop and publish a comprehensive schedule of testing services and fees. The schedule shall include a
description of each testing service and the maximum fee charged for each testing service. Along with the
schedule submitted to the director of the department of management and budget for approval under this
subsection, the department shall submit a statement of the rationale used in determining the fees contained in
the schedule. The department shall submit the schedule for approval to the director of the department of
management and budget. The fees contained in the schedule shall not exceed the amount necessary to fund
the testing service provided. The department also shall submit to the director of the department of
management and budget for approval any revision to the original schedule of testing services and fees.
(4) The department shall submit to the director of the department of management and budget and to the
legislature an annual report that contains all of the following information:
(a) The number of tests performed in the preceding year for which a fee can be charged under this section.
(b) The total amount of fees collected under this section.
(c) Any costs related to providing testing services for which a fee can be charged under this section.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1992, Act 79, Imd. Eff. June 2, 1992.
Compiler's note: For transfer of certain powers and duties of the bureau of infectious disease control from the department of public
health to the director of the department of community health, see E.R.O. No. 1996-1, compiled at MCL 330.3101 of the Michigan
Compiled Laws.
Popular name: Act 368
PART 97.
MICHIGAN PHARMACEUTICAL BEST PRACTICES INITIATIVE
***** 333.9701 THIS SECTION IS AMENDED EFFECTIVE AUGUST 1, 2017: See 333.9701.amended
*****
333.9701 Definitions.
Sec. 9701. As used in this part:
(a) Committee means the Michigan pharmacy and therapeutics committee established by Executive
Order No. 2001-8 and by section 9705.
(b) Controlled substance means that term as defined in section 7104.
(c) Department means the department of community health.
(d) Drug means that term as defined in section 17703.
(e) Initiative means the pharmaceutical best practices initiative established by this part.
(f) Medicaid means the program of medical assistance established under title XIX of the social security
act, 42 USC 1396 to 1396v.
(g) Pharmacist means an individual licensed by this state to engage in the practice of pharmacy under
article 15.
(h) Physician means an individual licensed by this state to engage in the practice of medicine or
osteopathic medicine and surgery under article 15.
(i) Prescriber means a licensed dentist, a licensed doctor of medicine, a licensed doctor of osteopathic
medicine and surgery, a licensed doctor of podiatric medicine and surgery, a licensed optometrist certified
under part 174 to administer and prescribe therapeutic pharmaceutical agents, or another licensed health
professional acting under the delegation and using, recording, or otherwise indicating the name of the
delegating licensed doctor of medicine or licensed doctor of osteopathic medicine and surgery.
(j) Prescription means that term as defined in section 17708.
(k) Prescription drug means that term as defined in section 17708.
(l) Type II transfer means that term as defined in section 3 of the executive organization act of 1965,
1965 PA 380, MCL 16.103.
History: Add. 2004, Act 250, Imd. Eff. July 23, 2004.
Popular name: Act 368
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333.9703 Pharmaceutical best practices initiative; implementation; prior authorization and
appeal process; establishment of disease management and health management programs;
hiring and retaining contractors, subcontractors, advisors, consultants, and agents; rules.
Sec. 9703. (1) The department may implement a pharmaceutical best practices initiative for the
department's various health care programs to control the costs of health care, to reduce the costs of
prescription drugs, and to assure continued access to pharmaceutical services at fair and reasonable prices. If
implemented, the initiative shall include, but is not limited to, the establishment and maintenance of each of
the following:
(a) A preferred drug list.
(b) A prior authorization and appeal process.
(2) The prior authorization and appeal process established under subsection (1) shall include the
establishment of a telephone hotline for prescribers that is accessible 24 hours per day and staffed to ensure
that a response is initiated to each prior authorization request within 24 hours after its receipt and to each
appeal of a prior authorization denial within 48 hours, excluding Saturday, Sunday, and legal holidays, after
all necessary documentation for reconsideration is received. Each appeal for reconsideration of a previous
denial for prior authorization shall be reviewed and decided by a physician.
(3) The department, in cooperation with a pharmaceutical manufacturer or its agent or another qualified
contractor, may establish disease management and health management programs that may be provided, as
negotiated, by the pharmaceutical manufacturer or its agent or another qualified contractor instead of a
supplemental rebate for the inclusion of certain products manufactured by that pharmaceutical manufacturer
on the department's preferred drug list. If the department negotiates a plan for the provision of services by the
pharmaceutical manufacturer instead of a supplemental rebate as provided under this subsection, the
department shall provide a written report on the effectiveness of the programs being offered and the savings
incurred as a result of those programs being provided instead of supplemental rebates to the members of the
house and senate appropriations subcommittees on community health.
(4) The department may hire or retain contractors, subcontractors, advisors, consultants, and agents and
may enter into contracts necessary or incidental to implement this part and carry out its responsibilities and
duties.
(5) The department may promulgate rules or medicaid policies to implement this part and to ensure
compliance with the published medicaid bulletin that initiated this initiative.
History: Add. 2004, Act 250, Imd. Eff. July 23, 2004.
Popular name: Act 368
333.9707 Functions.
Sec. 9707. The committee shall be advisory in nature and shall assist the department with the following
functions pursuant to applicable state and federal law:
(a) Advise and make recommendations to the department for the inclusion of prescription drugs on the
preferred drug list based on available information regarding the known potential impact on patient care, the
known potential fiscal impact on related medicaid covered services, and sound clinical evidence found in
labeling, drug compendia, and peer-reviewed literature pertaining to use of the drug in the relevant
population.
(b) Advise the department on issues affecting prescription drug coverage for the department's various
health care programs.
(c) Recommend to the department guidelines for prescription drug coverage under the department's various
health care programs.
(d) Develop a process to collect and review information about new prescription drugs. The department
shall post this process and the necessary forms on the department's website.
(e) Recommend to the department strategies to improve the initiative.
History: Add. 2004, Act 250, Imd. Eff. July 23, 2004.
Popular name: Act 368
ARTICLE 10
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ANATOMICAL GIFTS AND DISPOSITION OF HUMAN BODY PARTS
PART 101
REVISED UNIFORM ANATOMICAL GIFT LAW
333.10101 Short title of part.
Sec. 10101. This part shall be known and may be cited as the "revised uniform anatomical gift law".
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2008, Act 39, Eff. May 1, 2008.
Popular name: Act 368
Popular name: Uniform Anatomical Gift Act
333.10102 Definitions.
Sec. 10102. As used in this part:
(a) "Adult" means an individual who is at least 18 years of age.
(b) "Agent" means an individual who meets 1 or more of the following requirements:
(i) Is authorized to make health care decisions on the principal's behalf by a power of attorney for health
care.
(ii) Is expressly authorized to make an anatomical gift on the principal's behalf by any other record signed
by the principal.
(c) "Anatomical gift" means a donation of all or part of a human body to take effect after the donor's death
for the purpose of transplantation, therapy, research, or education.
(d) "Body part" means an organ, eye, or tissue of a human being. The term does not include the whole
body.
(e) "Decedent" means a deceased individual whose body or body part is or may be the source of an
anatomical gift. The term includes a stillborn infant and, subject to this subdivision and restrictions imposed
by law other than this part, a fetus. The term does not include a blastocyst, embryo, or fetus that is the subject
of an abortion. As used in this subdivision, "abortion" means that term as defined in section 17015.
(f) "Disinterested witness" means a witness who is not a spouse, child, parent, sibling, grandchild,
grandparent, or guardian of or other adult who exhibited special care and concern for the individual who
makes, amends, revokes, or refuses to make an anatomical gift. The term does not include a person to which
an anatomical gift could pass under section 10111.
(g) "Document of gift" means a donor card or other record used to make an anatomical gift. The term
includes a statement or symbol on a driver license, identification card, or donor registry.
(h) "Donor" means an individual whose body or body part is the subject of an anatomical gift.
(i) "Donor registry" means a database that contains records of anatomical gifts and amendments to or
revocations of anatomical gifts as provided for in section 10120.
(j) "Driver license" means an operator's or chauffeur's license or permit issued to an individual by the
secretary of state under chapter III of the Michigan vehicle code, 1949 PA 300, MCL 257.301 to 257.329, for
that individual to operate a vehicle, whether or not conditions are attached to the license or permit.
(k) "Eye" means a human eye or any portion of a human eye.
(l) "Eye bank" means a person that is licensed, accredited, or regulated under federal or state law to engage
in the recovery, screening, testing, processing, storage, or distribution of human eyes or portions of human
eyes.
(m) "Guardian" means a person appointed by a court to make decisions regarding the support, care,
education, health, or welfare of an individual. The term does not include a guardian ad litem.
(n) "Hospital" means a facility licensed as a hospital under the law of any state or a facility operated as a
hospital by the United States, a state, or a subdivision of a state.
(o) "Identification card" means an official state personal identification card issued by the secretary of state
under 1972 PA 222, MCL 28.291 to 28.300.
(p) "Know" means to have actual knowledge.
(q) "Minor" means an individual who is under 18 years of age.
(r) "Organ" means a human kidney, liver, heart, lung, pancreas, or intestine or multivisceral organs when
transplanted at the same time as an intestine.
(s) "Organ procurement organization" means a person certified or recertified by the secretary of the United
States department of health and human services as a qualified organ procurement organization under 42 USC
273(b).
(t) "Parent" means a parent whose parental rights have not been terminated.
(u) "Person" means an individual, corporation, business trust, estate, trust, partnership, limited liability
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company, association, joint venture, public corporation, government or governmental subdivision, agency, or
instrumentality or any other legal or commercial entity.
(v) "Physician" means an individual authorized to practice medicine or osteopathic medicine and surgery
under the law of any state.
(w) "Procurement organization" means an eye bank, organ procurement organization, or tissue bank.
(x) "Prospective donor" means an individual who is dead or near death and has been determined by a
procurement organization to have a body part that could be medically suitable for transplantation, therapy,
research, or education. The term does not include an individual who has made a refusal.
(y) "Reasonably available" means able to be contacted by a procurement organization without undue effort
and willing and able to act in a timely manner consistent with existing medical criteria necessary for the
making of an anatomical gift.
(z) "Recipient" means an individual into whose body a decedent's body part has been or is intended to be
transplanted.
(aa) "Record" means information that is inscribed on a tangible medium or that is stored in an electronic or
other medium and is retrievable in perceivable form.
(bb) "Refusal" means a record created under section 10107 that expressly refuses to make an anatomical
gift of an individual's body or body part.
(cc) "Sign" means that, with the present intent to authenticate or adopt a record, an individual does either
of the following:
(i) Executes or adopts a tangible symbol.
(ii) Attaches to or logically associates with the record an electronic symbol, sound, or process.
(dd) "State" means a state of the United States, the District of Columbia, Puerto Rico, the United States
Virgin Islands, or any territory or insular possession subject to the jurisdiction of the United States.
(ee) "Technician" means an individual determined to be qualified to remove or process body parts by an
appropriate organization that is licensed, accredited, or regulated under federal or state law. The term includes
an enucleator.
(ff) "Tissue" means a portion of the human body other than an organ or an eye. The term does not include
blood unless the blood is donated for the purpose of research or education.
(gg) "Tissue bank" means a person that is licensed, accredited, or regulated under federal or state law to
engage in the recovery, screening, testing, processing, storage, or distribution of tissue.
(hh) "Transplant hospital" means a hospital that furnishes organ transplants and other medical and surgical
specialty services required for the care of transplant patients.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2003, Act 62, Imd. Eff. July 22, 2003;Am. 2008, Act 39, Eff. May 1, 2008.
Popular name: Act 368
Popular name: Uniform Anatomical Gift Act
333.10104 Anatomical gift of donor's body or body part; purpose; persons making gift.
Sec. 10104. Subject to section 10108, an anatomical gift of a donor's body or body part may be made
during the life of the donor for the purpose of transplantation, therapy, research, or education in the manner
provided in section 10105 by any of the following:
(a) The donor, if the donor is an adult or if the donor is a minor and meets 1 or more of the following
requirements:
(i) Is emancipated.
(ii) Has been issued a driver license or identification card because the donor is at least 16 years of age.
(b) An agent of the donor, unless the power of attorney for health care or other record prohibits the agent
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from making an anatomical gift.
(c) A parent of the donor, if the donor is an unemancipated minor.
(d) The donor's guardian.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2003, Act 62, Imd. Eff. July 22, 2003;Am. 2005, Act 140, Imd. Eff. Sept. 29,
2005;Am. 2008, Act 39, Eff. May 1, 2008.
Popular name: Act 368
Popular name: Uniform Anatomical Gift Act
333.10105 Donor making anatomical gift; methods; gift by donor card or other record; effect
of revocation, suspension, expiration, or cancellation of driver license or identification
card upon which anatomical gift is indicated; anatomical gift made by will; effect of
probate or invalidation.
Sec. 10105. (1) A donor may make an anatomical gift by doing any of the following:
(a) By authorizing a statement or symbol indicating that the donor has made an anatomical gift to be
imprinted on the donor's driver license or identification card.
(b) In a will.
(c) During a terminal illness or injury of the donor, by any form of communication addressed to at least 2
adults, at least 1 of whom is a disinterested witness. However, the physician who attends the donor during the
terminal illness or injury shall not act as a recipient of the communication under this subdivision.
(d) As provided in subsection (2).
(2) A donor or other person authorized to make an anatomical gift under section 10104 may make a gift by
a donor card or other record signed by the donor or other person making the gift or by authorizing that a
statement or symbol indicating that the donor has made an anatomical gift be included on a donor registry. If
the donor or other person is physically unable to sign a record, the record may be signed by another individual
at the direction of the donor or other person and shall meet all of the following requirements:
(a) Be witnessed by at least 2 adults, at least 1 of whom is a disinterested witness, who have signed at the
request of the donor or the other person.
(b) State that it has been signed and witnessed as provided in subdivision (a).
(3) Revocation, suspension, expiration, or cancellation of a driver license or identification card upon which
an anatomical gift is indicated does not invalidate the gift.
(4) An anatomical gift made by will takes effect upon the donor's death whether or not the will is probated.
Invalidation of the will after the donor's death does not invalidate the gift.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2008, Act 39, Eff. May 1, 2008.
Popular name: Act 368
Popular name: Uniform Anatomical Gift Act
333.10108 Person other than donor barred from making, amending, or revoking anatomical
gift; conditions; revocation of anatomical gift not considered as refusal; unrevoked or
revocation of anatomical gift by person other than donor; certain conduct not considered
as limitation; donor as unemancipated minor.
Sec. 10108. (1) Except as otherwise provided in subsection (7) and subject to subsection (6), in the absence
of an express, contrary indication by the donor, a person other than the donor is barred from making,
amending, or revoking an anatomical gift of a donor's body or body part if the donor made an anatomical gift
of the donor's body or body part under section 10105 or an amendment to an anatomical gift of the donor's
body or body part under section 10106.
(2) A donor's revocation of an anatomical gift of the donor's body or body part under section 10106 is not a
refusal and does not bar another person specified in section 10104 or 10109 from making an anatomical gift
of the donor's body or body part under section 10105 or 10110.
(3) If a person other than the donor makes an unrevoked anatomical gift of the donor's body or body part
under section 10105 or an amendment to an anatomical gift of the donor's body or body part under section
10106, another person may not make, amend, or revoke the gift of the donor's body or body part under section
10110.
(4) A revocation of an anatomical gift of a donor's body or body part under section 10106 by a person
other than the donor does not bar another person from making an anatomical gift of the body or body part
under section 10105 or 10110.
(5) In the absence of an express, contrary indication by the donor or other person authorized to make an
anatomical gift under section 10104, an anatomical gift of a body part is neither a refusal to give another body
part nor a limitation on the making of an anatomical gift of another body part at a later time by the donor or
other person.
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(6) In the absence of an express, contrary indication by the donor or other person authorized to make an
anatomical gift under section 10104, an anatomical gift of a body part for 1 or more of the purposes set forth
in section 10104 is not a limitation on the making of an anatomical gift of the body part for any of the other
purposes by the donor or any other person under section 10105 or 10110.
(7) If a donor who is an unemancipated minor dies, a parent of the donor who is reasonably available may
revoke or amend an anatomical gift of the donor's body or body part.
(8) If an unemancipated minor who signed a refusal dies, a parent of the minor who is reasonably available
may revoke the minor's refusal.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1986, Act 186, Eff. Oct. 7, 1986;Am. 2006, Act 301, Imd. Eff. July 20, 2006;
Am. 2008, Act 39, Eff. May 1, 2008.
Popular name: Act 368
Popular name: Uniform Anatomical Gift Act
333.10109 Classes of persons making anatomical gift; priority; more than 1 member of class
making anatomical gift; availability of person in prior class.
Sec. 10109. (1) Subject to subsections (2) and (3) and unless barred by section 10107 or 10108, an
anatomical gift of a decedent's body or body part for purpose of transplantation, therapy, research, or
education may be made by any member of the following classes of persons who is reasonably available, in the
order of priority listed as follows:
(a) An agent of the decedent at the time of death who could have made an anatomical gift under section
10104(b) immediately before the decedent's death.
(b) The spouse of the decedent.
(c) Adult children of the decedent.
(d) Parents of the decedent.
(e) Adult siblings of the decedent.
(f) Adult grandchildren of the decedent.
(g) Grandparents of the decedent.
(h) An adult who exhibited special care and concern for the decedent.
(i) The persons who were acting as the guardians of the person of the decedent at the time of death.
(j) The persons assigned by the state of Michigan to authorize medical care for the decedent at the time of
death, including public ward custodians, correctional or mental health facility personnel, or foster parents.
(k) Any other person that has the authority to dispose of the decedent's body, including unidentified bodies,
under section 3206 of the estates and protected individuals code, 1998 PA 386, MCL 700.3206.
(2) If there is more than 1 member of a class listed in subsection (1)(a), (c), (d), (e), (f), (g), or (i) entitled
to make an anatomical gift, an anatomical gift may be made by a member of the class unless that member or a
person to which the gift may pass under section 10111 knows of an objection by another member of the class.
If an objection is known, the gift may be made only by a majority of the members of the class who are
reasonably available.
(3) A person shall not make an anatomical gift if, at the time of the decedent's death, a person in a prior
class under subsection (1) is reasonably available to make or to object to the making of an anatomical gift.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2008, Act 39, Eff. May 1, 2008.
Popular name: Act 368
Popular name: Uniform Anatomical Gift Act
333.10110 Document of gift; amendment or revocation of gift made under MCL 333.10109;
revocation effective before incision made or invasive procedures begun.
Sec. 10110. (1) A person authorized to make an anatomical gift under section 10109 may make an
anatomical gift by a document of gift signed by the person making the gift or by that person's oral
communication that is electronically recorded or is contemporaneously reduced to a record and signed by the
individual receiving the oral communication.
(2) Subject to subsection (3), an anatomical gift by a person authorized under section 10109 may be
amended or revoked orally or in a record by any member of a prior class who is reasonably available. If more
than 1 member of the prior class is reasonably available, the gift made by a person authorized under section
10109 may be amended or revoked as follows:
(a) Amended only if a majority of the reasonably available members agree to the amending of the gift.
(b) Revoked only if a majority of the reasonably available members agree to the revoking of the gift or if
they are equally divided as to whether to revoke the gift.
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(3) A revocation under subsection (2) is effective only if, before an incision has been made to remove a
part from the donor's body or before invasive procedures have begun to prepare the recipient, the procurement
organization, transplant hospital, or physician or technician knows of the revocation.
History: Add. 2008, Act 39, Eff. May 1, 2008.
Popular name: Act 368
Popular name: Uniform Anatomical Gift Act
333.10112 Search for document of gift or other information; persons required to make
search; document to be sent to hospital for documentation; failure to discharge duties;
administrative sanctions.
Sec. 10112. (1) As soon as practical after any necessary medical intervention or treatment, each of the
following persons shall make a reasonable search of an individual who the person reasonably believes is dead
or near death for a document of gift or other information identifying the individual as a donor or as an
individual who made a refusal:
(a) A law enforcement officer, firefighter, paramedic, other emergency rescuer finding the individual, or
medical examiner or his or her designee.
(b) If no other source of the information is immediately available, a hospital, as soon as practical after the
individual's arrival at the hospital.
(2) If a document of gift or a refusal to make an anatomical gift is located by the search required by
subsection (1)(a) and the individual or deceased individual to whom it relates is taken to a hospital, the person
responsible for conducting the search shall immediately send the document of gift or refusal to the hospital for
documentation.
(3) A person is not subject to criminal or civil liability for failing to discharge the duties imposed by this
section but may be subject to administrative sanctions.
History: Add. 2008, Act 39, Eff. May 1, 2008.
Popular name: Act 368
Popular name: Uniform Anatomical Gift Act
333.10116 Purchase or sale of body part for transplantation or therapy; violation as felony;
penalty; exception.
Sec. 10116. (1) Except as otherwise provided in subsection (2), a person that for valuable consideration
knowingly purchases or sells a body part for transplantation or therapy if removal of the body part from an
individual is intended to occur after the individual's death is guilty of a felony punishable by imprisonment for
not more than 5 years or a fine of not more than $50,000.00, or both.
(2) A person may charge a reasonable amount for the removal, processing, preservation, quality control,
storage, transportation, implantation, or disposal of a body part.
History: Add. 2008, Act 39, Eff. May 1, 2008.
Popular name: Act 368
Popular name: Uniform Anatomical Gift Act
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333.10118 Good faith acts.
Sec. 10118. (1) A person that acts in good faith in accord with the terms of this part or with the anatomical
gift laws of another state or a foreign country is not liable for damages in any civil or administrative action or
subject to prosecution in any criminal proceeding.
(2) Neither the person making an anatomical gift nor the donor's estate is liable for any injury or damage
that results from the making or use of the gift.
(3) In determining whether an anatomical gift has been made, amended, or revoked under this part, a
person may rely upon representations of an individual listed in section 10109(1)(b), (c), (d), (e), (f), (g), or (h)
relating to the individual's relationship to the donor or prospective donor unless the person knows that the
representation is untrue.
History: Add. 2008, Act 39, Eff. May 1, 2008.
Popular name: Act 368
Popular name: Uniform Anatomical Gift Act
333.10121 Definitions; medical suitability of body part; conflict with declaration or advance
health care directive or enrollment in hospice program; resolution.
Sec. 10121. (1) As used in this section:
(a) "Advance health care directive" means a power of attorney for health care or a record signed or
authorized by a prospective donor containing the prospective donor's direction concerning a health care
decision for the prospective donor. Advance health care directive includes a durable power of attorney and
designation of patient advocate under part 5 of article V of the estates and protected individuals code, 1998
PA 386, MCL 700.5501 to 700.5520.
(b) "Declaration" means a record signed by a prospective donor specifying the circumstances under which
a life support system may be withheld or withdrawn from the prospective donor.
(c) "Health care decision" means any decision regarding the health care of the prospective donor.
(2) If a prospective donor has a declaration or advance health care directive or is enrolled in a hospice
program, and the terms of the declaration, directive, or enrollment and the express or implied terms of a
potential anatomical gift are in conflict with regard to the administration of measures necessary to ensure the
medical suitability of a body part for transplantation or therapy, the prospective donor's attending physician,
the prospective donor, and, if appropriate, the hospice medical director shall confer to resolve the conflict. If
the prospective donor is incapable of resolving the conflict, an agent acting under the prospective donor's
declaration, directive, or hospice enrollment, or, if none or the agent is not reasonably available, another
person authorized by law other than this part to make health care decisions on behalf of the prospective donor,
shall act for the donor to resolve the conflict. The authorized parties shall attempt to resolve the conflict as
expeditiously as possible. Authorized parties may obtain information relevant to the resolution of the conflict
from the appropriate procurement organization and any other person authorized to make an anatomical gift for
the prospective donor under section 10109. Before resolution of the conflict, measures necessary to ensure the
medical suitability of the body part are permissible if they are not contraindicated by appropriate end-of-life
care as determined by the stated wishes of the prospective donor, by a written advance health care directive,
or, if appropriate, by the hospice medical director.
History: Add. 2008, Act 39, Eff. May 1, 2008.
Popular name: Act 368
Popular name: Uniform Anatomical Gift Act
PART 102
DISPOSITION OF HUMAN BODY PARTS
333.10201 Definitions.
Sec. 10201. As used in this part:
(a) Bank or storage facility means a facility licensed, accredited, or approved under the laws of any state
for storage of human bodies or physical parts of human bodies.
(b) Next of kin means the spouse of a deceased individual or a person related to a deceased individual
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within the third degree of consanguinity as determined by the civil law method.
History: Add. 1979, Act 32, Imd. Eff. June 19, 1979.
Popular name: Act 368
333.10205 Surgical removal of human organ for transplant, implant, infusion, injection or
other purpose; facilities; exceptions; rules; violation as felony.
Sec. 10205. (1) Except as otherwise provided in subsections (2) and (3), an individual who surgically
removes a human organ for transplantation, implantation, infusion, injection, or any other medical or
scientific purpose shall perform the surgery only in 1 of the following facilities:
(a) A hospital licensed under article 17.
(b) A facility approved by the director of the department of licensing and regulatory affairs under
subsection (4).
(c) A facility operated by a federally designated organ procurement organization for the state of Michigan.
(2) An individual who surgically removes a human organ consisting of tissue, a cornea, or a whole eye for
transplantation, implantation, infusion, injection, or any other medical or scientific purpose shall perform the
removal surgery only in 1 of the following facilities or in a hospital or other facility described in subsection
(1):
(a) A mortuary that is part of a funeral establishment owned or operated by the holder of a license for the
practice of mortuary science issued under article 18 of the occupational code, 1980 PA 299, MCL 339.1801 to
339.1812.
(b) A morgue or a facility operated by a county medical examiner appointed under 1953 PA 181, MCL
52.201 to 52.216.
(3) Subsections (1) and (2) do not apply to a licensed allopathic physician or osteopathic physician who
performs a biopsy or the routine removal of human tissue from a patient in the physician's private practice
office or other health facility licensed under article 17 for the diagnosis or treatment of that patient and not for
purposes of transplantation, implantation, infusion, or injection.
(4) The director of the department of licensing and regulatory affairs may promulgate rules to designate 1
or more approved facilities for purposes of subsection (1)(b).
(5) An individual who violates subsection (1) or (2) is guilty of a felony.
History: Add. 1999, Act 62, Eff. Sept. 1, 1999;Am. 2016, Act 71, Imd. Eff. April 5, 2016.
Compiler's note: Former MCL 333.10205, which pertained to expiration of part, was repealed by Act 158 of 1982, Imd. Eff. May
20, 1982.
Popular name: Act 368
333.10301 Peace of mind registry; creation, operation, and maintenance; report; rules;
immunity from civil liability; legal weight and validity; definitions.
Sec. 10301. (1) The department may create, operate, and maintain the peace of mind registry, which shall
contain the directives of voluntary registrants who are residents of this state. The peace of mind registry shall
be created, operated, and maintained as provided in this act.
(2) The department may by contract delegate the creation, operation, and maintenance of a peace of mind
registry to a peace of mind registry organization contingent upon the peace of mind registry organization
incurring all of the cost related to design, maintain, and operate the registry.
(3) Both of the following conditions apply to a directive:
(a) A directive may be submittable through the United States mail, or through uploaded portable document
format (PDF) or another secure electronic format as determined by the department.
(b) A directive shall contain a signature line for the registrant.
(4) The peace of mind registry shall meet all of the following requirements:
(a) Be accessible to registrants, health care providers, and the department by way of a designated user
identification and password.
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(b) Store all an individual's directive. However, the most recently signed directive supersedes any earlier
directive.
(c) Provide electronic access to stored directives on a continuous basis at no cost to the health care
providers and allow health care providers to transmit directives into their respective electronic medical
records.
(d) Provide electronic storage and access to directives submitted at no cost to the registrant.
(e) Include a unique identifier-searchable database, including, but not limited to, the last 4 digits of an
individual's social security number and the individual's date of birth and address.
(5) The department, the secretary of state, and the department of human services shall each provide on its
public website information on directives and the peace of mind registry. The department, the secretary of
state, and the department of human services shall promote public awareness of the advantages of creating
directives and the availability of the registry.
(6) The peace of mind registry shall satisfy all of the following conditions to the satisfaction of the
department:
(a) Maintain a record of each individual who files a directive to be stored in the peace of mind registry and
make the record available to the department.
(b) Create and provide forms for the registration of a directive.
(c) Create and provide forms for the revocation of a directive.
(7) The department and the peace of mind registry organization shall ensure the privacy and security of all
documents and information submitted to, transmitted from, or stored in the peace of mind registry. The
department and any person who accesses the peace of mind registry shall comply with all other provisions of
this act and any other law of this state or federal law establishing privacy and security standards applicable to
health or other personal identifying information.
(8) Information in the peace of mind registry shall not be accessed or used for any purpose unrelated to
decision making for health care or disposition of human remains, except that the information may be used
solely by the department or its designee for statistical or analytical purposes if the individual's identity is not
revealed and all personal identifying information remains confidential.
(9) The department or its designee shall provide both of the following to an individual who files a directive
with the peace of mind registry to be stored in the registry:
(a) A wallet-sized card indicating that the holder has a directive in the registry.
(b) An electronic mail message or postcard indicating confirmation of the registration of a directive.
(10) By January 31 of each year, the department or peace of mind organization, as applicable, shall report
to the standing committees of the house of representatives and senate on health policy stating the total number
of current and new registrants who have submitted directives during the preceding calendar year.
(11) The department may promulgate rules under the administrative procedures act of 1969, 1969 PA 306,
MCL 24.201 to 24.328, to provide for the implementation and administration of this section.
(12) A peace of mind registry organization, with which the department has contracted under subsection (2),
and its employees are immune from civil liability arising from the accuracy or content of the registry, except
in the case of willful negligence or gross negligence.
(13) A directive that was filed with and stored in the peace of mind registry shall not be considered to be of
greater legal weight or validity solely by virtue of that filing and storage.
(14) As used in this section:
(a) "Department" means the department of community health.
(b) "Directive" means a document that is registered or filed with the peace of mind registry as provided in
this act and that is either of the following:
(i) A durable power of attorney and designation of patient advocate under part 5 of article V of the estates
and protected individuals code, 1998 PA 386, MCL 700.5501 to 700.5520.
(ii) A signed or authorized record concerning an anatomical gift containing a donor's direction concerning
a health care decision for the donor under the revised uniform anatomical gift law, sections 10101 to 10123.
(c) "Health care provider" means any of the following:
(i) A health professional licensed, registered, or otherwise authorized to engage in a health profession
under part 170, 172, or 175, or a law of another state substantially similar to part 170, 172, or 175.
(ii) A health facility or agency licensed or certified under article 17 or a law of another state substantially
similar to article 17.
(d) "Peace of mind registry" or "registry" means an internet website containing access to directives as
provided under this act.
(e) "Peace of mind registry organization" means an organization certified or recertified by the secretary of
the United States department of health and human services as a qualified organ procurement organization
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under 42 USC 273(b), or its successor organization.
(f) "Sign" means that, with the present intent to authenticate or adopt a record, an individual does either of
the following:
(i) Executes or adopts a tangible symbol.
(ii) Attaches to or logically associates with the record an electronic symbol, sound, or process.
History: Add. 2012, Act 179, Imd. Eff. June 19, 2012.
Popular name: Act 368
ARTICLE 12
ENVIRONMENTAL HEALTH
PART 121
GENERAL PROVISIONS
333.12101 Environmental health defined; general definitions and principles of
construction.
Sec. 12101. (1) As used in this article, environmental health means the area of activity which deals with
the protection of human health through the management, control, and prevention of environmental factors
which may adversely affect the health of individuals. This activity is concerned with the existence of
substances, conditions, or facilities in quantities, of characteristics, and under conditions, circumstances, or
duration which are or can be injurious to human health.
(2) In addition, article 1 contains general definitions and principles of construction applicable to all articles
in this code.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Compiler's note: For transfer of powers and duties of the division of environmental health, with the exception of the food service
sanitation program and the shelter environment program, from the director of the department of public health to the director of the
department of environmental quality, see E.R.O. No. 1996-1, compiled at MCL 330.3101 of the Michigan Compiled Laws.
Popular name: Act 368
PART 122
HOUSING
333.12201-333.12222 Repealed. 1980, Act 431, Eff. Mar. 31, 1981.
Popular name: Act 368
PART 124
AGRICULTURAL LABOR CAMPS
333.12401 Definitions and principles of construction.
Sec. 12401. (1) As used in this part:
(a) Advisory board means the board appointed pursuant to section 12421.
(b) Agricultural labor camp means a tract of land and all tents, vehicles, buildings, or other structures
pertaining thereto, part of which is established, occupied, or used as living quarters for 5 or more migratory
laborers engaged in agricultural activities, including related food processing.
(c) Camp operator means a person who owns, establishes, operates, conducts, manages, or maintains an
agricultural labor camp or who causes or permits the occupancy or use of an agricultural labor camp whether
or not rent is charged for housing and facilities.
(d) Fund means the migratory labor housing fund.
(e) Migratory laborer means a person working, or available for work, who moves seasonally 1 or more
times from 1 place to another from within or without the state for the purpose of such employment or
availability or who is employed in the growing of mushrooms.
(f) Person means a person as defined in section 1106 or a governmental entity.
(g) Remodeling means the remodeling, improving, or reconstruction of existing housing or facilities
which are incidental or appurtenant thereto for migratory laborers or the construction of new housing or
facilities which are incidental or appurtenant thereto for migratory laborers.
(2) In addition, article 1 contains general definitions and principles of construction applicable to all articles
in this code.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.12411 License for operation of agricultural labor camp required; posting license or
license placard; notice of construction, enlargement, or conversion; violation; fine.
Sec. 12411. (1) A person shall not operate an agricultural labor camp or cause to be operated or allow an
agricultural labor camp to be occupied and used as an agricultural labor camp, without a license. The
agricultural labor camp shall be operated only while the license remains in effect. The camp operator shall
post the license or the license placard issued by the department in a conspicuous place in the agricultural labor
camp to which it applies. The license or placard shall continue to remain posted during the entire time the
agricultural labor camp is operated.
(2) A person shall not construct or alter for occupancy or use, an agricultural labor camp or any portion or
facility thereof, or convert a property for use or occupancy as an agricultural labor camp, without giving
written notice of the intent to do so to the department at least 30 days before the date of beginning the
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construction, enlargement, or conversion. The notice shall give the name of the city, village, or township in
which the property is located, the location of the property within that area, a brief description of the proposed
construction, enlargement, or conversion, the name and mailing address of the person giving the notice, and
the person's telephone number, if any.
(3) A person is not in violation of subsection (1) if the sole reason the person is operating the agricultural
labor camp without a license is due to the failure of the department to respond within a timely manner to an
application submitted in accordance with section 12412.
(4) In addition to any other penalty provided under this part, a person who violates subsection (1) by
operating an agricultural labor camp without a license is subject to an administrative civil fine of not more
than $1,000.00. Each day a person operates without a license is a separate violation, however the total
administrative civil fine for continued noncompliance shall not exceed $10,000.00. All fines collected under
this subsection shall be credited to the migratory labor housing fund created under section 12431.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2005, Act 43, Imd. Eff. June 16, 2005.
Popular name: Act 368
333.12412 License for operation of agricultural labor camp; form; fee; contents; time of
application.
Sec. 12412. (1) A person desiring to operate an agricultural labor camp in this state shall make application
to the department on the forms and in the manner prescribed by the department. At the time of submitting an
application under this section, the applicant shall remit to the department a nonrefundable agricultural labor
camp license application fee equal to the product of $5.00 and the maximum number of people permitted to
occupy the agricultural labor camp.
(2) The application shall include:
(a) The full name and address of the applicant.
(b) The location of the agricultural labor camp.
(c) The maximum number of people who will occupy the camp at any time.
(d) The months during which the camp will be used or occupied.
(e) A brief description of the tents, vehicles, buildings, or other structures in which individuals will be
housed.
(f) A brief description of the sanitary, water, cooking, and sewage facilities available.
(g) Other information required by the department.
(3) An application for a license to operate an agricultural labor camp shall be made at least 30 days before
the first day that the proposed camp is to be operated.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2010, Act 14, Imd. Eff. Mar. 16, 2010.
Popular name: Act 368
333.12413 License for operation of agricultural labor camp; issuance; duration; recital on
face of license; transferability or assignability.
Sec. 12413. (1) The department shall issue a license for the operation of the agricultural labor camp, if
after investigation and inspection, it finds that the camp and its proposed operation conforms or will conform
to the minimum standards of construction, health, sanitation, sewage, water supply, plumbing, garbage and
rubbish disposal, and operation set forth in the rules promulgated under section 12421. The license shall be
valid for the balance of the calendar year during which it is issued.
(2) The license shall recite on its face that the camp operator shall comply with this part and the rules
promulgated under this part.
(3) The license is not transferable or assignable, except with the express written consent of the department.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
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333.12415 Denial of application for license; notice; hearing.
Sec. 12415. When the department denies an application for a license to operate an agricultural labor camp,
it shall give written notice of the denial by certified mail to the applicant stating reasons for the denial. An
applicant denied a license may request a hearing before the department on the denial not later than 4 days
after receipt of the denial. The department shall hold the hearing on the denial not later than 7 days after
receipt of the request.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.12421 Rules.
Sec. 12421. (1) The department shall promulgate rules for the protection of the health, safety, and welfare
of migratory laborers and their families who occupy agricultural labor camps.
(2) The rules shall include provisions for:
(a) The appointment by the director of an advisory board representing, among others, growers, processors,
local health departments, and religious or fraternal organizations. The advisory board shall advise the
department on the allocation of the fund and any matter which pertains to this part and shall make
recommendations to the department as to legislation or other measures necessary or advisable to alleviate a
migratory farm labor housing problem.
(b) The collection, treatment, and disposal of human wastes and sewage at agricultural labor camps.
(c) The supply and maintenance of safe water at agricultural labor camps.
(d) The temporary storage and removal of food wastes and rubbish at agricultural labor camps.
(e) The housing of seasonal laborers and their families, including adequate and safe construction and
repair, fire protection, facilities for laborers and their families to keep and prepare food, and other necessary
matters relating to their good health, safety, and welfare.
(f) For the administration of migratory labor housing remodeling grants.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
Administrative rules: R 325.1501 et seq. and R 325.1531 et seq. of the Michigan Administrative Code.
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333.12426 Action for injunction or other process.
Sec. 12426. Notwithstanding the existence and pursuit of any other remedy, the department may maintain
an action in the name of this state for an injunction or other process against a person to restrain or prevent the
establishment, conduct, management, maintenance, or operation of an agricultural labor camp without a
license.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
PART 125
CAMPGROUNDS, SWIMMING AREAS, AND SWIMMERS' ITCH
333.12501 Definitions; principles of construction.
Sec. 12501. (1) As used in sections 12501 to 12516:
(a) "Campground" means a parcel or tract of land under the control of a person in which sites are offered
for the use of the public or members of an organization, either free of charge or for a fee, for the establishment
of temporary living quarters for 5 or more recreational units. Campground does not include a seasonal mobile
home park licensed under the mobile home commission act, 1987 PA 96, MCL 125.2301 to 125.2349.
(b) "Department" means the department of environmental quality.
(c) "Local health department" means that term as defined under section 1105.
(d) "Mobile home" means a structure, transportable in 1 or more sections, which is built on a chassis and
designed to be used as a dwelling with or without permanent foundation, when connected to the required
utilities, and includes the plumbing, heating, air conditioning, and electrical systems contained in the
structure.
(e) "Person" means a person as defined in section 1106 or a governmental entity.
(f) "Recreational unit" means a tent or vehicular-type structure, primarily designed as temporary living
quarters for recreational, camping, or travel use, which either has its own motive power or is mounted on or
drawn by another vehicle which is self-powered. A tent means a collapsible shelter of canvas or other fabric
stretched and sustained by poles and used for camping outdoors. Recreational unit includes the following:
(i) A travel trailer, which is a vehicular portable structure, mounted on wheels, of such a size or weight as
not to require special highway movement permits when drawn by a vehicle, primarily designed and
constructed to provide temporary living quarters for recreational, camping, or travel use.
(ii) A camping trailer, which is a vehicular portable structure mounted on wheels and constructed with
collapsible partial sidewalls of fabric, plastic, or other pliable material which fold for towing by another
vehicle and unfold at the campsite to provide temporary living quarters for recreational, camping, or travel
use.
(iii) A motor home, which is a vehicular structure built on a self-propelled motor vehicle chassis, primarily
designed to provide temporary living quarters for recreational, camping, or travel use.
(iv) A truck camper, which is a portable structure designed to be loaded onto, or affixed to, the bed or
chassis of a truck, constructed to provide temporary living quarters for recreational, camping, or travel use.
Truck campers are of 2 basic types:
(A) A slide-in camper, which is a portable structure designed to be loaded onto and unloaded from the bed
of a pickup truck, constructed to provide temporary living quarters for recreational, camping, or travel use.
(B) A chassis-mount camper, which is a portable structure designed to be affixed to a truck chassis, and
constructed to provide temporary living quarters for recreational, camping, or travel use.
(v) A single sectional mobile home used only to provide temporary living quarters for recreational,
camping, or travel use. Recreational unit does not include a mobile home used as a permanent dwelling,
residence, or living quarters.
(2) In addition, article 1 contains general definitions and principles of construction applicable to all articles
in this code.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1982, Act 525, Eff. Mar. 30, 1983;Am. 2004, Act 408, Imd. Eff. Nov. 29, 2004
.
Compiler's note: For transfer of powers and duties of the division of environmental health, with the exception of the food service
sanitation program and the shelter environment program, from the director of the department of public health to the director of the
department of environmental quality, see E.R.O. No. 1996-1, compiled at MCL 330.3101 of the Michigan Compiled Laws.
Popular name: Act 368
333.12511 Rules.
Sec. 12511. The department, with the advice, assistance, and approval of the advisory board, shall
promulgate rules regarding sanitation and safety standards for campgrounds and public health. The rules shall
recognize and provide controls for different types of campgrounds.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
Administrative rules: R 323.3101 et seq.; R 325.1551 et seq.; R 325.2101 et seq.; and R 325.2111 et seq. of the Michigan
Administrative Code.
333.12522 Public swimming pool; review of design, construction, and operation; rules;
exception.
Sec. 12522. (1) The department shall review the design, construction, and operation of public swimming
pools to protect the public health, prevent the spread of disease, and prevent accidents or premature deaths.
(2) Except as otherwise provided in subsection (3), the department shall promulgate rules to carry out
sections 12521 to 12534.
(3) Until December 31, 2018, rules pertaining to lifeguarding promulgated by the department under
subsection (2) do not apply to a pool that meets all of the following requirements:
(a) It is located in a health and wellness center that is owned or operated by a community hospital authority
as authorized under 1945 PA 47, MCL 331.1 to 331.11.
(b) The total pool water surface area within the swimming pool enclosure is not more than 2,400 square
feet.
(c) No diving board is provided.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2014, Act 430, Imd. Eff. Dec. 30, 2014.
Popular name: Act 368
Administrative rules: R 325.2111 et seq. of the Michigan Administrative Code.
333.12523 Construction and operation of public swimming pools; supervisory and visitorial
power; control.
Sec. 12523. The department has supervisory and visitorial power and control as limited in sections 12521
to 12534 over persons engaged in the construction and operation of public swimming pools.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.12527 Public swimming pool; license required; fee; display; expiration; renewal;
replacement.
Sec. 12527. (1) A public swimming pool shall not be operated without a license.
(2) A person engaged in the operation of a public swimming pool shall obtain a license to operate the
swimming pool from the department, its agent or representative, or a representative of a designated local
health department and shall pay an initial or renewal fee as specified in section 12527a.
(3) A license shall be displayed by the owner in a conspicuous place on the premises.
(4) A license shall expire December 31 of every third year if the annual renewal fee is paid or as stipulated
on the license, whichever is sooner.
(5) A license shall be renewed upon receipt of a proper application, an annual renewal fee as specified in
section 12527a, and evidence that the public swimming pool is being operated and maintained in accordance
with sections 12521 to 12534 and the applicable rules and regulations.
(6) A license shall not be transferred to another person but it may be replaced by another license upon
receipt of a proper application and the fee specified in section 12527a.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1980, Act 522, Imd. Eff. Jan. 26, 1981;Am. 2004, Act 408, Imd. Eff. Nov. 29,
2004.
Popular name: Act 368
333.12527a Fees.
Sec. 12527a. (1) The fees related to swimming pool regulation under this part are as follows:
(a) Construction permit fee for a swimming pool with a
surface area as follows:
(i) 500 square feet or less.................... $ 550.00
(ii) 501 to 1,500 square feet................... $ 700.00
(iii) 1,501 to 2,400 square feet................. $ 800.00
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(iv) 2,401 to 4,000 square feet................. $1,300.00
(v) More than 4,000 square feet................ $1,800.00
(b) Construction permit fee for modification
of an existing swimming pool............... $ 275.00
(c) Initial license fee for a swimming pool
with a surface area as follows:
(i) 500 square feet or less.................... $ 550.00
(ii) 501 to 1,000 square feet................... $ 600.00
(iii) 1,001 to 1,500 square feet................. $ 625.00
(iv) 1,501 to 2,000 square feet................. $ 650.00
(v) 2,001 to 2,500 square feet................. $ 700.00
(vi) 2,501 to 3,500 square feet................. $ 800.00
(vii) 3,501 to 4,500 square feet................. $ 900.00
(viii)More than 4,500 square feet................ $1,000.00
(d) Initial license fee for a modified swimming
pool....................................... $ 275.00
(e) Annual renewal license fee, to December 31. $ 55.00
(f) Late annual renewal license fee, after
December 31 through April 30............... $ 100.00
(g) Lapsed annual renewal license fee, after
April 30................................... $ 150.00
(h) Replacement license fee for transfer to
another person............................. $ 50.00
(2) The department may adjust the amounts prescribed in subsection (1) every 3 years by an amount
determined by the state treasurer to reflect the cumulative annual percentage change in the Detroit consumer
price index and rounded to the nearest dollar.
(3) A person that has a valid, current permit to operate a public swimming pool on the effective date of the
amendatory act that added this subsection is not required to pay an initial license fee as specified in this
section.
History: Add. 1980, Act 522, Imd. Eff. Jan. 26, 1981;Am. 1985, Act 19, Eff. Mar. 31, 1986;Am. 2004, Act 408, Imd. Eff. Nov.
29, 2004.
Popular name: Act 368
333.12527b Public swimming pool fund; creation; remaining balance; expenditures; use;
annual report.
Sec. 12527b. (1) The public swimming pool fund is created in the state treasury and shall be administered
by the department. The state treasurer shall credit to the public swimming pool fund all fees collected by the
department under section 12527a and all money, gifts, and devises received by the fund as otherwise provided
by law.
(2) The unencumbered balance remaining in the fund at the close of the fiscal year shall remain in the fund
and shall not revert to the general fund.
(3) The money in the public swimming pool fund shall be expended only as provided in this section. The
department shall use the fund to implement this part and to carry out its powers and duties under sections
12521 to 12534. The department shall not use the money in the public swimming pool fund for inspections of
any mobile home parks licensed under the mobile home commission act, 1987 PA 96, MCL 125.2301 to
125.2349.
(4) The department shall annually prepare a report containing an accounting of revenues and expenditures
from the public swimming pool fund. This report shall include details of the departmental costs and activities
of the previous year in administering this public swimming pool program. This report shall be provided to the
senate and house of representatives appropriations committees, the standing committees of the senate and
house of representatives with jurisdiction over issues pertaining to natural resources and the environment, and
the senate and house of representatives fiscal agencies.
History: Add. 2004, Act 408, Imd. Eff. Nov. 29, 2004.
Popular name: Act 368
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333.12533 Violation as misdemeanor; each day of violation as separate violation;
prosecution.
Sec. 12533. A person who violates sections 12521 to 12531a or a rule promulgated under those sections is
guilty of a misdemeanor. Each day upon which a violation occurs is a separate violation. The attorney general
or local prosecuting attorney shall be responsible for prosecuting a person who violates sections 12521 to
12531a.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1989, Act 153, Imd. Eff. July 19, 1989.
Popular name: Act 368
Administrative rules: R 325.2111 et seq. of the Michigan Administrative Code.
333.12541 Testing and evaluating quality of water at bathing beaches; purpose; posting
sign; injunction; definitions.
Sec. 12541. (1) The local health officer or an authorized representative of the local health department
having jurisdiction may test and otherwise evaluate the quality of water at bathing beaches to determine
whether the water is safe for bathing purposes. However, the local health officer or authorized representative
shall notify the city, village, or township in which the bathing beach is located prior to conducting the test or
evaluation.
(2) If a local health officer or an authorized representative of a local health department conducts a test or
evaluation of a bathing beach under subsection (1), within 36 hours of conducting the test or evaluation, he or
she shall notify the department, the city, village, or township in which the bathing beach is located, and the
owner of the bathing beach of the results of the test or evaluation.
(3) The owner of the bathing beach shall post at the main entrance to the bathing beach or other visible
location a sign that states whether or not the bathing beach has been tested or evaluated under subsection (1)
and, if the bathing beach has been tested, the location of where test results may be reviewed. Open stretches
of beach or beaches at road ends that are not advertised or posted as public bathing beaches do not need to
have signs posted.
(4) If a local health officer or authorized representative of the local health department conducts a test or
evaluation under subsection (1) and, based upon the standards promulgated under section 12544, the health
officer or the authorized representative determines that the water is unsafe for bathing, he or she may petition
the circuit court of the county in which the bathing beach is located for an injunction ordering the person
owning or operating the bathing beach to close the bathing beach for use by bathers or ordering other
measures to keep persons from entering on the bathing beach. Upon receipt of a petition under this subsection,
the court may grant an injunction if circumstances warrant it.
(5) As used in this section:
(a) Bathing beach means a beach or bathing area offered to the public for recreational bathing or
swimming. It does not include a public swimming pool as defined in section 12521.
(b) Department means the department of environmental quality.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2002, Act 507, Eff. Mar. 31, 2003.
Popular name: Act 368
333.12542 Public bathing beach; safety and rescue equipment; communication with outside
sources of assistance.
Sec. 12542. The owner or person in charge of a public bathing beach shall provide and maintain suitable
and adequate safety and rescue equipment and suitable and adequate means of communication with outside
sources of assistance, which shall be available and accessible at the public bathing beach when it is open to
bathers.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
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333.12543 Consulting and cooperating with local health officers; training for employees;
assistance.
Sec. 12543. The department or an authorized representative of the department shall consult and cooperate
with local health officers and shall provide training for employees thereof and otherwise assist in the effective
administration of sections 12541 to 12545.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
PART 126
SMOKING IN PUBLIC PLACES
333.12601 Definitions.
Sec. 12601. (1) As used in this part:
(a) "Casino" means that term as defined in section 2 of the Michigan gaming control and revenue act, 1996
IL 1, MCL 432.202. Casino does not include a casino operated under the Indian gaming regulatory act, 25
USC 2701 to 2721.
(b) "Child caring institution" and "child care center" mean those terms as defined in section 1 of 1973 PA
116, MCL 722.111.
(c) "Cigar" means any roll of tobacco weighing 3 or more pounds per 1,000, which roll has a wrapper or
cover consisting only of tobacco.
(d) "Cigar bar" means an establishment or area within an establishment that is open to the public and is
designated for the smoking of cigars, purchased on the premises or elsewhere.
(e) "County medical care facility" means that term as defined in section 20104.
(f) "Educational facility" means a building owned, leased, or under the control of a public or private school
system, college, or university.
(g) "Food service establishment" means a food service establishment as defined in section 12905.
(h) "Health facility" means a health facility or agency licensed under article 17, except a home for the
aged, nursing home, county medical care facility, hospice, or hospital long-term care unit.
(i) "Home for the aged" means that term as defined in section 20106.
(j) "Hospice" means that term as defined in section 20106.
(k) "Hospital long-term care unit" means that term as defined in section 20106.
(l) "Meeting" means a meeting as defined in section 2 of the open meetings act, 1976 PA 267, MCL
15.262.
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(m) "Motor vehicle" means that term as defined in section 33 of the Michigan vehicle code, 1949 PA 300,
MCL 257.33.
(n) "Nursing home" means that term as defined in section 20109.
(o) "Place of employment" means an enclosed indoor area that contains 1 or more work areas for 1 or more
persons employed by a public or private employer. Place of employment does not include any of the
following:
(i) A structure used primarily as the residence of the owner or lessee that is also used as an office for the
owner or lessee and for no other employees.
(ii) A food service establishment that is subject to section 12905.
(iii) A motor vehicle.
(p) "Public body" means a public body as defined in section 2 of the open meetings act, 1976 PA 267,
MCL 15.262.
(q) "Public place", except as otherwise provided in subsection (2), means any of the following:
(i) An enclosed, indoor area owned or operated by a state or local governmental agency and used by the
general public or serving as a meeting place for a public body, including an office, educational facility, home
for the aged, nursing home, county medical care facility, hospice, hospital long-term care unit, auditorium,
arena, meeting room, or public conveyance.
(ii) An enclosed, indoor area that is not owned or operated by a state or local governmental agency, is used
by the general public, and is any of the following:
(A) An educational facility.
(B) A home for the aged, nursing home, county medical care facility, hospice, or hospital long-term care
unit.
(C) An auditorium.
(D) An arena.
(E) A theater.
(F) A museum.
(G) A concert hall.
(H) Any other facility during the period of its use for a performance or exhibit of the arts.
(iii) Unless otherwise exempt under this part, a place of employment.
(r) "Smoking" or "smoke" means the burning of a lighted cigar, cigarette, pipe, or any other matter or
substance that contains a tobacco product.
(s) "Smoking paraphernalia" means any equipment, apparatus, or furnishing that is used in or necessary for
the activity of smoking.
(t) "Tobacco product" means a product that contains tobacco and is intended for human consumption,
including, but not limited to, cigarettes, noncigarette smoking tobacco, or smokeless tobacco, as those terms
are defined in section 2 of the tobacco products tax act, 1993 PA 327, MCL 205.422, and cigars.
(u) "Tobacco specialty retail store" means an establishment in which the primary purpose is the retail sale
of tobacco products and smoking paraphernalia, and in which the sale of other products is incidental. Tobacco
specialty retail store does not include a tobacco department or section of a larger commercial establishment or
any establishment with any type of liquor, food, or restaurant license.
(v) "Work area" means a site within a place of employment at which 1 or more employees perform
services for an employer.
(2) In addition, article 1 contains general definitions and principles of construction applicable to all articles
of this code.
History: Add. 1986, Act 198, Eff. Jan. 1, 1987;Am. 1988, Act 294, Eff. Oct. 1, 1988;Am. 1988, Act 296, Eff. Mar. 30, 1989;
Am. 1988, Act 315, Eff. Mar. 30, 1989;Am. 2009, Act 188, Eff. May 1, 2010.
Compiler's note: For transfer of certain powers and duties of the center for health promotion and chronic disease prevention from the
department of public health to the director of the department of community health, see E.R.O. No. 1996-1, compiled at MCL 330.3101 of
the Michigan Compiled Laws.
Popular name: Act 368
333.12603 Smoking in public place or at meeting of public body prohibited; duties of owner,
operator, manager, or person having control of public place, food establishment, or
casino; good faith effort to prohibit smoking; affirmative defense; affidavit; section
referred to as "Dr. Ron Davis Law."
Sec. 12603. (1) An individual shall not smoke in a public place or at a meeting of a public body, and a state
or local governmental agency or the person who owns, operates, manages, or is in control of a public place
shall make a reasonable effort to prohibit individuals from smoking in a public place.
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(2) The owner, operator, manager, or person having control of a public place, a food service establishment,
or a casino subject to section 12606b shall do all of the following:
(a) Clearly and conspicuously post "no smoking" signs or the international "no smoking" symbol at the
entrances to and in every building or other area where smoking is prohibited under this act.
(b) Remove all ashtrays and other smoking paraphernalia from anywhere smoking is prohibited under this
act.
(c) Inform individuals smoking in violation of this act that they are in violation of state law and subject to
penalties.
(d) If applicable, refuse to serve an individual smoking in violation of this act.
(e) Ask an individual smoking in violation of this act to refrain from smoking and, if the individual
continues to smoke in violation of this act, ask him or her to leave the public place, food service
establishment, or nonsmoking area of the casino.
(3) The owner, operator, manager, or person in control of a hotel, motel, or other lodging facility shall
comply with subsection (2) and section 12606. It is an affirmative defense to a prosecution or civil or
administrative action for a violation of this section that the owner, operator, manager, or person in control of a
hotel, motel, or other lodging facility where smoking is prohibited under this section made a good faith effort
to prohibit smoking by complying with subsection (2). To assert the affirmative defense under this subsection,
the owner, operator, manager, or person shall file a sworn affidavit setting forth his or her efforts to prohibit
smoking and his or her actions of compliance with subsection (2).
(4) This section may be referred to as the "Dr. Ron Davis Law".
History: Add. 1986, Act 198, Eff. Jan. 1, 1987;Am. 1988, Act 296, Eff. Mar. 30, 1989;Am. 1993, Act 217, Eff. Apr. 1, 1994;
Am. 2009, Act 188, Eff. May 1, 2010.
Popular name: Act 368
333.12604 Smoking in a child caring institution or child care center or on the real property
under control of institution or center; violation; penalties.
Sec. 12604. (1) An individual shall not smoke in a child caring institution or child care center or on real
property that is under the control of a child caring institution or a child care center and upon which the child
caring institution or child care center is located, including other related buildings.
(2) An individual who violates this section is subject to all the penalties described in section 15 of Act No.
116 of the Public Acts of 1973, being section 722.125 of the Michigan Compiled Laws, except imprisonment.
History: Add. 1988, Act 294, Eff. Oct. 1, 1988;Am. 1991, Act 178, Eff. June 21, 1992;Am. 1993, Act 217, Eff. Apr. 1, 1994.
Popular name: Act 368
333.12606a Cigar bar or tobacco specialty retail store in existence on effective date of
section; exemption from smoking prohibition; affidavit; request for additional information;
failure to file affidavit.
Sec. 12606a. (1) A cigar bar in existence on the effective date of this section that meets all of the
requirements of this section is exempt from the smoking prohibition of section 12603 and may allow smoking
on its premises. To qualify for the exemption under this section, the person who owns or operates a cigar bar
shall file an affidavit with the department on or before the expiration of 30 days after the effective date of this
section and on January 31 of each year after the effective date of this section. The affidavit shall be signed by
the owner or operator of the cigar bar and shall certify that the cigar bar was in existence on the effective date
of this section and that it meets all of the following requirements:
(a) In the 30-day period immediately preceding the effective date of this section, the cigar bar generated
10% or more of its total gross annual income from the on-site sale of cigars and the rental of on-site humidors.
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(b) For each calendar year after the calendar year in which the first affidavit is filed under this subsection,
the cigar bar generates 10% or more of its total gross annual income from the on-site sale of cigars and the
rental of on-site humidors.
(c) The cigar bar is located on premises that are physically separated from any areas of the same or
adjacent establishment in which smoking is prohibited under this part or part 129 and where smoke does not
infiltrate into those nonsmoking areas. As used in this subdivision, "physically separated" means an area that
is enclosed on all sides by any combination of solid walls, windows, or doors that extend from the floor to
ceiling.
(d) The cigar bar has installed on its premises an on-site humidor.
(e) The cigar bar prohibits entry to a person under the age of 18 during the time the cigar bar is open for
business.
(f) The cigar bar allows only the smoking of cigars on the premises that retail for over $1.00 per cigar.
(g) The cigar bar prohibits the smoking of all other tobacco products.
(2) A tobacco specialty retail store in existence on the effective date of this section that meets all of the
requirements of this section is exempt from the smoking prohibition of section 12603 and may allow smoking
on its premises. To qualify for the exemption under this section, the person who owns or operates a tobacco
specialty retail store shall file an affidavit with the department on or before the expiration of 30 days after the
effective date of this section and on January 31 of each year after the effective date of this section. The
affidavit shall be signed by the owner or operator of the tobacco specialty retail store and shall certify that the
tobacco specialty retail store was in existence on the effective date of this section and that it meets all of the
following requirements:
(a) In the 30-day period immediately preceding the filing of the effective date of this section, the tobacco
specialty retail store generated 75% or more of its total gross annual income from the on-site sale of tobacco
products and smoking paraphernalia.
(b) For each calendar year after the calendar year in which the first affidavit is filed under this subsection,
the tobacco specialty retail store generated 75% or more of its total gross annual income from the on-site sale
of tobacco products and smoking paraphernalia.
(c) The tobacco specialty retail store is located on premises that are physically separated from any areas of
the same or adjacent establishments in which smoking is prohibited under this part or part 129 and where
smoke does not infiltrate into those nonsmoking areas. As used in this subdivision, "physically separated"
means an area that is enclosed on all sides by any combination of solid walls, windows, or doors that extend
from the floor to ceiling.
(d) The tobacco specialty retail store prohibits entry to a person under the age of 18 during the time the
tobacco specialty retail store is open for business.
(3) The department may request additional information from a cigar bar or tobacco specialty retail store to
verify that the cigar bar or tobacco specialty retail store meets the requirements of this section. A cigar bar or
tobacco specialty retail store shall comply with requests from the department under this section.
(4) Except as otherwise provided in this subsection, a cigar bar or tobacco specialty retail store that does
not meet the requirements of this section or violates this section is not exempt from the smoking prohibition
of section 12603 and shall immediately prohibit smoking on its premises. A cigar bar or tobacco specialty
retail store that meets all of the requirements of this section other than filing the affidavit as required under
subsection (1) or (2), retains its exemption and may continue to allow smoking during the period beginning on
the date the affidavit is due and ending on the expiration of 21 days after that date. However, if the affidavit
remains unfiled after the 21-day grace period, the cigar bar or tobacco specialty retail store is not exempt from
the smoking prohibition of section 12603 and shall immediately prohibit smoking on its premises. A cigar bar
or tobacco specialty retail store that loses its exemption under this subsection is not exempt from the smoking
prohibition of section 12603, shall immediately prohibit smoking on its premises, and may only again qualify
for the exemption under this section by filing an affidavit and meeting all of the requirements of subsection
(1) or (2), as applicable.
History: Add. 2009, Act 188, Eff. May 1, 2010.
Popular name: Act 368
333.12609 Rules.
Sec. 12609. The department may promulgate rules to implement this part.
History: Add. 1986, Act 198, Eff. Jan. 1, 1987.
Popular name: Act 368
333.12613 Enforcement; civil fine; injunctive relief; remedies independent and cumulative.
Sec. 12613. (1) Subject to subsection (2), the department shall enforce this part and part 129 and any rules
promulgated under this part pursuant to sections 2262(2) and 2263. In addition to the civil fine authorized
under section 12611, the department may enforce this part and any rules promulgated under this part through
an action commenced pursuant to section 2255 or any other appropriate action authorized by law.
(2) Pursuant to section 2235, the department may authorize a local health department to enforce this part
and part 129 and any rules promulgated under this part. A local health department authorized to enforce this
part and part 129 and any rules promulgated under this part shall enforce this part and part 129 and any rules
promulgated under this part pursuant to sections 2461(2) and 2462. In addition to the civil fine authorized
under section 12611, a local health department may enforce this part and part 129 and any rules promulgated
under this part through an action commenced pursuant to section 2465 or any other appropriate action
authorized by law.
(3) In addition to any other enforcement action authorized by law, a person alleging a violation of this part
may bring a civil action for appropriate injunctive relief, if the person has used the public place, child caring
institution, or child care center within 60 days before the civil action is filed.
(4) The remedies under this part are independent and cumulative. The use of 1 remedy by a person shall
not bar the use of other lawful remedies by that person or the use of a lawful remedy by another person.
History: Add. 1986, Act 198, Eff. Jan. 1, 1987;Am. 1988, Act 294, Eff. Oct. 1, 1988;Am. 1988, Act 296, Eff. Mar. 30, 1989;
Am. 1988, Act 315, Eff. Mar. 30, 1989;Am. 2009, Act 188, Eff. May 1, 2010.
Popular name: Act 368
333.12614 Reports.
Sec. 12614. (1) The director shall report biennially to the legislature on the effect and enforcement of this
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part and part 129. The report shall include, at a minimum, compliance with sections 12603 and 12905.
(2) Upon request of the department, the director of the department of management and budget annually
shall report to the department, at a minimum, a list of each public place owned or operated by the state and its
compliance with section 12603.
History: Add. 1988, Act 296, Eff. Mar. 30, 1989;Am. 2009, Act 188, Eff. May 1, 2010.
Popular name: Act 368
PART 127
WATER SUPPLY AND SEWER SYSTEMS
333.12701 Definitions used in MCL 333.12701 to 333.12715.
Sec. 12701. (1) As used in sections 12701 to 12715:
(a) Person means a person as defined in section 1106 or a governmental entity.
(b) Pump means a mechanical equipment or device used to remove water from a well.
(c) Pump installer means a person who is qualified to engage in the installation, removal, alteration, or
repair of water well pumping equipment in connection with a water well.
(d) Well means an opening in the surface of the earth for the purpose of removing fresh water or a test
well, recharge well, waste disposal well, or a well used temporarily for dewatering purposes during
construction.
(e) Well drilling contractor means a person qualified to engage in well construction, well alteration, or
well repair and pump installation, who supervises the construction of water wells and the installation of
pumps, and who owns, rents, or leases equipment used in the construction of water wells.
(2) In addition, article 1 contains general definitions and principles of construction applicable to all articles
in this code.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Compiler's note: For transfer of powers and duties of the division of environmental health and the division of water supply from the
director of the department of public health to the director of the department of environmental quality, see E.R.O. No. 1996-1, compiled at
MCL 330.3101 of the Michigan Compiled Laws.
Popular name: Act 368
333.12704 Certificate of registration as well drilling contractor, pump installer, water well
drilling contractor, or dewatering well pump installer; application; fees; exemption.
Sec. 12704. (1) Before engaging in the business of well drilling or pump installing, a person shall obtain a
certificate of registration annually as a well drilling contractor or pump installer, using an application
prepared by the department.
(2) Before engaging in the business of constructing dewatering wells or installing dewatering well pumps,
a person shall obtain a certificate of registration annually as a water well drilling contractor limited to the
construction of dewatering wells or as a dewatering well pump installer, using an application prepared by the
department.
(3) The applicant shall pay a registration fee with the application. The initial registration fee and the annual
renewal registration fee for a well drilling contractor is $40.00 and for a pump installer is $25.00. A well
drilling contractor shall pay an additional annual fee of $10.00 for each additional drilling machine. A
registered well drilling contractor may do any of the work of a pump installer without payment of the fee for a
pump installer.
(4) A county, city, village, township, or other governmental unit engaged in well drilling or pump
installing shall be registered under sections 12701 to 12715, but shall be exempt from paying the registration
fees if the drilling or installing is done by regular employees of, and with equipment owned by, the
governmental unit and the work is on wells or pumps intended for use by the governmental unit.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.12707 Record required; contents; copies; forms; sufficiency of record for drive point
well.
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Sec. 12707. Not later than 60 days after the completion of a well, a well drilling contractor shall provide
the owner with a copy and the department, or local health department, with 2 copies of a record indicating the
well owner's name, location of the well, well depth, geologic materials and thicknesses of materials
penetrated, amount of casing, static water levels, and any other information which may be required by the
rules and construction code promulgated under section 12714. The department or local health department
shall send 1 copy of the record to the director of the department of natural resources not later than 30 days
after its receipt from the well drilling contractor. Standard forms for the record shall be provided by the
department or the contractor's forms may be used if approved by the department. A record for a drive point
well where no earth materials are removed from the well bore is sufficient if the owner's name, well location,
depth, casing, static water level, and screen data are stated.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
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333.12712 Advisory board; terms of members; vacancies.
Sec. 12712. Each member of the advisory board shall be appointed for a 3-year term. The terms of the 5
members registered under sections 12701 to 12715 shall alternate so that not more than 2 are appointed each
year, except that of the first appointees, 1 shall be appointed for 1 year and 2 each shall be appointed for 2 and
3 years. The terms of the members representing the department of natural resources, the water resources
commission, and the local health department shall alternate so that only 1 is appointed each year, except that
of the first appointees 1 member shall be appointed for 1 year, 1 for 2 years, and 1 for 3 years. Vacancies shall
be filled by appointment for the balance of the unexpired terms by the respective officials designated in
section 12711.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.12754 Failure to connect structure to public sanitary sewer; notice; action to compel
connection.
Sec. 12754. (1) When the structure in which sanitary sewage originates is not connected to an available
public sanitary sewer system within the time specified in section 12753, the governmental unit in which the
structure lies shall require the connection to be made immediately after notice, which may be by first class or
certified mail to the owner of the property or by posting on the property.
(2) The notice shall give the approximate location of the public sanitary sewer system which is available
for connection of the structure involved and shall advise the owner of the requirements and enforcement
provisions of sections 12752 to 12758 and any applicable ordinance or regulation.
(3) Where a structure in which sanitary sewage originates is not connected to an available public sanitary
sewer system within 90 days after the date of mailing or posting of the written notice, the governmental unit
which operates the available sanitary sewer system may bring an action for a mandatory injunction or order in
the district, municipal, or circuit court in the county in which the structure is situated to compel the owner to
connect to the available sanitary sewer system immediately. The governmental unit may join any number of
owners of structures situated within the governmental unit in the action to compel each owner to connect to an
available sanitary sewer system immediately.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
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Administrative rules: R 325.421 et seq. of the Michigan Administrative Code.
PART 129.
SMOKE-FREE FOOD SERVICE ESTABLISHMENTS
333.12901-333.12904 Repealed. 2000, Act 92, Eff. Nov. 8, 2000.
Compiler's note: The repealed sections pertained to definitions, preparation and service of wild game, creation of food service
sanitation advisory board, and license to operate food service establishment.
Popular name: Act 368
***** 333.12909 SUBSECTION (3) EXPIRES AUGUST 17, 1981: See (3) of 333.12909 *****
333.12909 Rules; manufacturing, processing, or freezing frozen desserts; compliance with
standards; adoption of federal provisions by reference; recognition of other enforcement
procedures; meanings of certain terms; expiration of subsection (3); food service
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establishment or vending machine in place before effective date of part; food service
sanitation program as required service.
Sec. 12909. (1) The department shall promulgate rules to prescribe criteria for programs by local health
departments and procedures for the administration and enforcement of this part. The department may
promulgate rules to prescribe minimum standards of sanitation for the protection of the public health and
otherwise provide for the implementation of this part. The department in promulgating these rules shall seek
the advice and counsel of local health departments and the food service industry.
(2) The manufacturing, processing, or freezing of frozen desserts as defined in section 2 of the frozen
desserts act of 1968, Act No. 298 of the Public Acts of 1968, being section 288.322 of the Michigan
Compiled Laws, in food service establishments licensed pursuant to this part, which frozen desserts are
intended only for use in the soft form by patrons, guests, patients, or employees, shall comply with the
standards of this part and rules promulgated pursuant to this part.
(3) Except as otherwise specifically defined or described in this part, the provisions of the 1976
recommendations of the United States food and drug administration for a food service sanitation manual,
including a model food service sanitation ordinance and the unabridged form of the vending of food and
beverages--a sanitation ordinance and code--1965 recommendations of the public health service are adopted,
except any reference in these ordinances and codes to adulteration, misbranding, advertising, and enforcement
procedures. Upon written request from a local health department, the department may recognize certain
enforcement procedures other than those contained in this part and rules promulgated under this part, when
the procedures will result in enforcement which is equivalent in effectiveness and have been legally adopted
by the local department of health. The words municipality of . . . as used in the recommendations for a
model food service sanitation ordinance shall mean the state and the term regulatory authority shall mean
the local health officer in charge of a local health department or the local health officer's designated
representative. This subsection shall expire September 30, 1981 or when the rules promulgated under
subsection (1) are promulgated, whichever is sooner.
(4) The design, construction, and equipment of a food service establishment or vending machine which
was in place before the effective date of standards developed or adopted under this part shall be considered to
be in compliance with this part if they are in compliance with the standards in effect on the date they were
installed and if they are in good repair and are being maintained in a sanitary condition.
(5) A food service sanitation program which meets the requirements of this part is a required service under
part 24.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1982, Act 324, Eff. Mar. 30, 1983.
Compiler's note: Subsection (3) of this section expired August 17, 1981, the date rules authorized under subsection (1) were
promulgated, being R 325.25101 et seq. of the Michigan Administrative Code.
For transfer of powers and duties of the food service sanitation program from the department of public health to the director of the
department of agriculture, see E.R.O. No. 1996-1, compiled at MCL 330.3101 of the Michigan Compiled Laws.
Popular name: Act 368
Administrative rules: R 285.514.1 of the Michigan Administrative Code.
333.12915 Local authority limited; exception; local permit; compliance with local codes,
regulations, or ordinances.
Sec. 12915. A county, city, village, or township shall not regulate those aspects of food service
establishments or vending machines which are subject to regulation under this part except to the extent
necessary to carry out the responsibility of a local health department pursuant to sections 12906 and 12908.
This part shall not relieve the applicant for a license or a licensee from responsibility for securing a local
permit or complying with applicable local codes, regulations, or ordinances not in conflict with this part.
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History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1982, Act 526, Eff. Mar. 30, 1983.
Popular name: Act 368
PART 131.
BODY ART FACILITIES
333.13101 Definitions.
Sec. 13101. (1) As used in this part:
(a) "Alcoholic liquor" means that term as defined in section 105 of the Michigan liquor control code of
1998, 1998 PA 58, MCL 436.1105.
(b) "Applicant" means the person who submits an application for a body art facility license under this part
and includes the owner or operator, an agent of the owner or operator, or any other person operating under the
apparent authority of the owner or operator of a body art facility that is required to be licensed under this part.
(c) "Body art facility" means the location at which an individual does 1 or more of the following:
(i) Performs tattooing.
(ii) Performs branding.
(iii) Performs body piercing.
(d) "Body piercing" means the perforation of human tissue other than an ear for a nonmedical purpose.
(e) "Branding" means a permanent mark made on human tissue by burning with a hot iron or other
instrument.
(f) "Controlled substance" means that term as defined in section 7104.
(g) "Critical violation" means a violation of this part that is determined by the department or a local health
department to be more likely than other violations of this part to contribute to illness in humans.
(h) "Licensee" means the person who is the holder of a license under this part or the person who is legally
responsible for the operation of a body art facility and includes the owner or operator, an agent of the owner
or operator, or any other person operating under the apparent authority of the owner or operator of a body art
facility that is required to be licensed under this part.
(i) "Local governing entity" means that term as defined in section 2406.
(j) "Minor" means an individual under 18 years of age who is not emancipated under section 4 of 1968 PA
293, MCL 722.4.
(k) "Smoking" means that term as defined in section 12601.
(l) "Tattoo" means 1 or more of the following:
(i) An indelible mark made upon the body of another individual by the insertion of a pigment under the
skin.
(ii) An indelible design made upon the body of another individual by production of scars other than by
branding.
(m) "Temporary body art facility" means a body art facility that operates at a fixed or temporary location in
this state for a time period that does not exceed 14 consecutive days and includes out-of-state facilities
operating within this state.
(2) In addition, article 1 contains general definitions and principles of construction applicable to all articles
in this code.
History: Add. 1996, Act 223, Eff. Sept. 1, 1996;Am. 2007, Act 149, Imd. Eff. Dec. 13, 2007;Am. 2010, Act 375, Imd. Eff. Dec.
22, 2010.
Popular name: Act 368
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333.13102 Tattoo, brand, or body piercing on minor; consent and proof of authority of parent
or guardian required.
Sec. 13102. An individual shall not tattoo, brand, or perform body piercing on a minor unless the
individual obtains the prior written informed consent of the minor's parent or legal guardian and proof of that
individual's authority to give the informed consent required under this section. The minor's parent or legal
guardian shall execute the written, informed consent required under this section in the presence of the licensee
or an employee or agent of the licensee. The minor's parent or legal guardian shall present to the licensee or
employee or agent of the licensee the minor's birth certificate or legal proof of guardianship to establish the
individual's authority to give the informed consent required under this section.
History: Add. 1996, Act 223, Eff. Sept. 1, 1996;Am. 2007, Act 149, Imd. Eff. Dec. 13, 2007;Am. 2010, Act 375, Imd. Eff. Dec.
22, 2010.
Popular name: Act 368
333.13103 Repealed. 2010, Act 375, Imd. Eff. Dec. 22, 2010.
Compiler's note: The repealed section pertained to violation of part or rules as misdemeanor.
Popular name: Act 368
333.13104 Tattooing, branding, or performing body piercing; licensure of body art facility
required; application; form; issuance; duration; temporary license; fees; adjustment.
Sec. 13104. (1) An individual shall not tattoo, brand, or perform body piercing on another individual unless
the tattooing, branding, or body piercing occurs at a body art facility licensed under this part. Any tattooing,
branding, or body piercing occurring in this state other than at a facility licensed under this part is considered
an imminent danger under section 2251 or 2451 and the department or a local health department shall order
the immediate cessation of that activity in the manner prescribed in this act.
(2) The owner or operator of a body art facility shall apply to the department for a body art facility license
under this part on a form provided by the department and at the time of application shall pay to the
department the appropriate fee prescribed under subsection (4). The department shall issue a license on an
annual basis to a body art facility that meets the requirements of this part or for a time period not to exceed 14
consecutive days to a temporary body art facility that meets the requirements of this part.
(3) If the department determines that the application is complete and the body art facility proposed or
operated by the applicant meets the requirements of this part and any rules promulgated under this part, the
department shall issue the appropriate license to the applicant for the operation of that body art facility.
Except for a temporary license issued under this part, the license is effective for up to 1 year and expires at 12
midnight on December 31. A temporary license issued under this part is effective for not more than 14
consecutive days and expires at 12 midnight on the date prescribed on the temporary license.
(4) Except as otherwise provided in this part, the applicant shall pay 1 of the following fees at the time of
application for a body art facility license:
(a) For an annual license....................... $ 500.00.
(b) For a temporary license to operate a body
art facility at a fixed location for not more than
14 consecutive days.................................. $ 150.00.
(5) An applicant for a new annual license that is filed on or after July 1 shall only pay 50% of the fee
prescribed in subsection (4)(a). A licensee that fails to submit an application for a license renewal on or before
December 1, in addition to the license fee under subsection (4)(a), shall pay an additional $250.00 late fee.
(6) The department shall issue a duplicate license upon request of a licensee and the payment of a duplicate
license fee of $50.00.
(7) Unless a different distribution is provided for in a cost reimbursement program under sections 2471 to
2498, the department shall distribute a portion of a fee collected under this section from an applicant or
licensee to a local health department authorized to enforce this part under section 13108 as follows:
(a) From the annual license fee under subsection (4)(a) or (5) and, if applicable, from the late fee under
subsection (5), 50%.
(b) From the temporary license fee under subsection (4)(b), 75%.
(c) From the duplicate license fee under subsection (6), 50%.
(8) The department shall adjust the fees prescribed in this section annually by an amount determined by the
state treasurer to reflect the cumulative annual percentage change in the Detroit-Ann Arbor-Flint consumer
price index, but not by an amount that exceeds 5%. As used in this subsection, "Detroit-Ann Arbor-Flint
consumer price index" means the most comprehensive index of consumer prices available for the Detroit, Ann
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Arbor, and Flint areas from the bureau of labor statistics of the United States department of labor.
History: Add. 2007, Act 149, Imd. Eff. Dec. 13, 2007;Am. 2010, Act 375, Imd. Eff. Dec. 22, 2010.
Popular name: Act 368
333.13105a Access to body art facility; books and records; findings; inspection report; order
to immediately cease operation of facility; license limitations.
Sec. 13105a. (1) An applicant or licensee shall give the local health department access to the body art
facility and all of its books and records during all hours of operation and during other reasonable hours to
allow the local health department to determine if the body art facility is in compliance with this part. An
inspection of a body art facility under this part may be announced or unannounced. An applicant or licensee
shall not do any of the following:
(a) Refuse to permit the local health department to enter or inspect a body art facility.
(b) Refuse to produce the body art facility's books and records for inspection.
(c) Any other activity that impedes the local health department's ability to carry out its duties prescribed in
this part.
(2) As part of an inspection under this part, the local health department may examine, take photographs, or
make copies of the books and records of the body art facility.
(3) Upon completion of an inspection under this part, the local health department shall reduce its findings
to writing on a form prescribed by the department. The inspection report shall include a summary of all
findings of the inspection with regard to items of compliance with this part. If any critical violations are
found, the inspection report shall include a compliance schedule for the body art facility to follow, which
schedule is consistent with the department's standards established under this part for body art facilities.
(4) An authorized representative of the local health department who participated in the conduct of the
inspection shall sign and date the inspection report and obtain the signature of the licensee on the report. A
copy of the signed and dated inspection report shall be delivered to the licensee.
(5) If the local health department determines that the continued operation of a body art facility is an
imminent danger under section 2451, the local health department shall order the immediate cessation of the
operation of that facility in the manner prescribed in this act. A body art facility ordered to cease operations
under this subsection shall immediately cease operations and shall not resume operations until the local health
department has conducted an inspection, has determined that the operation of the body art facility is no longer
an imminent danger, and has issued an order allowing the body art facility to resume operations.
(6) At any time it determines appropriate, a local health department may place limitations on the license of
a body art facility, which limitations include the imposition of restrictions or conditions, or both, on the
operations of that body art facility. A body art facility shall comply with all license limitations imposed under
this subsection until the local health department has conducted an inspection, has determined that the license
limitations are no longer necessary, and has issued an order allowing the body art facility to resume
operations without the license limitations.
History: Add. 2010, Act 375, Imd. Eff. Dec. 22, 2010.
Popular name: Act 368
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333.13106 License renewal.
Sec. 13106. The licensee shall apply to the department for renewal of the annual license on or before
December 1 each year. A licensee that fails to file an application for renewal as prescribed in this section is
subject to the late fee under section 13104.
History: Add. 2007, Act 149, Imd. Eff. Dec. 13, 2007;Am. 2010, Act 375, Imd. Eff. Dec. 22, 2010.
Popular name: Act 368
333.13108 Enforcement.
Sec. 13108. (1) Pursuant to section 2235, the department shall authorize a local health department to
enforce this part and any rules promulgated under this part. A local health department authorized to enforce
this part and any rules promulgated under this part shall enforce this part and any rules promulgated under this
part pursuant to sections 2461(2) and 2462. In addition to the penalties and remedies under this part, a local
health department may enforce this part and any rules promulgated under this part through an action
commenced pursuant to section 2465 or any other appropriate action authorized by law.
(2) If a local health department of a county or city under part 24 is unable or unwilling to perform the
functions required in this section and the county or city is not part of a district that has created a district health
department pursuant to section 2415, the county or city, through an intergovernmental agreement, may
contract with another local governing entity to have that entity's local health department perform the functions
required in this section. The contracting parties under this subsection shall obtain the department's approval
before execution of the intergovernmental agreement.
(3) Pursuant to section 2444, a local governing entity of a local health department authorized to enforce
this part under this section may fix and require the payment of fees by applicants and licensees for services
required to be performed by the local health department under this part.
(4) A local health department shall use as guidance in enforcing this part any safety standards or other
requirements issued by the department applicable to body art facilities.
(5) In addition to any other enforcement action authorized by law, a person alleging a violation of this part
may bring a civil action in a court of competent jurisdiction for appropriate injunctive relief.
History: Add. 2007, Act 149, Imd. Eff. Dec. 13, 2007;Am. 2010, Act 375, Imd. Eff. Dec. 22, 2010.
Popular name: Act 368
333.13110 Giving or selling tattooing, branding, body piercing kit or device to minor
prohibited; violation; fine.
Sec. 13110. A person shall not give or sell to a minor a tattooing, branding, or body piercing kit or other
tattooing, branding, or body piercing device. A person who violates this section is responsible for a state civil
infraction and is subject to a civil fine of not more than $500.00. This section shall be enforced pursuant to
chapter 88 of the revised judicature act of 1961, 1961 PA 236, MCL 600.8801 to 600.8835.
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History: Add. 2007, Act 149, Imd. Eff. Dec. 13, 2007;Am. 2010, Act 375, Imd. Eff. Dec. 22, 2010.
Popular name: Act 368
PART 133
DRY CLEANING
333.13301 Definitions and principles of construction.
Sec. 13301. (1) As used in this part:
(a) Approved means acceptable to the department.
(b) Class IV installation means a dry cleaning system utilizing solvents classified as nonflammable or as
nonflammable at ordinary temperatures and only slightly flammable at higher temperatures.
(c) Dry cleaning includes dry dyeing and means the process of removing dirt, grease, paints, and other
stains from wearing apparel, textiles, fabrics, and rugs by use of nonaqueous liquid solvents, including:
(i) Immersion and agitation in open vessels.
(ii) Immersion and agitation in closed machines.
(iii) Spotting or local application of flammable liquid solvents to spots of dirt, grease, paints, and stains not
removed by the immersion and agitation process.
(iv) Brushing or scouring with inflammable solutions.
(d) Dry dyeing means the process of dyeing clothes or other fabrics of textiles in a solution of dye colors
and nonaqueous solvents.
(e) Person means a person as defined in section 1106 or a governmental entity.
(2) In addition, article 1 contains general definitions and principles of construction applicable to all articles
in this code.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Compiler's note: For transfer of powers and duties of the dry cleaning program in the division of occupational health, with the
exception of the division of health risk assessment and the division of occupational health, from the director of the department of public
health to the director of the department of environmental quality, see E.R.O. No. 1996-1, compiled MCL 330.3101 of the Michigan
Compiled Laws.
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Popular name: Act 368
333.13306 License; application; issuance; duration; fee; fee adjustment; Detroit consumer
price index defined.
Sec. 13306. (1) The department may receive license applications for the operation of a class IV
installation. Upon compliance by an applicant with the requirements of this part and rules promulgated
pursuant to this part, the department shall issue a class IV installation license.
(2) The department shall issue a license under this part for a period of 1 year.
(3) Except as otherwise provided in subsection (4), the initial application and annual license fee for a class
IV installation license is $100.00 for each class IV installation with operating equipment and an additional
$2.75 per pound of rated capacity per cleaning wheel for each dry cleaning machine.
(4) The department shall adjust on an annual basis the installation license fees prescribed by subsection (3)
by an amount determined by the state treasurer to reflect the cumulative annual percentage change in the
Detroit consumer price index, not to exceed 5%. As used in this subsection, Detroit consumer price index
means the most comprehensive index of consumer prices available for the Detroit area from the bureau of
labor statistics of the United States department of labor.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1992, Act 53, Imd. Eff. May 20, 1992.
Popular name: Act 368
Administrative rules: R 325.17101 et seq. of the Michigan Administrative Code.
333.13310 Repealed. 2006, Act 195, Imd. Eff. June 19, 2006.
Compiler's note: The repealed section pertained to applicability of MCL 28.5i to class IV installation in same building or
establishment as other classes of dry cleaning installations.
Popular name: Act 368
PART 134.
TANNING FACILITIES
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333.13401 Definitions.
Sec. 13401. As used in this part:
(a) "Eye protection" or "protective eyewear" means protective eyewear that protects the eyes from
ultraviolet radiation, allows adequate vision to maintain balance, and meets the requirements of 21 CFR
1040.20.
(b) "Tanning device" means equipment that emits electromagnetic radiation with wavelengths in the air
between 200 and 400 nanometers and is used for tanning of the skin. Tanning device includes, but is not
limited to, a sunlamp, tanning booth, or tanning bed and accompanying equipment, including, but not limited
to, protective eyewear, timers, and handrails.
(c) "Tanning facility" means a location that provides individuals with access to a tanning device. Tanning
facility does not include a private residence with a tanning device if the tanning device is used only by an
owner or occupant of the private residence.
History: Add. 2008, Act 368, Imd. Eff. Dec. 23, 2008.
Popular name: Act 368
333.13405 Acknowledgment that customer has read statement required under MCL
333.13403; signing of statement and agreement to use protective eyewear; duties of owner
or operator of tanning facility; signing of statement by parent or legal guardian of
customer under 18 years of age.
Sec. 13405. (1) Before allowing a customer to use a tanning device, the owner or operator of any tanning
facility shall require the customer to sign a written statement acknowledging that the customer has read and
understood the written statement required under section 13403(1) and agrees to use protective eyewear. The
owner or operator of the tanning facility shall do all of the following:
(a) Require a customer to sign the statement at least once in a 1-year period.
(b) Retain the written statement for not less than 1 year.
(c) Make the written statement available for inspection upon request of a law enforcement officer.
(2) In the case of a customer under 18 years of age, the written statement described in subsection (1) shall
also be signed by the customer's parent or legal guardian while the parent or legal guardian is physically
present at the tanning facility and shall be signed in the presence of the owner or operator.
History: Add. 2008, Act 368, Imd. Eff. Dec. 23, 2008..
Popular name: Act 368
333.13407 Repealed. 2008, Act 368, Imd. Eff. Dec. 23, 2008.
Compiler's note: The repealed section pertained to use of tanning device by minor.
333.13409 Remedies.
Sec. 13409. The remedies under this part are independent and cumulative. The use of 1 remedy by a person
does not bar the use of other lawful remedies by that person or the use of a lawful remedy by another person.
History: Add. 2008, Act 368, Imd. Eff. Dec. 23, 2008..
Popular name: Act 368
PART 135
RADIATION CONTROL
333.13501 Definitions; principles of construction.
Sec. 13501. (1) As used in this part:
(a) General license means a license, effective pursuant to rules promulgated by the department without
the filing of an application, to transfer, acquire, own, possess, or use quantities of, or devices or equipment
utilizing, radioactive material.
(b) Ionizing radiation means gamma rays and x-rays, alpha particles, beta particles, high speed electrons,
neutrons, protons, high speed ions, and other high speed nuclear particles.
(c) Mammography means radiography of the breast for the purpose of enabling a physician to determine
the presence, size, location, and extent of cancerous or potentially cancerous tissue in the breast.
(d) Mammography authorization means authorization under section 13523 to use a radiation machine for
mammography.
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(e) Mammography interpreter means an individual who meets the requirements set forth in section
13523(2)(g) and is responsible for evaluating and interpreting mammographic images.
(f) Person means a person as defined in section 1106 or a governmental entity.
(g) Radioactive material means a solid, liquid, or gas material which emits ionizing radiation
spontaneously.
(h) Radiography means the making of a film or other record of an internal structure of the body by
passing x-rays or gamma rays through the body to act on film or other image receptor.
(i) Registration means registration of a source of ionizing radiation in writing with the department.
(j) Source of ionizing radiation means a device or material that emits ionizing radiation.
(k) Specific license means a license issued to use, manufacture, produce, transfer, receive, acquire, own,
or possess quantities of, or devices or equipment utilizing, radioactive material.
(2) In addition, article 1 contains general definitions and principles of construction applicable to all articles
in this code.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1989, Act 56, Imd. Eff. June 16, 1989;Am. 1994, Act 100, Imd. Eff. Apr. 18,
1994.
Compiler's note: For transfer of powers and duties of the radiation machine licensing and registration program in the division of
radiological health in the bureau of environmental and occupational health from the department of public health to the director of the
department of commerce, see E.R.O. No. 1996-1, compiled at MCL 330.3101 of the Michigan Compiled Laws.
For transfer of powers and duties of the division of radiological health, with the exception of the radiation machine licensing and
registration program, from the director of the department public health to the director of the department of environmental quality, see
E.R.O. No. 1996-1, compiled at MCL 330.3101 of the Michigan Compiled Laws.
Popular name: Act 368
Administrative rules: R 325.5001 et seq. of the Michigan Administrative Code.
333.13517 Right of entry to determine compliance or violation; warrant; search and seizure.
Sec. 13517. (1) The department may enter at all reasonable times upon private or public property upon
which sources of ionizing radiation are reasonably believed to be located, with the permission of the owner or
custodian thereof, to determine if there is compliance with or violation of this part or a rule or license.
(2) If the department has reasonable or probable cause to believe that a violation of this part or a rule or
license is being committed on private or public property or that there exists on the property evidence of a
violation, and permission to enter thereon is denied by the owner or custodian thereof, the department may
apply to the proper judicial officer under Act No. 189 of the Public Acts of 1966, being sections 780.651 to
780.659 of the Michigan Compiled Laws, for a warrant commanding the sheriff or a law enforcement officer,
with the aid of the department, to search the property and seize any source of ionizing radiation that is
possessed, controlled, or used wholly or partially in violation of this part or a rule or license, or any evidence
of a violation of this part or a rule or license.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.13522 Rules; avoiding dual licensing; recognition of other state or federal licenses;
schedule of fees; deposit of fees; nonrefundable fees in connection with mammography
authorization; waiver of fee; waiver prohibited; adjustment of fees.
Sec. 13522. (1) In promulgating rules pursuant to this part, the department shall avoid requiring dual
licensing, insofar as practical. Rules promulgated by the department may provide for recognition of other state
or federal licenses as the department considers desirable, subject to registration requirements prescribed by
the department. A person who, on the effective date of an agreement under Act No. 54 of the Public Acts of
1965, being sections 3.801 to 3.802 of the Michigan Compiled Laws, possesses a license issued by the federal
government for a source of ionizing radiation of the type for which the state assumes regulatory responsibility
under the agreement, is considered to possess an identical license issued pursuant to this part, which license
expires either 90 days after receipt of a written notice of termination from the department or on the date of
expiration stated in the federal license, whichever occurs first.
(2) The department may promulgate rules to establish a schedule of fees to be paid by applicants for
licenses for radioactive materials and devices and equipment utilizing the radioactive materials.
(3) Except as otherwise provided in this subsection, the department may promulgate rules to establish a
schedule of fees to be paid by an applicant for a license for other sources of ionizing radiation and the renewal
of the license, and by a person possessing sources of ionizing radiation that are subject to registration. The
registration or registration renewal fee for a radiation machine registered under this part is $45.00 for the first
veterinary or dental x-ray or electron tube and $25.00 for each additional veterinary or dental x-ray or electron
tube annually, or $75.00 annually per nonveterinary or nondental x-ray or electron tube. The department shall
not assess a fee for the amendment of a radiation machine registration certificate. In addition, the department
shall assess a fee of $100.00 for each follow-up inspection due to noncompliance during the same year. The
department may accept a written certification from the licensee or registrant that the items of noncompliance
have been corrected instead of performing a follow-up inspection. If the department does not inspect a source
of ionizing radiation for a period of 5 consecutive years, the licensee or registrant of the source of ionizing
radiation does not have to pay further license or registration fees as to that source of ionizing radiation until
the first license or registration renewal date following the time an inspection of the source of ionizing
radiation is made.
(4) A fee collected under this part shall be deposited in the state treasury and credited to the general fund of
this state.
(5) Except as otherwise provided in subsection (6), the department shall assess the following
nonrefundable fees in connection with mammography authorization:
(a) Inspection, per radiation machine............... $ 100.00
(b) Reinspection for reinstatement of mammography
authorization, per radiation machine..................... $ 100.00
(c) Department evaluation of compliance with section
13523(2)(a), per radiation machine....................... $ 700.00
Each reevaluation of a radiation machine due to
failure during the previous evaluation, relocation of the
radiation machine, or similar changes that could affect
earlier evaluation results............................... $ 300.00.
(6) If an applicant for mammography authorization submits an evaluation report issued by the American
college of radiology that evidences compliance with section 13523(2)(a), the department shall waive the fee
under subsection (5) for department evaluation of compliance with that provision.
(7) Except as otherwise provided in subsections (3) and (6), the department shall not waive a fee required
under this section.
(8) The department shall adjust on an annual basis the fees prescribed by subsections (3) and (5) by an
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amount determined by the state treasurer to reflect the cumulative annual percentage change in the Detroit
consumer price index, not to exceed 5%. As used in this subsection, "Detroit consumer price index" means the
most comprehensive index of consumer prices available for the Detroit area from the bureau of labor statistics
of the United States department of labor.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1980, Act 522, Imd. Eff. Jan. 26, 1981;Am. 1982, Act 403, Eff. Oct. 1, 1983;
Am. 1989, Act 56, Imd. Eff. June 16, 1989;Am. 1992, Act 88, Imd. Eff. June 4, 1992;Am. 1994, Act 100, Imd. Eff. Apr. 18, 1994.
Popular name: Act 368
Administrative rules: R 325.5001 et seq., R 325.5801 et seq., and R 325.5901 et seq. of the Michigan Administrative Code.
PART 136
RADIOACTIVE WASTE CONTROL COMMITTEE
333.13601-333.13606 Repealed. 1985, Act 190, Eff. Dec. 31, 1993.
Compiler's note: The repealed sections pertained to the radioactive waste control committee.
Popular name: Act 368
PART 137
333.13701 Meanings of words and phrases.
Sec. 13701. As used in this part, the words and phrases defined in sections 13702 to 13704 have the
meanings ascribed to them in those sections.
History: Add. 1987, Act 203, Imd. Eff. Dec. 22, 1987.
Popular name: Act 368
333.13702 Definitions; A to H.
Sec. 13702. (1) Above ground vault means an engineered structure with a floor, walls, and a roof
constructed at least partially above grade that is designed in a manner that is compatible with the requirements
of this part and the rules promulgated under this part.
(2) Above or below ground canisters are individual, engineered modular containers that contain 1 or
more waste packages that are approved by the department, in compliance with applicable federal law, and
designed in a manner that meets all of the requirements of this part and the rules promulgated under this part.
(3) Authority means the low-level radioactive waste authority created in the low-level radioactive waste
authority act, Act No. 204 of the Public Acts of 1987, being sections 333.26201 to 333.26226 of the Michigan
Compiled Laws.
(4) Below ground vault means an engineered structure with a floor, walls, and a roof constructed entirely
below grade that is designed in a manner that is compatible with the requirements of this part and the rules
promulgated under this part.
(5) Candidate site means a site designated by the authority as a possible host site.
(6) Carrier means a person authorized pursuant to this part who is engaged in the transportation of waste
by air, rail, highway, or water.
(7) Collector means a person authorized pursuant to this part who receives prepackaged waste from a
generator and who does not treat or repackage that waste.
(8) Compact means a contractual, cooperative agreement among 2 or more states to provide for the
disposal of low-level radioactive waste, that is reflected in the passage of statutes by the participating states.
(9) Disposal means the isolation of waste from the biosphere by emplacement in the disposal site or as
otherwise authorized in section 13709(3).
(10) Disposal site means a geographic location in this state upon which the disposal unit and any other
structures and appurtenances are located, the property upon which any monitoring equipment is located, and
the isolation distance from the disposal unit to adjacent property lines.
(11) Disposal unit means the portion of the disposal site into which waste is placed for disposal.
(12) Host site means the candidate site that is designated by the commissioner as the location for the
disposal site in this state.
History: Add. 1987, Act 203, Imd. Eff. Dec. 22, 1987;Am. 1994, Act 435, Imd. Eff. Jan. 6, 1995.
Compiler's note: For transfer of powers and duties of the division of radiological health, with the exception of the radiation machine
licensing and registration program, from the director of the department public health to the director of the department of environmental
quality, see E.R.O. No. 1996-1, compiled at MCL 330.3101 of the Michigan Compiled Laws.
Popular name: Act 368
333.13703 Definitions; G to M.
Sec. 13703. (1) Generator means any person licensed as a generator by the nuclear regulatory
commission and authorized pursuant to this part whose act or process results in the production of waste or
whose act first causes waste to become subject to regulation under this part or federal law.
(2) Groundwater means water below the land surface in a zone of saturation.
(3) Hazardous waste has the meaning attributed to it in part 111 (hazardous waste management) of the
natural resources and environmental protection act, Act No. 451 of the Public Acts of 1994, being sections
324.11101 to 324.11152 of the Michigan Compiled Laws.
(4) Host site means the candidate site that is designated by the authority as the location for the disposal
site in this state.
(5) Host site community means the municipality that is designated by the authority as the host site.
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(6) Institutional control means the continued surveillance, monitoring, and care of the disposal site after
site closure and stabilization to insure the protection of the public health, safety, and welfare, and the
environment until the contents of the disposal site no longer have a radioactive content that is greater than the
natural background radiation of the host site as determined during its site characterization.
(7) Local monitoring committee means a committee established pursuant to the low-level radioactive
waste authority act to provide for the participation of the residents of a candidate site community.
(8) Low-level radioactive waste or waste means radioactive material that consists of or contains class
A, B, or C radioactive waste as defined by 10 C.F.R. 61.55, as in effect on January 26, 1983 but does not
include waste or material that is any of the following:
(a) Owned or generated by the department of energy.
(b) Generated by or resulting from the operation or closure of a superconducting super collider.
(c) Owned or generated by the United States navy as a result of the decommissioning of vessels of the
United States navy.
(d) Owned or generated as a result of any research, development, testing, or production of an atomic
weapon.
(e) Identified under the formerly utilized sites remedial action program.
(f) High-level radioactive waste, spent nuclear fuel, or byproduct material as defined in section 11(e)(2) of
the atomic energy act of 1954, chapter 1073, 68 Stat. 922, 42 U.S.C.2014.
(g) Contains greater than or equal to 100 nanocuries per gram of transuranic elements.
(h) Contains concentrations of radionuclides that exceed the limits established by the nuclear regulatory
commission for class C radioactive waste as defined by 10 C.F.R. 61.55, as in effect on January 26, 1983.
(i) Classified as naturally occurring or accelerator-produced radioactive materials known as N.A.R.M.
waste.
(j) Waste that after the effective date of this part is determined by the nuclear regulatory commission to be
waste that is beneath regulatory concern, or B.R.C. waste as defined by the nuclear regulatory commission,
unless the department and the authority concur with this designation.
(9) Low-level radioactive waste management fund or fund means the fund created in section 20 of the
low-level radioactive waste authority act, Act No. 204 of the Public Acts of 1987, being section 333.26220 of
the Michigan Compiled Laws.
(10) Management means the collection, storage, packaging, processing, transportation, or disposal,
where applicable, of low-level radioactive waste.
(11) Manifest means a form provided or approved by the department that is used for identifying the
quantity; composition, including the class, curie count, and radioactive nuclides; origin; routing; and
destination of waste from the point of generation to the point of processing, collection, or disposal.
History: Add. 1987, Act 203, Imd. Eff. Dec. 22, 1987;Am. 1996, Act 67, Imd. Eff. Feb. 26, 1996.
Popular name: Act 368
333.13704 Definitions; M to S.
Sec. 13704. (1) Municipality means a city, village, township, or Indian tribe.
(2) Operation means the control, supervision, or implementation of the actual physical activities
involved in the acceptance, storage, disposal, and monitoring of waste at the disposal site, the maintenance of
the disposal site, and any other responsibility pertaining to the disposal unit and the disposal site.
(3) Performance assessment means an analysis of the potential pathways for release of waste to the
environment and the potential impacts of a release during the transportation of radioactive waste to the
disposal site and during the handling and disposal of waste at the disposal site, including, but not limited to:
(a) A description of the potential pathways for radioactive nuclide migration beyond the boundaries of the
disposal site during the operation of the site and in the event there is a release.
(b) A description of the potential pathways for radioactive nuclide migration beyond the packaging
boundaries in the event of a release that occurs during transportation.
(c) An analysis of safety factors pertaining to the transportation of waste.
(d) The identification of the potential impacts to air, surface water, and groundwater quality, and
vegetation, animals, and humans, or any other living thing beyond the boundaries of the disposal site.
(e) A description of potential mechanisms for radioactive release, including, but not limited to, mechanical
failure, structural failure, and human error.
(4) Person means a person as defined in section 1106, and, for the purposes of this part, includes the
authority, a municipality, county, the state, and any subdivision of the state.
(5) Postclosure observation and maintenance means the surveillance, monitoring, and maintenance of the
disposal site after it has been closed and continuing through site closure and stabilization and institutional
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control.
(6) Processing means any method, technique, or process, including storage to facilitate radioactive
decay, designed to change the physical, chemical, radioactive concentration, or biological characteristics or
composition of the waste, in order to render the waste safer for transport, storage, or disposal, amenable to
recovery, convertible to another usable material, or to reduce the volume of waste. Processing does not
include incineration or dilution of a material that has a radioactive concentration that is greater than the
radioactive concentration of low-level radioactive waste.
(7) Processor means a person authorized pursuant to this part who processes or repackages waste.
(8) Release means any intentional or unintentional spilling, leaking, pumping, emitting, emptying,
discharging, injecting, escaping, leaching, dumping, disposing, or placing of waste into the environment,
except in compliance with all of the following:
(a) This part.
(b) The rules promulgated under part 135.
(c) Any rules promulgated under this part.
(d) Federal law.
(e) A permit or license issued pursuant to federal law, if the person who is responsible for the release holds
such a permit or license.
(f) A permit or license issued pursuant to this part, if the person who is responsible for the release holds
such a permit or license.
(9) Remedial actions means those actions taken in the event of a radioactive release or threatened release
into the environment to prevent or minimize the radioactive release so that it does not migrate and cause
significant danger to the present or future public health, safety, or welfare, or to the environment. Remedial
action includes, but is not limited to, actions at the location of the release such as storage, confinement,
perimeter protection which may include dikes, trenches, and ditches, clay cover, neutralization, dredging or
excavation, repair or replacement of leaking containers, collection of leachate and runoff, efforts to minimize
the social and economic harm of processing, provision of alternative water supplies, and any required
monitoring to assure that the actions taken are sufficient to protect the public health, safety, and welfare, and
the environment.
(10) Shallow land burial means the disposal of waste in an excavated trench constructed entirely below
grade without a below-ground vault and without below-ground canisters.
(11) Site characterization means the site specific investigation of a candidate site undertaken pursuant to
section 12 of the low-level radioactive waste authority act.
(12) Site closure and stabilization means the actions taken at the disposal site during the time period after
the closure of the disposal unit during which on-site low-level radioactive waste is disposed in accordance
with this part, equipment is dismantled, decontaminated, removed for reuse or disposed of, and radioactive
residues are removed from, or properly isolated on, the disposal site.
(13) Storage means the temporary holding of low-level radioactive waste prior to processing or disposal.
History: Add. 1987, Act 203, Imd. Eff. Dec. 22, 1987.
Popular name: Act 368
Administrative rules: R 325.5001 et seq., R 325.5801 et seq., and R 325.5901 et seq. of the Michigan Administrative Code.
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333.13707 Review and recommendations; conflicting laws and rules.
Sec. 13707. (1) The department shall enter into negotiations with the federal government on behalf of this
state for full agreements providing for the discontinuance of specified federal authority with regard to waste
disposal, radioactive by-product, source and special nuclear material, or for other authority over radioactive
materials or sources of ionizing radiation in this state and assumption of that authority by this state. The
governor with the advice and consent of the senate may enter into 1 or more agreements with the federal
government negotiated pursuant to this subsection.
(2) The department and the attorney general shall review this part and all applicable federal and state laws
and rules pertaining to the authority, the disposal site, and to generators, carriers, collectors, and processors
and shall submit written recommendations to the legislature and the governor regarding whether this state
should require additional or more stringent regulations for generators, carriers, collectors, or processors to
protect the public health, safety, and welfare, and the environment. In addition, the department and the
attorney general shall submit written recommendations and the rationale supporting the recommendations to
the legislature regarding whether this state should include naturally occurring or accelerator produced
radioactive materials known as N.A.R.M. waste in the definition of waste that may be disposed of in the
disposal site. The recommendation required in this subsection shall be submitted by April 1, 1988.
(3) If a portion of this part or a rule that is promulgated under this part conflicts with part 135 or with a rule
that is promulgated under part 135 prior to the effective date of this part, this part and any rules promulgated
under this part shall be given precedence unless a contrary legislative intent is evident.
History: Add. 1987, Act 203, Imd. Eff. Dec. 22, 1987.
Popular name: Act 368
Administrative rules: R 325.5001 et seq., R 325.5801 et seq., and R 325.5901 et seq. of the Michigan Administrative Code.
333.13709 Compliance; disposal of waste; full agreement state status; waiver; acceptance of
waste for disposal.
Sec. 13709. (1) A person shall not possess, generate, collect, process, package, store, transport, or dispose
of waste in this state without complying with the requirements of this part.
(2) Except as otherwise provided in subsection (3), if this state has not obtained full agreement state status
with the federal government, a person shall not dispose of waste in this state except in the disposal site
licensed by the United States nuclear regulatory commission, or its successor agency, and by the director
through the issuance of a construction and operating license under this part. Except as otherwise provided in
subsection (3), if this state has full agreement state status, a person shall not dispose of waste in this state
except at the disposal site licensed by the director through the issuance of a construction and operating license
under this part.
(3) Prior to the issuance of a construction and operating license under this part, if a person obtains a waiver
pursuant to 10 C.F.R. 20.302, the requirement that waste be disposed of only in the disposal site shall be
waived by the director upon receipt of notice and evidence of such a waiver. Following the issuance of a
construction and operating license under this part, the director with the written concurrence of the authority
may grant or deny an application for a waiver of the requirement that waste be disposed of only in the
disposal site if either of the following occurs:
(a) If this state has obtained full agreement state status with the federal government, the department
approves the disposal of the waste in a location other than the disposal site and concludes that the waiver will
not harm the public health, safety, or welfare, or the environment and will not substantially impact on the
volume of waste available for disposal in the disposal site or the financial solvency of the disposal site.
(b) If this state has not obtained a full agreement state status with the federal government, the department
concludes that any waiver granted by the nuclear regulatory commission will not harm the public health,
safety, or welfare, or the environment and will not substantially impact on the volume of waste available for
disposal in the disposal site or the financial solvency of the disposal site.
(4) The department shall assure that waste that is not generated in this state or in a state with which this
state may elect to enter a compact shall not be accepted for disposal at the disposal site. In addition, if this
state is a member of a compact the department shall assure that this state does not accept waste for disposal
from any member of the compact that does either of the following:
(a) Is delinquent in paying dues or fees payable under the compact.
(b) Fails to establish or maintain a permitting and regulatory system, including penalties and remedies, that
equals or exceeds the laws and rules of this state as they apply to generators, carriers, processors, and
collectors.
(5) If this state is not a member of a compact, the department shall assure that the disposal site accepts only
waste generated in this state.
History: Add. 1987, Act 203, Imd. Eff. Dec. 22, 1987;Am. 1994, Act 435, Imd. Eff. Jan. 6, 1995.
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Legislative Council, State of Michigan Courtesy of www.legislature.mi.gov
Popular name: Act 368
333.13710 Minimum criteria for design, construction, and operation of disposal site.
Sec. 13710. (1) The director, following consultation with the department of natural resources, shall
establish minimum criteria for the design, construction, and operation of the disposal site. The minimum
criteria shall reflect and shall be updated to include state-of-the-art technology in regard to disposal site
design, construction, operation, and waste disposal technology. The criteria shall be developed and prepared
in the form of specifications to be included in the construction and operating license issued to the authority
pursuant to sections 13712 to 13714 and in any modification of that license. The criteria at a minimum shall
comply with criteria adopted under the atomic energy act of 1954, 42 U.S.C. 2011 to 2296 and regulations
pertaining to licensing requirements for land disposal of waste under 10 C.F.R. 61.1 to 61.81 and shall require
that the isolation distance between the disposal unit and adjacent property lines be at least 3,000 feet.
(2) Shallow land burial shall not be permitted. Acceptable disposal technologies shall be limited to above
and below ground canisters or above and below ground vaults, or both. The criteria shall also include
provisions for monitoring at the disposal site and within the disposal unit and provisions for the recoverability
of waste that has been disposed of in the disposal site.
History: Add. 1987, Act 203, Imd. Eff. Dec. 22, 1987;Am. 1994, Act 435, Imd. Eff. Jan. 6, 1995.
Popular name: Act 368
333.13711 Licensing requirements for design, construction, and operation of disposal site.
Sec. 13711. The licensing requirements for the design, construction, and operation of the disposal site shall
be at least as stringent as all applicable federal design, construction, and operating requirements. The director,
following consultation with the department of natural resources, shall establish requirements for the design,
construction, and operation of the disposal site that reflect those practices that are necessary to protect the
public health, safety, and welfare, and the environment, and that include at least all of the following:
(a) Requirements and performance standards for the operation of the disposal site.
(b) Requirements and standards for the keeping of records and the reporting and retaining of data collected
by the authority.
(c) Requirements, training, and standards for the personnel who operate, monitor, and maintain the
disposal site.
(d) Requirements and standards for the emergency closure of the disposal site.
(e) Requirements and standards for the postclosure observation and maintenance, and postclosure
ownership, monitoring, maintenance, and use, if any, of the disposal site.
(f) Specifications regarding the amounts, sources, form, chemical, and physical composition, and
concentrations of the waste that may be accepted at the disposal site.
History: Add. 1987, Act 203, Imd. Eff. Dec. 22, 1987.
Popular name: Act 368
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Popular name: Act 368
333.13714 Surety bond, secured trust fund, or other suitable secured instrument or
mechanism.
Sec. 13714. The authority shall file as a part of the application for a construction and operating license a
surety bond, secured trust fund, or other suitable secured instrument or mechanism that shall be approved by
the department and shall cover the cost of site closure and stabilization. In addition, the authority shall file a
surety bond, secured trust fund, or other suitable secured instrument or mechanism that shall be approved by
the department, and shall cover the cost of the postclosure observation and maintenance of the disposal site
and institutional control. The authority may use a combination of bonds, instruments, mechanisms, or funds,
as approved by the department, to satisfy the requirements of this section. The bond, instrument, mechanism,
or fund, or combination of these methods of assurance, shall be in an amount equal to a reasonable estimate of
the site closure and stabilization costs, based on the level of operations proposed in the application for the
construction and operating license, and for institutional control. The bond, instrument, mechanism, or fund, or
the combination of these methods of assurance, shall be adjusted periodically as determined by the
department to account for inflation or changes in the permitted level of operation of the disposal site. A failure
to maintain the bond, instrument, mechanism, or fund, or combination of these methods of assurance,
constitutes a violation of this part.
History: Add. 1987, Act 203, Imd. Eff. Dec. 22, 1987.
Popular name: Act 368
333.13719 Release of waste or hazardous waste; remedial action; site closure and
stabilization; cost.
Sec. 13719. (1) If there has been a release of waste or hazardous waste at the disposal site during its
operation, closure, or postclosure, the department shall assure that the authority takes appropriate remedial
action.
(2) If there is a release that requires the disposal site to be closed permanently, the department shall insure
that site closure and stabilization is complete and adequate and that the authority retains control of the
disposal site through the period of institutional control. The cost of site closure and stabilization shall be paid
from the low-level radioactive waste management fund.
History: Add. 1987, Act 203, Imd. Eff. Dec. 22, 1987.
Popular name: Act 368
333.13720 Site closure and stabilization; control; cost; rules; surveillance and maintenance
of disposal site.
Sec. 13720. (1) Beginning on January 1, 2014, or prior to that date if the disposal site has been
permanently closed for any reason, the authority shall begin site closure and stabilization. The department
shall assure that site closure and stabilization is complete and adequate and that the authority retains control of
the disposal site. The cost of site closure and stabilization shall be borne by the authority.
(2) The department shall promulgate rules pertaining to site closure and stabilization and the active
surveillance and maintenance of the disposal site.
(3) After completing site closure and stabilization, the authority shall be required by the department to
assure that surveillance and maintenance of the disposal site occurs in accordance with the requirements and
conditions of the construction and operating license and with any rules promulgated under this part. The
department shall assure that the authority retain control of the site through the period of institutional control.
History: Add. 1987, Act 203, Imd. Eff. Dec. 22, 1987.
Popular name: Act 368
333.13723 Operation of disposal site; inspection of shipment; refusal to accept waste; return
of waste; seizure and impoundment of vehicle and contents; imposition of surcharges;
notice; unloading; requirements as to transport vehicle; informing department of
violations.
Sec. 13723. (1) The disposal site shall be operated in accordance with this part, the rules promulgated
under this part, and in compliance with the terms and conditions of the construction and operating license and
any applicable federal requirements.
(2) Each shipment of waste that arrives at the disposal site shall not proceed into the unloading area until
inspected by both the authority and the department and found by the authority and the department to be in
compliance with this part, the rules promulgated under this part, the manifest, and any applicable provisions
of the construction and operating license. Shipments that are not in compliance shall proceed to a controlled
area for appropriate action to remedy the noncompliance or the authority may refuse to accept the waste. If
the authority refuses to accept the waste, the authority may order the waste returned by the carrier to the
generator or processor who contracted with the carrier to transport the waste to the disposal site. If the waste
is ordered to be returned, the authority shall specify on the manifest the address of the generator or processor
to whom the waste shall be returned. The authority may seize and impound a vehicle and the contents of that
vehicle if it transports waste in a manner that is not in compliance with this part or the rules promulgated
under this part or if the contents of the truck are not in compliance with this part or the rules promulgated
under this part. In addition, the authority may impose surcharges as provided in the low-level radioactive
waste authority act. A vehicle and its contents that are impounded as provided in this subsection shall not be
released until the department informs the authority that appropriate remedial and enforcement action has been
concluded. The authority or his or her authorized agent shall notify the department and the local monitoring
committee of the host site community of the noncomplying shipment. Shipments that are found to be in
compliance shall proceed to the unloading area. After a transport vehicle is unloaded, or leaves the unloading
area without being unloaded, it shall not leave the disposal site until it is inspected by the authorized agent of
the authority and the department and is decontaminated, if necessary.
(3) The authority shall promptly inform the department of any violation of this part, the rules promulgated
under this part, a permit issued under this part, or the low-level radioactive waste authority act, that is
committed or that the authority suspects was committed by a generator, collector, carrier, or processor.
History: Add. 1987, Act 203, Imd. Eff. Dec. 22, 1987.
Popular name: Act 368
333.13724 Compact member states; list of generators, carriers, processors, and collectors;
state laws and rules; valid permits; permitting and regulatory system; permission to
receive waste; equivalent privileges; expenses; liabilities; primary place of business;
eligibility for permit.
Sec. 13724. (1) If this state is a member of a compact, the department shall obtain from each compact
member a list of generators, carriers, processors, and collectors who hold permits to generate, transport,
process, or collect waste in each compact member state. The department shall also obtain an updated list of
the generators, carriers, processors, and collectors as necessary. In addition, the department shall obtain from
each state that is a member of a compact with this state the state laws and rules that regulate generators,
carriers, processors, and collectors in each compact member state.
(2) The department shall compile and maintain a list of all generators, carriers, processors, and collectors
who hold valid permits issued in this state under this part, including updated information regarding any
change in the status of a permit issued in this state under this part.
(3) If this state is a member of a compact, the department shall determine which compact member states
have established and maintained to the satisfaction of the department a permitting and regulatory system,
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including penalties and remedies, that equals or exceeds the laws and rules of this state as they apply to
generators, carriers, processors, and collectors, and the department shall prepare a master list that includes
only the names of generators, carriers, processors, and collectors who hold permits in those compact member
states and the names of generators, carriers, processors, and collectors who hold permits under this part.
(4) The department shall permit the authority to receive waste only from a generator, carrier, processor, or
collector whose name is on the master list and who holds a valid permit issued in this state under this part or
who holds a valid permit issued by a compact member state that has equivalent privileges in this state because
the state in which that person generates, carries, processes, or collects waste has established and maintains to
the satisfaction of the department a permitting and regulatory system, including penalties and remedies, that
equals or exceeds the laws and rules of this state as they pertain to generators, carriers, processors, and
collectors. If this state is a member of a compact, a compact member state that establishes and maintains a
permitting and regulatory system that the department determines equals or exceeds this state's system as
provided in subsection (3) shall, by accepting equivalent privileges in this state as provided in this subsection,
give its consent to the requirements of this part, the rules promulgated under this part, and the provisions of
the low-level radioactive waste authority act. In addition, each of the compact member states shall be
considered to have consented to share with this state and any other compact member states the expenses
incurred in the construction, operation, site closure and stabilization, postclosure observation and
maintenance, and institutional control of the disposal site and liabilities incurred as a result of the locating of
the disposal site in this state.
(5) A carrier, processor, or collector whose primary place of business is in this state shall be eligible to
seek a permit from the department under this part to transport, process, or collect waste in this state. A carrier,
processor, or collector whose primary place of business is in a state that is not a compact member state shall
be eligible to seek a permit from the department under this part to transport, process, or collect waste
generated in this state. The department shall issue a permit only to a generator who generates waste in this
state.
History: Add. 1987, Act 203, Imd. Eff. Dec. 22, 1987;Am. 1994, Act 435, Imd. Eff. Jan. 6, 1995.
Popular name: Act 368
333.13734 Implied consent; due process rights; surety bond, secured trust fund, or other
secured instrument or mechanism; reimbursement of costs resulting from violation;
conduct constituting violation.
Sec. 13734. (1) A generator, carrier, processor, and a collector who holds a permit issued under this part or
who holds a permit in a state that has been granted equivalent privileges in this state under section 13724 shall
by utilizing the disposal site in this state be considered to have given implied consent to the duties and
responsibilities imposed on that person under this part, rules promulgated under this part, and the low-level
radioactive waste management act.
(2) Nothing in subsection (1) shall be construed to impact upon the due process rights, including any
appellate rights, of a generator, carrier, processor, or a collector who gives implied consent as provided in
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subsection (1).
(3) A generator, carrier, processor, and collector who holds a permit issued under this part shall post a
surety bond or present evidence of a secured trust fund or other suitable secured instrument or mechanism in
an amount determined by the department. The bond, trust fund, or other instrument or mechanism shall be
payable to the department and conditioned upon performance in accordance with the terms and conditions of
the permit of the generator, carrier, collector, or processor. The bond, trust fund, or other instrument or
mechanism shall provide that if the generator, carrier, processor, or collector violates the provisions of this
part, any rules promulgated under this part, or any terms or conditions of a permit issued under this part, the
department shall be reimbursed for the costs that are incurred as a result of the violation. The failure to
maintain a surety bond, secured trust fund, or other suitable instrument or mechanism constitutes a violation
of this part.
History: Add. 1987, Act 203, Imd. Eff. Dec. 22, 1987.
Popular name: Act 368
333.13736 Sanctions for negligence or failure to exercise due care; grounds for suspending,
revoking, annulling, withdrawing, recalling, or cancelling license or permit; order;
procedures, hearings, oaths, subpoenas, and testimony; books, papers, or documents; aid
of circuit court; grounds for denial of application for license or permit; monitoring,
surveillance, and inspection; spot checks; advising authority of regulatory actions;
administrative inspection warrant; search warrant; probable cause.
Sec. 13736. (1) A person who holds a license or permit issued under this part may be subject to sanctions
as provided in subsection (2) for negligence or a failure to exercise due care, including negligent supervision,
regarding the license or permit holder's contractors, employees, agents, or subordinates.
(2) The department may suspend, revoke, annul, withdraw, recall, or cancel a license or permit issued
under this part in accordance with the administrative procedures act of 1969, Act No. 306 of the Public Acts
of 1969, being sections 24.201 to 24.328 of the Michigan Compiled Laws, if any of the following exists:
(a) Fraud or deceit in obtaining a permit or license or in registering under this part.
(b) A violation of this part, an order issued or a rule promulgated under this part, or the conditions of a
registration, permit, or license under this part.
(c) Negligence or failure to exercise due care, including negligent supervision, regarding contractors,
employees, agents, or subordinates.
(3) In addition to or in lieu of any action authorized in subsection (2), if the department finds any of the
circumstances listed in subsection (2)(a) to (c), the department may issue an order directing the person to do
either of the following:
(a) Discontinue handling or otherwise possessing waste.
(b) Comply with specific requirements of a permit or license issued under this part.
(4) The department may establish procedures, hold hearings, administer oaths, issue subpoenas, and order
testimony to be taken at a hearing or by deposition in a proceeding under this part. A person may be
compelled to appear and testify and to produce books, papers, or documents in a proceeding. In case of
disobedience of a subpoena, a party to a hearing may invoke the aid of the circuit court of the county in which
the hearing is held to require the attendance and testimony of witnesses. The circuit court may issue an order
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requiring an individual to appear and give testimony.
(5) An application for a license or permit under this part may be denied on a finding of any condition or
practice that would constitute a violation of this part or any rules promulgated under this part if the applicant
were a holder of the permit or a license that the applicant seeks or if there is fraud or deceit in attempting to
obtain a permit or license under this part.
(6) The director or his or her authorized representatives may enter the disposal site or other location where
waste is located or reasonably believed to be located at any time for the purpose of monitoring, surveillance,
and inspection, and may enter at all reasonable times upon any public or private property, building, premises,
place, or vehicle for the purpose of determining compliance with this part, or a permit, registration, or license
condition, rule, or an order issued pursuant to this part. In the conduct of an investigation, the director or his
or her authorized representatives may collect samples, conduct tests and inspections, and examine any book,
record, paper, document, or other physical evidence related to the generation, management, processing,
collecting, transport, storage, or disposal of waste.
(7) The department shall conduct unannounced spot checks of the premises of generators and processors
who hold permits issued under this part to assure the proper packaging of waste. The unannounced spot
checks provided for in this subsection shall only occur to the extent that the department has access to the
premises of the generator and processor under federal law.
(8) The department shall advise the authority of regulatory actions taken under this part and shall evaluate
and respond within 30 days to information received from the authority in which the authority recommends
that regulatory action should be undertaken by the department.
(9) An agent or employee of the department may apply for an administrative inspection warrant pursuant to
sections 2241 to 2247, or for a search warrant for purposes of collecting samples, testing, inspecting, or
examining any radioactive material or any public or private property, building, premises, place, vehicle, book,
record, paper, sample results, or other physical evidence related to the generation, processing, collecting,
management, transport, storage, disposal, or possession of waste. It shall be sufficient probable cause to show
any of the following:
(a) The sample collection, test, inspection, or examination is pursuant to a general administrative action to
determine compliance with this part.
(b) An agent or employee of the department has reason to believe that a violation of this part has occurred
or may occur.
(c) An agent or employee of the department has been refused access to the waste, property, building,
premise, place, vehicle, book, record, document, paper, sample results, or other physical evidence related to
the generation, management, processing, collecting, transport, or disposal of waste, or has been prevented
from collecting samples or conducting tests, surveillance, inspections, monitoring, or examinations.
History: Add. 1987, Act 203, Imd. Eff. Dec. 22, 1987.
Popular name: Act 368
333.13737 Action to restrain, enjoin, prevent, or correct violation; rules adopting schedule of
monetary civil fines.
Sec. 13737. (1) Notwithstanding the existence and pursuit of any other remedy, the director, without
posting a bond, may request the attorney general to bring an action in the name of the people of this state to
restrain, enjoin, prevent, or correct a violation of this part, rules promulgated under this part, or a permit or
license or order issued under this part.
(2) The department may promulgate rules to adopt a schedule of monetary civil fines in accordance with
sections 2262 and 2263 to enforce this part.
History: Add. 1987, Act 203, Imd. Eff. Dec. 22, 1987.
Popular name: Act 368
333.13738 Order requiring compliance or remedial action; emergency order; civil action;
venue; civil fine; violation as misdemeanor or felony; penalty; state of mind; placing
person in imminent danger of death or serious bodily injury; affirmative defense;
serious bodily injury; action for damage; costs of litigation; intervention.
Sec. 13738. (1) If the director finds that a person is in violation of this part, a rule promulgated under this
part, or a permit or license issued under this part, the director may issue an order requiring the person to
comply with this part, rule, permit, or license. An order issued pursuant to this section may require remedial
actions considered necessary by the department to correct violations. An order issued by the director pursuant
to this section may be an emergency order as authorized by section 2251 upon a finding and determination
that an imminent danger to the health or lives of individuals exists as a result of conditions associated with the
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generation, processing, collecting, management, transporting, handling, disposal, or possession of waste. The
attorney general may commence a civil action against a person for appropriate relief, including injunctive
relief for a violation of this part or a rule promulgated under this part. An action under this subsection may be
brought in the circuit court for the county of Ingham or for the county in which the defendant is located,
resides, or is doing business. In addition to any other relief granted under this subsection, the court may
impose a civil fine of not more than $25,000.00 for each instance of violation and, if the violation is
continuous, for each day of continued noncompliance. A fine collected under this subsection shall be
forwarded to the state treasurer for deposit in the general fund.
(2) A person who possesses, generates, processes, collects, transports, or disposes of waste in violation of
this part, or contrary to a license, permit, order, or rule issued or promulgated under this part, or who makes a
false statement, representation, or certification in an application for, or form pertaining to, a permit or license,
is guilty of a misdemeanor, punishable by a fine of not more than $25,000.00 for each instance of violation
and, if the violation is continuous, for each day of violation, or imprisonment for not more than 1 year, or
both. If the conviction is for a violation committed after a first conviction of the person under this subsection,
the person is guilty of a misdemeanor, punishable by a fine of not more than $50,000.00 for each instance of
violation and, if the violation is continuous, for each day of violation, or by imprisonment for not more than 5
years, or both.
(3) Any person who knowingly possesses, generates, processes, collects, transports, or disposes of waste in
violation of subsection (2) and who knows at that time that he or she thereby places another person in
imminent danger of death or serious bodily injury, and if his or her conduct in the circumstances manifests an
unjustified and inexcusable disregard for human life, or if his or her conduct in the circumstances manifests
an extreme indifference for human life, is guilty of a misdemeanor, punishable by a fine of not more than
$250,000.00 or imprisonment for not more than 2 years, or both, except that any person whose actions
constitute an extreme indifference for human life is guilty of a felony punishable by a fine of not less than
$250,000.00 and not more than $500,000.00 and imprisonment for not less than 5 years and not more than 20
years. A defendant that is not an individual and not a governmental entity shall be subject, upon conviction, to
a fine of not more than $1,000,000.00.
(4) For the purposes of subsection (3), a person's state of mind is knowing with respect to:
(a) His or her conduct, if he or she is aware of the nature of his or her conduct.
(b) An existing circumstance, if he or she is aware or believes that the circumstance exists.
(c) A result of his or her conduct, if he or she is aware or believes that his or her conduct is substantially
certain to cause danger of death or serious bodily injury.
(5) For purposes of subsection (3), in determining whether a defendant who is an individual knew that his
or her conduct placed another person in imminent danger of death or serious bodily injury, both of the
following apply:
(a) The person is responsible only for actual awareness or actual belief that he or she possessed.
(b) Knowledge possessed by a person other than the defendant but not by the defendant himself or herself
may not be attributed to the defendant. However, in proving the defendant's possession of actual knowledge,
circumstantial evidence may be used, including evidence that the defendant took affirmative steps to shield
himself or herself from relevant information.
(6) It is an affirmative defense to a prosecution under this part that the conduct charged was consented to
by the person endangered and that the danger and conduct charged were reasonably foreseeable hazards of
either of the following:
(a) An occupation, business, profession, or through the undertaking of an inspection of the disposal site as
a representative of the local monitoring committee of the host site community.
(b) Medical treatment or professionally approved methods and such other person had been made aware of
the risks involved prior to giving consent.
(7) The defendant may establish an affirmative defense under subsection (6) by a preponderance of the
evidence.
(8) For purposes of subsection (3), serious bodily injury means each of the following:
(a) Bodily injury which involves a substantial risk of death.
(b) Unconsciousness.
(c) Extreme physical pain.
(d) Protracted and obvious disfigurement.
(e) Protracted loss or impairment of the function of a bodily member, organ, or mental faculty.
(9) In addition to a fine, the attorney general may bring an action in a court of competent jurisdiction to
recover the full value of the damage done to the natural resources of this state and the costs of surveillance
and enforcement by the state resulting from the violation. The damages and cost collected under this
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subsection shall be forwarded to the state treasurer for deposit in the general fund.
(10) The court, in issuing a final order in an action brought under this part, may award costs of litigation,
including reasonable attorney and expert witness fees to a party, including the state, if the court determines
that the award is appropriate.
(11) A person who has an interest which is or may be affected by a civil or administrative action
commenced under this part shall have a right to intervene in that action.
History: Add. 1987, Act 203, Imd. Eff. Dec. 22, 1987.
Popular name: Act 368
333.13740 Disposition of receipts from civil fines and fees; appropriations; construction of
section; expenditures required as result of release.
Sec. 13740. (1) The department shall deposit all receipts from civil fines and fees collected pursuant to this
part and from judgments, settlements, and any other payments collected pursuant to this part in the state
treasury to the credit of the general fund.
(2) Funds credited to the general fund as required by this section shall be appropriated for the purposes
provided in this section and if insufficient funds are available or appropriated from the general fund, the
department may seek appropriations by the legislature from the low-level radioactive waste management fund
for purposes authorized by this part, including, but not limited to, any of the following:
(a) Hiring personnel and any other operating and contingent expenses necessary for the proper
administration of this part, to fulfill the state's obligations under the low-level radioactive waste policy act,
Public Law 96-573, 42 U.S.C. 2021b to 2021d, and if this state is a member of a compact to assure adequate
involvement by this state in any compact activities and responsibilities.
(b) Regulatory costs, including, but not limited to, the costs of promulgating and enforcing administrative
rules if this state enters into an agreement with the United States nuclear regulatory commission as provided
in section 13707.
(c) Contracting with any person or vendor for the purpose of carrying out this part and the rules
promulgated under this part.
(d) Taking any actions necessary to protect the public health, safety, and welfare, and the environment
from actual or threatened harm from activities regulated under this part.
(3) This section shall not be construed to limit the financial responsibilities of a person who holds a permit
or license under this part, or establish or imply any liability on the part of the state.
(4) If expenditures are required as a result of a release or threatened release, the department, the attorney
general on behalf of the department, the department of natural resources, and the authority shall seek to obtain
funds from a responsible party including a surety bond, secured trust fund, or other instrument, mechanism,
fund, or liability insurance held by that party.
History: Add. 1987, Act 203, Imd. Eff. Dec. 22, 1987;Am. 1994, Act 435, Imd. Eff. Jan. 6, 1995.
Popular name: Act 368
PART 138
MEDICAL WASTE
333.13801 Short title.
Sec. 13801. This part shall be known and may be cited as the medical waste regulatory act.
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History: Add. 1990, Act 18, Eff. May 31, 1990.
Popular name: Act 368
333.13805 Definitions; A to M.
Sec. 13805. (1) Advisory council means the interdepartmental medical waste advisory council created in
section 13827.
(2) Autoclave means to sterilize using superheated steam under pressure.
(3) Decontamination means rendering medical waste safe for routine handling as solid waste.
(4) Fund means the medical waste emergency response fund created in section 13829.
(5) Health facility or agency means that term as defined in section 20106.
(6) Household means a single detached dwelling unit or a single unit of a multiple dwelling.
(7) Infectious agent means a pathogen that is sufficiently virulent so that if a susceptible host is exposed
to the pathogen in an adequate concentration and through a portal of entry, the result could be transmission of
disease to a human.
(8) Medical waste means any of the following that are not generated from a household, a farm operation
or other agricultural business, a home for the aged, or a home health care agency:
(a) 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.
(b) Liquid human and animal waste, including blood and blood products and body fluids, but not including
urine or materials stained with blood or body fluids.
(c) Pathological waste.
(d) Sharps.
(e) Contaminated wastes from animals that have been exposed to agents infectious to humans, these being
primarily research animals.
History: Add. 1990, Act 21, Eff. June 4, 1990.
Popular name: Act 368
333.13807 Definitions; P to T.
Sec. 13807. (1) "Pathogen" means a microorganism that produces disease.
(2) "Pathological waste" means human organs, tissues, body parts other than teeth, products of conception,
and fluids removed by trauma or during surgery, autopsy, or other medical procedure, and not fixed in
formaldehyde. Pathological waste does not include a fetus or fetal body parts.
(3) "Point of generation" means the point at which medical waste leaves the producing facility site.
(4) "Producing facility" means a facility that generates, stores, decontaminates, or incinerates medical
waste.
(5) "Products of conception" means any tissues or fluids, placenta, umbilical cord, or other uterine contents
resulting from a pregnancy. Products of conception do not include a fetus or fetal body parts.
(6) "Release" means any spilling, leaking, pumping, pouring, emitting, emptying, discharging, injecting,
escaping, leaching, dumping, or disposing of medical waste into the environment in violation of this part.
(7) "Response activity" means an activity necessary to protect the public health, safety, welfare, and the
environment, and includes, but is not limited to, evaluation, cleanup, removal, containment, isolation,
treatment, monitoring, maintenance, replacement of water supplies, and temporary relocation of people.
(8) "Sharps" means needles, syringes, scalpels, and intravenous tubing with needles attached.
(9) "Storage" means the containment of medical waste in a manner that does not constitute disposal of the
medical waste.
(10) "Transport" means the movement of medical waste from the point of generation to any intermediate
point and finally to the point of treatment or disposal. Transport does not include the movement of medical
waste from a health facility or agency to another health facility or agency for the purposes of testing and
research.
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History: Add. 1990, Act 21, Eff. June 4, 1990;Am. 2012, Act 499, Eff. Mar. 31, 2013.
Popular name: Act 368
333.13809 Producing facility not incinerating medical waste on site; containment of medical
waste.
Sec. 13809. A producing facility that does not incinerate medical waste on site shall do all of the following
to contain medical waste:
(a) Package, contain, and locate medical waste in a manner that protects and prevents the medical waste
from release at the producing facility or at any time before ultimate disposal.
(b) Separate the categories of medical waste at the point of origin into appropriate containers that are
labelled as required under subdivision (c).
(c) Label the containers required under subdivision (b) with a biohazard symbol or the words medical
waste or pathological waste in letters not less than 1 inch high.
(d) Not compact or mix medical waste with other waste materials before decontamination, incineration,
and disposal.
(e) If decontaminated medical waste is mixed with other solid waste, clearly label the container to indicate
that it contains decontaminated medical waste.
(f) Store medical waste in such a manner that prevents putrefaction and also prevents infectious agents
from coming in contact with the air or with individuals.
(g) If medical waste is stored outside of the producing facility, store the medical waste in a secured area or
locked in a container that weighs more than 500 pounds and prevent access to the area or container by vermin
or unauthorized individuals.
(h) Not store medical waste on the premises of the producing facility for more than 90 days.
History: Add. 1990, Act 21, Eff. June 4, 1990.
Popular name: Act 368
333.13813 Producing facility; registration; form; medical waste management plan required;
registration fee; certificate of registration; investigation of complaint; inspection of facility;
disposition of fees.
Sec. 13813. (1) Each producing facility shall register with the department on a form prescribed by the
department. A producing facility shall have a written medical waste management plan that contains
information required in section 13817 on file on the premises within 90 days after registration.
(2) A producing facility shall submit the following registration fee with the registration form:
(a) For a producing facility that is a private practice office with fewer than 4 licensees under article 15 who
are physicians, dentists, podiatrists, certified nurse practitioners, certified nurse midwives, or veterinarians
employed by, under contract to, or working at the producing facility, a registration fee of $50.00.
(b) For a producing facility that is a private practice office with 4 or more licensees under article 15 who
are physicians, dentists, podiatrists, certified nurse practitioners, certified nurse midwives, or veterinarians
employed by, under contract to, or working at the producing facility, a registration fee of $20.00 for each
licensee, up to a maximum total registration fee of $80.00.
(3) Upon receipt of a complete registration form and registration fee under this section or section 13815,
the department shall issue a certificate of registration to the producing facility. A certificate of registration
issued under this section is valid for 3 years from its date of issuance. The department shall investigate each
complaint received and may inspect a producing facility registered under this section pursuant to the receipt
of a complaint.
(4) Registration fees collected pursuant to this section and section 13815 shall be forwarded to the state
treasury and deposited pursuant to section 13829.
History: Add. 1990, Act 18, Eff. May 31, 1990.
Popular name: Act 368
333.13823 Investigation and confirmation of reported medical waste on land or water; report;
protective measures; consultations; information on results of investigation.
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Sec. 13823. (1) If suspected medical waste is discovered on any land or water in the state and reported to
the department of natural resources, the department of public health, a local health department, the department
of state police, or any other state or local governmental agency, the agency or department receiving the report
shall promptly investigate to confirm the existence of medical waste. If the existence of medical waste is
confirmed by a department or agency other than the department of natural resources, a report shall be
transmitted immediately to the department of natural resources. The department of natural resources may if
appropriate take measures to contain the medical waste, to close off the area, to remove the medical waste
from the environment, and to do all things necessary to protect the public health, safety, and welfare and the
environment. The department of natural resources may if appropriate conduct an investigation to determine
the source of the medical waste.
(2) The department of natural resources may consult with the department of public health, the appropriate
local health department, the department of state police, and the department of attorney general on the actions
taken by the department of natural resources under this section.
(3) After the department of natural resources confirms the existence of medical waste under this section,
the department of natural resources shall inform the legislature, the governor, the advisory council, and the
public on the results of any investigation conducted within 30 days after the investigation is completed.
History: Add. 1990, Act 18, Eff. May 31, 1990.
Popular name: Act 368
333.13831 Violation; administrative fine; failure to register or have plan available for
inspection; injunction.
Sec. 13831. (1) Except as provided in subsection (2), a person who violates this part or a rule promulgated
under this part is subject to an administrative fine of not more than $2,500.00 for each violation and an
additional fine of not more than $1,000.00 for each day during which the violation continues. For a first
offense, the department of public health or the department of natural resources may postpone the levying of a
fine under this subsection for not more than 45 days or until the violation is corrected, whichever occurs first.
(2) A person who fails to register with the department or have a medical waste management plan available
for inspection in compliance with sections 13813 and 13817 is subject to an administrative fine of $500.00.
(3) A person who violates this act may be enjoined by a court of competent jurisdiction from continuing
the violation.
History: Add. 1990, Act 18, Eff. May 31, 1990.
Popular name: Act 368
ARTICLE 15
OCCUPATIONS
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PART 161
GENERAL PROVISIONS
333.16101 Meanings of words and phrases; general definitions and principles of
construction.
Sec. 16101. (1) For purposes of this article, the words and phrases defined in sections 16102 to 16109 have
the meanings ascribed to them in those sections.
(2) In addition article 1 contains general definitions and principles of construction applicable to all articles
in this code.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Compiler's note: For transfer of powers and duties of certain health-related functions, boards, and commissions from the Department
of Licensing and Regulation to the Department of Commerce, see E.R.O. No. 1991-9, compiled at MCL 338.3501 of the Michigan
Compiled Laws.
For transfer of rule-making authority of occupational and health occupation boards and related task forces from the department of
commerce to the director of the department of consumer and industry services, see E.R.O. No. 1996-2, compiled at MCL 445.2001 of the
Michigan Compiled Laws.
For transfer of powers and duties of the bureau of health services from the department of consumer and industry services to the
director of the department of community health by Type II transfer, see E.R.O. No. 2003-1, compiled at MCL 445.2011.
Popular name: Act 368
333.16103 Definitions; B, C.
Sec. 16103. (1) Board as used in this part means each board created in this article and as used in any
other part covering a specific health profession means the board created in that part.
(2) Certificate of licensure means a document issued as evidence of authorization to practice and use a
designated title.
(3) Certificate of registration means a document issued as evidence of authorization to use a designated
title.
(4) Controlled substance means that term as defined in section 7104.
(5) Conviction means a judgment entered by a court upon a plea of guilty, guilty but mentally ill, or nolo
contendere or upon a jury verdict or court finding that a defendant is guilty or guilty but mentally ill.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1990, Act 247, Imd. Eff. Oct. 12, 1990;Am. 1993, Act 80, Eff. Apr. 1, 1994.
Popular name: Act 368
333.16104 Definitions; D to G.
Sec. 16104. (1) "DEA registration number" means the number associated with a certificate of registration
issued to a practitioner to prescribe, dispense, or administer controlled substances by the United States
department of justice drug enforcement administration.
(2) "Delegation" means an authorization granted by a licensee to a licensed or unlicensed individual to
perform selected acts, tasks, or functions that fall within the scope of practice of the delegator and that are not
within the scope of practice of the delegatee and that, in the absence of the authorization, would constitute
illegal practice of a licensed profession.
(3) "Department" means the department of licensing and regulatory affairs.
(4) "Director" means the director of the department or the director's designee.
(5) "Disciplinary subcommittee" means a disciplinary subcommittee appointed under section 16216.
(6) "Good moral character" means good moral character as defined and determined under 1974 PA 381,
MCL 338.41 to 338.47.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1993, Act 80, Eff. Apr. 1, 1994;Am. 2011, Act 210, Imd. Eff. Nov. 8, 2011.
Popular name: Act 368
333.16105 Definitions; H.
Sec. 16105. (1) Health occupation means a health related vocation, calling, occupation, or employment
performed by an individual whether or not the individual is licensed or registered under this article.
(2) Health profession means a vocation, calling, occupation, or employment performed by an individual
acting pursuant to a license or registration issued under this article.
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(3) Health profession specialty field means an area of practice established under this article that is within
the scope of activities, functions, and duties of a licensed health profession and that requires advanced
education and training beyond that required for initial licensure.
(4) Health profession specialty field license means an authorization to use a title issued to a licensee who
has met qualifications established by the Michigan board of dentistry for registration in a health profession
specialty field. An individual who holds a dental specialty certification on the effective date of the
amendatory act that added this subsection is considered to hold a health profession specialty field license in
that speciality and may obtain renewal of the health profession specialty field license in that speciality on the
expiration date of the specialty certification. The health profession specialty field license is not a license as
that term is defined in section 16106(2).
(5) Health profession subfield means an area of practice established under this article which is within the
scope of the activities, functions, and duties of a licensed health profession, and requires less comprehensive
knowledge and skill than is required to practice the full scope of the health profession.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2002, Act 643, Imd. Eff. Dec. 23, 2002.
Popular name: Act 368
333.16106 Definitions; I to L.
Sec. 16106. (1) Incompetence means a departure from, or failure to conform to, minimal standards of
acceptable and prevailing practice for a health profession, whether or not actual injury to an individual occurs.
(2) License, except as otherwise provided in this subsection, means an authorization issued under this
article to practice where practice would otherwise be unlawful. License includes an authorization to use a
designated title which use would otherwise be prohibited under this article and may be used to refer to a
health profession subfield license, limited license, or a temporary license. For purposes of the definition of
prescriber contained in section 17708(2) only, license includes an authorization issued under the laws of
another state, or the country of Canada to practice in that state or in the country of Canada, where practice
would otherwise be unlawful, and is limited to a licensed doctor of medicine, a licensed doctor of osteopathic
medicine and surgery, or another licensed health professional acting under the delegation and using,
recording, or otherwise indicating the name of the delegating licensed doctor of medicine or licensed doctor
of osteopathic medicine and surgery. License does not include a health profession specialty field license.
(3) Licensee, as used in a part that regulates a specific health profession, means an individual to whom a
license is issued under that part, and as used in this part means each licensee regulated by this article.
(4) Limitation means an action by which a board imposes restrictions or conditions, or both, on a license.
(5) Limited license means a license to which restrictions or conditions, or both, as to scope of practice,
place of practice, supervision of practice, duration of licensed status, or type or condition of patient or client
served are imposed by a board.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1997, Act 153, Eff. Mar. 31, 1998;Am. 2002, Act 643, Imd. Eff. Dec. 23, 2002.
Popular name: Act 368
333.16106a Definitions.
Sec. 16106a. "Impaired" or "impairment" means the inability or immediately impending inability of a
health professional to practice his or her health profession in a manner that conforms to the minimum
standards of acceptable and prevailing practice for that health profession due to the health professional's
substance abuse, chemical dependency, or mental illness or the health professional's use of drugs or alcohol
that does not constitute substance abuse or chemical dependency. As used in this section:
(a) "Chemical dependency" means a group of cognitive, behavioral, and physiological symptoms that
indicate that an individual has a substantial lack of or no control over the individual's use of 1 or more
psychoactive substances.
(b) "Mental illness" means that term as defined in section 400 of the mental health code, 1974 PA 258,
MCL 330.1400.
(c) "Substance abuse" means substance use disorder as defined in section 100d of the mental health code,
1974 PA 258, MCL 330.1100d.
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History: Add. 1993, Act 80, Eff. Apr. 1, 1994;Am. 2012, Act 501, Eff. Jan. 1, 2013.
Popular name: Act 368
333.16107 Definitions; P.
Sec. 16107. (1) "Permanent revocation" means the permanent cancellation or withdrawal of a license,
registration, or authorization to engage in the practice of a health profession under this article that is issued by
the department, board, or task force.
(2) "Probation" means a sanction that permits a board to evaluate over a period of time a licensee's or
registrant's fitness to continue to practice under a license or registration.
(3) "Public member" means a member of the general public who is not a licensee or registrant, is a resident
of this state, is not less than 18 years of age, and does not have a material financial interest in the provision of
health services and has not had a material financial interest within the 12 months before appointment.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2014, Act 410, Eff. Mar. 30, 2015.
Popular name: Act 368
333.16108 Definitions; R.
Sec. 16108. (1) Reclassification means an action by a disciplinary subcommittee by which restrictions or
conditions, or both, applicable to a license are added or removed.
(2) Registration means an authorization only for the use of a designated title which use would otherwise
be prohibited under this article. Registration includes specialty certification of a licensee and a health
profession specialty field license.
(3) Registrant as used in a part that regulates the use of a title means an individual to whom a
registration, a specialty certification, or a health profession specialty field license is issued under that part, and
as used in this part means each registrant regulated by this article.
(4) Reinstatement means the granting of a license or certificate of registration, with or without
limitations or conditions, to an individual whose license or certificate of registration has been suspended or
revoked.
(5) Relicensure means the granting of a license to an individual whose license has lapsed for failure to
renew the license within 60 days after the expiration date.
(6) Reregistration means the granting of a certificate of registration to an individual whose certificate of
registration has lapsed for failure to renew the certificate within 60 days after the expiration date.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1986, Act 174, Imd. Eff. July 7, 1986;Am. 1988, Act 462, Eff. Sept. 1, 1989;
Am. 1993, Act 80, Eff. Apr. 1, 1994;Am. 2002, Act 643, Imd. Eff. Dec. 23, 2002.
Popular name: Act 368
333.16109 Definitions; S to T.
Sec. 16109. (1) Specialty certification means an authorization to use a title by a licensee who has met
qualifications established by a board for registration in a health profession specialty field.
(2) Supervision, except as otherwise provided in this article, means the overseeing of or participation in
the work of another individual by a health professional licensed under this article in circumstances where at
least all of the following conditions exist:
(a) The continuous availability of direct communication in person or by radio, telephone, or
telecommunication between the supervised individual and a licensed health professional.
(b) The availability of a licensed health professional on a regularly scheduled basis to review the practice
of the supervised individual, to provide consultation to the supervised individual, to review records, and to
further educate the supervised individual in the performance of the individual's functions.
(c) The provision by the licensed supervising health professional of predetermined procedures and drug
protocol.
(3) Task force means a task force created by this article.
(4) Temporary license means a license of limited duration granted to an applicant who has completed all
requirements for licensure except an examination or other required evaluation procedure.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1991, Act 58, Imd. Eff. June 27, 1991.
Popular name: Act 368
333.16111 Applicability of part; part controlling over other parts in article; effect of part on
other licenses and registrants.
Sec. 16111. (1) This part applies to health professions, but, except for sections 16201, 16261, 16299,
16301, 16303, 16305, 16307, 16309, and 16313, does not apply to a pharmacy, dispensing prescriber, or drug
manufacturer or wholesaler who is regulated by part 177.
(2) Except as otherwise provided by this article, this part controls over all other parts in this article.
(3) A part in this article does not prohibit a licensee under another part or other law of this state from
performing activities and using designated titles authorized by a license issued to him or her under that other
part or other law of this state.
(4) A part in this article does not prohibit a registrant under another part or other state law from using
designated titles authorized by a registration issued to him or her under that other part or other state law.
(5) This article shall not prohibit a licensee from advising a patient to seek professional services or advice
from another person.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1988, Act 462, Eff. Sept. 1, 1989;Am. 2006, Act 392, Imd. Eff. Sept. 27, 2006.
Popular name: Act 368
333.16115 Board created as successor to former board with same or similar name.
Sec. 16115. A board created by this article is the successor to the board with the same or similar name
created or continued by a statute repealed by this code.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.16128 Health profession subfield task force and health profession specialty field task
force; membership.
Sec. 16128. (1) A health profession subfield task force shall be composed of a majority of members
licensed in the subfields of the health profession that are created by this article and shall include at least 1
licensed member from each of the subfields of the health profession that is created by this article. A health
profession subfield task force shall include at least 1 public member and 1 member of that profession who
holds a license other than a subfield license in that health profession.
(2) A health profession specialty field task force shall be composed of a majority of members registered in
the specialty fields of the health profession that are created by this article. A health profession specialty field
task force shall include at least 1 public member and 1 member of that health profession who is a member of
the board.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2002, Act 643, Imd. Eff. Dec. 23, 2002.
Popular name: Act 368
333.16131 Repealed. 2006, Act 392, Imd. Eff. Sept. 27, 2006
Compiler's note: The repealed section pertained to terms of office of members of boards and task forces.
Popular name: Act 368
333.16138 Board, committee, or task force; meetings; quorum; final action; voting by proxy
prohibited; times and places of meetings; minutes; record of actions; meetings open to
public.
Sec. 16138. (1) A board, the committee, or a task force shall hold regular meetings at places and on
separate dates fixed by it. The committee shall meet not less than quarterly. Special meetings may be called
by the chairperson, by a majority of the members of the committee, a board, or a task force, or by the
department. Except as otherwise provided in this article or in the bylaws of the committee, a board, or a task
force, a majority of the members appointed and serving constitute a quorum. Final action by the committee, a
board, or a task force shall be taken only by affirmative vote of a majority of the members present at a
meeting or for a hearing. A member shall not vote by proxy.
(2) The department shall make available the times and places of meetings of the boards and the task forces
and keep minutes of their meetings and a record of their actions. Meetings of a board, or a task force shall be
open to the public in accordance with the open meetings act, Act No. 267 of the Public Acts of 1976, being
sections 15.261 to 15.275 of the Michigan Compiled Laws.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1986, Act 174, Imd. Eff. July 7, 1986;Am. 1993, Act 80, Eff. Apr. 1, 1994.
Compiler's note: Section 3 of Act 174 of 1986 provides: This amendatory act shall only apply to contested cases filed on or after
July 1, 1986.
Popular name: Act 368
333.16141 Committee, board, or task force; office services; offices, records and money;
managerial and administrative functions; administrative and secretarial staff, clerks, and
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employees; salaries and expenses; rules.
Sec. 16141. (1) The department shall furnish office services to the committee, the boards, and the task
forces; have charge of their offices, records, and money collected; and perform managerial and administrative
functions for them.
(2) The department shall appoint administrative and secretarial staff, clerks, and employees necessary to
allow the proper exercise of the powers and duties of the committee, a board, or a task force. Salaries and
other expenses incurred by the committee, a board, or a task force and staff and expenses for studies and
activities authorized under this article shall be paid out of funds appropriated by the legislature for those
purposes.
(3) The department may promulgate rules to promote the effective and consistent administration of this
article. However, the department shall not promulgate rules that constitute the licensure, registration, or
examination of health professionals.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1993, Act 80, Eff. Apr. 1, 1994.
Popular name: Act 368
Administrative rules: R 338.951 et seq. of the Michigan Administrative Code.
333.16143 Committee, board, or task force; bylaws; annual report; actions and
determinations; contracts for assistance.
Sec. 16143. (1) The committee, a board, or a task force may adopt bylaws for the regulation of its internal
affairs.
(2) The committee, a disciplinary subcommittee, a board, or a task force shall report its activities annually
to the department. The report shall include statistical data on applicants for examination, licensure, and
registration; allegations and disciplinary actions against licensees and registrants; and other matters relating to
the licensure, registration, and regulatory activity of the boards or a task force as prescribed by the
department.
(3) The committee, a disciplinary subcommittee, a board, or a task force may perform acts and make
determinations necessary and proper to carry out its functions and the department may contract with other
state agencies, private agencies, organizations, and consultants to assist the committee, disciplinary
subcommittee, board, or task force to perform the acts or to aid in carrying out functions of the committee,
board, or task force.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1986, Act 174, Imd. Eff. July 7, 1986;Am. 1993, Act 80, Eff. Apr. 1, 1994.
Compiler's note: Section 3 of Act 174 of 1986 provides: This amendatory act shall only apply to contested cases filed on or after
July 1, 1986.
Popular name: Act 368
333.16148 Rules; establishing standards for education and training for practice of health
profession; training standards for identifying victims of human trafficking; accreditation of
training programs; requirements for action or decision; voting; applicability of R 338.10305
to certain members of nursing faculties.
Sec. 16148. (1) Except as otherwise provided in this section or section 17060, the department, in
consultation with a board, may promulgate rules to establish standards for the education and training of
individuals to be licensed or registered, or whose licenses or registrations are to be renewed, for the purposes
of determining whether graduates of a training program have the knowledge and skills requisite for practice of
a health profession or use of a title. By 2 years after the effective date of the amendatory act that added this
sentence, the department shall promulgate rules to include training standards for identifying victims of human
trafficking required for individuals licensed or registered under this article, except those licensed under part
188 or subject to section 17060. The training standards for identifying victims of human trafficking shall
apply for a license or registration renewal beginning with the first renewal cycle after the rules are
promulgated and for an initial license or registration issued 5 or more years after the rules are promulgated.
(2) Except as otherwise provided in section 17060 and subject to subsections (6) and (7), only a board may
accredit training programs in hospitals, schools, colleges, universities, and institutions offering training
programs meeting educational standards and may deny or withdraw accreditation of training programs for
failure to meet established standards. The board shall give a hospital, school, college, university, or institution
that has its program accreditation withdrawn an opportunity for a hearing.
(3) The board shall take action or make a decision under subsection (1) or (2) relating to a specific health
profession subfield only after consultation with the task force in the affected health profession subfield and
with at least 1 of the affected health profession subfield board members present.
(4) A member of a licensing board from the health profession subfield shall vote as an equal member in all
matters except those issues designated in subsections (1) and (2) that are outside the health profession
subfield.
(5) A decision of a board on standards for the education and training of individuals or the accreditation of a
training program under subsection (1) or (2) must be concurred in by a majority of the board members who
are not health profession subfield licensees if the decision relates solely to licenses that are not health
profession subfield licenses.
(6) The requirement of subsection (2)(b)(iii) of R 338.10305 of the Michigan administrative code, that
each member of the nursing faculty in a program of nursing education for registered nurses who provides
instruction in the clinical laboratory or cooperating agencies hold a baccalaureate degree in nursing science
does not apply to a member of the nursing faculty described in this subsection who meets both of the
following requirements:
(a) Was employed by or under contract to a program of nursing education on or before September 1, 1989.
(b) Is employed by or under contract to a program of nursing education on June 29, 1995.
(7) The requirement of subsection (2)(c)(ii) of R 338.10305 of the Michigan administrative code, that each
member of the nursing faculty in a program of nursing education for licensed practical nurses hold a
baccalaureate degree in nursing science does not apply to a member of the nursing faculty described in this
subsection who meets both of the following requirements:
(a) Was employed by or under contract to a program of nursing education on or before September 1, 1989.
(b) Is employed by or under contract to a program of nursing education on June 29, 1995.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1995, Act 115, Imd. Eff. June 29, 1995;Am. 2014, Act 343, Eff. Jan. 14, 2015.
Compiler's note: In subsections (6) and (7), the reference to "subsection" evidently should read "subrule."
Popular name: Act 368
Administrative rules: R 325.321 et seq.; R 338.91 et seq.; R 338.101 et seq.; R 338.251 et seq.; R 338.281; R 338.291; R 338.311 et
seq.; R 338.471a et seq.; R 338.1201 et seq.; R 338.3031; R 338.3701 et seq.; R 338.4101 et seq.; and R 340.801 et seq. of the Michigan
Administrative Code.
333.16161 Health profession subfield task force and health profession specialty field task
force; function.
Sec. 16161. (1) If a health profession subfield task force is created for a health profession, that task force
shall serve as the task force for all health profession subfields within the scope of practice of the health
profession and shall function as set forth in this part.
(2) If a health profession specialty field task force is created for a health profession, that task force shall
serve as the task force for all health profession specialty fields within the scope of practice of the health
profession and shall function as set forth in this part.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1989, Act 202, Imd. Eff. Oct. 23, 1989.
Popular name: Act 368
333.16168 Contracts with private entities to assist with health professional recovery
program; report.
Sec. 16168. (1) The department shall enter into a contract with a private entity to act as a consultant to
assist the committee with the administration of the health professional recovery program including, but not
limited to, the duties described in section 16167(b) and (c). The department shall require the private entity to
demonstrate that it has expertise and knowledge regarding the treatment of impaired health professionals.
(2) In the contract between the department and the private entity entered into under subsection (1), the
department shall require the private entity to report immediately to the department any circumstances known
to the private entity that indicate that an impaired health professional may be a threat to the public health,
safety, or welfare.
History: Add. 1993, Act 80, Eff. Apr. 1, 1994.
Popular name: Act 368
333.16194 Expiration of licenses and registrations for health professions; authority to issue
part-term licenses and registrations.
Sec. 16194. (1) Licenses and registrations for health professions expire on dates prescribed by the
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department by rule, unless sooner terminated by death of the individual licensed or registered or otherwise
terminated pursuant to this part.
(2) Administrative authority to issue part-term licenses and registrations due to changing the terms from
annual to a longer term in subsection (1) and to provide for initial issuances for terms longer or shorter than a
normal term is granted in section 1222.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
Administrative rules: R 338.7001 et seq. of the Michigan Administrative Code.
333.16216 Disciplinary subcommittee for board or task force; members; voting; chairperson;
final decision; set aside by department; issuance of different final action; inclusion of final
decision on website.
Sec. 16216. (1) The chair of each board or task force shall appoint 1 or more disciplinary subcommittees
for that board or task force. A disciplinary subcommittee for a board or task force shall consist of 2 public
members and 3 professional members from the board or task force.
(2) A final decision of a disciplinary subcommittee finding a violation of this article, article 7, or article 8
requires a majority vote of the members appointed and serving on the disciplinary subcommittee.
(3) A final decision of a disciplinary subcommittee imposing a sanction under this article, article 7, or
article 8 or a final decision of a disciplinary subcommittee other than a final decision described in subsection
(2) requires a majority vote of the members appointed and serving on the disciplinary subcommittee with an
affirmative vote by at least 1 public member.
(4) The chair of a board or task force shall appoint a public member of the disciplinary subcommittee of
that board or task force as the chairperson of that disciplinary subcommittee. The chair of a board or task
force shall not serve as a member of the disciplinary subcommittee of that board or task force.
(5) The department may review a final decision of a disciplinary subcommittee within 30 days after the
date of the disciplinary subcommittee's decision. If the department determines that the action taken by a
disciplinary subcommittee does not protect the health, safety, and welfare of the public, the department, with
the approval of the board chair, may set aside the decision of the disciplinary subcommittee and issue a
different final action. The final action of the department serves as the final action on the matter and is subject
to judicial review in the same manner as the final decision of the disciplinary subcommittee.
(6) Beginning January 1, 2015, the department shall include on its public licensing and registration website
each final decision that imposes disciplinary action against a licensee, including the reason for and description
of that disciplinary action.
History: Add. 1993, Act 87, Eff. Apr. 1, 1994;Am. 2013, Act 268, Imd. Eff. Dec. 30, 2013;Am. 2014, Act 98, Eff. July 1, 2014;
Am. 2014, Act 413, Eff. Mar. 30, 2015.
Compiler's note: Former MCL 333.16216, which pertained to disciplinary subcommittee for board or task force, was repealed by
Act 87 of 1993, Eff. Apr. 1, 1994.
Popular name: Act 368
***** 333.16221 THIS SECTION IS AMENDED EFFECTIVE AUGUST 1, 2017: See 333.16221.amended
*****
333.16221 Investigation of licensee, registrant, or applicant for licensure or registration;
hearings, oaths, and testimony; complaint; grounds for proceeding under MCL 333.16226.
Sec. 16221. The department shall investigate any allegation that 1 or more of the grounds for disciplinary
subcommittee action under this section exist, and may investigate activities related to the practice of a health
profession by a licensee, a registrant, or an applicant for licensure or registration. The department may hold
hearings, administer oaths, and order the taking of relevant testimony. After its investigation, the department
shall provide a copy of the administrative complaint to the appropriate disciplinary subcommittee. The
disciplinary subcommittee shall proceed under section 16226 if it finds that 1 or more of the following
grounds exist:
(a) Except as otherwise specifically provided in this section, a violation of general duty, consisting of
negligence or failure to exercise due care, including negligent delegation to or supervision of employees or
other individuals, whether or not injury results, or any conduct, practice, or condition that impairs, or may
impair, the ability to safely and skillfully engage in the practice of the health profession.
(b) Personal disqualifications, consisting of 1 or more of the following:
(i) Incompetence.
(ii) Subject to sections 16165 to 16170a, substance use disorder as defined in section 100d of the mental
health code, 1974 PA 258, MCL 330.1100d.
(iii) Mental or physical inability reasonably related to and adversely affecting the licensee's or registrant's
ability to practice in a safe and competent manner.
(iv) Declaration of mental incompetence by a court of competent jurisdiction.
(v) Conviction of a misdemeanor punishable by imprisonment for a maximum term of 2 years; conviction
of a misdemeanor involving the illegal delivery, possession, or use of a controlled substance; or conviction of
any felony other than a felony listed or described in another subparagraph of this subdivision. A certified copy
of the court record is conclusive evidence of the conviction.
(vi) Lack of good moral character.
(vii) Conviction of a criminal offense under section 520e or 520g of the Michigan penal code, 1931 PA
328, MCL 750.520e and 750.520g. A certified copy of the court record is conclusive evidence of the
conviction.
(viii) Conviction of a violation of section 492a of the Michigan penal code, 1931 PA 328, MCL 750.492a.
A certified copy of the court record is conclusive evidence of the conviction.
(ix) Conviction of a misdemeanor or felony involving fraud in obtaining or attempting to obtain fees
related to the practice of a health profession. A certified copy of the court record is conclusive evidence of the
conviction.
(x) Final adverse administrative action by a licensure, registration, disciplinary, or certification board
involving the holder of, or an applicant for, a license or registration regulated by another state or a territory of
the United States, by the United States military, by the federal government, or by another country. A certified
copy of the record of the board is conclusive evidence of the final action.
(xi) Conviction of a misdemeanor that is reasonably related to or that adversely affects the licensee's or
registrant's ability to practice in a safe and competent manner. A certified copy of the court record is
conclusive evidence of the conviction.
(xii) Conviction of a violation of section 430 of the Michigan penal code, 1931 PA 328, MCL 750.430. A
certified copy of the court record is conclusive evidence of the conviction.
(xiii) Conviction of a criminal offense under section 83, 84, 316, 317, 321, 520b, 520c, 520d, or 520f of the
Michigan penal code, 1931 PA 328, MCL 750.83, 750.84, 750.316, 750.317, 750.321, 750.520b, 750.520c,
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750.520d, and 750.520f. A certified copy of the court record is conclusive evidence of the conviction.
(c) Prohibited acts, consisting of 1 or more of the following:
(i) Fraud or deceit in obtaining or renewing a license or registration.
(ii) Permitting a license or registration to be used by an unauthorized person.
(iii) Practice outside the scope of a license.
(iv) Obtaining, possessing, or attempting to obtain or possess a controlled substance as defined in section
7104 or a drug as defined in section 7105 without lawful authority; or selling, prescribing, giving away, or
administering drugs for other than lawful diagnostic or therapeutic purposes.
(d) Except as otherwise specifically provided in this section, unethical business practices, consisting of 1 or
more of the following:
(i) False or misleading advertising.
(ii) Dividing fees for referral of patients or accepting kickbacks on medical or surgical services, appliances,
or medications purchased by or in behalf of patients.
(iii) Fraud or deceit in obtaining or attempting to obtain third party reimbursement.
(e) Except as otherwise specifically provided in this section, unprofessional conduct, consisting of 1 or
more of the following:
(i) Misrepresentation to a consumer or patient or in obtaining or attempting to obtain third party
reimbursement in the course of professional practice.
(ii) Betrayal of a professional confidence.
(iii) Promotion for personal gain of an unnecessary drug, device, treatment, procedure, or service.
(iv) Either of the following:
(A) A requirement by a licensee other than a physician or a registrant that an individual purchase or secure
a drug, device, treatment, procedure, or service from another person, place, facility, or business in which the
licensee or registrant has a financial interest.
(B) A referral by a physician for a designated health service that violates 42 USC 1395nn or a regulation
promulgated under that section. For purposes of this subdivision, 42 USC 1395nn and the regulations
promulgated under that section as they exist on June 3, 2002 are incorporated by reference. A disciplinary
subcommittee shall apply 42 USC 1395nn and the regulations promulgated under that section regardless of
the source of payment for the designated health service referred and rendered. If 42 USC 1395nn or a
regulation promulgated under that section is revised after June 3, 2002, the department shall officially take
notice of the revision. Within 30 days after taking notice of the revision, the department shall decide whether
or not the revision pertains to referral by physicians for designated health services and continues to protect the
public from inappropriate referrals by physicians. If the department decides that the revision does both of
those things, the department may promulgate rules to incorporate the revision by reference. If the department
does promulgate rules to incorporate the revision by reference, the department shall not make any changes to
the revision. As used in this sub-subparagraph, "designated health service" means that term as defined in 42
USC 1395nn and the regulations promulgated under that section and "physician" means that term as defined
in sections 17001 and 17501.
(v) For a physician who makes referrals under 42 USC 1395nn or a regulation promulgated under that
section, refusing to accept a reasonable proportion of patients eligible for Medicaid and refusing to accept
payment from Medicaid or Medicare as payment in full for a treatment, procedure, or service for which the
physician refers the individual and in which the physician has a financial interest. A physician who owns all
or part of a facility in which he or she provides surgical services is not subject to this subparagraph if a
referred surgical procedure he or she performs in the facility is not reimbursed at a minimum of the
appropriate Medicaid or Medicare outpatient fee schedule, including the combined technical and professional
components.
(vi) Any conduct by a health professional with a patient while he or she is acting within the health
profession for which he or she is licensed or registered, including conduct initiated by a patient or to which
the patient consents, that is sexual or may reasonably be interpreted as sexual, including, but not limited to,
sexual intercourse, kissing in a sexual manner, or touching of a body part for any purpose other than
appropriate examination, treatment, or comfort.
(vii) Offering to provide practice-related services, such as drugs, in exchange for sexual favors.
(f) Failure to notify under section 16222(3) or (4).
(g) Failure to report a change of name or mailing address as required in section 16192.
(h) A violation, or aiding or abetting in a violation, of this article or of a rule promulgated under this
article.
(i) Failure to comply with a subpoena issued pursuant to this part, failure to respond to a complaint issued
under this article, article 7, or article 8, failure to appear at a compliance conference or an administrative
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hearing, or failure to report under section 16222(1) or 16223.
(j) Failure to pay an installment of an assessment levied under the insurance code of 1956, 1956 PA 218,
MCL 500.100 to 500.8302, within 60 days after notice by the appropriate board.
(k) A violation of section 17013 or 17513.
(l) Failure to meet 1 or more of the requirements for licensure or registration under section 16174.
(m) A violation of section 17015, 17015a, 17017, 17515, or 17517.
(n) A violation of section 17016 or 17516.
(o) Failure to comply with section 9206(3).
(p) A violation of section 5654 or 5655.
(q) A violation of section 16274.
(r) A violation of section 17020 or 17520.
(s) A violation of the medical records access act, 2004 PA 47, MCL 333.26261 to 333.26271.
(t) A violation of section 17764(2).
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1986, Act 174, Imd. Eff. July 7, 1986;Am. 1986, Act 195, Imd. Eff. July 8,
1986;Am. 1986, Act 319, Imd. Eff. Dec. 26, 1986;Am. 1987, Act 178, Imd. Eff. Nov. 19, 1987;Am. 1989, Act 15, Imd. Eff. May
15, 1989;Am. 1993, Act 79, Eff. Apr. 1, 1994;Am. 1993, Act 133, Eff. Apr. 1, 1994;Am. 1995, Act 196, Imd. Eff. Nov. 22, 1995;
Am. 1996, Act 273, Eff. Mar. 31, 1997;Am. 1996, Act 540, Imd. Eff. Jan. 15, 1997;Am. 1996, Act 594, Eff. Mar. 31, 1997;
Am. 1998, Act 109, Eff. Mar. 23, 1999;Am. 1998, Act 227, Imd. Eff. July 3, 1998;Am. 2000, Act 29, Imd. Eff. Mar. 15, 2000;
Am. 2002, Act 402, Imd. Eff. June 3, 2002;Am. 2003, Act 234, Imd. Eff. Dec. 29, 2003;Am. 2004, Act 48, Imd. Eff. Apr. 1, 2004;
Am. 2004, Act 214, Eff. Oct. 12, 2004;Am. 2011, Act 222, Imd. Eff. Nov. 15, 2011;Am. 2012, Act 499, Eff. Mar. 31, 2013;
Am. 2012, Act 501, Eff. Jan. 1, 2013;Am. 2013, Act 268, Imd. Eff. Dec. 30, 2013;Am. 2014, Act 97, Eff. July 1, 2014;Am. 2014,
Act 411, Eff. Mar. 30, 2015.
Compiler's note: Section 3 of Act 174 of 1986 provides: This amendatory act shall only apply to contested cases filed on or after
July 1, 1986.
Section 2 of Act 319 of 1986 provides: Section 16221(e)(iv) of Act No. 368 of the Public Acts of 1978, as added by this amendatory
act, shall take effect April 1, 1987.
Popular name: Act 368
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Popular name: Act 368
***** 333.16226 THIS SECTION IS AMENDED EFFECTIVE AUGUST 1, 2017: See 333.16226.amended
*****
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333.16226 Sanctions; determination; judicial review; maximum and minimum fine for
violation of MCL 333.16221(a) or (b); completion of program or examination; permanent
revocation; finding.
Sec. 16226. (1) After finding the existence of 1 or more of the grounds for disciplinary subcommittee
action listed in section 16221, a disciplinary subcommittee shall impose 1 or more of the following sanctions
for each violation:
Violations of Section 16221 Sanctions
Subdivision (a), (b)(i), Probation, limitation, denial,
(b)(ii), (b)(iii), (b)(iv), suspension, revocation,
(b)(v), (b)(vi), (b)(vii), permanent revocation,
(b)(ix), (b)(x), (b)(xi), restitution, or fine.
or (b)(xii)
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Subdivision (e)(vi) Probation, suspension, revocation,
or (e)(vii) limitation, denial,
restitution, or fine.
333.16233 Investigation; order to cease and desist; hearing; violation of order; summary
suspension of license or registration; notice from federal agency.
Sec. 16233. (1) The department may conduct an investigation necessary to administer and enforce this
article. Investigations may include written, oral, or practical tests of a licensee's or registrant's competency.
The department may establish a special paralegal unit to assist the department.
(2) The department may order an individual to cease and desist from a violation of this article, article 7, or
article 8 or a rule promulgated under this article, article 7, or article 8.
(3) An individual ordered to cease and desist under subsection (2) is entitled to a hearing before a hearings
examiner if the individual files a written request for a hearing within 30 days after the effective date of the
cease and desist order. The department shall subsequently present the notice, if any, of the individual's failure
to respond to a complaint, or attend or be represented at a hearing as described in sections 16231 and 16231a,
or the recommended findings of fact and conclusions of law to the appropriate disciplinary subcommittee to
determine whether the order is to remain in effect or be dissolved.
(4) Upon a violation of a cease and desist order issued under subsection (2), the department of attorney
general may apply in the circuit court to restrain and enjoin, temporarily or permanently, an individual from
further violating the cease and desist order.
(5) After consultation with the chair of the appropriate board or task force or his or her designee, the
department may summarily suspend a license or registration if the public health, safety, or welfare requires
emergency action in accordance with section 92 of the administrative procedures act of 1969, MCL 24.292. If
a licensee or registrant is convicted of a felony; a misdemeanor punishable by imprisonment for a maximum
term of 2 years; or a misdemeanor involving the illegal delivery, possession, or use of a controlled substance,
the department shall find that the public health, safety, or welfare requires emergency action and, in
accordance with section 92 of the administrative procedures act of 1969, MCL 24.292, shall summarily
suspend the licensee's license or the registrant's registration. If a licensee or registrant is convicted of a
misdemeanor involving the illegal delivery, possession, or use of alcohol that adversely affects the licensee's
ability to practice in a safe and competent manner, the department may find that the public health, safety, or
welfare requires emergency action and, in accordance with section 92 of the administrative procedures act of
1969, MCL 24.292, may summarily suspend the licensee's license or the registrant's registration.
(6) The department may summarily suspend a pharmacy license if the department has received a notice
from the United States food and drug administration or the centers for disease control and prevention that
there is an imminent risk to the public health, safety, or welfare and emergency action in accordance with
section 92 of the administrative procedures act of 1969, MCL 24.292, is appropriate. A suspension under this
subsection remains in effect for the duration of the emergency situation that poses a risk to the public health,
safety, or welfare. Notwithstanding any provision of this act to the contrary, the department is not required to
conduct an investigation or consult with the board of pharmacy to take emergency action under this
subsection.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1986, Act 174, Imd. Eff. July 7, 1986;Am. 1993, Act 79, Eff. Apr. 1, 1994;
Am. 1995, Act 196, Imd. Eff. Nov. 22, 1995;Am. 2010, Act 382, Imd. Eff. Dec. 22, 2010;Am. 2013, Act 268, Imd. Eff. Dec. 30,
2013;Am. 2014, Act 280, Eff. Sept. 30, 2014.
Compiler's note: Section 3 of Act 174 of 1986 provides: This amendatory act shall only apply to contested cases filed on or after
July 1, 1986.
Popular name: Act 368
333.16239 Pamphlet.
Sec. 16239. Each licensee or registrant who is in private practice shall make available upon request of a
patient a pamphlet provided by the department outlining the procedure for filing an allegation with the
department under section 16231. The department shall prepare the pamphlet in consultation with appropriate
professional associations and the boards and task forces. The department shall prepare and print the pamphlet
in languages that are appropriate to the ethnic composition of the patient population where the pamphlet will
be available.
History: Add. 1993, Act 79, Eff. Apr. 1, 1994.
Popular name: Act 368
333.16261 Health profession; prohibited use of insignia, title, letter, word, or phrase.
Sec. 16261. (1) An individual who is not licensed or registered under this article shall not use an insignia,
title, or letter, or a word, letter, or phrase singly or in combination, with or without qualifying words, letters,
or phrases, under a circumstance to induce the belief that the person is licensed or registered in this state, is
lawfully entitled in this state to engage in the practice of a health profession regulated by this article, or is
otherwise in compliance with this article.
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(2) An individual shall not announce or hold himself or herself out to the public as limiting his or her
practice to, as being specially qualified in, or as giving particular attention to a health profession specialty
field for which a board issues a specialty certification or a health profession specialty field license, without
first having obtained a specialty certification or a health profession specialty field license.
(3) An individual shall not announce or hold himself or herself out to the public as being able to perform a
chiropractic adjustment, chiropractic manipulation, or other chiropractic services or chiropractic opinion,
unless the individual is a chiropractor licensed under this article.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2002, Act 643, Imd. Eff. Dec. 23, 2002;Am. 2002, Act 734, Imd. Eff. Dec. 30,
2002.
Popular name: Act 368
333.16263 Repealed. 2006, Act 392, Imd. Eff. Sept. 27, 2006.
Compiler's note: The repealed section pertained to restricted use of words, titles, or letters.
Popular name: Act 368
333.16266 Compliance.
Sec. 16266. Each licensee who owns or operates, or who owns and operates, a private practice office shall
comply with part 138.
History: Add. 1990, Act 21, Eff. June 4, 1990.
Popular name: Act 368
333.16273 Artificial insemination services on anonymous basis; use of frozen sperm; testing
sperm donor for presence of HIV or antibody to HIV; violation; liability; definitions.
Sec. 16273. (1) A licensee, except a veterinarian licensed under this article, who provides artificial
insemination services on an anonymous basis shall use only frozen sperm, and shall test each potential sperm
donor for the presence in the donor of HIV or an antibody to HIV. The donated sperm shall be frozen, stored,
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and quarantined for not less than 6 months. Before frozen sperm is used for artificial insemination, and not
less than 6 months after the date of the donation, the licensee shall take a second blood sample from the donor
and have that blood sample tested for HIV or an antibody to HIV. If at any time the test results are positive,
the licensee shall not use the sperm of the donor for artificial insemination purposes.
(2) A licensee who violates this section shall be liable in a civil action for damages for the loss or damage
resulting from the violation.
(3) As used in this section:
(a) Anonymous basis means that the recipient of the sperm does not know the identity of the donor, but
the licensee who provides the artificial insemination services or collects the sperm from the donor does know
the identity of the donor.
(b) HIV means human immunodeficiency virus.
History: Add. 1988, Act 487, Eff. July 1, 1989.
Popular name: Act 368
333.16274 Human cloning; prohibited acts; exception; violation of subsection (1); private
right of action; definitions.
Sec. 16274. (1) A licensee or registrant shall not engage in or attempt to engage in human cloning.
(2) Subsection (1) does not prohibit scientific research or cell-based therapies not specifically prohibited by
that subsection.
(3) A licensee or registrant who violates subsection (1) is subject to the administrative penalties prescribed
in sections 16221 and 16226 and to the civil penalty prescribed in section 16275.
(4) This section does not give a person a private right of action.
(5) As used in this section:
(a) Human cloning means the use of human somatic cell nuclear transfer technology to produce a human
embryo.
(b) Human embryo means a human egg cell with a full genetic composition capable of differentiating
and maturing into a complete human being.
(c) Human somatic cell means a cell of a developing or fully developed human being that is not and will
not become a sperm or egg cell.
(d) Human somatic cell nuclear transfer means transferring the nucleus of a human somatic cell into an
egg cell from which the nucleus has been removed or rendered inert.
History: Add. 1998, Act 108, Eff. Mar. 23, 1999.
Popular name: Act 368
333.16275 Human cloning; prohibition; exception; violation; penalty; private right of action;
human cloning defined.
Sec. 16275. (1) A licensee or registrant or other individual shall not engage in or attempt to engage in
human cloning.
(2) Subsection (1) does not prohibit scientific research or cell-based therapies not specifically prohibited by
that subsection.
(3) A licensee or registrant or other individual who violates subsection (1) is subject to a civil penalty of
$10,000,000.00. A fine collected under this subsection shall be distributed in the same manner as penal fines
are distributed in this state.
(4) This section does not give a person a private right of action.
(5) As used in this section, human cloning means that term as defined in section 16274.
History: Add. 1998, Act 109, Eff. Mar. 23, 1999.
Popular name: Act 368
***** 333.16283.added THIS ADDED SECTION IS EFFECTIVE MARCH 29, 2017 *****
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333.16283.added Definitions.
Sec. 16283. As used in this section and sections 16284 to 16288:
(a) "Health professional" means an individual who is engaging in the practice of a health profession.
(b) "Prescriber" means that term as defined in section 17708.
(c) "Telehealth" means the use of electronic information and telecommunication technologies to support or
promote long-distance clinical health care, patient and professional health-related education, public health, or
health administration. Telehealth may include, but is not limited to, telemedicine. As used in this subdivision,
"telemedicine" means that term as defined in section 3476 of the insurance code of 1956, 1956 PA 218, MCL
500.3476.
(d) "Telehealth service" means a health care service that is provided through telehealth.
History: Add. 2016, Act 359, Eff. Mar. 29, 2017.
Popular name: Act 368
***** 333.16284.added THIS ADDED SECTION IS EFFECTIVE MARCH 29, 2017 *****
333.16284.added Telehealth service; consent required; exception.
Sec. 16284. Except as otherwise provided in this section, a health professional shall not provide a
telehealth service without directly or indirectly obtaining consent for treatment. This section does not apply to
a health professional who is providing a telehealth service to an inmate who is under the jurisdiction of the
department of corrections and is housed in a correctional facility.
History: Add. 2016, Act 359, Eff. Mar. 29, 2017.
Popular name: Act 368
***** 333.16285.added THIS ADDED SECTION IS EFFECTIVE MARCH 29, 2017 *****
333.16285.added Telehealth service; prescribing patient with drug; conditions.
Sec. 16285. A health professional who is providing a telehealth service may prescribe the patient a drug if
both of the following are met:
(a) The health professional is a prescriber.
(b) The drug is not a controlled substance.
History: Add. 2016, Act 359, Eff. Mar. 29, 2017.
Popular name: Act 368
***** 333.16286.added THIS ADDED SECTION IS EFFECTIVE MARCH 29, 2017 *****
333.16286.added Telehealth service; restrictions or conditions; findings by disciplinary
subcommittee.
Sec. 16286. In a manner consistent with this part and in addition to the provisions set forth in this part, a
disciplinary subcommittee may place restrictions or conditions on a health professional's ability to provide a
telehealth service if the disciplinary subcommittee finds that the health professional has violated section
16284 or 16285.
History: Add. 2016, Act 359, Eff. Mar. 29, 2017.
Popular name: Act 368
***** 333.16287.added THIS ADDED SECTION IS EFFECTIVE MARCH 29, 2017 *****
333.16287.added Rules.
Sec. 16287. The department, in consultation with a board, may promulgate rules to implement sections
16284 and 16285.
History: Add. 2016, Act 359, Eff. Mar. 29, 2017.
Popular name: Act 368
***** 333.16288.added THIS ADDED SECTION IS EFFECTIVE MARCH 29, 2017 *****
333.16288.added MCL 333.16284 to 333.16287; limitations.
Sec. 16288. Sections 16284 to 16287 do not do any of the following:
(a) Require new or additional third party reimbursement for health care services rendered by a health
professional through telehealth.
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(b) Limit the provision of a health care service otherwise allowed by law.
(c) Authorize a health care service otherwise prohibited by law.
History: Add. 2016, Act 359, Eff. Mar. 29, 2017.
Popular name: Act 368
333.16303 Nonrefundable application processing fee; examination or inspection fee; fee for
initial license or registration period.
Sec. 16303. Each application for a license or registration shall be accompanied by a nonrefundable
application processing fee. The department may also require that the application be accompanied by a fee for
a required examination or inspection or the fee for the initial license or registration period.
History: Add. 1988, Act 462, Eff. Sept. 1, 1989.
Popular name: Act 368
333.16315 Health professions regulatory fund; nurse professional fund; pain management
education and controlled substances electronic monitoring and antidiversion fund.
Sec. 16315. (1) The health professions regulatory fund is established in the state treasury. Except as
otherwise provided in this section, the state treasurer shall credit the fees collected under sections 16319 to
16349 to the health professions regulatory fund. The money in the health professions regulatory fund shall be
expended only as provided in subsection (5).
(2) The state treasurer shall direct the investment of the health professions regulatory fund. Interest and
earnings from health professions regulatory fund investment shall be credited to the health professions
regulatory fund.
(3) The unencumbered balance in the health professions regulatory fund at the close of the fiscal year shall
remain in the health professions regulatory fund and shall not revert to the general fund.
(4) The health professions regulatory fund may receive gifts and devises and other money as provided by
law.
(5) The department shall use the health professions regulatory fund to carry out its powers and duties under
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this article, article 7, and article 8, including, but not limited to, reimbursing the department of attorney
general for the reasonable cost of services provided to the department under this article, article 7, and article
8.
(6) The nurse professional fund is established in the state treasury. Of the money that is attributable to
per-year license fees collected under section 16327, the state treasurer shall credit $8.00 of each individual
annual license fee collected to the nurse professional fund. The money in the nurse professional fund shall be
expended only as provided in subsection (9).
(7) The state treasurer shall direct the investment of the nurse professional fund, and shall credit interest
and earnings from the investment to the nurse professional fund. The nurse professional fund may receive
gifts and devises and other money as provided by law.
(8) The unencumbered balance in the nurse professional fund at the close of the fiscal year shall remain in
the nurse professional fund and shall not revert to the general fund.
(9) The department of community health shall use the nurse professional fund each fiscal year only as
follows:
(a) To promote safe patient care in all nursing practice environments.
(b) To advance the safe practice of the nursing profession.
(c) To assure a continuous supply of high-quality direct care nurses, nursing faculty, and nursing education
programs.
(d) To operate a nursing scholarship program.
(10) The pain management education and controlled substances electronic monitoring and antidiversion
fund is established in the state treasury.
(11) The state treasurer shall direct the investment of the pain management education and controlled
substances electronic monitoring and antidiversion fund. Interest and earnings from investment of the pain
management education and controlled substances electronic monitoring and antidiversion fund shall be
credited to the pain management education and controlled substances electronic monitoring and antidiversion
fund.
(12) The unencumbered balance in the pain management education and controlled substances electronic
monitoring and antidiversion fund at the close of the fiscal year shall remain in the pain management
education and controlled substances electronic monitoring and antidiversion fund and shall not revert to the
general fund. The pain management education and controlled substances electronic monitoring and
antidiversion fund may receive gifts and devises and other money as provided by law. Twenty dollars of the
license fee received by the department under section 16319 shall be deposited with the state treasurer to the
credit of the pain management education and controlled substances electronic monitoring and antidiversion
fund. The department shall use the pain management education and controlled substances electronic
monitoring and antidiversion fund only in connection with programs relating to pain management education
for health professionals, preventing the diversion of controlled substances, and development and maintenance
of the electronic monitoring system for controlled substances data required by section 7333a.
History: Add. 1993, Act 138, Eff. Apr. 1, 1994;Am. 2001, Act 232, Imd. Eff. Jan. 3, 2002;Am. 2007, Act 166, Imd. Eff. Dec.
21, 2007;Am. 2009, Act 216, Imd. Eff. Jan. 4, 2010;Am. 2013, Act 268, Imd. Eff. Dec. 30, 2013.
Compiler's note: Former MCL 333.16315, which pertained to health professions regulatory fund and nurse professional fund, was
repealed by Acts 87 and 138 of 1993, Eff. Apr. 1, 1994.
Popular name: Act 368
333.16319 Fees.
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Sec. 16319. Fees for a person licensed or seeking licensure to engage in manufacturing, distributing,
prescribing, dispensing, or conducting research with controlled substances under part 73 are as follows:
(a) Application processing fee................. $ 10.00
(b) License fee, per year...................... 75.00.
History: Add. 1993, Act 138, Eff. Apr. 1, 1994.
Compiler's note: Former MCL 333.16319, which pertained to licensure and fees for manufacturing, distributing, prescribing, or
dispensing controlled substances or conducting research, was repealed by Act 138 of 1993, Eff. Apr. 1, 1994.
Popular name: Act 368
333.16323 Dentist, dental assistant, or dental hygienist; fees; waiver; "armed forces"
defined.
Sec. 16323. (1) Except as otherwise provided in subsection (2), fees for an individual licensed or seeking
licensure to practice as a dentist, dental assistant, or dental hygienist under part 166 are as follows:
(a) Application processing fees:
(i) Dentist................................. $ 20.00
(ii) Dental assistant........................ 10.00
(iii) Dental hygienist........................ 15.00
(iv) Health profession specialty field
license for a dentist................... 20.00
(b) Examination fees:
(i) Dental assistant's examination,
complete................................ 70.00
(ii) Dental assistant's examination,
per part................................ 35.00
(iii) Dentist's health profession specialty
field license examination, complete..... 300.00
(iv) Dentist's health profession specialty
field license examination, per part..... 100.00
(c) License fees, per year:
(i) Dentist................................. 90.00
(ii) Dental assistant........................ 10.00
(iii) Dental hygienist........................ 20.00
(iv) Dentist's health profession specialty
field license........................... 15.00
(d) Temporary license fees:
(i) Dentist................................. 20.00
(ii) Dental assistant........................ 5.00
(iii) Dental hygienist........................ 10.00
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(e) Limited license fee, per year:
(i) Dentist................................. 25.00
(ii) Dental assistant........................ 5.00
(iii) Dental hygienist........................ 10.00
(f) Examination review fees:
(i) Dental preclinical or dentist's health
profession specialty field license...... 50.00
(ii) Dental assistant........................ 20.00
(2) The department shall waive the application processing and license fees required under subsection (1)
for an initial license to engage in practice as a dental assistant if the applicant for initial licensure, while on
active duty as a member of the armed forces, served as a military dental specialist and was separated from
service with an honorable character of service or under honorable conditions (general) character of service in
the armed forces. The applicant shall provide a form DD214, DD215, or any other form that is satisfactory to
the department to be eligible for the waiver of fees under this subsection. As used in this subsection, "armed
forces" means that term as defined in section 2 of the veteran right to employment services act, 1994 PA 39,
MCL 35.1092.
History: Add. 1993, Act 80, Eff. Apr. 1, 1994;Am. 2002, Act 643, Imd. Eff. Dec. 23, 2002;Am. 2014, Act 305, Eff. Jan. 9, 2015
.
Popular name: Act 368
333.16323a Fees.
Sec. 16323a. Fees for a person licensed or seeking licensure as an audiologist under part 168 are as
follows:
(a) Application processing fee.................. $ 120.00
(b) License fee, per year....................... 150.00
History: Add. 2004, Act 97, Imd. Eff. May 7, 2004.
Popular name: Act 368
333.16348 Licensed bachelor's social worker, licensed master's social worker, or registered
social service technician; fees.
Sec. 16348. Fees for a person licensed or seeking licensure as a licensed bachelor's social worker or a
licensed master's social worker or a person registered or seeking registration as a registered social service
technician under part 185 are as follows:
(a) Application processing fee...................$ 15.00
(b) License fee, per year:
(i) Licensed bachelor's social worker.......... 25.00
(ii) Licensed master's social worker............. 25.00
(c) Registration fee, per year, for a social
service technician.......................... 25.00
History: Add. 2000, Act 11, Imd. Eff. Mar. 7, 2000;Am. 2004, Act 61, Eff. July 1, 2005.
Popular name: Act 368
PART 164
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CHIROPRACTIC
333.16401 Definitions; scope; principles of construction.
Sec. 16401. (1) As used in this part:
(a) "Chiropractor", "chiropractic physician", "doctor of chiropractic", or "d.c." means an individual
licensed under this article to engage in the practice of chiropractic.
(b) "Dislocation" means complete disruption in the normal relationship of 2 bones forming a joint resulting
in no contact of the articular surfaces. A dislocation does not include a subluxation.
(c) "Joint dysfunction" means a joint that is impaired so that it does not function properly.
(d) "Musculoskeletal system" means the system of muscles, tendons, ligaments, bones, joints, and
associated tissues that moves the body and maintains its form.
(e) "Practice of chiropractic" means that discipline within the healing arts that deals with the human
nervous system and the musculoskeletal system and their interrelationship with other body systems. Practice
of chiropractic includes the following:
(i) The diagnosis of human conditions and disorders of the human musculoskeletal and nervous systems as
they relate to subluxations, misalignments, and joint dysfunctions. These diagnoses shall be for the purpose of
detecting and correcting those conditions and disorders or offering advice to seek treatment from other health
professionals in order to restore and maintain health.
(ii) The evaluation of conditions or symptoms related to subluxations, misalignments, and joint
dysfunction through any of the following:
(A) Physical examination.
(B) The taking and reviewing of patient health information.
(C) The performance, ordering, or use of tests. The performance, ordering, or use of tests in the practice of
chiropractic is regulated by rules promulgated under section 16423.
(D) The performance, ordering, or use of x-ray.
(E) The performance, ordering, or use of tests that were allowed under section 16423 as of December 1,
2009.
(iii) The chiropractic adjustment of subluxations, misalignments, and joint dysfunction and the treatment of
related bones and tissues for the establishment of neural integrity and structural stability.
(iv) The use of physical measures, analytical instruments, nutritional advice, rehabilitative exercise, and
adjustment apparatus regulated by rules promulgated under section 16423.
(2) The practice of chiropractic does not include any of the following:
(a) The performance of any procedure that cuts or punctures the skin.
(b) The dispensing or prescribing of drugs or medicine.
(c) Except for diagnostic purposes only, the use of x-ray.
(d) The performance of an invasive procedure involving a body orifice or cavity unless allowed by rules
promulgated under section 16423 and limited to examinations involving the ears, nose, and throat.
(e) The treatment of fractures or dislocations.
(f) The performance or ordering of non-x-ray diagnostic imaging tests that were not allowed under section
16423 as of December 1, 2009.
(3) In addition to the definitions in this part, article 1 contains general definitions and principles of
construction applicable to all articles in this act and part 161 contains definitions applicable to this part.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2002, Act 734, Imd. Eff. Dec. 30, 2002;Am. 2009, Act 223, Imd. Eff. Jan. 5,
2010.
Compiler's note: For transfer of powers and duties of certain health-related functions, boards, and commissions from the Department
of Licensing and Regulation to the Department of Commerce, see E.R.O. No. 1991-9, compiled at MCL 338.3501 of the Michigan
Compiled Laws.
Popular name: Act 368
333.16411 Practice of chiropractic; license or authorization required; scope and effect of act;
use of words, titles, or letters.
Sec. 16411. (1) An individual shall not engage in the practice of chiropractic, including, but not limited to,
performing a chiropractic adjustment, chiropractic manipulation, or other chiropractic services or chiropractic
opinion, unless licensed, or otherwise authorized by a chiropractor, under this article.
(2) 2002 PA 734 is intended to codify existing law and to clarify and cure any misinterpretation of the
operation of sections 16261, 16401, and 16411 since December 30, 2002.
(3) 2002 PA 734 is not intended to affect the authority of a veterinarian to delegate certain functions as
provided by law.
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(4) 2002 PA 734 does not affect the scope of practice of medicine or osteopathic medicine and surgery
provided for in parts 170 and 175. 2002 PA 734 does not amend the scope of practice of physical therapy
provided for in part 178.
(5) The following words, titles, or letters or a combination thereof, with or without qualifying words or
phrases, are restricted in use only to those persons authorized under this part to use the following terms and in
a way prescribed in this part: "chiropractic", "doctor of chiropractic", "chiropractor", "d.c.", and "chiropractic
physician".
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2002, Act 734, Imd. Eff. Dec. 30, 2002;Am. 2006, Act 396, Imd. Eff. Sept. 27,
2006.
Popular name: Act 368
333.16423 Performance and ordering of tests and approval of analytical instruments and
adjustment apparatus; rules; criteria; standards.
Sec. 16423. (1) The department, in consultation with the board, shall promulgate rules to establish criteria
for the performance and ordering of tests and the approval of analytical instruments and adjustment apparatus
to be used for the purpose of examining and treating patients for subluxations and misalignments that produce
nerve interference or joint dysfunction. The criteria established shall be substantially equivalent to nationally
recognized standards in the profession for the performance and ordering of tests and the use and operation of
the instruments and apparatus. The board may approve types and makes of analytical instruments and
adjustment apparatus that meet these criteria.
(2) An individual shall not perform or order tests or use analytical instruments or adjustment apparatus that
do not meet nationally recognized standards or that are not approved by the board.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2009, Act 221, Imd. Eff. Jan. 5, 2010.
Popular name: Act 368
Administrative rules: R 338.2201 et seq. and R 338.12001 et seq. of the Michigan Administrative Code.
PART 165.
333.16501 Definitions.
Sec. 16501. (1) As used in this part:
(a) "Acupuncture" means the insertion and manipulation of needles through the surface of the human body
at specific locations on the human body for the prevention or correction of disease, injury, pain, or other
condition.
(b) "Acupuncturist" means an individual who practices acupuncture and is registered, or otherwise
authorized, under this part.
(2) In addition to the definitions in this part, article 1 contains general definitions and principles of
construction applicable to all articles in the code and part 161 contains definitions applicable to this part.
History: Add. 2006, Act 30, Eff. July 1, 2006.
Popular name: Act 368
333.16525 Rules.
Sec. 16525. (1) The department, in consultation with the board, shall promulgate rules setting forth the
minimum standards for registration as an acupuncturist. The department, in consultation with the board, may
adopt by reference the professional standards issued by a certified program that is recognized by the national
commission for certifying agencies or by a nationally recognized trade association.
(2) The department, in consultation with the board, shall not promulgate rules under this section that
diminish competition or exceed the minimum level of regulation necessary to protect the public.
History: Add. 2006, Act 30, Eff. July 1, 2006.
Popular name: Act 368
PART 166
DENTISTRY
333.16601 Definitions; principles of construction.
Sec. 16601. (1) As used in this part:
(a) Assignment means that a dentist has designated a patient of record upon whom services are to be
performed and has described the procedures to be performed. The dentist need not be physically present in the
office or in the treatment room at the time the procedures are being performed.
(b) Dental laboratory means a dental workroom operated as a part of a dental office or otherwise, by a
person, other than a dentist, who is engaged in, or holds himself, herself, or itself out as being directly or
indirectly engaged in, constructing, repairing, or altering prosthetic dentures, bridges, orthodontic or other
appliances, or structures to be used as substitutes for or as a part of human teeth or jaws or associated
structures, or for the correction of malocclusions or deformities.
(c) Dentist means an individual licensed under this article to engage in the practice of dentistry.
(d) Practice of dentistry means the diagnosis, treatment, prescription, or operation for a disease, pain,
deformity, deficiency, injury, or physical condition of the human tooth, teeth, alveolar process, gums or jaws,
or their dependent tissues, or an offer, undertaking, attempt to do, or holding oneself out as able to do any of
these acts.
(e) Practice as a dental assistant means assistance in the clinical practice of dentistry based on formal
education, specialized knowledge, and skill at the assignment and under the supervision of a dentist.
(f) Practice as a dental hygienist means practice at the assignment of a dentist in that specific area of
dentistry based on specialized knowledge, formal education, and skill with particular emphasis on preventive
services and oral health education.
(2) In addition, article 1 contains general definitions and principles of construction applicable to all articles
in this code and part 161 contains definitions applicable to this part.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Compiler's note: For transfer of powers and duties of certain health-related functions, boards, and commissions from the Department
of Licensing and Regulation to the Department of Commerce, see E.R.O. No. 1991-9, compiled at MCL 338.3501 of the Michigan
Compiled Laws.
Popular name: Act 368
333.16631 Applicability of section to dentist who uses dental amalgam and who removes
dental amalgam; exceptions; procedures; rules; violations; preemption.
Sec. 16631. (1) Except as otherwise provided, this section applies to a dentist who uses dental amalgam
and to a dentist who removes dental amalgam. This section does not apply to any of the following:
(a) Oral and maxillofacial surgeons.
(b) Oral and maxillofacial radiologists.
(c) Oral pathologists.
(d) Orthodontists.
(e) Periodontists.
(f) Dentists while providing services in a dental school, in a hospital, or through a local health department.
(2) On or before December 31, 2013, a dentist described in subsection (1) shall install or have installed and
use on each wastewater drain in the dentist's office that is used to discharge dental amalgam a separator that
has an efficiency of 95% or more as determined through testing in accordance with standards published by the
international organization for standardization in ISO 11143:2008 "Dental equipment Amalgam separators".
(3) On or before the expiration of 90 days after the effective date of this section, the department, in
consultation with the department of environmental quality, shall promulgate rules regarding best management
practice for dental amalgam collection, disposal, and recycling and the retention and inspection of dental
office records regarding the following:
(a) The make, model, and type of dental amalgam separator installed and in use in the office.
(b) The method used to dispose of or recycle the dental amalgam waste collected.
(c) The shipping or other delivery records documenting the transfer of the dental amalgam waste collected
to licensed recyclers or disposers.
(d) The proper operation of the dental amalgam separator, including scheduled maintenance as specified in
the manufacturer's owner's manual for that separator.
(e) Compliance with dental amalgam best management practices.
(4) A violation of subsection (1) or (2) or a rule promulgated under subsection (3) is a violation of section
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16221(h).
(5) Beginning on the effective date of this section and subject to this subsection, this section preempts and
supersedes any local ordinance, regulation, or resolution that imposes conflicting, different, or additional
standards or requirements on dentists than those contained in this section or rules promulgated by the board
under this section. A local unit of government may enact, adopt, maintain, amend, or enforce an ordinance,
regulation, or resolution that requires implementation of the requirement in subsections (2) and (3) before the
date required in subsection (2). A local unit of government shall not enact, adopt, maintain, or enforce an
ordinance, regulation, or resolution that imposes conflicting, different, or additional standards or requirements
on dentists than those contained in this section or rules promulgated by the board under this section,
including, but not limited to, the requirement to obtain a permit that limits the discharge of mercury into
wastewater with a limitation greater than that capable of being achieved by full compliance with this section.
History: Add. 2008, Act 503, Imd. Eff. Jan. 13, 2009.
333.16641 Work authorization for dental laboratory services required; retention and
inspection of work authorizations and copies.
Sec. 16641. (1) A dentist shall not use the services of a dental laboratory without furnishing a written work
authorization to the dental laboratory and a carbon copy to the patient for constructing, repairing, or altering
prosthetic dentures, bridges, orthodontic or other appliances, or structures to be used as substitutes for or as a
part of human teeth or jaws or associated structures, or for the correction of malocclusions or deformities.
(2) A dentist shall retain a written work authorization furnished to a dental laboratory or a copy of the
authorization for not less than 3 years and allow the board, its agents, or employees to inspect the file of
written work authorizations or copies.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.16642 Work authorization for dental laboratory work; form; contents; name or number of
work authorization to accompany invoice; prohibition.
Sec. 16642. (1) A written authorization for dental laboratory work shall be in a form prescribed by the
board and shall contain the following:
(a) The name and address of the laboratory.
(b) An identification of the patient by name or number.
(c) The date on which the authorization was written.
(d) The description of the work to be done, with diagrams if necessary.
(e) A specification of the type and quality of materials to be used.
(f) The dentist's signature, complete business address, and license number.
(2) A dental laboratory shall return completed prescribed work to the prescribing dentist or the dentist's
office with the name or number of the written work authorization accompanying the invoice.
(3) A dental laboratory shall not have in its possession a prosthetic denture, bridge, orthodontic or other
appliance, or structure to be used as a substitute for or as a part of human teeth or jaws or associated structures
or for the correction of malocclusions or deformities, completed or being fabricated without having in its
possession a written work authorization therefor.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.16644 Record of dental treatment required; retention; rules prescribing form and
content; using record for identification purposes.
Sec. 16644. (1) A dentist shall make a record of all dental treatment which has been performed upon a
patient, and shall retain that treatment record for a period of not less than 10 years after the performance of the
last service upon the patient.
(2) The board shall promulgate rules to prescribe the form and content of the record required by subsection
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(1), so that the record may be used for identification purposes.
History: Add. 1982, Act 482, Eff. Mar. 30, 1983.
Popular name: Act 368
PART 168.
AUDIOLOGY
333.16801 Definitions; scope of practice; limitation.
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Sec. 16801. (1) As used in this part:
(a) Audiologist means an individual licensed under this article to engage in the practice of audiology.
(b) Practice of audiology means the nonmedical and nonsurgical application of principles, methods, and
procedures related to disorders of hearing, including all of the following:
(i) Facilitating the conservation of auditory system function.
(ii) Developing and implementing hearing conservation programs.
(iii) Preventing, identifying, and assessing hearing disorders of the peripheral and central auditory system.
(iv) Selecting, fitting, and dispensing of amplification systems, including hearing aids and related devices,
and providing training for their use.
(v) Providing auditory training, consulting, education, and speech reading to individuals with hearing
disorders.
(vi) Administering and interpreting tests of vestibular function and tinnitus in compliance with section
16809 and in adherence to the mandate of subsection (2).
(vii) Routine cerumen removal from the cartilaginous portion of the external ear in otherwise healthy ears
except that if the audiologist, while engaged in routine cerumen removal, discovers any trauma, including, but
not limited to, continuous uncontrolled bleeding, lacerations, or other traumatic injuries, he or she shall, as
soon as practically possible, refer the patient to a person licensed in the practice of medicine or osteopathic
medicine and surgery.
(viii) Speech and language screening limited to a pass-fail determination for the purpose of identification
of individuals with disorders of communication.
(2) Practice of audiology does not include the practice of medicine or osteopathic medicine and surgery or
medical diagnosis or treatment.
(3) In addition to the definitions in this part, article 1 contains general definitions and principles of
construction applicable to all articles in this code and part 161 contains definitions applicable to this part.
History: Add. 2004, Act 97, Imd. Eff. May 7, 2004.
Popular name: Act 368
333.16809 Administration of tests; compliance with federal guidelines for fitting and
dispensing hearing instruments; sale of hearing instrument to person under 18 years of
age.
Sec. 16809. (1) An audiologist shall administer tests of vestibular function only to patients who have been
referred to him or her by a person licensed to practice medicine or osteopathic medicine and surgery.
(2) If an audiologist administers an audiometric test for tinnitus and his or her examination of the patient
reflects the presence of otologic or systemic diseases, the audiologist shall promptly refer the patient to a
person licensed to practice medicine or osteopathic medicine and surgery.
(3) An audiologist shall comply with the federal food and drug administration medical referral guidelines
for fitting and dispensing hearing instruments, 21 CFR 801.621, incorporated by reference.
(4) A licensed audiologist may not sell a hearing instrument to a person under 18 years of age unless the
person or the parent or guardian of the person presents to the audiologist a written statement signed by a
licensed physician who specializes in diseases of the ear stating that both of the following exist:
(a) The person's hearing loss has been medically evaluated during the 6-month period preceding the date
the statement is presented.
(b) The person may be considered a candidate for a hearing instrument.
History: Add. 2004, Act 97, Imd. Eff. May 7, 2004.
Popular name: Act 368
PART 169
MARRIAGE AND FAMILY THERAPY
333.16901 Definitions; principles of construction.
Sec. 16901. (1) As used in this part:
(a) Advertise means issuing or ordering the printing or distribution of a card, sign, or device or causing,
permitting, or allowing a sign or marking on or in a building or structure, or placing material in a newspaper,
magazine, or directory, or on radio or television.
(b) Marriage and family therapist means an individual licensed under this article to engage in the
practice of marriage and family therapy.
(c) Practice of marriage and family therapy means the providing of guidance, testing, discussions,
therapy, instruction, or advice that is intended to avoid, eliminate, relieve, manage, or resolve marital or
family conflict or discord, to create, improve, or restore marital or family harmony, or to prepare couples for
marriage. Practice of marriage and family therapy does not include the administration and interpretation of
psychological tests except for those tests that are consistent with the individual's education and training and
with the code of ethics for licensed marriage and family therapists.
(2) In addition to the definitions of this part, article 1 contains general definitions and principles of
construction applicable to all articles in this code and part 161 contains definitions applicable to this part.
History: Add. 1995, Act 126, Eff. Jan. 1, 1996.
Popular name: Act 368
333.16903 Restricted use of title; advertising; limited license; use of title during training
period; use of words, titles, or letters.
Sec. 16903. (1) An individual licensed under this part as a marriage and family therapist shall use only the
title "licensed marriage and family therapist" or "licensed marriage counselor" or the abbreviation "l.m.f.t." in
representing his or her services in the practice of marriage and family therapy to the public.
(2) Unless exempt under section 16905(3), only an individual licensed under this part may advertise that he
or she offers marriage and family therapy; marriage or family counseling service or advice; marriage or
family guidance service or advice; marriage or family relations service or advice; marriage or family
problems service or advice; marriage or family relations advice or assistance; service in the alleviation of a
marital or family problem; or service of similar import or effect that is included in the practice of marriage
and family therapy.
(3) The board may grant a limited license to an individual who has met the requirements of section
16909(a) and (b) in order to permit that individual to obtain the experience required under section 16909(c).
The board shall not renew a limited license for more than 6 years. A limited licensee shall do all of the
following:
(a) Use only the title "limited licensed marriage and family therapist" or "limited licensed marriage
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counselor".
(b) Not represent that he or she is engaged in the independent practice of marriage and family therapy.
(c) Practice only under the supervision of a fully licensed marriage and family therapist.
(d) Confine his or her practice to an organized health care setting or other arrangement approved by the
board.
(4) An individual engaged in obtaining experience required under section 16909(b) may use the title
"marriage and family therapist intern" or "marriage and family therapist trainee" during the training period.
The board shall not require an individual obtaining experience required under section 16909(b) to hold a
limited license.
(5) The following words, titles, or letters or a combination thereof, with or without qualifying words or
phrases, are restricted in use only to those individuals authorized under this part to use the terms and in a way
prescribed by this part: "marriage advisor" or "marriage consultant"; "family counselor", "family advisor",
"family therapist", or "family consultant"; "family guidance counselor", "family guidance advisor", or "family
guidance consultant"; "marriage guidance counselor", "marriage guidance advisor", or "marriage guidance
consultant"; "family relations counselor"; "marriage relations counselor", "marriage relations advisor", or
"marriage relations consultant"; or "marital counselor" or "marital therapist".
History: Add. 1995, Act 126, Eff. Jan. 1, 1996;Am. 2006, Act 388, Imd. Eff. Sept. 27, 2006.
Popular name: Act 368
333.16905 Exceptions.
Sec. 16905. (1) This part does not apply to an individual engaged in the practice of social work as defined
in part 185, in the course of employment with a governmental agency or a reputable social service agency
regularly providing social work services as an agency.
(2) This part does not apply to an ordained cleric or other religious practitioner who is employed by or
working under the authority of an organization exempt from taxation under section 501(c)(3) of the internal
revenue code of 1986, 26 USC 501, if the advice or counsel given by the cleric or other religious practitioner
is incidental to his or her duties as a cleric or other religious practitioner, and if the cleric or other religious
practitioner does not hold himself or herself out to the public as a marriage and family therapist licensed
under this article or use 1 or more of the titles listed in section 16903 and if no fee or donation is exacted for
the service.
(3) This part does not apply to a physician licensed under this article who has completed an accredited
psychiatric residency program approved by the Michigan board of medicine or to a psychologist fully licensed
under this article, if both of the following circumstances exist:
(a) The individual is practicing his or her profession in a manner consistent with his or her education and
training and is practicing in a manner consistent with the code of ethics of that profession.
(b) The individual does not hold himself or herself out to the public as a marriage and family therapist
licensed under this article or use any of the titles listed in section 16903 for advertising purposes. However,
this subdivision does not prohibit the individual from advertising under a telephone or other business
directory listing that uses those titles if the individual discloses in the listing, in an unabbreviated fashion, the
profession in which he or she is licensed.
(4) This part does not limit an individual in, or prevent an individual from, the practice of a statutorily
regulated profession or occupation if services to families, couples, or subsystems of families are part of the
services provided by that profession or occupation, and if the individual does not hold himself or herself out
to the public as a marriage and family therapist licensed under this article or use 1 or more of the titles listed
in section 16903. As used in this subsection, "statutorily regulated profession or occupation" means an
occupation or profession regulated by statute that includes, but is not limited to, all of the following: a
physician, attorney, social worker, social service technician, fully licensed psychologist, limited licensed
psychologist, temporary limited licensed psychologist, licensed professional counselor, limited licensed
counselor, or school counselor.
History: Add. 1995, Act 126, Eff. Jan. 1, 1996;Am. 2006, Act 388, Imd. Eff. Sept. 27, 2006.
Popular name: Act 368
333.16913 Licenses issued under former article; terms of board members appointed under
former section; effect of rules promulgated under former article.
Sec. 16913. (1) An individual who holds a license issued under former article 15 of Act No. 299 of the
Public Acts of 1980 on the effective date of the amendatory act that added this part is licensed under this part
until that license expires and may renew his or her license pursuant to part 161.
(2) The members of the board of marriage and family therapy created under former section 1502 of Act
No. 299 of the Public Acts of 1980 shall serve as the initial members of the Michigan board of marriage and
family therapy until their successors are appointed under this article or until the expiration of their respective
terms, whichever occurs first. However, if the term of a member of the board of marriage and family therapy
created under former section 1502 of Act No. 299 of the Public Acts of 1980 has not expired on the effective
date of the amendatory act that added this part, that term expires on June 30 of the year in which the term will
expire.
(3) Rules promulgated by the board of marriage and family therapy under former article 15 of Act No. 299
of the Public Acts of 1980 and under section 308 of the occupational code, Act No. 299 of the Public Acts of
1980, being section 339.308 of the Michigan Compiled Laws, and in effect on the effective date of the
amendatory act that added this part continue in effect to the extent that they do not conflict with this article.
The rules shall be enforced by and may be amended or rescinded by the Michigan board of marriage and
family therapy.
History: Add. 1995, Act 126, Eff. Jan. 1, 1996.
Popular name: Act 368
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PART 170
MEDICINE
***** 333.17001 THIS SECTION IS AMENDED EFFECTIVE AUGUST 1, 2017: See 333.17001.amended
*****
333.17001 Definitions; principles of construction.
Sec. 17001. (1) As used in this part:
(a) "Academic institution" means either of the following:
(i) A medical school approved by the board.
(ii) A hospital licensed under article 17 that meets all of the following requirements:
(A) Was the sole sponsor or a co-sponsor, if each other co-sponsor is either a medical school approved by
the board or a hospital owned by the federal government and directly operated by the United States
department of veterans' affairs, of not less than 4 postgraduate education residency programs approved by the
board under section 17031(1) for not less than the 3 years immediately preceding the date of an application
for a limited license under section 16182(2)(c) or an application for a full license under section 17031(2),
provided that at least 1 of the residency programs is in the specialty area of medical practice, or in a specialty
area that includes the subspecialty of medical practice, in which the applicant for a limited license proposes to
practice or in which the applicant for a full license has practiced for the hospital.
(B) Has spent not less than $2,000,000.00 for medical education during each of the 3 years immediately
preceding the date of an application for a limited license under section 16182(2)(c) or an application for a full
license under section 17031(2). As used in this subparagraph, "medical education" means the education of
physicians and candidates for degrees or licenses to become physicians, including, but not limited to,
physician staff, residents, interns, and medical students.
(b) "Electrodiagnostic studies" means the testing of neuromuscular functions utilizing nerve conduction
tests and needle electromyography. It does not include the use of surface electromyography.
(c) "Medical care services" means those services within the scope of practice of physicians licensed by the
board, except those services that the board determines shall not be delegated by a physician without
endangering the health and safety of patients as provided for in section 17048(3).
(d) "Physician" means an individual licensed under this article to engage in the practice of medicine.
(e) "Podiatrist" means an individual licensed under this article to engage in the practice of podiatric
medicine and surgery.
(f) "Practice of medicine" means the diagnosis, treatment, prevention, cure, or relieving of a human
disease, ailment, defect, complaint, or other physical or mental condition, by attendance, advice, device,
diagnostic test, or other means, or offering, undertaking, attempting to do, or holding oneself out as able to do,
any of these acts.
(g) "Practice as a physician's assistant" means the practice of medicine, osteopathic medicine and surgery,
or podiatric medicine and surgery performed under the supervision of a physician or podiatrist licensed under
this article.
(h) "Supervision" means that term as defined in section 16109, except that it also includes the existence of
a predetermined plan for emergency situations, including, but not limited to, the designation of a physician to
supervise a physician's assistant in the absence of the primary supervising physician.
(i) "Task force" means the joint task force created in section 17025.
(2) In addition to the definitions in this part, article 1 contains definitions and principles of construction
applicable to all articles in this code and part 161 contains definitions applicable to this part.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1990, Act 247, Imd. Eff. Oct. 12, 1990;Am. 1990, Act 248, Imd. Eff. Oct. 12,
1990;Am. 2005, Act 264, Eff. Mar. 30, 2006;Am. 2006, Act 161, Eff. Nov. 26, 2006.
Compiler's note: For transfer of powers and duties of certain health-related functions, boards, and commissions from the Department
of Licensing and Regulation to the Department of Commerce, see E.R.O. No. 1991-9, compiled at MCL 338.3501 of the Michigan
Compiled Laws.
Popular name: Act 368
333.17012 Postgraduate medical study requiring practice of medicine; full or limited license
required; requirements of limited license; training; renewing limited license.
Sec. 17012. (1) An individual shall not engage in postgraduate medical study which requires the practice of
medicine by that individual without a full or limited license to practice under this part.
(2) A limited license for a postgraduate shall require that the individual confine his or her practice and
training to a hospital or institution approved by the board for the training. The hospital or institution is
responsible for the training. A limited license for a postgraduate is renewable for not more than 5 years.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
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333.17017 Physical examination required; certain other means prohibited; right to abortion
not created; definitions.
Sec. 17017. (1) This section and section 17517 do not apply after December 31, 2018.
(2) Except as otherwise provided in this section, a physician shall not diagnose and prescribe a medical
abortion for a patient who is or is presumed to be pregnant unless the physician or an individual licensed and
qualified by education and training first personally performs a physical examination of the patient. A
physician shall not utilize other means including, but not limited to, an internet web camera, to diagnose and
prescribe a medical abortion.
(3) A physician shall obtain the informed consent of a patient in the manner prescribed under section
17015 to perform a medical abortion. The physician shall be physically present at the location of the medical
abortion when the prescription drug used to initiate the medical abortion is dispensed. An individual under the
direct supervision of the prescribing physician who is qualified by education and training as provided in this
act may dispense or administer the prescription drug used to initiate the medical abortion.
(4) This section does not create a right to abortion. Notwithstanding any other provision of this section, a
person shall not perform an abortion that is prohibited by law.
(5) As used in this section:
(a) "Abortion" means that term as defined in section 17015.
(b) "Medical abortion" means an abortion procedure that is not a surgical procedure and that utilizes a
prescription drug to induce an abortion.
(c) "Prescription drug" means that term as defined in section 17708.
History: Add. 2012, Act 499, Eff. Mar. 31, 2013.
Popular name: Act 368
***** 333.17021 THIS SECTION IS AMENDED EFFECTIVE AUGUST 1, 2017: See 333.17021.amended
*****
333.17021 Michigan board of medicine; creation; membership; waiver; limitation on powers
and duties.
Sec. 17021. (1) The Michigan board of medicine is created in the department and shall consist of the
following 19 voting members who shall meet the requirements of part 161: 10 physicians, 1 physician's
assistant, and 8 public members.
(2) The requirement of section 16135(d) that a board member shall have practiced that profession for 2
years immediately before appointment is waived until September 30, 1980 for members of the board licensed
in a health profession subfield created by this part.
(3) The board of medicine shall not have the powers and duties vested in the task force by sections 17060
to 17084.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1993, Act 79, Eff. Apr. 1, 1994.
Popular name: Act 368
333.17031 Condition for more than limited licensure; requirements for full license to practice
medicine; filing and contents of written statement; civil or criminal liability; rebuttable
presumption.
Sec. 17031. (1) Except as provided in subsection (2), an applicant, in addition to completing the
requirements for the degree in medicine, shall complete a period of postgraduate education to attain
proficiency in the practice of the profession, as prescribed by the board in rules, as a condition for more than
limited licensure.
(2) The board may grant a full license to practice medicine to an applicant who has completed the
requirements for a degree in medicine at a medical school located outside the United States or Canada if the
applicant demonstrates to the board all of the following:
(a) That the applicant has engaged in the practice of medicine for not less than 10 years after completing
the requirements for a degree in medicine.
(b) That the applicant has completed not less than 3 years of postgraduate clinical training in an institution
that has an affiliation with a medical school that is listed in a directory of medical schools published by the
world health organization as approved by the board.
(c) That the applicant has achieved a score determined by the board to be a passing score on an initial
medical licensure examination approved by the board.
(d) That the applicant has safely and competently practiced medicine under a clinical academic limited
license granted by the board under this article for 1 or more academic institutions located in this state for not
less than the 2 years immediately preceding the date of application for a license under this subsection, during
which time the applicant functioned not less than 800 hours per year in the observation and treatment of
patients.
(3) An applicant under subsection (2) shall file with the board a written statement from each academic
institution upon which the applicant relies to satisfy subsection (2)(d). The statement shall indicate, at a
minimum, that the applicant functioned for the academic institution in the observation and treatment of
patients not less than 800 hours per year and that in so doing the applicant practiced medicine safely and
competently. A person who in good faith makes a written statement that is filed under this subsection is not
civilly or criminally liable for that statement. There is a rebuttable presumption that a person who makes a
written statement that is filed under this subsection has done so in good faith.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1990, Act 248, Imd. Eff. Oct. 12, 1990;Am. 2002, Act 643, Imd. Eff. Dec. 23,
2002.
Popular name: Act 368
333.17040-333.17047 Repealed. 1990, Act 247, Imd. Eff. Oct. 12, 1990.
Compiler's note: The repealed sections pertained to supervision or employment of physician's assistants.
Popular name: Act 368
***** 333.17048 THIS SECTION IS AMENDED EFFECTIVE AUGUST 1, 2017: See 333.17048.amended
*****
333.17048 Limitation on number of physician's assistants supervised; prohibiting or
restricting delegation of medical care service or requiring higher levels of supervision;
delegation of ultimate responsibility prohibited; rules as to drugs; ordering, receiving, and
dispensing complimentary starter dose drugs; physician's assistant as shareholder in
professional service corporation or as member in professional limited liability company.
Sec. 17048. (1) Except as otherwise provided in this section and section 17049(5), a physician who is a
sole practitioner or who practices in a group of physicians and treats patients on an outpatient basis shall not
supervise more than 4 physician's assistants. If a physician described in this subsection supervises physician's
assistants at more than 1 practice site, the physician shall not supervise more than 2 physician's assistants by a
method other than the physician's actual physical presence at the practice site.
(2) A physician who is employed by, under contract or subcontract to, or has privileges at a health facility
or agency licensed under article 17 or a state correctional facility may supervise more than 4 physician's
assistants at the health facility or agency or state correctional facility.
(3) To the extent that a particular selected medical care service requires extensive medical training,
education, or ability or poses serious risks to the health and safety of patients, the board may prohibit or
otherwise restrict the delegation of that medical care service or may require higher levels of supervision.
(4) A physician shall not delegate ultimate responsibility for the quality of medical care services, even if
the medical care services are provided by a physician's assistant.
(5) Subject to section 17076(3) and (4), the board may promulgate rules for the delegation by a supervising
physician to a physician's assistant of the function of prescription of drugs. The rules may define the drugs or
classes of drugs the prescription of which shall not be delegated and other procedures and protocols necessary
to promote consistency with federal and state drug control and enforcement laws.
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(6) A supervising physician may delegate in writing to a physician's assistant the ordering, receipt, and
dispensing of complimentary starter dose drugs including controlled substances that are included in schedules
2 to 5 of part 72. When the delegated ordering, receipt, or dispensing of complimentary starter dose drugs
occurs, both the physician's assistant's name and the supervising physician's name shall be used, recorded, or
otherwise indicated in connection with each order, receipt, or dispensing. When the delegated ordering,
receipt, or dispensing of complimentary starter dose drugs that are included in schedules 2 to 5 occurs, both
the physician's assistant's and the supervising physician's DEA registration numbers shall be used, recorded,
or otherwise indicated in connection with each order, receipt, or dispensing. As used in this subsection,
"complimentary starter dose" means that term as defined in section 17745. It is the intent of the legislature in
enacting this subsection to allow a pharmaceutical manufacturer or wholesale distributor, as those terms are
defined in part 177, to distribute complimentary starter dose drugs to a physician's assistant, as described in
this subsection, in compliance with section 503(d) of the federal food, drug, and cosmetic act, 21 USC 353.
(7) Beginning on July 19, 2010, if 1 or more individuals licensed under part 170 to engage in the practice
of medicine, licensed under part 175 to engage in the practice of osteopathic medicine and surgery, or
licensed under part 180 to engage in the practice of podiatric medicine and surgery, and 1 or more physician's
assistants organize a professional service corporation under section 4 of former 1962 PA 192, a professional
corporation under section 284 of the business corporation act, 1972 PA 284, MCL 450.1284, or a professional
limited liability company under section 904 of the Michigan limited liability company act, 1993 PA 23, MCL
450.4904, the individuals who are the supervising physicians of the physician's assistants shall be
shareholders in the same professional service corporation or professional corporation or members in the same
professional limited liability company as the physician's assistants and shall meet all of the applicable
requirements of part 170, 175, or 180. If 1 or more physician's assistants organized a professional service
corporation under section 4 of former 1962 PA 192, a professional corporation under section 284 of the
business corporation act, 1972 PA 284, MCL 450.1284, or a professional limited liability company under
section 904 of the Michigan limited liability company act, 1993 PA 23, MCL 450.4904, before July 19, 2010
that has only physician's assistants as shareholders or members, the individuals who are the supervising
physicians of the physician's assistants shall meet all of the applicable requirements of part 170, 175, or 180.
(8) In addition to the requirements of section 17068 and beginning on July 19, 2010, the department shall
include on the form used for renewal of licensure a space for a physician's assistant to disclose whether he or
she is a shareholder in a professional service corporation under section 4 of former 1962 PA 192, or a member
in a professional limited liability company under section 904 of the Michigan limited liability company act,
1993 PA 23, MCL 450.4904, that was organized before July 19, 2010. A physician's assistant who is a
shareholder in a professional service corporation or a member in a professional limited liability company
described in this subsection shall disclose all of the following in the form used for renewal of licensure
provided by the department:
(a) Whether any individuals licensed under part 170 to engage in the practice of medicine, licensed under
part 175 to engage in the practice of osteopathic medicine and surgery, or licensed under part 180 to engage in
the practice of podiatric medicine and surgery are shareholders in the professional service corporation or
members in the professional limited liability company.
(b) The name and license number of the individual licensed under part 170 to engage in the practice of
medicine, licensed under part 175 to engage in the practice of osteopathic medicine and surgery, or licensed
under part 180 to engage in the practice of podiatric medicine and surgery who supervises the physician's
assistant.
(c) Whether the individual licensed under part 170 to engage in the practice of medicine, licensed under
part 175 to engage in the practice of osteopathic medicine and surgery, or licensed under part 180 to engage in
the practice of podiatric medicine and surgery disclosed in subdivision (b) is a shareholder in the same
professional service corporation or member in a professional limited liability company as the physician's
assistant.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1986, Act 174, Imd. Eff. July 7, 1986;Am. 1990, Act 247, Imd. Eff. Oct. 12,
1990;Am. 1996, Act 355, Imd. Eff. July 1, 1996;Am. 2010, Act 124, Imd. Eff. July 19, 2010;Am. 2011, Act 210, Imd. Eff. Nov.
8, 2011;Am. 2012, Act 618, Imd. Eff. Jan. 9, 2013.
Compiler's note: Section 3 of Act 174 of 1986 provides: This amendatory act shall only apply to contested cases filed on or after
July 1, 1986.
Popular name: Act 368
Administrative rules: R 338.6101 et seq. of the Michigan Administrative Code.
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333.17048.amended Prohibiting or restricting delegation of medical care service or requiring
higher levels of supervision; rules concerning prescribing of drugs; organization as
professional service corporation or professional limited liability company; shareholders.
Sec. 17048. (1) Except for a medical care service within a practice agreement, to the extent that a particular
selected medical care service requires extensive medical training, education, or ability or poses serious risks
to the health and safety of patients, the board may prohibit or otherwise restrict the delegation of that medical
care service or may require higher levels of supervision. To the extent that a particular medical care service
requires extensive training, education, or ability or poses serious risks to the health or safety of patients, the
board may prohibit or otherwise restrict that medical care service within a practice agreement.
(2) For purposes of section 17076(2) and (3), the department, in consultation with the board, may
promulgate rules concerning the prescribing of drugs by a physician's assistant. Subject to section 17076, the
rules may define the drugs or classes of drugs that a physician's assistant may not prescribe and other
procedures and protocols necessary to promote consistency with federal and state drug control and
enforcement laws.
(3) Beginning on July 19, 2010, if 1 or more individuals licensed under part 170 to engage in the practice
of medicine, licensed under part 175 to engage in the practice of osteopathic medicine and surgery, or
licensed under part 180 to engage in the practice of podiatric medicine and surgery, and 1 or more physician's
assistants organize a professional service corporation under section 4 of former 1962 PA 192, a professional
corporation under section 284 of the business corporation act, 1972 PA 284, MCL 450.1284, or a professional
limited liability company under section 904 of the Michigan limited liability company act, 1993 PA 23, MCL
450.4904, the physicians who are parties to a practice agreement with the physician's assistants shall be
shareholders in the same professional service corporation or professional corporation or members in the same
professional limited liability company as the physician's assistants and shall meet all of the applicable
requirements of part 170, 175, or 180. If 1 or more physician's assistants organized a professional service
corporation under section 4 of former 1962 PA 192, a professional corporation under section 284 of the
business corporation act, 1972 PA 284, MCL 450.1284, or a professional limited liability company under
section 904 of the Michigan limited liability company act, 1993 PA 23, MCL 450.4904, before July 19, 2010
that has only physician's assistants as shareholders or members, the physicians who are parties to a practice
agreement with the physician's assistants shall meet all of the applicable requirements of part 170, 175, or
180.
(4) In addition to the requirements of section 17068 and beginning on July 19, 2010, the department shall
include on the form used for renewal of licensure a space for a physician's assistant to disclose whether he or
she is a shareholder in a professional service corporation under section 4 of former 1962 PA 192, or a member
in a professional limited liability company under section 904 of the Michigan limited liability company act,
1993 PA 23, MCL 450.4904, that was organized before July 19, 2010. A physician's assistant who is a
shareholder in a professional service corporation or a member in a professional limited liability company
described in this subsection shall disclose all of the following in the form used for renewal of licensure
provided by the department:
(a) Whether any individuals licensed under part 170 to engage in the practice of medicine, licensed under
part 175 to engage in the practice of osteopathic medicine and surgery, or licensed under part 180 to engage in
the practice of podiatric medicine and surgery are shareholders in the professional service corporation or
members in the professional limited liability company.
(b) The name and license number of the individual licensed under part 170 to engage in the practice of
medicine, licensed under part 175 to engage in the practice of osteopathic medicine and surgery, or licensed
under part 180 to engage in the practice of podiatric medicine and surgery who is a party to a practice
agreement with the physician's assistant.
(c) Whether the individual licensed under part 170 to engage in the practice of medicine, licensed under
part 175 to engage in the practice of osteopathic medicine and surgery, or licensed under part 180 to engage in
the practice of podiatric medicine and surgery disclosed in subdivision (b) is a shareholder in the same
professional service corporation or member in a professional limited liability company as the physician's
assistant.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1986, Act 174, Imd. Eff. July 7, 1986;Am. 1990, Act 247, Imd. Eff. Oct. 12,
1990;Am. 1996, Act 355, Imd. Eff. July 1, 1996;Am. 2010, Act 124, Imd. Eff. July 19, 2010;Am. 2011, Act 210, Imd. Eff. Nov.
8, 2011;Am. 2012, Act 618, Imd. Eff. Jan. 9, 2013;Am. 2016, Act 379, Eff. Aug. 1, 2017.
Compiler's note: Section 3 of Act 174 of 1986 provides: This amendatory act shall only apply to contested cases filed on or after
July 1, 1986.
Popular name: Act 368
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Administrative rules: R 338.6101 et seq. of the Michigan Administrative Code.
***** 333.17049 THIS SECTION IS AMENDED EFFECTIVE AUGUST 1, 2017: See 333.17049.amended
*****
333.17049 Responsibilities of physician supervising physician's assistant.
Sec. 17049. (1) In addition to the other requirements of this section and subject to subsection (5), a
physician who supervises a physician's assistant is responsible for all of the following:
(a) Verification of the physician's assistant's credentials.
(b) Evaluation of the physician's assistant's performance.
(c) Monitoring the physician's assistant's practice and provision of medical care services.
(2) Subject to section 16215 or 17048, as applicable, a physician who supervises a physician's assistant
may delegate to the physician's assistant the performance of medical care services for a patient who is under
the case management responsibility of the physician, if the delegation is consistent with the physician's
assistant's training.
(3) A physician who supervises a physician's assistant is responsible for the clinical supervision of each
physician's assistant to whom the physician delegates the performance of medical care service under
subsection (2).
(4) Subject to subsection (5), a physician who supervises a physician's assistant shall keep on file in the
physician's office or in the health facility or agency or correctional facility in which the physician supervises
the physician's assistant a permanent, written record that includes the physician's name and license number
and the name and license number of each physician's assistant supervised by the physician.
(5) A group of physicians practicing other than as sole practitioners may designate 1 or more physicians in
the group to fulfill the requirements of subsections (1) and (4).
(6) Notwithstanding any law or rule to the contrary, a physician is not required to countersign orders
written in a patient's clinical record by a physician's assistant to whom the physician has delegated the
performance of medical care services for a patient. Notwithstanding any law or rule to the contrary, a
physician is not required to sign an official form that lists the physician's signature as the required signatory if
that official form is signed by a physician's assistant to whom the physician has delegated the performance of
medical care services.
History: Add. 1990, Act 247, Imd. Eff. Oct. 12, 1990;Am. 2004, Act 512, Imd. Eff. Jan. 3, 2005;Am. 2011, Act 210, Imd. Eff.
Nov. 8, 2011.
Popular name: Act 368
***** 333.17050 THIS SECTION IS AMENDED EFFECTIVE AUGUST 1, 2017: See 333.17050.amended
*****
333.17050 Supervision prohibited; grounds.
Sec. 17050. In addition to its other powers and duties under this article, the board may prohibit a physician
from supervising 1 or more physician's assistants for any of the grounds set forth in section 16221 or for
failure to supervise a physician's assistant in accordance with this part and rules promulgated under this part.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1990, Act 247, Imd. Eff. Oct. 12, 1990.
Popular name: Act 368
Administrative rules: R 338.6101 et seq. of the Michigan Administrative Code.
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***** 333.17050.amended THIS AMENDED SECTION IS EFFECTIVE AUGUST 1, 2017 *****
333.17050.amended Prohibiting physician or physician's assistant from entering into
practice agreement; grounds.
Sec. 17050. In addition to its other powers and duties under this article, the board may prohibit a physician
or a physician's assistant from entering into a practice agreement for any of the grounds set forth in section
16221.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1990, Act 247, Imd. Eff. Oct. 12, 1990;Am. 2016, Act 379, Eff. Aug. 1, 2017.
Popular name: Act 368
Administrative rules: R 338.6101 et seq. of the Michigan Administrative Code.
333.17054 Criteria for licensure of physician's assistants and for evaluation of training
programs; recommendations.
Sec. 17054. The board shall make written recommendations on criteria for the licensure of physician's
assistants and on criteria for the evaluation of physician's assistants' training programs to the task force on
physician's assistants.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.17056 Exception.
Sec. 17056. This part does not apply to a student in training to become a physician's assistant while
performing duties assigned as part of the training.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
***** 333.17060 THIS SECTION IS AMENDED EFFECTIVE AUGUST 1, 2017: See 333.17060.amended
*****
333.17060 Duties of task force.
Sec. 17060. The task force shall:
(a) Promulgate rules necessary for the implementation of its powers and duties and may perform the acts
and make the determinations necessary for the proper implementations of those powers and duties.
(b) Promulgate rules to establish the requirements for the education, training, or experience of physician's
assistants for licensure in this state. The requirements shall take into account nationally recognized standards
for education, training, and experience and the desired utilization of physician's assistants. By 2 years after the
effective date of the amendatory act that added this sentence, the rules must include training standards for
identifying victims of human trafficking. The training standards for identifying victims of human trafficking
shall apply for a physician's assistant license or registration renewal beginning with the first renewal cycle
after the rules are promulgated and for an initial license or registration issued 5 or more years after the rules
are promulgated.
(c) Develop and make public guidelines on the appropriate delegation of functions to and supervision of
physician's assistants according to the level of education, training, or experience of physician's assistants. The
guidelines are not binding, but shall serve to explain how the task force's training criteria coincides with the
board's expectation for delegation to and supervision of physician's assistants by physicians.
(d) Direct the department to issue licenses to applicants who meet the requirements of this part and the
rules promulgated under this part for practice and use of the title of physician's assistant.
(e) Promulgate rules to establish criteria for the evaluation of programs for the education and training of
physician's assistants for the purpose of determining whether graduates of the programs have the knowledge
and skills requisite for practice and use of the title physician's assistant in this state as defined by this part and
the rules promulgated under this part. The criteria established shall be substantially consistent with nationally
recognized standards for the education and training of physician's assistants. Until the criteria are established,
the criteria developed by the advisory commission on physician's assistants shall remain in effect. The task
force shall consider and may use where appropriate the criteria established by professional associations,
education accrediting bodies, or governmental agencies. In establishing criteria for the evaluation of education
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and training programs, the task force may seek the advice of the boards and the department of education.
(f) Make written recommendations to the boards concerning the rules to be developed for approval by the
boards of physicians to supervise physician's assistants, including recommendations for appropriate utilization
of physician's assistants by level of preparation where appropriate.
(g) File an annual report with the department and the boards containing matters prescribed by the
department and boards.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1980, Act 59, Imd. Eff. Apr. 1, 1980;Am. 1986, Act 290, Imd. Eff. Dec. 22,
1986;Am. 1990, Act 247, Imd. Eff. Oct. 12, 1990;Am. 2014, Act 343, Eff. Jan. 14, 2015.
Popular name: Act 368
Administrative rules: R 338.6101 et seq. of the Michigan Administrative Code.
***** 333.17066 THIS SECTION IS REPEALED BY ACT 379 of 2016 EFFECTIVE AUGUST 1, 2017 *****
***** 333.17074 THIS SECTION IS AMENDED EFFECTIVE AUGUST 1, 2017: See 333.17074.amended
*****
333.17074 Prohibited undertakings, representations, and services by physician's assistant;
permissible services; acting under supervision of supervising podiatrist.
Sec. 17074. (1) A physician's assistant shall not undertake or represent that he or she is qualified to
undertake provision of a medical care service that he or she knows or reasonably should know to be outside
his or her competence or is prohibited by law.
(2) A physician's assistant shall not:
(a) Perform acts, tasks, or functions to determine the refractive state of a human eye or to treat refractive
anomalies of the human eye, or both.
(b) Determine the spectacle or contact lens prescription specifications required to treat refractive anomalies
of the human eye, or determine modification of spectacle or contact lens prescription specifications, or both.
(3) A physician's assistant may perform routine visual screening or testing, postoperative care, or
assistance in the care of medical diseases of the eye under the supervision of a physician.
(4) A physician's assistant acting under the supervision of a podiatrist shall only perform those duties
included within the scope of practice of that supervising podiatrist.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1990, Act 247, Imd. Eff. Oct. 12, 1990;Am. 2006, Act 161, Eff. Nov. 26, 2006.
Popular name: Act 368
***** 333.17076 THIS SECTION IS AMENDED EFFECTIVE AUGUST 1, 2017: See 333.17076.amended
*****
333.17076 Medical care services by physician's assistant; supervision required; making calls
or going on rounds; prescribing drugs; indicating name of supervising physician;
ordering, receiving, and dispensing complimentary starter dose drugs.
Sec. 17076. (1) Except in an emergency situation, a physician's assistant shall provide medical care
services only under the supervision of a physician or properly designated alternative physician, and only if
those medical care services are within the scope of practice of the supervising physician and are delegated by
the supervising physician.
(2) A physician's assistant may make calls or go on rounds under the supervision of a physician in private
homes, public institutions, emergency vehicles, ambulatory care clinics, hospitals, intermediate or extended
care facilities, health maintenance organizations, nursing homes, or other health care facilities.
Notwithstanding any law or rule to the contrary, a physician's assistant may make calls or go on rounds as
provided in this subsection without restrictions on the time or frequency of visits by the physician or the
physician's assistant.
(3) A physician's assistant may prescribe drugs as a delegated act of a supervising physician in accordance
with procedures and protocol for the prescription established by rule of the appropriate board. A physician's
assistant may prescribe a drug, including a controlled substance that is included in schedules 2 to 5 of part 72,
as a delegated act of the supervising physician. When delegated prescription occurs, both the physician's
assistant's name and the supervising physician's name shall be used, recorded, or otherwise indicated in
connection with each individual prescription so that the individual who dispenses or administers the
prescription knows under whose delegated authority the physician's assistant is prescribing. When delegated
prescription of drugs that are included in schedules 2 to 5 occurs, both the physician's assistant's and the
supervising physician's DEA registration numbers shall be used, recorded, or otherwise indicated in
connection with each individual prescription.
(4) A physician's assistant may order, receive, and dispense complimentary starter dose drugs, including
controlled substances that are included in schedules 2 to 5 of part 72, as a delegated act of a supervising
physician. When the delegated ordering, receipt, or dispensing of complimentary starter dose drugs occurs,
both the physician's assistant's name and the supervising physician's name shall be used, recorded, or
otherwise indicated in connection with each order, receipt, or dispensing so that the individual who processes
the order or delivers the complimentary starter dose drugs or to whom the complimentary starter dose drugs
are dispensed knows under whose delegated authority the physician's assistant is ordering, receiving, or
dispensing. When the delegated ordering, receipt, or dispensing of complimentary starter dose drugs that are
included in schedules 2 to 5 occurs, both the physician's assistant's and the supervising physician's DEA
registration numbers shall be used, recorded, or otherwise indicated in connection with each order, receipt, or
dispensing. As used in this subsection, "complimentary starter dose" means that term as defined in section
17745. It is the intent of the legislature in enacting this subsection to allow a pharmaceutical manufacturer or
wholesale distributor, as those terms are defined in part 177, to distribute complimentary starter dose drugs to
a physician's assistant, as described in this subsection, in compliance with section 503(d) of the federal food,
drug, and cosmetic act, 21 USC 353.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1990, Act 247, Imd. Eff. Oct. 12, 1990;Am. 1996, Act 355, Imd. Eff. July 1,
1996;Am. 2011, Act 210, Imd. Eff. Nov. 8, 2011.
Popular name: Act 368
Administrative rules: R 338.6101 et seq. of the Michigan Administrative Code.
***** 333.17078 THIS SECTION IS AMENDED EFFECTIVE AUGUST 1, 2017: See 333.17078.amended
*****
333.17078 Physician's assistant as agent of supervising physician or podiatrist; privileged
communications; minimal standards.
Sec. 17078. (1) A physician's assistant is the agent of his or her supervising physician under this part or
part 175 or supervising podiatrist under part 180. A communication made to a physician's assistant that would
be a privileged communication if made to the supervising physician under this part or part 175 or supervising
podiatrist under part 180 is a privileged communication to the physician's assistant and the supervising
physician or supervising podiatrist to the same extent as if the communication were made to the supervising
physician or supervising podiatrist.
(2) A physician's assistant shall conform to minimal standards of acceptable and prevailing practice for the
supervising physician under this part or part 175 or supervising podiatrist under part 180.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1990, Act 247, Imd. Eff. Oct. 12, 1990;Am. 2006, Act 161, Eff. Nov. 26, 2006;
Am. 2011, Act 210, Imd. Eff. Nov. 8, 2011.
Popular name: Act 368
333.17082 Investigations and evaluations by task force; purpose; revision of criteria for
education and training; continuation of program approval and criteria.
Sec. 17082. (1) The task force may conduct or cause to be conducted, investigations and evaluations
necessary to determine whether a program meets the criteria established by this part and rules promulgated
under this part.
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(2) At times the task force determines appropriate, the task force may revise the criteria for the education
and training of graduates to determine whether the graduates meet the requirements for practice and use of the
title physician's assistant in this state.
(3) A program approval of the director of public health and the criteria developed or recommended by the
physician's assistant's advisory commission permitted under section 20 of former Act No. 420 of the Public
Acts of 1976 shall be continued for the duration of its initial approval, unless disapproved by the task force.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Compiler's note: Act 420 of 1976, referred to in this section, was repealed by Act 368 of 1978 .
Popular name: Act 368
PART 172
NURSING
333.17201 Definitions; principles of construction.
Sec. 17201. (1) As used in this part:
(a) Practice of nursing means the systematic application of substantial specialized knowledge and skill,
derived from the biological, physical, and behavioral sciences, to the care, treatment, counsel, and health
teaching of individuals who are experiencing changes in the normal health processes or who require
assistance in the maintenance of health and the prevention or management of illness, injury, or disability.
(b) Practice of nursing as a licensed practical nurse or l.p.n. means the practice of nursing based on
less comprehensive knowledge and skill than that required of a registered professional nurse and performed
under the supervision of a registered professional nurse, physician, or dentist.
(c) Registered professional nurse or r.n. means an individual licensed under this article to engage in
the practice of nursing which scope of practice includes the teaching, direction, and supervision of less skilled
personnel in the performance of delegated nursing activities.
(2) In addition to the definitions in this part, article 1 contains general definitions and principles of
construction applicable to all articles in the code and part 161 contains definitions applicable to this part.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Compiler's note: For transfer of powers and duties of certain health-related functions, boards, and commissions from the Department
of Licensing and Regulation to the Department of Commerce, see E.R.O. No. 1991-9, compiled at MCL 338.3501 of the Michigan
Compiled Laws.
Popular name: Act 368
333.17224, 333.17225 Repealed. 1989, Act 201, Imd. Eff. Oct. 23, 1989.
Compiler's note: The repealed sections pertained to task force for health professional subfields and health profession specialty fields.
Popular name: Act 368
PART 173
333.17301 Definitions; principles of construction.
Sec. 17301. (1) As used in this part:
(a) Nursing home means that term as defined in section 20109.
(b) Nursing home administrator means the individual licensed under this article to engage in the practice
of nursing home administration.
(c) Practice of nursing home administration means planning, organizing, directing, and controlling the
total operation of the nursing home on behalf of the governing board or owner of a nursing home.
(2) In addition to the definitions of this part, article 1 contains general definitions and principles of
construction applicable to all articles in this code and part 161 contains definitions applicable to this part.
History: Add. 2001, Act 139, Imd. Eff. Oct. 26, 2001.
Popular name: Act 368
333.17315 Nursing home administrator of Christian Science nursing home; limited license.
Sec. 17315. (1) Subject to section 16182, this part or a rule promulgated under this part shall not require an
applicant for a limited license as a nursing home administrator of a Christian Science nursing home to meet a
medical educational qualification or to pass an examination on medical subjects.
(2) A license issued under this section shall describe its limitation.
History: Add. 2001, Act 139, Imd. Eff. Oct. 26, 2001.
Popular name: Act 368
PART 174
OPTOMETRY
333.17401 Definitions; principles of construction.
Sec. 17401. (1) As used in this part:
(a) Optometrist means an individual licensed under this article to engage in the practice of optometry.
(b) Practice of optometry means 1 or more of the following, but does not include the performance of
invasive procedures:
(i) The examination of the human eye to ascertain the presence of defects or abnormal conditions that may
be corrected, remedied, or relieved, or the effects of which may be corrected, remedied, or relieved by the use
of lenses, prisms, or other mechanical devices.
(ii) The employment of objective or subjective physical means to determine the accommodative or
refractive conditions or the range of powers of vision or muscular equilibrium of the human eye.
(iii) The adaptation or the adjustment of the lenses or prisms or the use of therapeutic pharmaceutical
agents to correct, remedy, or relieve a defect or abnormal condition or to correct, remedy, or relieve the effect
of a defect or abnormal condition of the human eye.
(iv) The examination of the human eye for contact lenses and the fitting or insertion of contact lenses to the
human eye.
(v) The employment of objective or subjective means, including diagnostic pharmaceutical agents by an
optometrist who meets the requirements of section 17412, for the examination of the human eye for the
purpose of ascertaining a departure from the normal, measuring of powers of vision, and adapting lenses for
the aid of those powers.
(c) Diagnostic pharmaceutical agent means a topically administered prescription drug or other topically
administered drug used for the purpose of investigating, analyzing, and diagnosing a defect or abnormal
condition of the human eye or ocular adnexa.
(d) Therapeutic pharmaceutical agent means 1 or more of the following:
(i) A topically administered prescription drug or other topically administered drug used for the purpose of
investigating, analyzing, diagnosing, correcting, remedying, or relieving a defect or abnormal condition of the
anterior segment of the human eye or for the purpose of correcting, remedying, or relieving the effects of a
defect or abnormal condition of the anterior segment of the human eye.
(ii) A topically or orally administered antiglaucoma drug.
(iii) An orally administered prescription drug or other orally administered drug used for the purpose of
investigating, analyzing, diagnosing, correcting, remedying, or relieving a defect or abnormal condition of the
anterior segment of the human eye and adnexa or for the purpose of investigating, analyzing, diagnosing,
correcting, remedying, or relieving the effects of a defect or abnormal condition of the anterior segment of the
human eye and adnexa that is administered by an optometrist who has completed 50% of the continuing
education hours required for renewal of a license in the category of pharmacological management of ocular
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conditions.
(e) Drug means that term as defined in section 17703, but does not include a controlled substance as
defined in section 7104 and included in schedule 2 under section 7214, an oral cortical steroid, or a
prescription drug. However, drug does include a controlled substance included in schedules 3, 4, and 5 under
sections 7216, 7218, and 7220, respectively, and dihydrocodeinone combination drugs.
(f) Prescription drug means that term as defined in section 17708, but does not include a controlled
substance as defined in section 7104 and included in schedule 2 under section 7214 or an oral cortical steroid.
However, prescription drug does include a controlled substance included in schedules 3, 4, and 5 under
sections 7216, 7218, and 7220, respectively, and dihydrocodeinone combination drugs.
(g) Physician means that term as defined in section 17001 or 17501.
(h) Invasive procedures means all of the following:
(i) The use of lasers other than for observation.
(ii) The use of ionizing radiation.
(iii) The use of therapeutic ultrasound.
(iv) The administration of medication by injection.
(v) Procedures that include an incision.
(2) In addition to the definitions in this part, article 1 contains general definitions and principles of
construction applicable to all articles in this code and part 161 contains definitions applicable to this part.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1984, Act 42, Eff. Apr. 12, 1984;Am. 1994, Act 384, Eff. Mar 30, 1995;Am.
1997, Act 151, Imd. Eff. Dec. 2, 1997;Am. 2002, Act 599, Imd. Eff. Dec. 16, 2002.
Compiler's note: For transfer of powers and duties of certain health-related functions, boards, and commissions from the Department
of Licensing and Regulation to the Department of Commerce, see E.R.O. No. 1991-9, compiled at MCL 338.3501 of the Michigan
Compiled Laws.
Popular name: Act 368
PART 175
OSTEOPATHIC MEDICINE AND SURGERY
***** 333.17501 THIS SECTION IS AMENDED EFFECTIVE AUGUST 1, 2017: See 333.17501.amended
*****
333.17501 Definitions; principles of construction.
Sec. 17501. (1) As used in this part:
(a) "Electrodiagnostic studies" means the testing of neuromuscular functions utilizing nerve conduction
tests and needle electromyography. It does not include the use of surface electromyography.
(b) "Medical care services" means those services within the scope of practice of physicians licensed and
approved by the board, except those services that the board determines shall not be delegated by a physician
without endangering the health and safety of patients as provided for in section 17548(3).
(c) "Physician" means an individual licensed under this article to engage in the practice of osteopathic
medicine and surgery.
(d) "Practice of osteopathic medicine and surgery" means a separate, complete, and independent school of
medicine and surgery utilizing full methods of diagnosis and treatment in physical and mental health and
disease, including the prescription and administration of drugs and biologicals, operative surgery, obstetrics,
radiological and other electromagnetic emissions, and placing special emphasis on the interrelationship of the
musculoskeletal system to other body systems.
(e) "Practice as a physician's assistant" means the practice of medicine, osteopathic medicine and surgery,
and podiatric medicine and surgery performed under the supervision of a physician or podiatrist licensed
under this article.
(f) "Supervision" has the meaning ascribed to it in section 16109 except that it includes the existence of a
predetermined plan for emergency situations, including, but not limited to, the designation of a physician to
supervise a physician's assistant in the absence of the primary supervising physician.
(g) "Task force" means the joint task force created in section 17025.
(2) In addition to the definitions in this part, article 1 contains general definitions and principles of
construction applicable to all articles in the code and part 161 contains definitions applicable to this part.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1990, Act 247, Imd. Eff. Oct. 12, 1990;Am. 2005, Act 264, Eff. Mar. 30, 2006;
Am. 2006, Act 161, Eff. Nov. 26, 2006.
Compiler's note: For transfer of powers and duties of certain health-related functions, boards, and commissions from the Department
of Licensing and Regulation to the Department of Commerce, see E.R.O. No. 1991-9, compiled at MCL 338.3501 of the Michigan
Compiled Laws.
Popular name: Act 368
333.17515 Compliance with MCL 333.17015 and 333.17015a before performing abortion.
Sec. 17515. A physician, before performing an abortion on a patient, shall comply with sections 17015 and
17015a.
History: Add. 1993, Act 133, Eff. Apr. 1, 1994;Am. 2012, Act 499, Eff. Mar. 31, 2013.
Popular name: Act 368
***** 333.17521 THIS SECTION IS AMENDED EFFECTIVE AUGUST 1, 2017: See 333.17521.amended
*****
333.17521 Michigan board of osteopathic medicine and surgery; creation; membership;
waiver; certain powers and duties prohibited.
Sec. 17521. (1) The Michigan board of osteopathic medicine and surgery is created in the department and
shall consist of the following 11 voting members who shall meet the requirements of part 161: 7 physicians, 1
physician's assistant, and 3 public members.
(2) The requirement of section 16135(d) that a board member shall have practiced that profession for 2
years immediately before appointment is waived until September 30, 1980 for members of the board who are
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licensed in a health profession subfield created by this part. The Michigan board of osteopathic medicine and
surgery does not have the powers and duties vested in the task force by sections 17060 to 17084.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1993, Act 79, Eff. Apr. 1, 1994;Am. 1993, Act 138, Imd. Eff. Aug. 2, 1993;
Am. 2006, Act 582, Imd. Eff. Jan. 3, 2007.
Popular name: Act 368
333.17540-333.17547 Repealed. 1990, Act 247, Imd. Eff. Oct. 12, 1990.
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Compiler's note: The repealed sections pertained to supervision of physician's assistants.
Popular name: Act 368
***** 333.17548 THIS SECTION IS AMENDED EFFECTIVE AUGUST 1, 2017: See 333.17548.amended
*****
333.17548 Limitation on number of physician's assistants supervised; prohibiting or
restricting delegation of medical care service or requiring higher levels of supervision;
delegation of ultimate responsibility prohibited; making calls or going on rounds; rules as
to drugs; prescribing drugs as delegated act; ordering, receiving, and dispensing
complimentary starter dose drugs.
Sec. 17548. (1) Except as otherwise provided in this subsection and section 17549(5), a physician who is a
sole practitioner or who practices in a group of physicians and treats patients on an outpatient basis shall not
supervise more than 4 physician's assistants. If a physician described in this subsection supervises physician's
assistants at more than 1 practice site, the physician shall not supervise more than 2 physician's assistants by a
method other than the physician's actual physical presence at the practice site.
(2) A physician who is employed by or under contract or subcontract to or has privileges at a health facility
licensed under article 17 or a state correctional facility may supervise more than 4 physician's assistants at the
health facility or agency or state correctional facility.
(3) To the extent that a particular selected medical care service requires extensive medical training,
education, or ability or pose serious risks to the health and safety of patients, the board may prohibit or
otherwise restrict the delegation of that medical care service or may require higher levels of supervision.
(4) A physician shall not delegate ultimate responsibility for the quality of medical care services, even if
the medical care services are provided by a physician's assistant.
(5) A physician's assistant may make calls or go on rounds under the supervision of a physician in private
homes, public institutions, emergency vehicles, ambulatory care clinics, hospitals, intermediate or extended
care facilities, health maintenance organizations, nursing homes, or other health care facilities.
Notwithstanding any law or rule to the contrary, a physician's assistant may make calls or go on rounds as
provided in this subsection without restrictions on the time or frequency of visits by the physician or the
physician's assistant.
(6) Subject to subsections (7) and (8), the board may promulgate rules for the delegation by a supervising
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physician to a physician's assistant of the function of prescription of drugs. Subject to subsections (7) and (8),
the rules may define the drugs or classes of drugs the prescription of which shall not be delegated and other
procedures and protocols necessary to promote consistency with federal and state drug control and
enforcement laws.
(7) A physician's assistant may prescribe drugs as a delegated act of a supervising physician in accordance
with procedures and protocol for the prescription established by rule of the appropriate board. A physician's
assistant may prescribe a drug, including a controlled substance that is included in schedules 2 to 5 of part 72,
as a delegated act of the supervising physician. When delegated prescription occurs, both the physician's
assistant's name and the supervising physician's name shall be used, recorded, or otherwise indicated in
connection with each individual prescription so that the individual who dispenses or administers the
prescription knows under whose delegated authority the physician's assistant is prescribing. When delegated
prescription of drugs that are included in schedules 2 to 5 occurs, both the physician's assistant's and the
supervising physician's DEA registration numbers shall be used, recorded, or otherwise indicated in
connection with each individual prescription.
(8) A supervising physician may delegate in writing to a physician's assistant the ordering, receipt, and
dispensing of complimentary starter dose drugs including controlled substances that are included in schedules
2 to 5 of part 72. When the delegated ordering, receipt, or dispensing of complimentary starter dose drugs
occurs, both the physician's assistant's name and the supervising physician's name shall be used, recorded, or
otherwise indicated in connection with each order, receipt, or dispensing. When the delegated ordering,
receipt, or dispensing of complimentary starter dose drugs that are included in schedules 2 to 5 occurs, both
the physician's assistant's and the supervising physician's DEA registration numbers shall be used, recorded,
or otherwise indicated in connection with each order, receipt, or dispensing. As used in this subsection,
"complimentary starter dose" means that term as defined in section 17745. It is the intent of the legislature in
enacting this subsection to allow a pharmaceutical manufacturer or wholesale distributor, as those terms are
defined in part 177, to distribute complimentary starter dose drugs to a physician's assistant, as described in
this subsection, in compliance with section 503(d) of the federal food, drug, and cosmetic act, 21 USC 353.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1988, Act 462, Eff. Sept. 1, 1989;Am. 1990, Act 247, Imd. Eff. Oct. 12, 1990;
Am. 1996, Act 355, Imd. Eff. July 1, 1996;Am. 2011, Act 210, Imd. Eff. Nov. 8, 2011;Am. 2012, Act 618, Imd. Eff. Jan. 9, 2013.
Compiler's note: In subsection (3), pose evidently should read poses.
Popular name: Act 368
Administrative rules: R 338.6101 et seq. of the Michigan Administrative Code.
***** 333.17549 THIS SECTION IS AMENDED EFFECTIVE AUGUST 1, 2017: See 333.17549.amended
*****
333.17549 Responsibilities of physician supervising physician's assistant.
Sec. 17549. (1) In addition to the other requirements of this section and subject to subsection (5), a
physician who supervises a physician's assistant is responsible for all of the following:
(a) Verification of the physician's assistant's credentials.
(b) Evaluation of the physician's assistant's performance.
(c) Monitoring the physician's assistant's practice and provision of medical care services.
(2) Subject to section 16215 or 17548, as applicable, a physician who supervises a physician's assistant
may delegate to the physician's assistant the performance of medical care services for a patient who is under
the case management responsibility of the physician, if the delegation is consistent with the physician's
assistant's training.
(3) A physician who supervises a physician's assistant is responsible for the clinical supervision of each
physician's assistant to whom the physician delegates the performance of medical care service under
subsection (2).
(4) Subject to subsection (5), a physician who supervises a physician's assistant shall keep on file in the
physician's office or in the health facility or agency or state correctional facility in which the physician
supervises the physician's assistant a permanent, written record that includes the physician's name and license
number and the name and license number of each physician's assistant supervised by the physician.
(5) A group of physicians practicing other than as sole practitioners may designate 1 or more physicians in
the group to fulfill the requirements of subsections (1) and (4).
(6) Notwithstanding any law or rule to the contrary, a physician is not required to countersign orders
written in a patient's clinical record by a physician's assistant to whom the physician has delegated the
performance of medical care services for a patient. Notwithstanding any law or rule to the contrary, a
physician is not required to sign an official form that lists the physician's signature as the required signatory if
that official form is signed by a physician's assistant to whom the physician has delegated the performance of
medical care services.
History: Add. 1990, Act 247, Imd. Eff. Oct. 12, 1990;Am. 2004, Act 512, Imd. Eff. Jan. 3, 2005;Am. 2011, Act 210, Imd. Eff.
Nov. 8, 2011.
Popular name: Act 368
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333.17549.amended Practice agreement; designation of physician; countersigning order or
signing official form not required.
Sec. 17549. (1) A group of physicians practicing other than as sole practitioners may designate 1 or more
physicians in the group to enter into a practice agreement under section 17547.
(2) Notwithstanding any law or rule to the contrary, a physician is not required to countersign orders
written in a patient's clinical record by a physician's assistant with whom the physician has a practice
agreement. Notwithstanding any law or rule to the contrary, a physician is not required to sign an official
form that lists the physician's signature as the required signatory if that official form is signed by a physician's
assistant with whom the physician has a practice agreement.
History: Add. 1990, Act 247, Imd. Eff. Oct. 12, 1990;Am. 2004, Act 512, Imd. Eff. Jan. 3, 2005;Am. 2011, Act 210, Imd. Eff.
Nov. 8, 2011;Am. 2016, Act 379, Eff. Aug. 1, 2017.
Popular name: Act 368
***** 333.17550 THIS SECTION IS AMENDED EFFECTIVE AUGUST 1, 2017: See 333.17550.amended
*****
333.17550 Supervision prohibited; grounds.
Sec. 17550. In addition to its other powers and duties under this article, the board may prohibit a physician
from supervising 1 or more physician's assistants for any of the grounds set forth in section 16221 or for
failure to supervise a physician's assistant in accordance with this part and rules promulgated under this part.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1990, Act 247, Imd. Eff. Oct. 12, 1990.
Popular name: Act 368
Administrative rules: R 338.6101 et seq. of the Michigan Administrative Code.
333.17556 Exemption.
Sec. 17556. This part does not apply to a student in training to become a physician's assistant while
performing duties assigned as part of the training.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
PART 176.
SPEECH-LANGUAGE PATHOLOGY
333.17601 Definitions; limitation on scope of practice.
Sec. 17601. (1) As used in this part:
(a) "Practice of speech-language pathology", subject to subsection (2), means the application of principles,
methods, and procedures related to the development of disorders of human communication including the
following:
(i) Identifying by history or nonmedical physical examination, assessing, treating with therapy,
rehabilitating, and preventing disorders of speech, voice, and language.
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(ii) Identifying by history or nonmedical physical examination, assessing, treating with therapy,
rehabilitating, and preventing disorders of oral-pharyngeal function and disorders related to swallowing
dysfunction.
(iii) Identifying by history or nonmedical physical examination, assessing, treating with therapy,
rehabilitating, and preventing cognitive-communicative disorders.
(iv) Assessing, selecting, and developing augmentative and alternative communication systems and
providing training in their use.
(v) Providing speech-language treatment or therapy and related counseling services to deaf, deafblind, and
hard of hearing persons and their families.
(vi) Enhancing speech-language proficiency and communication effectiveness.
(vii) Screening of hearing for the purpose of speech-language assessment provided that judgments and
descriptive statements about results of that screening are limited to pass-fail determinations.
(b) "Speech-language pathologist" means an individual who is engaged in the practice of speech-language
pathology.
(2) Practice of speech-language pathology does not include either of the following:
(a) The practice of medicine or osteopathic medicine and surgery or medical diagnosis, medical
management with medication, surgical interventions, ordering medical testing, or medical treatment.
(b) The fitting and dispensing of hearing aids under article 13 of the occupational code, 1980 PA 299,
MCL 339.1301 to 339.1309.
(3) In addition to the definitions in this part, article 1 contains general definitions and principles of
construction applicable to all articles in this act and part 161 contains definitions applicable to this part.
History: Add. 2008, Act 524, Imd. Eff. Jan. 13, 2009;Am. 2016, Act 238, Eff. Sept. 22, 2016.
Popular name: Act 368
333.17610 Rules.
Sec. 17610. (1) The department, in consultation with the board, may promulgate rules under section 16145
as necessary or appropriate to fulfill its functions under this article and to supplement the requirements for
licensure under this part, including adopting updated standards of that organization or standards of any
successor organization of the American speech-language-hearing association.
(2) Subject to section 16204, the department shall by rule prescribe continuous professional development
as a condition for licensure renewal.
(3) The department, in consultation with the board, shall promulgate rules regarding the performance of
speech-language pathology that includes, but is not limited to, the performance of procedures described in
section 17601(1)(a)(ii). The rules shall recognize and incorporate the requirements described in section
17607(3) and (4) and the need for collaboration among a speech-language pathologist and a person licensed in
the practice of medicine or osteopathic medicine and surgery and other licensed health care professionals.
History: Add. 2008, Act 524, Imd. Eff. Jan. 13, 2009.
Popular name: Act 368
PART 177
PHARMACY PRACTICE AND DRUG CONTROL
333.17701 Meanings of words and phrases; general definitions and principles of
construction.
Sec. 17701. (1) For purposes of this part the words and phrases defined in sections 17702 to 17709 have
the meanings ascribed to them in those sections.
(2) In addition, article 1 contains general definitions and principles of construction applicable to all articles
in this code and part 161 contains definitions applicable to this part.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Compiler's note: For transfer of powers and duties of certain health-related functions, boards, and commissions from the Department
of Licensing and Regulation to the Department of Commerce, see E.R.O. No. 1991-9, compiled at MCL 338.3501 of the Michigan
Compiled Laws.
Popular name: Act 368
333.17702 Definitions; A to C.
Sec. 17702. (1) "Agent" means an individual designated by a prescriber to act on behalf of or at the
discretion of that prescriber as provided in section 17744.
(2) "Brand name" means the registered trademark name given to a drug product by its manufacturer.
(3) Except as otherwise provided in subsection (4), "compounding" means the preparation, mixing,
assembling, packaging, and labeling of a drug or device by a pharmacist under the following circumstances:
(a) Upon the receipt of a prescription for a specific patient.
(b) Upon the receipt of a medical or dental order from a prescriber or agent for use in the treatment of
patients within the course of the prescriber's professional practice.
(c) In anticipation of the receipt of a prescription or medical or dental order based on routine, regularly
observed prescription or medical or dental order patterns.
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(d) For the purpose of or incidental to research, teaching, or chemical analysis and not for the purpose of
sale or dispensing.
(4) "Compounding" does not include any of the following:
(a) Except as provided in section 17748c, the compounding of a drug product that is essentially a copy of a
commercially available product.
(b) The reconstitution, mixing, or other similar act that is performed pursuant to the directions contained in
approved labeling provided by the manufacturer of a commercially available product.
(c) The compounding of allergenic extracts or biologic products.
(5) "Compounding pharmacy" means a pharmacy that is licensed under this part and is authorized to offer
compounding services under sections 17748, 17748a, and 17748b.
(6) "Current selling price" means the retail price for a prescription drug that is available for sale from a
pharmacy.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1986, Act 304, Eff. Mar. 31, 1987;Am. 2006, Act 672, Imd. Eff. Jan. 10, 2007;
Am. 2012, Act 209, Imd. Eff. June 27, 2012;Am. 2014, Act 280, Eff. Sept. 30, 2014.
Popular name: Act 368
333.17703 Definitions; D, E.
Sec. 17703. (1) "Device" means an instrument, apparatus, or contrivance, including its components, parts,
and accessories, intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease in
human beings or other animals, or to affect the structure or function of the body of human beings or other
animals.
(2) "Dispense" means to issue 1 or more doses of a drug for subsequent administration to, or use by, a
patient.
(3) "Dispensing prescriber" means a prescriber, other than a veterinarian, who dispenses prescription
drugs.
(4) "Drug" means any of the following:
(a) A substance recognized or for which the standards or specifications are prescribed in the official
compendium.
(b) A substance intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease in
human beings or other animals.
(c) A substance, other than food, intended to affect the structure or a function of the body of human beings
or other animals.
(d) A substance intended for use as a component of a substance specified in subdivision (a), (b), or (c), but
not including a device or its components, parts, or accessories.
(5) "Electronic signature" means an electronic sound, symbol, or process attached to or logically associated
with a record and executed or adopted by a person with the intent to sign the record.
(6) "Electronically transmitted prescription" means the communication of an original prescription or refill
authorization by electronic means including computer to computer, computer to facsimile machine, or
electronic mail transmission that contains the same information it contained when the prescriber or his or her
agent transmitted the prescription. Electronically transmitted prescription does not include a prescription or
refill authorization transmitted by telephone or facsimile machine.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1980, Act 431, Eff. Mar. 31, 1981;Am. 1992, Act 281, Imd. Eff. Dec. 18, 1992;
Am. 2006, Act 672, Imd. Eff. Jan. 10, 2007;Am. 2012, Act 209, Imd. Eff. June 27, 2012;Am. 2014, Act 285, Eff. Dec. 22, 2014.
Popular name: Act 368
333.17704 Definitions; F to I.
Sec. 17704. (1) "Federal act" means the federal food, drug, and cosmetic act, 21 USC 301 to 399f.
(2) "Food and drug administration" or "FDA" means the United States food and drug administration.
(3) "Generic name" means the established or official name of a drug or drug product.
(4) "Harmful drug" means a drug intended for use by human beings that is harmful because of its toxicity,
habit-forming nature, or other potential adverse effect; the method of its use; or the collateral measures
necessary to its safe and effective use and that is designated as harmful by a rule promulgated under this part.
(5) "Internship" means an educational program of professional and practical experience for an intern.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2014, Act 280, Eff. Sept. 30, 2014.
Popular name: Act 368
333.17705 Definitions; L.
Sec. 17705. (1) Label means a display of written, printed, or graphic matter on the immediate container
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of a drug or device, but does not include package liners. A requirement made by or under authority of this part
that a word, statement, or other information appear on the label is not complied with unless the word,
statement, or other information appears on the outside container or wrapper of the retail package of the drug
or device as displayed for sale or is easily legible through an outside container or wrapper.
(2) Labeling means the labels and other written, printed, or graphic matter on a drug or device or its
container or wrapper, or accompanying the drug or device.
(3) License in addition to the definition in section 16106 means a pharmacy license, drug control license,
or a manufacturer or wholesale distributor of drugs or devices license.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1986, Act 304, Eff. Mar. 31, 1987.
Popular name: Act 368
333.17706 Definitions; M, O.
Sec. 17706. (1) "Manufacturer" means a person that prepares, produces, derives, propagates, compounds,
processes, packages, or repackages a drug or device salable on prescription only, or otherwise changes the
container or the labeling of a drug or device salable on prescription only, and that supplies, distributes, sells,
offers for sale, barters, or otherwise disposes of that drug or device and any other drug or device salable on
prescription only, to another person for resale, compounding, or dispensing.
(2) "Official compendium" means the United States pharmacopoeia and the national formulary, or the
homeopathic pharmacopoeia of the United States, as applicable. If an official compendium is revised after the
effective date of the amendatory act that added this sentence, the department shall officially take notice of the
revision. Within 30 days after taking notice of the revision, the department, in consultation with the board,
shall decide whether the revision continues to protect the public health as it relates to the manner that the
official compendium is used in this act. If the department, in consultation with the board, decides that the
revision continues to protect the public health, the department may issue an order to incorporate the revision
by reference. If the department issues an order under this subsection to incorporate the revision by reference,
the department shall not make any changes to the revision.
(3) "Outsourcing facility" means that term as defined in 21 USC 353b.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1986, Act 304, Eff. Mar. 31, 1987;Am. 2014, Act 280, Eff. Sept. 30, 2014.
Popular name: Act 368
333.17707 Definitions; P.
Sec. 17707. (1) "Personal charge" means the immediate physical presence of a pharmacist or dispensing
prescriber.
(2) "Pharmacist" means an individual licensed under this article to engage in the practice of pharmacy.
(3) "Pharmacist in charge" or "PIC" means the pharmacist who is designated by a pharmacy, manufacturer,
or wholesale distributor as its pharmacist in charge under section 17748(2).
(4) "Pharmacist intern" or "intern" means an individual who satisfactorily completes the requirements set
forth in rules promulgated by the department in consultation with the board and is licensed by the board for
the purpose of obtaining instruction in the practice of pharmacy from a preceptor approved by the board.
(5) "Pharmacy" means a building or part of a building in which the practice of pharmacy is conducted. For
the purpose of a duty placed on a pharmacy under this part, "pharmacy" means the person to which the
pharmacy license is issued, unless otherwise specifically provided.
(6) "Pharmacy technician" means an individual who is required to hold a health profession subfield license
under this part to serve as a pharmacy technician.
(7) "Practice of pharmacy" means a health service, the clinical application of which includes the
encouragement of safety and efficacy in the prescribing, dispensing, administering, and use of drugs and
related articles for the prevention of illness, and the maintenance and management of health. Practice of
pharmacy includes the direct or indirect provision of professional functions and services associated with the
practice of pharmacy. Professional functions associated with the practice of pharmacy include:
(a) The interpretation and evaluation of the prescription.
(b) Drug product selection.
(c) The compounding, dispensing, safe storage, and distribution of drugs and devices.
(d) The maintenance of legally required records.
(e) Advising the prescriber and the patient as required as to contents, therapeutic action, utilization, and
possible adverse reactions or interactions of drugs.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1990, Act 333, Eff. Mar. 28, 1991;Am. 2014, Act 280, Eff. Sept. 30, 2014;
Am. 2014, Act 285, Eff. Dec. 22, 2014.
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Popular name: Act 368
***** 333.17708 THIS SECTION IS AMENDED EFFECTIVE AUGUST 1, 2017: See 333.17708.amended
*****
***** 333.17708 THIS SECTION IS AMENDED EFFECTIVE MARCH 28, 2017: See
333.17708.amended[2] *****
333.17708 Definitions; P.
Sec. 17708. (1) "Preceptor" means a pharmacist approved by the board to direct the training of an intern in
an approved pharmacy.
(2) "Prescriber" means a licensed dentist, a licensed doctor of medicine, a licensed doctor of osteopathic
medicine and surgery, a licensed doctor of podiatric medicine and surgery, a licensed optometrist certified
under part 174 to administer and prescribe therapeutic pharmaceutical agents, a licensed veterinarian, or
another licensed health professional acting under the delegation and using, recording, or otherwise indicating
the name of the delegating licensed doctor of medicine or licensed doctor of osteopathic medicine and
surgery.
(3) "Prescription" means an order by a prescriber to fill, compound, or dispense a drug or device written
and signed; written or created in an electronic format, signed, and transmitted by facsimile; or transmitted
electronically or by other means of communication. An order transmitted in other than written or hard-copy
form must be electronically recorded, printed, or written and immediately dated by the pharmacist, and that
record constitutes the original prescription. In a health facility or agency licensed under article 17 or other
medical institution, an order for a drug or device in the patient's chart constitutes for the purposes of this
definition the original prescription. Subject to section 17751(2) and (5), prescription includes, but is not
limited to, an order for a drug, not including a controlled substance as defined in section 7104 except under
circumstances described in section 17763(e), written and signed; written or created in an electronic format,
signed, and transmitted by facsimile; or transmitted electronically or by other means of communication by a
physician prescriber, dentist prescriber, or veterinarian prescriber licensed to practice dentistry, medicine,
osteopathic medicine and surgery, or veterinary medicine in another state.
(4) "Prescription drug" means a drug to which 1 or more of the following apply:
(a) The drug is dispensed pursuant to a prescription.
(b) The drug bears the federal legend "CAUTION: federal law prohibits dispensing without prescription"
or "Rx only".
(c) The drug is designated by the board as a drug that may only be dispensed pursuant to a prescription.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1994, Act 384, Eff. Mar 30, 1995;Am. 1997, Act 153, Eff. Mar. 31, 1998;
Am. 2005, Act 85, Imd. Eff. July 19, 2005;Am. 2006, Act 672, Imd. Eff. Jan. 10, 2007;Am. 2009, Act 150, Imd. Eff. Nov. 19, 2009;
Am. 2011, Act 155, Imd. Eff. Sept. 27, 2011;Am. 2012, Act 209, Imd. Eff. June 27, 2012;Am. 2016, Act 49, Eff. June 13, 2016.
Compiler's note: Enacting section 1 of Act 49 of 2016 provides:
"Enacting section 1. Section 16349 of the public health code, 1978 PA 368, MCL 333.16349, as amended by this amendatory act,
applies to licensing fees required to be paid after December 31, 2018."
Popular name: Act 368
***** 333.17708.amended[2] THIS AMENDED SECTION IS EFFECTIVE MARCH 28, 2017 *****
333.17708.amended[2] Definitions; P.
Sec. 17708. (1) "Preceptor" means a pharmacist approved by the board to direct the training of an intern in
an approved pharmacy.
(2) "Prescriber" means a licensed dentist, a licensed doctor of medicine, a licensed doctor of osteopathic
medicine and surgery, a licensed doctor of podiatric medicine and surgery, a licensed optometrist certified
under part 174 to administer and prescribe therapeutic pharmaceutical agents, a licensed veterinarian, or
another licensed health professional acting under the delegation and using, recording, or otherwise indicating
the name of the delegating licensed doctor of medicine or licensed doctor of osteopathic medicine and
surgery.
(3) "Prescription" means an order by a prescriber to fill, compound, or dispense a drug or device written
and signed; written or created in an electronic format, signed, and transmitted by facsimile; or transmitted
electronically or by other means of communication. An order transmitted in other than written or hard-copy
form must be electronically recorded, printed, or written and immediately dated by the pharmacist, and that
record is considered the original prescription. In a health facility or agency licensed under article 17 or other
medical institution, an order for a drug or device in the patient's chart is considered for the purposes of this
definition the original prescription. For purposes of this part, prescription also includes a standing order issued
under section 17744e. Subject to section 17751(2) and (5), prescription includes, but is not limited to, an order
for a drug, not including a controlled substance except under circumstances described in section 17763(e),
written and signed; written or created in an electronic format, signed, and transmitted by facsimile; or
transmitted electronically or by other means of communication by a physician prescriber, dentist prescriber,
or veterinarian prescriber who is licensed to practice dentistry, medicine, osteopathic medicine and surgery, or
veterinary medicine in another state.
(4) "Prescription drug" means a drug to which 1 or more of the following apply:
(a) The drug is dispensed pursuant to a prescription.
(b) The drug bears the federal legend "CAUTION: federal law prohibits dispensing without prescription"
or "Rx only".
(c) The drug is designated by the board as a drug that may only be dispensed pursuant to a prescription.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1994, Act 384, Eff. Mar 30, 1995;Am. 1997, Act 153, Eff. Mar. 31, 1998;
Am. 2005, Act 85, Imd. Eff. July 19, 2005;Am. 2006, Act 672, Imd. Eff. Jan. 10, 2007;Am. 2009, Act 150, Imd. Eff. Nov. 19, 2009;
Am. 2011, Act 155, Imd. Eff. Sept. 27, 2011;Am. 2012, Act 209, Imd. Eff. June 27, 2012;Am. 2016, Act 49, Eff. June 13, 2016;
Am. 2016, Act 379, Eff. Aug. 1, 2017;Am. 2016, Act 383, Eff. Mar. 28, 2017.
Compiler's note: Enacting section 1 of Act 49 of 2016 provides:
"Enacting section 1. Section 16349 of the public health code, 1978 PA 368, MCL 333.16349, as amended by this amendatory act,
applies to licensing fees required to be paid after December 31, 2018."
Popular name: Act 368
333.17709 Definitions; S to W.
Sec. 17709. (1) "Sign" means to affix one's signature manually to a document or to use an electronic
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signature when transmitting a prescription electronically.
(2) "Sterile pharmaceutical" means a dosage form of a drug that is essentially free from living microbes
and chemical or physical contamination to the point at which it poses no present risk to the patient, in
accordance with USP standards. As used in this subsection, "dosage form" includes, but is not limited to,
parenteral, injectable, and ophthalmic dosage forms.
(3) "Substitute" means to dispense, without the prescriber's authorization, a different drug in place of the
drug prescribed.
(4) "USP standards" means the pharmacopeial standards for drug substances, dosage forms, and
compounded preparations based on designated levels of risk as published in the official compendium.
(5) "Wholesale distributor" means a person, other than a manufacturer, who supplies, distributes, sells,
offers for sale, barters, or otherwise disposes of, to other persons for resale, compounding, or dispensing, a
drug or device salable on prescription only that the distributor has not prepared, produced, derived,
propagated, compounded, processed, packaged, or repackaged, or otherwise changed the container or the
labeling of the drug or device.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2006, Act 672, Imd. Eff. Jan. 10, 2007;Am. 2014, Act 280, Eff. Sept. 30, 2014.
Popular name: Act 368
333.17723 Pilot project to maintain or improve patient care in delivery of pharmacy services
and improving patient outcomes.
Sec. 17723. (1) Subject to this section, the board may approve a pilot project that is designed to utilize new
or expanded technology or processes and to provide patients with better pharmacy products or provide
pharmacy services in a more efficient manner. The board shall ensure that a pilot project it approves under
this section is focused on maintaining or improving patient care in the delivery of pharmacy services and
improving patient outcomes. The department may charge petitioners a filing fee sufficient to cover the
department's costs incurred while administering and monitoring the pilot project under this section.
(2) The department shall do all of the following:
(a) Establish and administer a process to receive, review, and accept or deny petitions for proposed pilot
projects.
(b) Establish time frames for the receipt, review, and approval or denial of petitions for proposed pilot
projects.
(c) Designate the individuals who will review and evaluate petitions for proposed pilot projects.
(3) The board shall not approve more than 10 pilot projects under this section. If it determines necessary,
the board or department may further limit the number of approved pilot projects based on the scope and type
of petitions for proposed pilot projects received.
(4) The board shall not approve a pilot project that does any of the following:
(a) Expands the definition of the practice of pharmacy.
(b) Provides for the therapeutic substitution or substitution of medical devices used in patient care.
(c) Allows a pharmacy or pharmacist to be involved with a pilot project if the pharmacy's or pharmacist's
license is not current or is under investigation for or subject to a sanction for a violation of this act.
(5) The department, in consultation with the board, may grant to a petitioner conducting an approved pilot
project under this section an exception to a rule promulgated under this part. The department shall not grant
an exception under this subsection from any law relating to the practice of pharmacy. The department shall
grant an exception under this subsection for a specified period of time, which period must not exceed 18
months unless extended under subsection (12).
(6) A petitioner who wishes the board to consider a pilot project for approval under this section shall
submit to the department a petition that contains all of the following information:
(a) The name, address, telephone number, electronic mail address, and Michigan license number of the
pharmacist responsible for overseeing the proposed pilot project.
(b) The specific location where the proposed pilot project will be conducted. The petitioner shall include
the Michigan license number of the pharmacy and a statement that the Michigan license of the pharmacy and
any pharmacist involved with the pilot project is current, is not under investigation for or subject to a sanction
for a violation of this act, and will remain in good standing for the duration of the pilot project.
(c) A detailed summary of the proposed pilot project that includes all of the following:
(i) The goals, hypothesis, and objectives, as applicable, of the proposed pilot project.
(ii) A full explanation of the proposed pilot project and how the project will be conducted.
(iii) The initial time frame for the pilot project, including the proposed start date and length of the project,
which initial time frame must not exceed 18 months.
(iv) All background information and literature review, as applicable, to support the proposed pilot project.
(v) If applicable, identification of the rules promulgated under this part from which the petitioner is
requesting an exception as provided in subsection (5) in order to complete the proposed pilot project and a
request for that exception.
(vi) If applicable, procedures the petitioner will use during the proposed pilot project to ensure that the
public's health and safety are not compromised as a result of an exception to a rule being granted under
subsection (5).
(vii) The procedures the petitioner will use to protect the identity and privacy of patients in accordance
with existing federal and state law and consistent with regulations promulgated under the health insurance
portability and accountability act of 1996, Public Law 104-191.
(7) Upon approval of a petition for a pilot project, the department shall specify a time period for the
operation of that pilot project, which period must not exceed 18 months unless extended under subsection
(11). The department, in consultation with the board, may include appropriate conditions or qualifications on
the approval of a pilot project. The department or board may suspend the operation of a pilot project if it
determines that the petitioner or any person involved with the pilot project has deviated the operation of the
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pilot project from the plan of operation that was approved.
(8) If determined appropriate for the pilot project approved under this section, the board or department may
require the petitioner to notify patients that pharmacy services are being provided as part of a pilot project. If
required under this subsection, the petitioner shall notify patients in the manner required by the board or
department.
(9) The petitioner shall allow the department to inspect and review pilot project documentation and the
pilot project site at any time during the review process and after the pilot project is approved. The pharmacist
responsible for overseeing an approved pilot project shall forward all of the following to the department:
(a) Progress reports at intervals specified by the department.
(b) A summary of the results of the project and conclusions drawn from the results of the project within 3
months after completion of the pilot project.
(10) The individuals designated to review and evaluate petitions under subsection (2)(c) shall review the
progress reports and the summary of the results of the pilot project submitted under subsection (9). Within 90
days after receipt of the summary of the results of the pilot project under subsection (9), the individuals
designated to review and evaluate petitions under subsection (2)(c) shall submit a written report to the
department regarding the results of the pilot project. The department shall provide a copy of the written report
submitted under this subsection to the board. The individuals designated to review and evaluate petitions
under subsection (2)(c) shall submit a copy of the written report to the petitioner at least 2 weeks before the
board meeting at which the report will be considered by the board. Upon the request of the petitioner, the
board shall allow the petitioner to make a presentation to the board.
(11) If determined appropriate by the board at the meeting at which the written report is considered under
subsection (10), and if approved by the department, the specified period of time for conducting a pilot project
under subsection (7) may be extended for an additional period of up to 18 months. The board or department
shall not grant an extension that would result in a specified period of time for conducting a pilot project under
this section to exceed 36 months.
(12) If the department, in consultation with the board, determines that a pilot project for which an
exception to a rule has been granted under subsection (5) should be extended so that rules may be
promulgated in order to allow the pilot project to be conducted on a permanent basis, the department may
extend the exception to the rule for an additional period of up to 18 months.
History: Add. 2013, Act 267, Eff. Mar. 30, 2014.
Popular name: Act 368
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Administrative rules: R 338.3041 et seq. of the Michigan Administrative Code.
333.17737 Rules establishing standards for internship program; limited license required.
Sec. 17737. (1) The board shall promulgate rules to establish standards for an internship program and
participation therein by interns and preceptors.
(2) An individual shall not engage in an internship program which includes the practice of pharmacy
without a limited license under this part.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
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History: Add. 2014, Act 285, Eff. Dec. 22, 2014;Am. 2015, Act 133, Imd. Eff. Sept. 30, 2015.
Popular name: Act 368
***** 333.17744b THIS SECTION IS AMENDED EFFECTIVE MARCH 29, 2017: See
333.17744b.amended *****
333.17744b Prescribing, possessing, or dispensing opioid antagonist; liability.
Sec. 17744b. (1) Notwithstanding any provision of this act to the contrary, a prescriber may issue a
prescription for and a dispensing prescriber or pharmacist may dispense an opioid antagonist to any of the
following:
(a) An individual patient at risk of experiencing an opioid-related overdose.
(b) A family member, friend, or other individual in a position to assist an individual at risk of experiencing
an opioid-related overdose.
(c) A person other than an individual that meets all of the following requirements:
(i) Acts at the direction of the prescriber or dispensing prescriber.
(ii) Upon receipt of an opioid antagonist, stores the opioid antagonist in compliance with this part.
(iii) Dispenses or administers an opioid antagonist under a valid prescription issued to an individual or a
patient.
(iv) Performs the requirements under this subsection without charge or compensation.
(2) When issuing a prescription for or dispensing an opioid antagonist as authorized under this section to a
person other than a patient, the prescriber, dispensing prescriber, or pharmacist, as appropriate, shall insert the
name of the person as the name of the patient.
(3) Notwithstanding any provision of this act to the contrary, a person that is acting in good faith and with
reasonable care may possess and dispense an opioid antagonist.
(4) A prescriber who issues a prescription for or a dispensing prescriber or pharmacist who dispenses an
opioid antagonist as authorized under this section is not liable in a civil action for a properly stored and
dispensed opioid antagonist that was a proximate cause of injury or death to an individual due to the
administration of or failure to administer the opioid antagonist.
History: Add. 2014, Act 311, Imd. Eff. Oct. 14, 2014.
Popular name: Act 368
***** 333.17744b.amended THIS AMENDED SECTION IS EFFECTIVE MARCH 29, 2017 *****
333.17744b.amended Prescribing, possessing, or dispensing opioid antagonist; liability.
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Sec. 17744b. (1) Notwithstanding any provision of this act to the contrary, a prescriber may issue a
prescription for and a dispensing prescriber or pharmacist may dispense an opioid antagonist to any of the
following:
(a) An individual patient at risk of experiencing an opioid-related overdose.
(b) A family member, friend, or other individual in a position to assist an individual at risk of experiencing
an opioid-related overdose.
(c) A school board for purposes of section 1179b of the revised school code, 1976 PA 451, MCL
380.1179b.
(d) A person other than an individual that meets all of the following requirements:
(i) Acts at the direction of the prescriber or dispensing prescriber.
(ii) Upon receipt of an opioid antagonist, stores the opioid antagonist in compliance with this part.
(iii) Dispenses or administers an opioid antagonist under a valid prescription issued to an individual or a
patient.
(iv) Performs the requirements under this subsection without charge or compensation.
(2) When issuing a prescription for or dispensing an opioid antagonist as authorized under this section to a
school board or a person other than a patient, the prescriber, dispensing prescriber, or pharmacist, as
appropriate, shall insert the name of the school board or the person as the name of the patient.
(3) Notwithstanding any provision of this act to the contrary, a person that is acting in good faith and with
reasonable care may possess and dispense an opioid antagonist.
(4) Notwithstanding any provision of this act to the contrary, a school employee who is a licensed
registered professional nurse or who is trained in the administration of an opioid antagonist under section
1179b of the revised school code, 1976 PA 451, MCL 380.1179b, may possess and administer an opioid
antagonist dispensed to a school board under this section.
(5) A prescriber who issues a prescription for or a dispensing prescriber or pharmacist who dispenses an
opioid antagonist as authorized under this section is not liable in a civil action for a properly stored and
dispensed opioid antagonist that was a proximate cause of injury or death to an individual due to the
administration of or failure to administer the opioid antagonist.
History: Add. 2014, Act 311, Imd. Eff. Oct. 14, 2014;Am. 2016, Act 384, Eff. Mar. 29, 2017.
Popular name: Act 368
333.17744c Person administering opioid antagonist under certain conditions; immunity from
criminal prosecution or sanction.
Sec. 17744c. A person that administers an opioid antagonist to an individual who he or she believes is
suffering an opioid-related overdose and that acts in good faith and with reasonable care is immune from
criminal prosecution or sanction under any professional licensing act for that act.
History: Add. 2014, Act 313, Imd. Eff. Oct. 14, 2014.
Popular name: Act 368
***** 333.17744e.added THIS ADDED SECTION IS EFFECTIVE MARCH 28, 2017 *****
333.17744e.added Dispensing opioid antagonist to individual pursuant to standing order
issued by chief medical executive.
Sec. 17744e. (1) Notwithstanding any provision of this act to the contrary, the chief medical executive in
the office of chief medical executive created within the department of health and human services may issue a
standing order that does not identify particular patients at the time it is issued for the purpose of a pharmacist
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dispensing opioid antagonists to individuals under this section.
(2) Notwithstanding any provision of this act to the contrary, a pharmacist may dispense an opioid
antagonist to any individual pursuant to a standing order issued by the chief medical executive under
subsection (1) and the rules promulgated under this section.
(3) The chief medical executive who issues a standing order for an opioid antagonist under this section or a
pharmacist who dispenses an opioid antagonist as authorized under this section is not liable in a civil action
for damages resulting from the dispensing of the opioid antagonist or the administration of or failure to
administer the opioid antagonist.
(4) The department, in consultation with the department of health and human services and local health
departments, shall promulgate rules regarding dispensing, training, and referral to implement this section.
History: Add. 2016, Act 383, Eff. Mar. 28, 2017.
Popular name: Act 368
***** 333.17745 THIS SECTION IS AMENDED EFFECTIVE AUGUST 1, 2017: See 333.17745.amended
*****
333.17745 Drug control license; patient's chart or clinical record to include record of drugs
dispensed; delegating authority to dispense drugs; storage of drugs; container; label;
complimentary starter dose drug; information; compliance with MCL 333.7303a; inspection
of locations; limitation on delegation; receipt of complimentary starter dose drugs by
pharmacist; "complimentary starter dose" defined.
Sec. 17745. (1) Except as otherwise provided in this subsection, a prescriber who wishes to dispense
prescription drugs shall obtain from the board a drug control license for each location in which the storage
and dispensing of prescription drugs occur. A drug control license is not necessary if the dispensing occurs in
the emergency department, emergency room, or trauma center of a hospital licensed under article 17 or if the
dispensing involves only the issuance of complimentary starter dose drugs.
(2) Except as otherwise authorized for expedited partner therapy in section 5110 or as provided in section
17744a or 17744b, a dispensing prescriber shall dispense prescription drugs only to his or her own patients.
(3) A dispensing prescriber shall include in a patient's chart or clinical record a complete record, including
prescription drug names, dosages, and quantities, of all prescription drugs dispensed directly by the
dispensing prescriber or indirectly under his or her delegatory authority. If prescription drugs are dispensed
under the prescriber's delegatory authority, the delegatee who dispenses the prescription drugs shall initial the
patient's chart, clinical record, or log of prescription drugs dispensed. In a patient's chart or clinical record, a
dispensing prescriber shall distinguish between prescription drugs dispensed to the patient, prescription drugs
prescribed for the patient, prescription drugs dispensed or prescribed for expedited partner therapy as
authorized in section 5110, and prescription drugs dispensed or prescribed as authorized under section 17744a
or 17744b. A dispensing prescriber shall retain information required under this subsection for not less than 5
years after the information is entered in the patient's chart or clinical record.
(4) A dispensing prescriber shall store prescription drugs under conditions that will maintain their stability,
integrity, and effectiveness and will assure that the prescription drugs are free of contamination, deterioration,
and adulteration.
(5) A dispensing prescriber shall store prescription drugs in a substantially constructed, securely lockable
cabinet. Access to the cabinet shall be limited to individuals authorized to dispense prescription drugs in
compliance with this part and article 7.
(6) Unless otherwise requested by a patient, a dispensing prescriber shall dispense a prescription drug in a
safety closure container that complies with the poison prevention packaging act of 1970, 15 USC 1471 to
1477.
(7) A dispensing prescriber shall dispense a drug in a container that bears a label containing all of the
following information:
(a) The name and address of the location from which the prescription drug is dispensed.
(b) Except as otherwise authorized under section 5110, 17744a, or 17744b, the patient's name and record
number.
(c) The date the prescription drug was dispensed.
(d) The prescriber's name or, if dispensed under the prescriber's delegatory authority, the name of the
delegatee.
(e) The directions for use.
(f) The name and strength of the prescription drug.
(g) The quantity dispensed.
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(h) The expiration date of the prescription drug or the statement required under section 17756.
(8) A dispensing prescriber who dispenses a complimentary starter dose drug to a patient shall give the
patient the information required in this subsection, by dispensing the complimentary starter dose drug to the
patient in a container that bears a label containing the required information or by giving the patient a written
document that may include, but is not limited to, a preprinted insert that comes with the complimentary starter
dose drug and that contains the required information. The information required to be given to the patient
under this subsection includes all of the following:
(a) The name and strength of the complimentary starter dose drug.
(b) Directions for the patient's use of the complimentary starter dose drug.
(c) The expiration date of the complimentary starter dose drug or the statement required under section
17756.
(9) The information required under subsection (8) is in addition to, and does not supersede or modify, other
state or federal law regulating the labeling of prescription drugs.
(10) In addition to meeting the requirements of this part, a dispensing prescriber who dispenses controlled
substances shall comply with section 7303a.
(11) The board may periodically inspect locations from which prescription drugs are dispensed.
(12) The act, task, or function of dispensing prescription drugs shall be delegated only as provided in this
part and sections 16215, 17048, 17076, 17212, and 17548.
(13) A supervising physician may delegate in writing to a pharmacist practicing in a hospital pharmacy
within a hospital licensed under article 17 the receipt of complimentary starter dose drugs other than
controlled substances as defined by article 7 or federal law. When the delegated receipt of complimentary
starter dose drugs occurs, both the pharmacist's name and the supervising physician's name shall be used,
recorded, or otherwise indicated in connection with each receipt. A pharmacist described in this subsection
may dispense a prescription for complimentary starter dose drugs written or transmitted by facsimile,
electronic transmission, or other means of communication by a prescriber.
(14) As used in this section, "complimentary starter dose" means a prescription drug packaged, dispensed,
and distributed in accordance with state and federal law that is provided to a dispensing prescriber free of
charge by a manufacturer or distributor and dispensed free of charge by the dispensing prescriber to his or her
patients.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1980, Act 431, Eff. Mar. 31, 1981;Am. 1986, Act 304, Eff. Mar. 31, 1987;
Am. 1990, Act 333, Eff. Mar. 28, 1991;Am. 1992, Act 281, Imd. Eff. Dec. 18, 1992;Am. 1993, Act 305, Imd. Eff. Dec. 28, 1993;
Am. 1996, Act 355, Imd. Eff. July 1, 1996;Am. 1997, Act 186, Eff. Mar. 31, 1998;Am. 2006, Act 672, Imd. Eff. Jan. 10, 2007;
Am. 2011, Act 210, Imd. Eff. Nov. 8, 2011;Am. 2013, Act 186, Eff. Mar. 14, 2014;Am. 2014, Act 311, Imd. Eff. Oct. 14, 2014;
Am. 2014, Act 525, Imd. Eff. Jan. 14, 2015.
Popular name: Act 368
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***** 333.17745a THIS SECTION IS AMENDED EFFECTIVE AUGUST 1, 2017: See 333.17745a.amended
*****
333.17745a Definitions; individuals delegated authority to dispense prescriptions; delegating
delivery of certain oral contraceptives; circumstances; delegating delivery of methadone.
Sec. 17745a. (1) As used in this section:
(a) Medicaid means the program of medical assistance established under title XIX of the social security
act, chapter 531, 49 Stat. 620, 42 U.S.C. 1396 to 1396f, 1396g-1 to 1396r-6, and 1396r-8 to 1396v.
(b) Medicare means the federal medicare program established under title XVIII of the social security act,
chapter 531, 49 Stat. 620, 42 U.S.C. 1395 to 1395b, 1395b-2, 1395b-6 to 1395b-7, 1395c to 1395i, 1395i-2 to
1395i-5, 1395j to 1395t, 1395u to 1395w, 1395w-2 to 1395w-4, 1395w-21 to 1395w-28, 1395x to 1395yy,
and 1395bbb to 1395ggg.
(c) Public health program means 1 of the following:
(i) A local health department.
(ii) A migrant health center or a community health center as defined under sections 329 and 330 of subpart
I of part C of title III of the public health service act, 42 U.S.C. 254b and 254c.
(iii) A family planning program designated by the family independence agency as a provider type 23 under
the social welfare act, 1939 PA 280, MCL 400.1 to 400.119b, and verified by the department of community
health.
(iv) A methadone treatment program licensed under article 6.
(v) A rural health clinic.
(vi) A hospice rendering emergency care services in a patient's home as described in section 17746.
(d) Rural health clinic means a rural health clinic as defined in section 1861 of part C of title XVIII of
the social security act, 42 U.S.C. 1395x, that is certified to participate in medicaid and medicare.
(2) Except as otherwise provided in subsections (3) and (4), in a public health program without an on-site
pharmacy, a dispensing prescriber may delegate the dispensing of prescription drugs only to the following
individuals:
(a) A registered professional nurse licensed under part 172.
(b) A physician's assistant licensed under part 170 or part 175, if the delegating dispensing prescriber is
responsible for the clinical supervision of the physician's assistant.
(3) In a public health program without an on-site pharmacy, a dispensing prescriber may delegate the
delivery of prescription drugs consisting only of prelabeled, prepackaged oral contraceptives under the
following circumstances:
(a) The delivery is delegated to an appropriately trained individual.
(b) The delivery is performed pursuant to specific, written protocols.
(4) In a methadone treatment program licensed under article 6 without an on-site pharmacy, a dispensing
prescriber may delegate the delivery of a prescription drug consisting only of 1 or more single doses of
methadone, up to the maximum number of single doses allowed by law, to a registered client of the
methadone treatment program, if all of the following requirements are met:
(a) The delivery is delegated to 1 of the following individuals:
(i) A registered professional nurse or a licensed practical nurse licensed under part 172.
(ii) A physician's assistant licensed under part 170 or part 175, but only if the delegating dispensing
prescriber is responsible for the clinical supervision of the physician's assistant.
(b) The delivery is performed pursuant to specific, written protocols.
(c) The prescription drug described in this subsection is labeled in accordance with section 17745.
History: Add. 1993, Act 305, Imd. Eff. Dec. 28, 1993;Am. 1999, Act 190, Imd. Eff. Nov. 24, 1999.
Popular name: Act 368
***** 333.17745b THIS SECTION IS AMENDED EFFECTIVE AUGUST 1, 2017: See 333.17745b.amended
*****
333.17745b Industrial clinic or prescriber practice without on-site pharmacy; dispensing
prescription drug.
Sec. 17745b. (1) Subject to subsection (3), in an industrial clinic or other prescriber practice location
without an on-site pharmacy, a dispensing prescriber may delegate the dispensing of prescription drugs only
to the following individuals:
(a) A registered professional nurse licensed under part 172.
(b) A physician's assistant licensed under part 170 or part 175, if the dispensing prescriber is responsible
for the clinical supervision of the physician's assistant.
(2) In an industrial clinic or other prescriber practice location without an on-site pharmacy, if a dispensing
prescriber does not delegate the dispensing of a prescription drug, the dispensing prescriber shall do both of
the following:
(a) Be physically present at the time the prescription drug is dispensed.
(b) Immediately before the prescription drug is dispensed, perform a final inspection of the type of
prescription drug, labeling, dosage, and amount of the prescription drug dispensed.
(3) A dispensing prescriber who delegates the dispensing of a prescription drug to a patient in an industrial
clinic or other prescriber practice location without an on-site pharmacy shall not delegate the dispensing of
more than a 72-hour supply of the prescription drug.
(4) Before dispensing a prescription drug to a patient in an industrial clinic or other prescriber practice
location without an on-site pharmacy, a dispensing prescriber who intends to charge for dispensing the drug
shall give a written prescription to the patient and shall instruct the patient that he or she may elect to have the
prescription filled by the dispensing prescriber or the patient's pharmacy of choice.
(5) If a dispensing prescriber intends to charge for dispensing a prescription drug to a patient in an
industrial clinic or other prescriber practice location without an on-site pharmacy, the dispensing prescriber
shall inform the patient of that fact before dispensing the prescription drug to the patient. The dispensing
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prescriber also shall list the charge for dispensing the prescription drug as a separate item on the patient's bill.
(6) This section does not apply to public health programs as defined in section 17745a.
History: Add. 1993, Act 306, Imd. Eff. Dec. 28, 1993.
Popular name: Act 368
333.17746 Hospice emergency care services in patients' homes; medication box exchange
program.
Sec. 17746. A pharmacy may establish a medication box exchange program for hospice emergency care
services rendered in patients' homes, pursuant to this section and rules promulgated under this section. The
pharmacist in charge of the pharmacy shall be responsible for developing, implementing, and coordinating the
program in conjunction with the medical director of the hospice program. The pharmacist in charge of the
pharmacy shall be responsible for obtaining prescriptions from the hospice medical director for the drugs
dispensed from a medication box. The board may promulgate rules to implement this section.
History: Add. 1993, Act 305, Imd. Eff. Dec. 28, 1993.
Popular name: Act 368
Administrative rules: R 338.471 et seq. of the Michigan Administrative Code.
333.17755 Dispensing lower cost generically equivalent drug product; notice; contents of
prescription label; passing on savings; restrictions; limitation on total charge.
Sec. 17755. (1) When a pharmacist receives a prescription for a brand name drug product, the pharmacist
may, or when a purchaser requests a lower cost generically equivalent drug product, the pharmacist shall
dispense a lower cost but not higher cost generically equivalent drug product if available in the pharmacy,
except as provided in subsection (3). If a drug is dispensed which is not the prescribed brand, the purchaser
shall be notified and the prescription label shall indicate both the name of the brand prescribed and the name
of the brand dispensed and designate each respectively. If the dispensed drug does not have a brand name, the
prescription label shall indicate the generic name of the drug dispensed, except as otherwise provided in
section 17756.
(2) If a pharmacist dispenses a generically equivalent drug product, the pharmacist shall pass on the
savings in cost to the purchaser or to the third party payment source if the prescription purchase is covered by
a third party pay contract. The savings in cost is the difference between the wholesale cost to the pharmacist
of the 2 drug products.
(3) The pharmacist shall not dispense a generically equivalent drug product under subsection (1) if any of
the following applies:
(a) The prescriber, in the case of a prescription in writing signed by the prescriber, writes in his or her own
handwriting dispense as written or d.a.w. on the prescription.
(b) The prescriber, having preprinted on his or her prescription blanks the statement another brand of a
generically equivalent product, identical in dosage, form, and content of active ingredients, may be dispensed
unless initialed d.a.w., writes in his or her own handwriting, the initials d.a.w. in a space, box, or square
adjacent to the statement.
(c) The prescriber, in the case of a prescription other than one in writing signed by the prescriber, expressly
indicates the prescription is to be dispensed as communicated.
(4) A pharmacist may not dispense a drug product with a total charge that exceeds the total charge of the
drug product originally prescribed, unless agreed to by the purchaser.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
***** 333.17757 THIS SECTION IS AMENDED EFFECTIVE MARCH 28, 2017: See 333.17757.amended
*****
333.17757 Price information; notice; receipt evidencing transactions; omission; retention of
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copy of receipt; rules.
Sec. 17757. (1) Upon a request made in person or by telephone, a pharmacist engaged in the business of
selling drugs at retail shall provide the current selling price of a drug dispensed by that pharmacy or
comparative current selling prices of generic and brand name drugs dispensed by that pharmacy. The
information shall be provided to the person making the request before a drug is dispensed to the person. A
person who makes a request for price information under this subsection is not obligated to purchase the drug
for which the price or comparative prices are requested.
(2) A pharmacist engaged in the business of selling drugs at retail shall conspicuously display the notice
described in subsection (3) at each counter over which prescription drugs are dispensed.
(3) The notice required under subsection (2) shall be in substantially the following form:
NOTICE TO CONSUMERS
ABOUT PRESCRIPTION DRUGS
Under Michigan law, you have the right to find out the price of a prescription drug before the pharmacist
fills the prescription. You are under no obligation to have the prescription filled here and may use this price
information to shop around at other pharmacies. You may request price information in person or by
telephone.
Every pharmacy has the current selling prices of both generic and brand name drugs dispensed by the
pharmacy.
Ask your pharmacist if a lower-cost generic drug is available to fill your prescription. A generic drug
contains the same medicine as a brand name drug and is a suitable substitute in most instances.
A generic drug may not be dispensed by your pharmacist if your doctor has written "dispense as written"
or the initials "d.a.w." on the prescription.
If you have questions about the drugs that have been prescribed for you, ask your doctor or pharmacist for
more information.
To avoid dangerous drug interactions, let your doctor and pharmacist know about any other medications
you are taking. This is especially important if you have more than 1 doctor or have prescriptions filled at more
than 1 pharmacy.
(4) The notice required under subsection (2) shall also contain the address and phone number of the board
and the department. The text of the notice shall be in at least 32-point bold type and shall be printed on paper
at least 11 inches by 17 inches in size. The notice may be printed on multiple pages.
(5) The department shall provide a copy of the notice required under subsection (2) to each licensee. The
department shall provide additional copies if needed. A person may duplicate or reproduce the notice if the
duplication or reproduction is a true copy of the notice as produced by the department, without any additions
or deletions.
(6) The pharmacist shall furnish to the purchaser of a prescription drug at the time the drug is delivered to
the purchaser a receipt evidencing the transactions that contains all of the following:
(a) The brand name of the drug, if applicable.
(b) The name of the manufacturer or the supplier of the drug, if the drug does not have a brand name.
(c) The strength of the drug, if significant.
(d) The quantity dispensed, if applicable.
(e) The name and address of the pharmacy.
(f) The serial number of the prescription.
(g) The date the prescription was originally dispensed.
(h) The name of the prescriber or, if prescribed under the prescriber's delegatory authority, the name of the
delegatee.
(i) Except as otherwise authorized under section 5110, 17744a, or 17744b, the name of the patient for
whom the drug was prescribed.
(j) The price for which the drug was sold to the purchaser.
(7) The items required under subsection (6)(a), (b), and (c) may be omitted from a receipt by a pharmacist
only if the omission is expressly required by the prescriber. The pharmacist shall retain a copy of each receipt
furnished under subsection (6) for 90 days. The inclusion of the items required under subsection (6) on the
prescription container label is a valid receipt to the purchaser. Including the items required under subsection
(6) on the written prescription form and retaining the form constitutes retention of a copy of the receipt.
(8) The board may promulgate rules to implement this section.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1986, Act 304, Eff. Mar. 31, 1987;Am. 2011, Act 210, Imd. Eff. Nov. 8, 2011;
Am. 2013, Act 186, Eff. Mar. 14, 2014;Am. 2014, Act 311, Imd. Eff. Oct. 14, 2014;Am. 2014, Act 525, Imd. Eff. Jan. 14, 2015.
Popular name: Act 368
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***** 333.17757.amended THIS AMENDED SECTION IS EFFECTIVE MARCH 28, 2017 *****
333.17757.amended Price information; notice; receipt evidencing transactions; omission;
retention of copy of receipt; rules.
Sec. 17757. (1) Upon a request made in person or by telephone, a pharmacist engaged in the business of
selling drugs at retail shall provide the current selling price of a drug dispensed by that pharmacy or
comparative current selling prices of generic and brand name drugs dispensed by that pharmacy. The
information must be provided to the person making the request before a drug is dispensed to the person. A
person that makes a request for price information under this subsection is not obligated to purchase the drug
for which the price or comparative prices are requested.
(2) A pharmacist engaged in the business of selling drugs at retail shall conspicuously display the notice
described in subsection (3) at each counter over which prescription drugs are dispensed.
(3) The notice required under subsection (2) must be in substantially the following form:
NOTICE TO CONSUMERS
ABOUT PRESCRIPTION DRUGS
Under Michigan law, you have the right to find out the price of a prescription drug before the pharmacist
fills the prescription. You are under no obligation to have the prescription filled here and may use this price
information to shop around at other pharmacies. You may request price information in person or by
telephone.
Every pharmacy has the current selling prices of both generic and brand name drugs dispensed by the
pharmacy.
Ask your pharmacist if a lower-cost generic drug is available to fill your prescription. A generic drug
contains the same medicine as a brand name drug and is a suitable substitute in most instances.
A generic drug may not be dispensed by your pharmacist if your doctor has written "dispense as written"
or the initials "d.a.w." on the prescription.
If you have questions about the drugs that have been prescribed for you, ask your doctor or pharmacist for
more information.
To avoid dangerous drug interactions, let your doctor and pharmacist know about any other medications
you are taking. This is especially important if you have more than 1 doctor or have prescriptions filled at more
than 1 pharmacy.
(4) The notice required under subsection (2) must also contain the address and phone number of the board
and the department. The text of the notice must be in at least 32-point bold type and must be printed on paper
at least 11 inches by 17 inches in size. The notice may be printed on multiple pages.
(5) The department shall provide a copy of the notice required under subsection (2) to each licensee. The
department shall provide additional copies if needed. A person may duplicate or reproduce the notice if the
duplication or reproduction is a true copy of the notice as produced by the department, without any additions
or deletions.
(6) The pharmacist shall furnish to the purchaser of a prescription drug at the time the drug is delivered to
the purchaser a receipt evidencing the transactions that contains all of the following:
(a) The brand name of the drug, if applicable.
(b) The name of the manufacturer or the supplier of the drug, if the drug does not have a brand name.
(c) The strength of the drug, if significant.
(d) The quantity dispensed, if applicable.
(e) The name and address of the pharmacy.
(f) The serial number of the prescription or a reference to the standing order issued under section 17744e.
(g) The date the prescription was originally dispensed.
(h) The name of the prescriber or, if prescribed under the prescriber's delegatory authority, the name of the
delegatee.
(i) Except as otherwise authorized under section 5110, 17744a, 17744b, or 17744e, the name of the patient
for whom the drug was prescribed.
(j) The price for which the drug was sold to the purchaser.
(7) The items required under subsection (6)(a), (b), and (c) may be omitted from a receipt by a pharmacist
only if the omission is expressly required by the prescriber. The pharmacist shall retain a copy of each receipt
furnished under subsection (6) for 90 days. The inclusion of the items required under subsection (6) on the
prescription container label is a valid receipt to the purchaser. Including the items required under subsection
(6) on the written prescription form and retaining the form constitutes retention of a copy of the receipt.
(8) The department, in consultation with the board, may promulgate rules to implement this section.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1986, Act 304, Eff. Mar. 31, 1987;Am. 2011, Act 210, Imd. Eff. Nov. 8, 2011;
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Am. 2013, Act 186, Eff. Mar. 14, 2014;Am. 2014, Act 311, Imd. Eff. Oct. 14, 2014;Am. 2014, Act 525, Imd. Eff. Jan. 14, 2015;
Am. 2016, Act 383, Eff. Mar. 28, 2017.
Popular name: Act 368
333.17757a Providing selling price of drugs dispensed upon request; notice to consumers
about prescription drugs; contents; form; display; copies.
Sec. 17757a. (1) Upon a request made in person or by telephone, a dispensing prescriber engaged in the
business of selling prescription drugs shall provide the current selling price of a drug dispensed by that
dispensing prescriber or comparative current selling prices of generic and brand name drugs dispensed by that
dispensing prescriber. The information shall be provided to the person making the request before a
prescription drug is dispensed to the person. A person who makes a request for price information under this
subsection is not obligated to purchase the prescription drug for which the price or comparative prices are
requested.
(2) A dispensing prescriber engaged in the business of selling prescription drugs shall conspicuously
display the notice described in subsection (3) in the location within the dispensing prescriber's practice where
the dispensing occurs.
(3) The notice required under subsection (2) shall be in substantially the following form:
NOTICE TO CONSUMERS ABOUT PRESCRIPTION DRUGS
Under Michigan law, you have the right to find out the price of a prescription drug before the doctor
provides a prescription drug directly to you. You are under no obligation to have the prescription filled here
and may use this price information to shop around.
You may choose to have the prescription filled by your doctor or the pharmacy of your choice. Your
doctor may not force you to have the prescription filled by the doctor. Your doctor cannot charge you for
medications marked sample. Ask your doctor or pharmacist if a lower-cost generic drug is available to fill
your prescription. A generic drug contains the same medicine as a brand name drug and is a suitable substitute
in most cases. If you have questions about the drugs which have been prescribed for you, ask your doctor or
pharmacist for more information. To avoid dangerous drug interactions, let your doctor and pharmacist know
about any other medications you are taking. This is especially important if you have more than 1 doctor or
have prescriptions filled at more than 1 location.
(4) The notice required under subsection (2) shall also contain the address and phone number of the board
and the department. The text of the notice shall be in at least 32-point bold type and shall be printed on paper
at least 11 inches by 17 inches in size. The notice may be printed on multiple pages.
(5) A copy of the notice required under subsection (2) shall be provided to each dispensing prescriber by
the department. Additional copies shall be available if needed from the department. A person may duplicate
or reproduce the notice if the duplication or reproduction is a true copy of the notice as produced by the
department, without any additions or deletions.
History: Add. 1990, Act 333, Eff. Mar. 28, 1991;Am. 1993, Act 305, Imd. Eff. Dec. 28, 1993.
Popular name: Act 368
333.17763 Grounds for fine, reprimand, or probation; grounds for denying, limiting,
suspending, or revoking license.
Sec. 17763. In addition to the grounds set forth in part 161, the disciplinary subcommittee may fine,
reprimand, or place a pharmacist licensee on probation, or deny, limit, suspend, or revoke the license of a
pharmacist or order restitution or community service for a violation or abetting in a violation of this part or
rules promulgated under this part, or for 1 or more of the following grounds:
(a) Permitting the dispensing of prescriptions by an individual who is not a pharmacist, pharmacist intern,
or dispensing prescriber.
(b) Permitting the dispensing of prescriptions by a pharmacist intern, except in the presence and under the
personal charge of a pharmacist.
(c) Selling at auction drugs in bulk or in open packages unless the sale has been approved in accordance
with rules of the board.
(d) Promoting a prescription drug to the public in any manner.
(e) In addition to the prohibition contained in section 7405(1)(e), dispensing a prescription for a controlled
substance as defined in section 7104 that is written and signed; written or created in an electronic format,
signed, and transmitted by facsimile; or transmitted electronically or by other means of communication by a
physician prescriber, dentist prescriber, or veterinarian prescriber in another state, unless the prescription is
issued by a physician prescriber, dentist prescriber, or veterinarian prescriber who is authorized under the
laws of that state to practice dentistry, medicine, osteopathic medicine and surgery, or veterinary medicine
and to prescribe controlled substances.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1993, Act 79, Eff. Apr. 1, 1994;Am. 1997, Act 153, Eff. Mar. 31, 1998;Am.
2004, Act 214, Eff. Oct. 12, 2004;Am. 2004, Act 536, Imd. Eff. Jan. 3, 2005;Am. 2005, Act 85, Imd. Eff. July 19, 2005;Am.
2006, Act 672, Imd. Eff. Jan. 10, 2007;Am. 2009, Act 150, Imd. Eff. Nov. 19, 2009;Am. 2011, Act 155, Imd. Eff. Sept. 27, 2011;
Am. 2012, Act 209, Imd. Eff. June 27, 2012;Am. 2016, Act 49, Eff. June 13, 2016.
Compiler's note: Enacting section 1 of Act 49 of 2016 provides:
"Enacting section 1. Section 16349 of the public health code, 1978 PA 368, MCL 333.16349, as amended by this amendatory act,
applies to licensing fees required to be paid after December 31, 2018."
Popular name: Act 368
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333.17766a Repealed. 2001, Act 236, Imd. Eff. Jan. 3, 2002.
Compiler's note: The repealed section pertained to use, possession, or delivery of androgenic anabolic steroid.
Popular name: Act 368
333.17768 Grounds for fine, reprimand, or probation, or for denying, limiting, suspending, or
revoking license or ordering restitution or community service; applicability of subsection
(2)(b).
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Sec. 17768. (1) In a manner consistent with part 161, the disciplinary subcommittee may fine, reprimand,
or place on probation a person licensed under this part, may deny, limit, suspend, or revoke a person's license,
or may order restitution or community service for a violation of this part or rules promulgated under this part.
(2) In addition to the grounds set forth in subsection (1), and in a manner consistent with part 161, the
board may fine, reprimand, or place on probation a person licensed under this part, may deny, limit, suspend,
or revoke a license issued under this part, or may order restitution or community service if the board finds that
any of the following apply to an applicant; a partner, officer, or member of the board of directors of a
pharmacy, manufacturer, or wholesale distributor licensed under this part; a stockholder of a pharmacy,
manufacturer, or wholesale distributor that is a privately held corporation licensed under this part; or a facility
manager for a wholesale distributor designated under section 17748(2):
(a) The applicant or other person described in this subsection lacks good moral character.
(b) Subject to subsection (3), the applicant or other person described in this subsection has been convicted
of a misdemeanor or a felony under a state or federal law relating to a controlled substance or the practice of
pharmacy.
(c) The applicant or other person described in this subsection has furnished false or fraudulent material
information or has knowingly omitted material information in an application filed under this part.
(d) The applicant or other person described in this subsection has maintained a financial interest in a
pharmacy, manufacturer, or wholesale distributor that has been denied a license or federal registration, has
had its license or federal registration limited, suspended, or revoked, or has been subject to any other criminal,
civil, or administrative penalty.
(e) The applicant or other person described in this subsection is not in compliance with article 7 or article 8
or the rules promulgated under article 7 or article 8.
(f) The applicant or other person described in this subsection has violated section 17748.
(3) Except for a conviction for a misdemeanor under section 7404(2)(d) or a local ordinance that is
substantially similar to section 7404(2)(d), the reference to a misdemeanor in subsection (2)(b) applies only to
a conviction for a misdemeanor that is directly related to the manufacture, delivery, possession, possession
with intent to manufacture or deliver, use, distribution, prescription, or dispensing of a controlled substance.
Subsection (2)(b) does not apply to a conviction for a misdemeanor based upon an unintentional error or
omission involving a clerical or record-keeping function.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1987, Act 250, Imd. Eff. Dec. 28, 1987;Am. 1993, Act 79, Eff. Apr. 1, 1994;
Am. 2013, Act 268, Imd. Eff. Dec. 30, 2013;Am. 2014, Act 413, Eff. Mar. 30, 2015.
Popular name: Act 368
333.17770 Exceptions.
Sec. 17770. Except as to the labeling of poisonous or deleterious drugs and to adulterating, misbranding,
and substituting, this part shall not apply:
(a) To the sale of paris green, white hellebore, and other insecticides.
(b) To the sale of any substance for use in the arts.
(c) To the retailing of non-narcotic, or nonprescription medicine or drug which is prepackaged, fully
prepared by the manufacturer or producer for use by the consumer, and labeled in accordance with the
requirements of the state and federal act.
(d) To the sale by merchants of ammonia, sulphur, any nonpoisonous flavoring essences or extracts, salt,
bicarbonate of soda, or other prepackaged common household remedies or any food or food product which
may also be found in any of the official compendiums and is not also considered as a poisonous, deleterious,
or habit forming drug.
(e) To surgical or dental instruments and accessories, hearing aids, gases, oxygen tents, gas pressure
reducing regulators, x-ray apparatus, therapeutic lamps, splints, and stethoscopes, and their component parts
and accessories, or to equipment, instruments, apparatus, and contrivances used to render the articles effective
in medical, surgical, or dental treatment; or to articles intended for external use.
(f) To articles or substances intended for generally recognized mechanical, agricultural, horticultural, or
industrial consumption or use or photographic chemicals for home use.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
PART 178
PHYSICAL THERAPY
333.17801 Definitions; principles of construction.
Sec. 17801. (1) As used in this part:
(a) "Physical therapist" means an individual licensed under this article to engage in the practice of physical
therapy.
(b) "Physical therapist assistant" means an individual with a health profession subfield license under this
part who assists a physical therapist in physical therapy intervention.
(c) "Practice as physical therapist assistant" means the practice of physical therapy performed under the
supervision of a physical therapist licensed under this part.
(d) "Practice of physical therapy" means the evaluation of, education of, consultation with, or treatment of
an individual by the employment of effective properties of physical measures and the use of therapeutic
exercises and rehabilitative procedures, with or without assistive devices, for the purpose of preventing,
correcting, or alleviating a physical or mental disability. Physical therapy includes treatment planning,
performance of tests and measurements, interpretation of referrals, initiation of referrals, instruction,
consultative services, and supervision of personnel. Physical measures include massage, mobilization, heat,
cold, air, light, water, electricity, and sound. Practice of physical therapy does not include the identification of
underlying medical problems or etiologies, establishment of medical diagnoses, or the prescribing of
treatment.
(2) In addition to the definitions in this part, article 1 contains general definitions and principles of
construction applicable to all articles in this code and part 161 contains definitions applicable to this part.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1982, Act 177, Imd. Eff. June 9, 1982;Am. 1987, Act 213, Imd. Eff. Dec. 22,
1987;Am. 2009, Act 55, Imd. Eff. June 25, 2009.
Compiler's note: For transfer of powers and duties of certain health-related functions, boards, and commissions from the Department
of Licensing and Regulation to the Department of Commerce, see E.R.O. No. 1991-9, compiled at MCL 338.3501 of the Michigan
Compiled Laws.
Popular name: Act 368
333.17831 Repealed. 1987, Act 213, Imd. Eff. Dec. 22, 1987.
Compiler's note: The repealed section provided penalties.
Popular name: Act 368
PART 179.
ATHLETIC TRAINING
333.17901 Definitions.
Sec. 17901. (1) As used in this part:
(a) "Athletic trainer" means an individual engaged in the practice of athletic training.
(b) "Practice of athletic training" means the treatment of an individual for risk management and injury
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prevention, the clinical evaluation and assessment of an individual for an injury or illness, or both, the
immediate care and treatment of an individual for an injury or illness, or both, and the rehabilitation and
reconditioning of an individual's injury or illness, or both, if those activities are within the rules promulgated
under section 17904 and performed under the direction of, on the prescription of, or in collaboration with an
individual licensed under part 170 or 175. The practice of athletic training does not include the practice of
physical therapy, the practice of medicine, the practice of osteopathic medicine and surgery, the practice of
chiropractic, or medical diagnosis or treatment.
(2) In addition to the definitions in this part, article 1 contains general definitions and principles of
construction applicable to all articles in this code and part 161 contains definitions applicable to this part.
History: Add. 2006, Act 54, Eff. Dec. 1, 2006;Am. 2015, Act 166, Eff. Jan. 26, 2016.
Compiler's note: Act 368
333.17904 Rules.
Sec. 17904. (1) The department shall promulgate rules establishing the minimum standards for licensure as
an athletic trainer under this part and the minimum standards of care for the practice of athletic training.
(2) In promulgating the rules required under this section, the department may consult the professional
standards issued by the national athletic trainer's association, by the national athletic trainer's association
board of certification, or by another nationally recognized professional association. The department may
incorporate by reference, in whole or in part, existing standards in the rules.
(3) As needed, the department may amend or supplement any standards by promulgation of a rule.
History: Add. 2006, Act 54, Eff. Dec. 1, 2006.
Compiler's note: Act 368
PART 179A.
MASSAGE THERAPY
333.17951 Definitions.
Sec. 17951. (1) As used in this part:
(a) "Feldenkrais method" means a system of somatic education in which touch and words are used to
eliminate faulty habits, learn new patterns of self-organization and action, and improve a person's own
functional movement patterns. Feldenkrais method is based on principles of physics, biomechanics, and an
understanding of, or learning about, human development.
(b) "Massage therapist" means an individual engaged in the practice of massage therapy.
(c) "Polarity therapy" means diverse applications affecting the human energy system and includes
energetic approaches to somatic contact, verbal facilitation, nutrition, exercise, and health education. Polarity
therapy does not make medical claims, diagnose physical ailments, or allow prescription of medications.
(d) "Practice of massage therapy" means the application of a system of structured touch, pressure,
movement, and holding to the soft tissue of the human body in which the primary intent is to enhance or
restore the health and well-being of the client. Practice of massage therapy includes complementary methods,
including the external application of water, heat, cold, lubrication, salt scrubs, body wraps, or other topical
preparations; and electromechanical devices that mimic or enhance the actions possible by the hands. Practice
of massage therapy does not include medical diagnosis; practice of physical therapy; high-velocity,
low-amplitude thrust to a joint; electrical stimulation; application of ultrasound; or prescription of medicines.
(e) "School" means any of the following accredited or licensed institutions of higher education that meet
the minimum standards and curriculum, in compliance with section 16148:
(i) A public or private community college, college, or university.
(ii) A public or private trade, vocational, or occupational school.
(f) "Trager approach" means a form of movement education that uses subtle directed movements and the
skilled touch of a practitioner. The Trager approach combines physical movement with sensory awareness and
internal imagery designed to increase the client's self-awareness and generate physiological changes in the
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body tissues so as to allow the client to experience a new way of moving his or her body.
(2) In addition to the definitions in this part, article 1 contains general definitions and principles of
construction applicable to all articles in this act and part 161 contains definitions applicable to this part.
History: Add. 2008, Act 471, Imd. Eff. Jan. 9, 2009.
Popular name: Act 368
333.17961 Examination.
Sec. 17961. (1) The board shall provide that applicants pass an examination that measures entry level
competence before issuance of a license under this part.
(2) For licensure purposes under this part, the board shall adopt only those examinations that meet all of
the following requirements:
(a) Are statistically validated through a job analysis under current standards for educational and
professional testing.
(b) Has examination standards that comply with pertinent state and federal equal employment opportunity
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guidelines.
(c) Are available to all potential candidates for licensure.
History: Add. 2008, Act 471, Imd. Eff. Jan. 9, 2009.
Popular name: Act 368
333.17963 Rules.
Sec. 17963. (1) The board shall promulgate rules to create a code of professional ethics.
(2) A licensee shall make a written referral of a client to an appropriate health professional if the client's
physical or medical condition appears to constitute a contraindication for massage therapy.
(3) The board and department shall not, by rule or otherwise, restrict the right of a licensee to participate in
and become a member of any nationally recognized trade or professional association.
History: Add. 2008, Act 471, Imd. Eff. Jan. 9, 2009.
Popular name: Act 368
PART 180
PODIATRIC MEDICINE AND SURGERY
***** 333.18001 THIS SECTION IS AMENDED EFFECTIVE AUGUST 1, 2017: See 333.18001.amended
*****
333.18001 Definitions; principles of construction.
Sec. 18001. (1) As used in this part:
(a) "Podiatrist" means a physician and surgeon licensed under this article to engage in the practice of
podiatric medicine and surgery.
(b) "Practice as a physician's assistant" means the practice of medicine, osteopathic medicine and surgery,
and podiatric medicine and surgery under the supervision of a physician or podiatrist licensed under this
article.
(c) "Practice of podiatric medicine and surgery" means the examination, diagnosis, and treatment of
abnormal nails, superficial excrescenses occurring on the human hands and feet, including corns, warts,
callosities, and bunions, and arch troubles or the treatment medically, surgically, mechanically, or by
physiotherapy of ailments of human feet or ankles as they affect the condition of the feet. It does not include
amputation of human feet, or the use or administration of anesthetics other than local.
(d) "Supervision" means that term as defined under section 16109 except that it includes the existence of a
predetermined plan for emergency situations including, but not limited to, the designation of a podiatrist to
supervise a physician's assistant in the absence of the primary supervising podiatrist.
(e) "Task force" means the joint task force created in section 17025.
(2) In addition to the definitions in this part, article 1 contains general definitions and principles of
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construction applicable to all articles in this code and part 161 contains definitions applicable to this part.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2006, Act 161, Eff. Nov. 26, 2006.
Compiler's note: For transfer of powers and duties of certain health-related functions, boards, and commissions from the Department
of Licensing and Regulation to the Department of Commerce, see E.R.O. No. 1991-9, compiled at MCL 338.3501 of the Michigan
Compiled Laws.
Popular name: Act 368
***** 333.18021 THIS SECTION IS AMENDED EFFECTIVE AUGUST 1, 2017: See 333.18021.amended
*****
333.18021 Michigan board of podiatric medicine and surgery; creation; membership; terms.
Sec. 18021. (1) The Michigan board of podiatric medicine and surgery is created in the department and
shall consist of the following 9 voting members who shall meet the requirements of part 161: 5 podiatrists, 1
physician's assistant, and 3 public members.
(2) The board of podiatric medicine and surgery does not have the powers and duties vested in the task
force by sections 17060 to 17084.
(3) The terms of office of individual members of the board created under this section, except those
appointed to fill vacancies, expire 4 years after appointment on June 30 of the year in which the term expires.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1993, Act 79, Eff. Apr. 1, 1994;Am. 2006, Act 161, Eff. Nov. 26, 2006;Am.
2006, Act 391, Imd. Eff. Sept. 27, 2006.
Popular name: Act 368
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***** 333.18047.added THIS ADDED SECTION IS EFFECTIVE AUGUST 1, 2017 *****
333.18047.added Practice as physician's assistant; practice agreement; requirements.
Sec. 18047. (1) A physician's assistant shall not engage in the practice as a physician's assistant except
under the terms of a practice agreement that meets the requirements of this section.
(2) A practice agreement must include all of the following:
(a) A process between the physician's assistant and participating podiatrist for communication, availability,
and decision making when providing medical treatment to a patient. The process must utilize the knowledge
and skills of the physician's assistant and participating podiatrist based on their education, training, and
experience.
(b) A protocol for designating an alternative podiatrist for consultation in situations in which the
participating podiatrist is not available for consultation.
(c) The signature of the physician's assistant and the participating podiatrist.
(d) A termination provision that allows the physician's assistant or participating podiatrist to terminate the
practice agreement by providing written notice at least 30 days before the date of termination.
(e) Subject to section 18048, the duties and responsibilities of the physician's assistant and participating
podiatrist. The practice agreement shall not include as a duty or responsibility of the physician's assistant or
participating podiatrist an act, task, or function that the physician's assistant or participating podiatrist is not
qualified to perform by education, training, or experience and that is not within the scope of the license held
by the physician's assistant or participating podiatrist.
(f) A requirement that the participating podiatrist verify the physician's assistant's credentials.
(3) The number of physician's assistants in a practice agreement with a participating podiatrist and the
number of individuals to whom a podiatrist has delegated the authority to perform acts, tasks, or functions are
subject to section 16221.
History: Add. 2016, Act 379, Eff. Aug. 1, 2017.
Popular name: Act 368
***** 333.18048 THIS SECTION IS AMENDED EFFECTIVE AUGUST 1, 2017: See 333.18048.amended
*****
333.18048 Supervision of physician's assistants by podiatrist; limitation.
Sec. 18048. (1) Except as otherwise provided in this section and section 18049(5), a podiatrist who is a
sole practitioner or who practices in a group of podiatrists and treats patients on an outpatient basis shall not
supervise more than 4 physician's assistants. If a podiatrist described in this subsection supervises physician's
assistants at more than 1 practice site, the podiatrist shall not supervise more than 2 physician's assistants by a
method other than the podiatrist's actual physical presence at the practice site.
(2) A podiatrist who is employed by or under contract or subcontract to or has privileges at a health facility
licensed under article 17 may supervise more than 4 physician's assistants at the health facility or agency.
(3) The department may promulgate rules for the appropriate delegation and utilization of a physician's
assistant by a podiatrist, including, but not limited to, rules to prohibit or otherwise restrict the delegation of
certain podiatric services or require higher levels of supervision if the board determines that these services
require extensive training, education, or ability or pose serious risks to the health or safety of patients.
History: Add. 2006, Act 161, Eff. Nov. 26, 2006;Am. 2011, Act 210, Imd. Eff. Nov. 8, 2011.
Popular name: Act 368
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***** 333.18049 THIS SECTION IS AMENDED EFFECTIVE AUGUST 1, 2017: See 333.18049.amended
*****
333.18049 Supervision of physician's assistant by podiatrist; responsibilities; delegation of
services; record; designation.
Sec. 18049. (1) In addition to the other requirements of this section and subject to subsection (5), a
podiatrist who supervises a physician's assistant is responsible for all of the following:
(a) Verification of the physician's assistant's credentials.
(b) Evaluation of the physician's assistant's performance.
(c) Monitoring the physician's assistant's practice and provision of podiatric services.
(2) Subject to section 16215 or 18048, as applicable, a podiatrist who supervises a physician's assistant
may only delegate to the physician's assistant the performance of podiatric services for a patient who is under
the case management responsibility of the podiatrist, if the delegation is consistent with the physician's
assistant's training. A podiatrist shall only supervise a physician's assistant in the performance of those duties
included within his or her scope of practice.
(3) A podiatrist who supervises a physician's assistant is responsible for the clinical supervision of each
physician's assistant to whom the physician delegates the performance of podiatric services under subsection
(2).
(4) Subject to subsection (5), a podiatrist who supervises a physician's assistant shall keep on file in the
physician's office or in the health facility or agency in which the podiatrist supervises the physician's assistant
a permanent, written record that includes the podiatrist's name and license number and the name and license
number of each physician's assistant supervised by the podiatrist.
(5) A group of podiatrists practicing other than as sole practitioners may designate 1 or more podiatrists in
the group to fulfill the requirements of subsections (1) and (4).
History: Add. 2006, Act 161, Eff. Nov. 26, 2006;Am. 2011, Act 210, Imd. Eff. Nov. 8, 2011.
Popular name: Act 368
***** 333.18050 THIS SECTION IS AMENDED EFFECTIVE AUGUST 1, 2017: See 333.18050.amended
*****
333.18050 Podiatrist prohibited from supervising physician's assistant; grounds.
Sec. 18050. In addition to its other powers and duties under this article, the board may prohibit a podiatrist
from supervising 1 or more physician's assistants for any of the grounds set forth in section 16221 or for
failure to supervise a physician's assistant in accordance with this part and rules promulgated under this part.
History: Add. 2006, Act 161, Eff. Nov. 26, 2006.
Popular name: Act 368
PART 181
COUNSELING
333.18101 Definitions.
Sec. 18101. As used in this part:
(a) Counseling principles, methods, or procedures means a developmental approach that systematically
assists an individual through the application of any of the following procedures:
(i) Evaluation and appraisal techniques. As used in this subparagraph, appraisal techniques means
selecting, administering, scoring, and interpreting instruments and procedures designed to assess an
individual's aptitudes, interests, attitudes, abilities, achievements, and personal characteristics for
developmental purposes and not for psychodiagnostic purposes.
(ii) Exploring alternative solutions.
(iii) Developing and providing a counseling plan for mental and emotional development.
(iv) Guidance.
(v) Psychoeducational consulting.
(vi) Learning theory.
(vii) Individual and group techniques emphasizing prevention.
(viii) Counseling techniques.
(ix) Behavioral modification techniques.
(x) Referrals. As used in this subparagraph, referral includes determining the need for referral to 1 or more
statutorily regulated mental health professionals whose expertise, skills, and competence are appropriate to
the problems of the individual, informing the individual of the referral, and communicating as appropriate
with the professional to whom the individual has been referred.
(b) Licensed professional counselor means an individual licensed under this article to engage in the
practice of counseling.
(c) Limited licensed counselor means an individual who has been granted a limited license by the board
to offer counseling services under the supervision of a licensed professional counselor.
(d) Practice of counseling or counseling means the rendering to individuals, groups, families,
organizations, or the general public a service involving the application of clinical counseling principles,
methods, or procedures for the purpose of achieving social, personal, career, and emotional development and
with the goal of promoting and enhancing healthy self actualizing and satisfying lifestyles whether the
services are rendered in an educational, business, health, private practice, or human services setting. The
practice of counseling does not include the practice of psychology except for those preventive techniques,
counseling techniques, or behavior modification techniques for which the licensed professional counselor or
limited licensed counselor has been specifically trained. The practice of counseling does not include the
practice of medicine such as prescribing drugs or administering electroconvulsive therapy. A counselor shall
not hold himself or herself out as a psychologist as defined in section 18201. A counselor shall not hold
himself or herself out as a marriage and family counselor providing marriage counseling pursuant to section
1501 of the occupational code, Act No. 299 of the Public Acts of 1980, being section 339.1501 of the
Michigan Compiled Laws.
History: Add. 1988, Act 421, Eff. Mar. 30, 1989.
Compiler's note: For transfer of powers and duties of certain health-related functions, boards, and commissions from the Department
of Licensing and Regulation to the Department of Commerce, see E.R.O. No. 1991-9, compiled at MCL 338.3501 of the Michigan
Compiled Laws.
Popular name: Act 368
*****333.18107 SUBDIVISION (C) OF SUBSECTION (1) IS EFFECTIVE OCTOBER 1, 1994: See (1)(c) of
333.18107 *****
333.18107 Professional counselor license; qualifications.
Sec. 18107. (1) The board may grant a professional counselor license to an individual who is or does all of
the following:
(a) Is not less than 21 years of age.
(b) Has received a masters or doctoral degree in counseling or student personnel work in a program
approved by the board. The board shall promulgate rules to establish standards to approve only those
programs that include graduate studies in the following areas: research, group techniques, counseling theories,
ethics, counseling techniques, counseling philosophy, testing procedures, career development, consulting,
practicum, and internship.
(c) Has at least 2 years of counseling experience under the supervision of a licensed professional
counselor. The board may decrease the required length of counseling experience under the supervision of a
licensed professional counselor to 1 year if an applicant has completed 30 hours of graduate study in
counseling beyond the master's degree. An applicant shall not be licensed before completing 1 year of
counseling experience under the supervision of a licensed professional counselor. This subdivision shall take
effect on October 1, 1994.
(2) By October 1, 1993, an individual who meets the requirement of subsection (1)(a), has 2 years of
experience, and holds a master's or doctoral degree in counseling or student personnel work that does not
meet the requirements of subsection (1)(b), may be granted a license by the board.
History: Add. 1988, Act 421, Eff. Mar. 30, 1989;Am. 1989, Act 262, Imd. Eff. Dec. 26, 1989.
Compiler's note: In subsection (1)(b), Has received a masters evidently should read Has received a master's.
Popular name: Act 368
PART 182
PSYCHOLOGY
333.18201 Definitions; principles of construction.
Sec. 18201. (1) As used in this part:
(a) Psychologist means an individual licensed under this article to engage in the practice of psychology.
(b) Practice of psychology means the rendering to individuals, groups, organizations, or the public of
services involving the application of principles, methods, and procedures of understanding, predicting, and
influencing behavior for the purposes of the diagnosis, assessment related to diagnosis, prevention,
amelioration, or treatment of mental or emotional disorders, disabilities or behavioral adjustment problems by
means of psychotherapy, counseling, behavior modification, hypnosis, biofeedback techniques, psychological
tests, or other verbal or behavioral means. The practice of psychology shall not include the practice of
medicine such as prescribing drugs, performing surgery, or administering electro-convulsive therapy.
(2) In addition to the definitions in this part, article 1 contains general definitions and principles of
construction applicable to all articles in this code and part 161 contains definitions applicable to this part.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Compiler's note: For transfer of powers and duties of certain health-related functions, boards, and commissions from the Department
of Licensing and Regulation to the Department of Commerce, see E.R.O. No. 1991-9, compiled at MCL 338.3501 of the Michigan
Compiled Laws.
Popular name: Act 368
PART 182A
APPLIED BEHAVIOR ANALYSIS
PART 183
OCCUPATIONAL THERAPISTS
333.18301 Definitions; principles of construction.
Sec. 18301. (1) As used in this part:
(a) "Occupational therapy assistant" means an individual licensed under this article to engage in practice as
an occupational therapy assistant.
(b) "Occupational therapist" means an individual licensed under this article to engage in the practice of
occupational therapy.
(c) "Occupational therapy services" means those services provided to promote health and wellness, prevent
disability, preserve functional capabilities, prevent barriers, and enable or improve performance in everyday
activities, including, but not limited to, the following:
(i) Establishment, remediation, or restoration of a skill or ability that is impaired or not yet developed.
(ii) Compensation, modification, or adaptation of a person, activity, or environment.
(iii) Evaluation of factors that affect activities of daily living, instrumental activities of daily living, and
other activities relating to education, work, play, leisure, and social participation. Those factors include, but
are not limited to, body functions, body structure, habits, routines, role performance, behavior patterns,
sensory motor skills, cognitive skills, communication and interaction skills, and cultural, physical,
psychosocial, spiritual, developmental, environmental, and socioeconomic contexts and activities that affect
performance.
(iv) Interventions and procedures, including, but not limited to, any of the following:
(A) Task analysis and therapeutic use of occupations, exercises, and activities.
(B) Training in self-care, self-management, home management, and community or work reintegration.
(C) Development remediation, or compensation of client factors such as body functions and body structure.
(D) Education and training.
(E) Care coordination, case management, transition, and consultative services.
(F) Modification of environments and adaptation processes such as the application of ergonomic and safety
principles.
(G) Assessment, design, fabrication, application, fitting, and training in rehabilitative and assistive
technology, adaptive devices, and low temperature orthotic devices, and training in the use of prosthetic
devices. For the purposes of this sub-subparagraph, the design and fabrication of low temperature orthotic
devices does not include permanent orthotics.
(H) Assessment, recommendation, and training in techniques to enhance safety, functional mobility, and
community mobility such as wheelchair management and mobility.
(I) Management of feeding, eating, and swallowing.
(J) Application of physical agent modalities and use of a range of specific therapeutic procedures,
including, but not limited to, techniques to enhance sensory-motor, perceptual, and cognitive processing,
manual therapy techniques, and adjunctive and preparatory activities.
(K) Providing vision therapy services or low vision rehabilitation services, if those services are provided
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pursuant to a referral or prescription from, or under the supervision or comanagement of, a physician licensed
under part 170 or 175 or an optometrist licensed under part 174.
(d) "Practice as an occupational therapy assistant" means the practice of occupational therapy under the
supervision of an occupational therapist licensed under this article.
(e) "Practice of occupational therapy" means the therapeutic use of everyday life occupations and
occupational therapy services to aid individuals or groups to participate in meaningful roles and situations in
the home, school, workplace, community, and other settings, to promote health and wellness through research
and practice, and to serve those individuals or groups who have or are at risk for developing an illness, injury,
disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. The
practice of occupational therapy addresses the physical, cognitive, psychosocial, sensory, and other aspects of
performance in a variety of contexts to support engagement in everyday life activities that affect a person's
health, well-being, and quality of life throughout his or her life span. The practice of occupational therapy
does not include any of the following:
(i) The practice of medicine or osteopathic medicine and surgery or medical diagnosis or treatment.
(ii) The practice of physical therapy.
(iii) The practice of optometry.
(2) In addition to the definitions in this part, article 1 contains general definitions and principles of
construction applicable to all articles in this code and part 161 contains definitions applicable to this part.
History: Add. 1988, Act 473, Imd. Eff. Dec. 28, 1988;Am. 2008, Act 523, Imd. Eff. Jan. 13, 2009.
Compiler's note: For transfer of powers and duties of certain health-related functions, boards, and commissions from the Department
of Licensing and Regulation to the Department of Commerce, see E.R.O. No. 1991-9, compiled at MCL 338.3501 of the Michigan
Compiled Laws.
Popular name: Act 368
333.18311 Assistance.
Sec. 18311. Pursuant to section 16143, the department may contract with other state agencies, private
agencies, organizations, and consultants to assist the board in carrying out its functions.
History: Add. 1988, Act 473, Imd. Eff. Dec. 28, 1988.
Popular name: Act 368
PART 183A.
DIETETICS AND NUTRITION
333.18351-333.18363 Repealed. 2014, Act 267, Imd. Eff. July 1, 2014.
Compiler's note: The repealed sections pertained to licensure of dietitians and nutritionists.
Popular name: Act 368
PART 184
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SANITARIANS
333.18401 Definitions; principles of construction.
Sec. 18401. (1) As used in this part:
(a) Environmental health means an area of activity dealing with the protection of human health through
the management, control, and prevention of environmental factors that may adversely affect the health of
individuals. Environmental health is concerned with the existence of substances, conditions, or facilities in
quantities, of characteristics, and under conditions, circumstances, or duration that are or can be injurious to
human health.
(b) Registered sanitarian means a sanitarian registered in accordance with this article.
(c) Sanitarian means an individual who has specialized education and experience in the physical,
biological, and sanitary sciences as applied to the educational, investigational, and technical duties in the field
of environmental health.
(2) In addition to the definitions in this part, article 1 contains general definitions and principles of
construction applicable to all articles in this code and part 161 contains definitions applicable to this part.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2004, Act 308, Eff. Jan. 1, 2005.
Compiler's note: For transfer of powers and duties of certain health-related functions, boards, and commissions from the Department
of Licensing and Regulation to the Department of Commerce, see E.R.O. No. 1991-9, compiled at MCL 338.3501 of the Michigan
Compiled Laws.
For transfer of powers and duties of the board of sanitarians from the department of commerce to the director of the department of
consumer and industry services, and abolishment of the board of sanitarians, see E.R.O. No. 1996-2, compiled at MCL 445.2001 of the
Michigan Compiled Laws.
Popular name: Act 368
PART 185.
Social Work
333.18501 Definitions; scope.
Sec. 18501. (1) As used in this part:
(a) Health facility means a health facility or agency licensed under article 17 or a hospital, psychiatric
hospital, or psychiatric unit licensed under the mental health code, 1974 PA 258, MCL 330.1001 to 330.2106.
(b) Licensed bachelor's social worker means an individual licensed under this article to engage in the
practice of social work at the bachelor's level.
(c) Licensed master's social worker means an individual licensed under this article to engage in the
practice of social work at the master's level.
(d) Practice of medicine means that term as defined in section 17001.
(e) Practice of osteopathic medicine and surgery means that term as defined in section 17501.
(f) Practice of social work at the bachelor's level means, subject to subsections (2) and (4), all of the
following applied within the scope of social work values, ethics, principles, and skills:
(i) The application of social work theory, knowledge, methods, and ethics to restore or enhance social,
psychosocial, or biopsychosocial functioning of individuals, couples, families, groups, organizations, or
communities, with particular attention to the person-in-environment configuration.
(ii) Social work case management and casework, including assessments, planning, referral, and
intervention with individuals, families, couples, groups, communities, or organizations within the context of
social work values, ethics, principles, and skills.
(iii) Helping communities, organizations, individuals, or groups improve their social or health services by
utilizing social work practice skills.
(iv) The administration of assessment checklists that do not require special training and that do not require
interpretation.
(g) Practice of social work at the master's level means, subject to subsection (5), all of the following
applied within the scope of social work values, ethics, principles, and advanced skills:
(i) The advanced application of the knowledge of human development and behavior and social, economic,
and cultural institutions.
(ii) The advanced application of macro social work processes and systems to improve the social or health
services of communities, groups, or organizations through planned interventions.
(iii) The application of specialized clinical knowledge and advanced clinical skills in the areas of
assessment, diagnosis, and treatment of mental, emotional, and behavioral disorders, conditions, and
addictions. Treatment methods include the provision of advanced social work case management and casework
and individual, couple, family, or group counseling and psychotherapy whether in private practice or other
settings.
(h) Social service technician means an individual registered under this article who is specially trained to
practice only under the supervision of a licensed master's social worker or a licensed bachelor's social worker.
(2) An individual who performs 1 or more of the functions described in subdivision (f)(i) through (iv) but
not all of those functions is not considered engaged in the practice of social work at the bachelor's level.
(3) In addition to the definitions of this part, article 1 contains general definitions and principles of
construction applicable to all articles in this code and part 161 contains definitions applicable to this part.
(4) The practice of social work at the bachelor's level does not include the practice of medicine or the
practice of osteopathic medicine and surgery, including, but not limited to, the prescribing of drugs, the
administration of electroconvulsive therapy, the practice of psychotherapy, and other advanced clinical skills
pursuant to section 18501(g)(iii) or the administration or interpretation of psychological tests, except as
otherwise provided in subdivision (f)(iv).
(5) The practice of social work at the master's level does not include the practice of medicine or the
practice of osteopathic medicine and surgery, including, but not limited to, the prescribing of drugs or
administration of electroconvulsive therapy.
History: Add. 2000, Act 11, Imd. Eff. Mar. 7, 2000;Am. 2004, Act 61, Eff. July 1, 2005.
Popular name: Act 368
333.18515 Registration issued under former act; term of member of board of examiners of
social workers; continuation of rules; full licensure upon renewal application.
Sec. 18515. (1) An individual who holds a registration issued under former article 16 of the occupational
code, 1980 PA 299, on March 7, 2000 is registered under this part until that registration expires and may
renew his or her registration pursuant to part 161.
(2) The members of the board of examiners of social workers created under former section 1602 of the
occupational code, 1980 PA 299, shall serve as the initial members of the Michigan board of social work until
their successors are appointed under this article or until the expiration of their respective terms, whichever
occurs first. However, if the term of a member of the board of examiners of social workers has not expired on
March 7, 2000, that term expires on June 30 of the year in which the term will expire.
(3) Rules promulgated by the board of examiners of social workers or the director under former article 16
of the occupational code, 1980 PA 299, and in effect on March 7, 2000 continue in effect to the extent that
they do not conflict with this article and shall continue to be enforced. The rules may be amended or
rescinded by the director.
(4) The board shall grant a full license as a licensed bachelor's social worker to an individual who holds a
certificate of registration as a social worker issued before the effective date of this subsection upon the next
renewal application for registration.
(5) The board shall grant a full license as a licensed master's social worker to an individual who holds a
registration as a certified social worker issued before the effective date of this subsection upon the next
renewal application for registration.
History: Add. 2000, Act 11, Imd. Eff. Mar. 7, 2000;Am. 2004, Act 61, Eff. July 1, 2005.
Popular name: Act 368
PART 187.
RESPIRATORY CARE
333.18701 Definitions.
Sec. 18701. (1) As used in this part:
(a) Health facility means a health facility or agency licensed under article 17.
(b) Medical director means a physician who is responsible for the quality, safety, appropriateness, and
effectiveness of the respiratory care services provided by a respiratory therapist, who assists in quality
monitoring, protocol development, and competency validation, and who meets all of the following:
(i) Is the medical director of an inpatient or outpatient respiratory care service or department within a
health facility, or of a home care agency, durable medical equipment company, or educational program.
(ii) Has special interest and knowledge in the diagnosis and treatment of cardiopulmonary disorders and
diseases.
(iii) Is qualified by training or experience, or both, in the management of acute and chronic
cardiopulmonary disorders and diseases.
(c) Physician means that term as defined in sections 17001 and 17501.
(d) Practice of respiratory care means the provision of respiratory care services. Practice of respiratory
care may be provided by an inpatient or outpatient service or department within a health facility, by a home
care agency or durable medical equipment company, or by an educational program.
(e) Respiratory care services means preventative services, diagnostic services, therapeutic services, and
rehabilitative services under the written, verbal, or telecommunicated order of a physician to an individual
with a disorder, disease, or abnormality of the cardiopulmonary system as diagnosed by a physician.
Respiratory care services involve, but are not limited to, observing, assessing, and monitoring signs and
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symptoms, reactions, general behavior, and general physical response of individuals to respiratory care
services, including determination of whether those signs, symptoms, reactions, behaviors, or general physical
response exhibit abnormal characteristics; the administration of pharmacological, diagnostic, and therapeutic
agents related to respiratory care services; the collection of blood specimens and other bodily fluids and
tissues for, and the performance of, cardiopulmonary diagnostic testing procedures including, but not limited
to, blood gas analysis; development, implementation, and modification of respiratory care treatment plans
based on assessed abnormalities of the cardiopulmonary system, respiratory care protocols, clinical pathways,
referrals, and written, verbal, or telecommunicated orders of a physician; application, operation, and
management of mechanical ventilatory support and other means of life support; and the initiation of
emergency procedures under the rules promulgated by the board.
(f) Respiratory therapist and respiratory care practitioner mean an individual engaged in the practice of
respiratory care and who is responsible for providing respiratory care services and who is licensed under this
article as a respiratory therapist or respiratory care practitioner.
(2) In addition to the definitions in this part, article 1 contains general definitions and principles of
construction applicable to all articles in this code and part 161 contains definitions applicable to this part.
History: Add. 2004, Act 3, Eff. July 1, 2004.
Popular name: Act 368
PART 188
VETERINARY MEDICINE
333.18801 Meanings of words and phrases; general definitions and principles of
construction.
Sec. 18801. (1) For purposes of this part the words and phrases defined in sections 18802 to 18805 have
the meanings ascribed to them in those sections.
(2) In addition, article 1 contains general definitions and principles of construction applicable to all articles
in this code and part 161 contains definitions applicable to this part.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Compiler's note: For transfer of powers and duties of certain health-related functions, boards, and commissions from the Department
of Licensing and Regulation to the Department of Commerce, see E.R.O. No. 1991-9, compiled at MCL 338.3501 of the Michigan
Compiled Laws.
Popular name: Act 368
333.18802 Definitions; A to S.
Sec. 18802. (1) Abandoned by its owner means any of the following:
(a) Failure of an owner to return to regain custody of an animal left in the custody of a veterinarian by its
owner for treatment, boarding, or other services at the scheduled time for the animal's return or at completion
of the services.
(b) Refusal of an owner to accept custody of an animal left in the custody of a veterinarian by its owner for
treatment, boarding, or other services at the scheduled time for the animal's return or at completion of the
services.
(c) Failure of an owner to provide payment for treatment, boarding, or other services on an animal left in
the custody of a veterinarian by its owner as agreed upon by the owner and the veterinarian.
(2) Animal means an animal other than a human being and includes all fowl, birds, fish, and reptiles,
wild or domestic, living or dead, which may be carriers of infectious diseases.
(3) Owner means the actual owner of an animal, an agent of the owner of the animal, or a person with
the apparent authority to act as the owner or as the agent of the owner of an animal.
(4) Supervision includes that degree of close physical proximity necessary for the supervising
veterinarian to observe and monitor the performance of a veterinary technician.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1982, Act 353, Imd. Eff. Dec. 21, 1982;Am. 2000, Act 22, Imd. Eff. Mar. 13,
2000.
Popular name: Act 368
333.18805 Definitions; P to V.
Sec. 18805. (1) Practice as a veterinary technician means the practice of veterinary medicine based on
less comprehensive knowledge and skill than that required of a veterinarian and performed under supervision
of a veterinarian.
(2) Practice of veterinary medicine means:
(a) Prescribing or administering a drug, medicine, treatment, or method of procedure; performing an
operation or manipulation; applying an apparatus or appliance; or giving an instruction or demonstration
designed to alter an animal from its normal condition.
(b) Curing, ameliorating, correcting, reducing, or modifying a disease, deformity, defect, wound, or injury
in or to an animal.
(c) Diagnosing or prognosing, or both, a disease, deformity, or defect in an animal by a test, procedure,
manipulation, technique, autopsy, biopsy, or other examination.
(3) Veterinarian means an individual licensed under this article to engage in the practice of veterinary
medicine.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1982, Act 353, Imd. Eff. Dec. 21, 1982.
Popular name: Act 368
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333.18808 Veterinary technician; health profession subfield.
Sec. 18808. Practice as a veterinary technician is a health profession subfield of the practice of veterinary
medicine.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1982, Act 353, Imd. Eff. Dec. 21, 1982.
Popular name: Act 368
333.18812 Limited license for practice apart from veterinary education; requirements;
graduates of nonapproved veterinary education programs.
Sec. 18812. (1) A limited license for practice apart from veterinary education shall require that the
individual be a senior student in an approved school of veterinary medicine and be under the supervision of a
veterinarian licensed by this state.
(2) Graduates of nonapproved veterinary education programs may be granted a limited license under
section 16182(1).
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1982, Act 337, Imd. Eff. Dec. 16, 1982.
Popular name: Act 368
***** 333.18813 THIS SECTION IS AMENDED EFFECTIVE MARCH 28, 2017: See 333.18813.amended
*****
333.18813 Veterinarian or veterinary technician license renewal; continuing education;
evidence; license cycle.
Sec. 18813. (1) A licensee seeking renewal of a veterinarian's license shall, if requested, furnish the
department with satisfactory evidence that during the 3 years immediately preceding application for renewal,
he or she attended at least 45 hours of continuing education courses or programs approved by the board.
(2) A licensee seeking renewal of a veterinary technician's license shall, if requested, furnish the
department with satisfactory evidence that during the 3 years immediately preceding application for renewal,
he or she attended at least 15 hours of continuing education courses or programs approved by the board.
(3) The license cycle for a veterinarian's license and a veterinary technician's license is 3 years.
History: Add. 2016, Act 47, Eff. June 13, 2016.
Popular name: Act 368
***** 333.18813.amended THIS AMENDED SECTION IS EFFECTIVE MARCH 28, 2017 *****
333.18813.amended Veterinarian or veterinary technician license renewal; continuing
education; evidence; license cycle.
Sec. 18813. (1) Beginning January 1, 2020, a licensee seeking renewal of a veterinarian's license shall, if
requested, furnish the department with satisfactory evidence that during the 3 years immediately preceding
application for renewal, he or she attended at least 45 hours of continuing education courses or programs
approved by the board.
(2) Beginning January 1, 2020, a licensee seeking renewal of a veterinary technician's license shall, if
requested, furnish the department with satisfactory evidence that during the 3 years immediately preceding
application for renewal, he or she attended at least 15 hours of continuing education courses or programs
approved by the board.
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(3) The license cycle for a veterinarian's license and a veterinary technician's license is 3 years.
History: Add. 2016, Act 47, Eff. June 13, 2016;Am. 2016, Act 383, Eff. Mar. 28, 2017.
Popular name: Act 368
333.18824 Repealed. 1989, Act 201, Imd. Eff. Oct. 23, 1989.
Compiler's note: The repealed section pertained to task force to advise board.
Popular name: Act 368
333.18835 Grounds for fine, reprimand, or probation; grounds for denying, limiting,
suspending, or revoking license.
Sec. 18835. In addition to the grounds set forth in part 161, the disciplinary subcommittee may fine,
reprimand, or place a licensee on probation, or deny, limit, suspend, or revoke the license of a veterinarian for
fraudulent use or misuse of a health certificate, inspection certificate, vaccination certificate, test chart, meat
inspection stamp, or other blank form used in the practice of veterinary medicine that might lead to the
dissemination of disease, unlawful transportation of diseased animals, or the sale of inedible products of
animal origin for human consumption.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1993, Act 79, Eff. Apr. 1, 1994.
Popular name: Act 368
ARTICLE 17
FACILITIES AND AGENCIES
PART 201
GENERAL PROVISIONS
333.20101 Meanings of words and phrases; principles of construction.
Sec. 20101. (1) The words and phrases defined in sections 20102 to 20109 apply to all parts in this article
except part 222 and have the meanings ascribed to them in those sections.
(2) In addition, article 1 contains general definitions and principles of construction applicable to all articles
in this code.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1988, Act 332, Eff. Oct. 1, 1988.
Compiler's note: For transfer of powers and duties of the division of health facility licensing and certification in the bureau of health
systems, division of federal support services, and the division of emergency medical services, with the exception of the division of
managed care and division of health facility development, from the department of public health to the director of the department of
commerce, see E.R.O. No. 1996-1, compiled at MCL 330.3101 of the Michigan Compiled Laws.
For transfer of powers and duties of the bureau of health services from the department of consumer and industry services to the
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director of the department of community health by Type II transfer, see E.R.O. No. 2003-1, compiled at MCL 445.2011.
For transfer of powers and duties of the bureau of family services from the department of consumer and industry services to the
family independence agency by Type II transfer, see E.R.O. No. 2003-1, compiled at MCL 445.2011.
Popular name: Act 368
333.20102 Definitions; A.
Sec. 20102. (1) "Advisory commission" means the health facilities and agencies advisory commission
created in section 20121.
(2) "Aircraft transport operation" means that term as defined in section 20902.
(3) "Ambulance operation" means that term as defined in section 20902.
(4) "Attending physician" means the physician selected by, or assigned to, the patient and who has primary
responsibility for the treatment and care of the patient.
(5) "Authorized representative" means the individual designated in writing by the board of directors of the
corporation or by the owner or person with legal authority to act on behalf of the company or organization on
licensing matters. The authorized representative who is not an owner or licensee shall not sign the original
license application or amendments to the application.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1978, Act 493, Eff. Mar. 30, 1979;Am. 1981, Act 79, Imd. Eff. June 30, 1981;
Am. 1990, Act 179, Imd. Eff. July 2, 1990;Am. 2010, Act 381, Imd. Eff. Dec. 22, 2010.
Popular name: Act 368
333.20104 Definitions; C to G.
Sec. 20104. (1) "Certification" means the issuance of a document by the department to a health facility or
agency attesting to the fact that the health facility or agency meets both of the following:
(a) It complies with applicable statutory and regulatory requirements and standards.
(b) It is eligible to participate as a provider of care and services in a specific federal or state health
program.
(2) "Consumer" means a person who is not a health care provider as defined in section 300jj of title 15 of
the public health service act, 42 USC 300jj.
(3) "County medical care facility" means a nursing care facility, other than a hospital long-term care unit,
that provides organized nursing care and medical treatment to 7 or more unrelated individuals who are
suffering or recovering from illness, injury, or infirmity and that is owned by a county or counties.
(4) "Department" means the department of licensing and regulatory affairs.
(5) "Direct access" means access to a patient or resident or to a patient's or resident's property, financial
information, medical records, treatment information, or any other identifying information.
(6) "Director" means the director of the department.
(7) "Freestanding surgical outpatient facility" means a facility, other than the office of a physician, dentist,
podiatrist, or other private practice office, offering a surgical procedure and related care that in the opinion of
the attending physician can be safely performed without requiring overnight inpatient hospital care.
Freestanding surgical outpatient facility does not include a surgical outpatient facility owned by and operated
as part of a hospital.
(8) "Good moral character" means that term as defined in section 1 of 1974 PA 381, MCL 338.41.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1978, Act 493, Eff. Mar. 30, 1979;Am. 2010, Act 381, Imd. Eff. Dec. 22, 2010;
Am. 2015, Act 104, Eff. Oct. 1, 2015;Am. 2015, Act 155, Eff. Jan. 18, 2016.
Popular name: Act 368
333.20106 Definitions; H.
Sec. 20106. (1) "Health facility or agency", except as provided in section 20115, means:
(a) An ambulance operation, aircraft transport operation, nontransport prehospital life support operation, or
medical first response service.
(b) A county medical care facility.
(c) A freestanding surgical outpatient facility.
(d) A health maintenance organization.
(e) A home for the aged.
(f) A hospital.
(g) A nursing home.
(h) A hospice.
(i) A hospice residence.
(j) A facility or agency listed in subdivisions (a) to (g) located in a university, college, or other educational
institution.
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(2) "Health maintenance organization" means that term as defined in section 3501 of the insurance code of
1956, 1956 PA 218, MCL 500.3501.
(3) "Home for the aged" means a supervised personal care facility, other than a hotel, adult foster care
facility, hospital, nursing home, or county medical care facility that provides room, board, and supervised
personal care to 21 or more unrelated, nontransient, individuals 60 years of age or older. Home for the aged
includes a supervised personal care facility for 20 or fewer individuals 60 years of age or older if the facility
is operated in conjunction with and as a distinct part of a licensed nursing home. Home for the aged does not
include an area excluded from this definition by section 17(3) of the continuing care community disclosure
act, 2014 PA 448, MCL 554.917.
(4) "Hospice" means a health care program that provides a coordinated set of services rendered at home or
in outpatient or institutional settings for individuals suffering from a disease or condition with a terminal
prognosis.
(5) "Hospital" means a facility offering inpatient, overnight care, and services for observation, diagnosis,
and active treatment of an individual with a medical, surgical, obstetric, chronic, or rehabilitative condition
requiring the daily direction or supervision of a physician. Hospital does not include a mental health hospital
licensed or operated by the department of community health or a hospital operated by the department of
corrections.
(6) "Hospital long-term care unit" means a nursing care facility, owned and operated by and as part of a
hospital, providing organized nursing care and medical treatment to 7 or more unrelated individuals suffering
or recovering from illness, injury, or infirmity.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1980, Act 293, Eff. Mar. 31, 1981;Am. 1981, Act 79, Imd. Eff. June 30, 1981;
Am. 1982, Act 354, Imd. Eff. Dec. 21, 1982;Am. 1984, Act 311, Eff. Mar. 29, 1985;Am. 1990, Act 179, Imd. Eff. July 2, 1990;
Am. 1996, Act 267, Imd. Eff. June 12, 1996;Am. 2000, Act 253, Imd. Eff. June 29, 2000;Am. 2014, Act 449, Imd. Eff. Jan. 2, 2015;
Am. 2015, Act 104, Eff. Oct. 1, 2015.
Popular name: Act 368
333.20108 Definitions; I to N.
Sec. 20108. (1) Intermediate care facility means a hospital long-term care unit, nursing home, county
medical care facility, or other nursing care facility, or distinct part thereof, certified by the department to
provide intermediate care or basic care that is less than skilled nursing care but more than room and board.
(2) License means an authorization, annual or as otherwise specified, granted by the department and
evidenced by a certificate of licensure or permit granting permission to a person to establish or maintain and
operate, or both, a health facility or agency. For purposes of part 209, license includes a license issued to an
individual under that part.
(3) Licensee means the holder of a license or permit to establish or maintain and operate, or both, a
health facility or agency. For purposes of part 209, licensee includes an individual licensed under that part.
(4) Limited license means a provisional license or temporary permit or a license otherwise limited as
prescribed by the department.
(5) Medically contraindicated means, with reference to nursing homes only, having a substantial adverse
effect on the patient's physical health, as determined by the attending physician, which effect is explicitly
stated in writing with the reasons therefor in the patient's medical record.
(6) Medical first response service means that term as defined in section 20906.
(7) Nontransport prehospital life support operation means that term as defined in section 20908.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1978, Act 493, Eff. Mar. 30, 1979;Am. 1986, Act 78, Imd. Eff. Apr. 7, 1986;
Am. 1990, Act 179, Imd. Eff. July 2, 1990.
Popular name: Act 368
333.20109 Definitions; N to S.
Sec. 20109. (1) "Nursing home" means a nursing care facility, including a county medical care facility, that
provides organized nursing care and medical treatment to 7 or more unrelated individuals suffering or
recovering from illness, injury, or infirmity. As used in this subsection, "medical treatment" includes
treatment by an employee or independent contractor of the nursing home who is an individual licensed or
otherwise authorized to engage in a health profession under part 170 or 175. Nursing home does not include
any of the following:
(a) A unit in a state correctional facility.
(b) A hospital.
(c) A veterans facility created under 1885 PA 152, MCL 36.1 to 36.12.
(d) A hospice residence that is licensed under this article.
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(e) A hospice that is certified under 42 CFR 418.100.
(2) "Person" means that term as defined in section 1106 or a governmental entity.
(3) "Public member" means a member of the general public who is not a provider; who does not have an
ownership interest in or contractual relationship with a nursing home other than a resident contract; who does
not have a contractual relationship with a person who does substantial business with a nursing home; and who
is not the spouse, parent, sibling, or child of an individual who has an ownership interest in or contractual
relationship with a nursing home, other than a resident contract.
(4) "Skilled nursing facility" means a hospital long-term care unit, nursing home, county medical care
facility, or other nursing care facility, or a distinct part thereof, certified by the department to provide skilled
nursing care.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1978, Act 493, Eff. Mar. 30, 1979;Am. 1991, Act 39, Imd. Eff. June 11, 1991;
Am. 1996, Act 224, Eff. June 12, 1996;Am. 2015, Act 156, Eff. Jan. 18, 2016.
Popular name: Act 368
333.20121 Health facilities and agencies advisory commission; creation; appointment and
qualification of members; director as ex officio member without vote.
Sec. 20121. The health facilities and agencies advisory commission is created in the department. The
governor shall appoint the members with the advice and consent of the senate. Half the members shall be
consumers and half the members shall be representative of different types of licensees, with at least 1
representative of each type. Membership shall include at least 1 practicing physician, 1 registered nurse, and 1
enrollee of a health maintenance organization who is a consumer of health care. The director shall serve as an
ex officio member of the advisory commission without vote.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Compiler's note: For transfer of authority, powers, duties, functions, and responsibilities of the health facilities and agencies
advisory commission to the director of the Michigan state department of public health, see E.R.O. No. 1994-1, compiled at MCL
333.26322 of the Michigan Compiled Laws.
Popular name: Act 368
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Popular name: Act 368
Administrative rules: R 325.3801 et seq. and R 325.20101 et seq. of the Michigan Administrative Code.
333.20155 Visit to health facility or agency; survey and evaluation for purpose of licensure;
nursing home surveyor; criminal history check; survey team; composition and
membership; waiver; confidentiality of accreditation information; limitation and effect;
consultation engineering survey; summary of substantial noncompliance or deficiencies
and response; investigations or inspections; prior notice as misdemeanor; record;
periodic reports; access to documents; disclosure; delegation of functions; voluntary
inspections; forwarding evidence of violation to licensing agency; reports; clarification of
terms; quarterly meeting; resident care policies and compliance protocols; nursing
home's survey report; posting; other state and federal law; definitions.
Sec. 20155. (1) Except as otherwise provided in this section and section 20155a, the department shall make
at least 1 visit to each licensed health facility or agency every 3 years for survey and evaluation for the
purpose of licensure. A visit made according to a complaint shall be unannounced. Except for a county
medical care facility, a home for the aged, a nursing home, or a hospice residence, the department shall
determine whether the visits that are not made according to a complaint are announced or unannounced. The
department shall ensure that each newly hired nursing home surveyor, as part of his or her basic training, is
assigned full-time to a licensed nursing home for at least 10 days within a 14-day period to observe actual
operations outside of the survey process before the trainee begins oversight responsibilities.
(2) The department shall establish a process that ensures both of the following:
(a) A newly hired nursing home surveyor does not make independent compliance decisions during his or
her training period.
(b) A nursing home surveyor is not assigned as a member of a survey team for a nursing home in which he
or she received training for 1 standard survey following the training received in that nursing home.
(3) The department shall perform a criminal history check on all nursing home surveyors in the manner
provided for in section 20173a.
(4) A member of a survey team must not be employed by a licensed nursing home or a nursing home
management company doing business in this state at the time of conducting a survey under this section. The
department shall not assign an individual to be a member of a survey team for purposes of a survey,
evaluation, or consultation visit at a nursing home in which he or she was an employee within the preceding 3
years.
(5) The department shall invite representatives from all nursing home provider organizations and the state
long-term care ombudsman or his or her designee to participate in the planning process for the joint provider
and surveyor training sessions. The department shall include at least 1 representative from nursing home
provider organizations that do not own or operate a nursing home representing 30 or more nursing homes
statewide in internal surveyor group quality assurance training provided for the purpose of general
clarification and interpretation of existing or new regulatory requirements and expectations.
(6) The department shall make available online the general civil service position description related to the
required qualifications for individual surveyors. The department shall use the required qualifications to hire,
educate, develop, and evaluate surveyors.
(7) The department shall ensure that each annual survey team is composed of an interdisciplinary group of
professionals, 1 of whom must be a registered nurse. Other members may include social workers, therapists,
dietitians, pharmacists, administrators, physicians, sanitarians, and others who may have the expertise
necessary to evaluate specific aspects of nursing home operation.
(8) The department shall semiannually provide for joint training with nursing home surveyors and
providers on at least 1 of the 10 most frequently issued federal citations in this state during the past calendar
year. The department shall develop a protocol for the review of citation patterns compared to regional
outcomes and standards and complaints regarding the nursing home survey process. The department shall
include the review under this subsection in the report required under subsection (20). Except as otherwise
provided in this subsection, each member of a department nursing home survey team who is a health
professional licensee under article 15 shall earn not less than 50% of his or her required continuing education
credits, if any, in geriatric care. If a member of a nursing home survey team is a pharmacist licensed under
article 15, he or she shall earn not less than 30% of his or her required continuing education credits in geriatric
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care.
(9) Subject to subsection (12), the department may waive the visit required by subsection (1) if a health
facility or agency, requests a waiver and submits the following as applicable and if all of the requirements of
subsection (11) are met:
(a) Evidence that it is currently fully accredited by a body with expertise in the health facility or agency
type and the accrediting organization is accepted by the United States Department of Health and Human
Services for purposes of section 1865 of the social security act, 42 USC 1395bb.
(b) A copy of the most recent accreditation report, or executive summary, issued by a body described in
subdivision (a), and the health facility's or agency's responses to the accreditation report is submitted to the
department at least 30 days from license renewal. Submission of an executive summary does not prevent or
prohibit the department from requesting the entire accreditation report if the department considers it
necessary.
(c) For a nursing home, a standard federal certification survey conducted within the immediately preceding
9 to 15 months that shows substantial compliance or has an accepted plan of correction, if applicable.
(10) Except as otherwise provided in subsection (14), accreditation information provided to the department
under subsection (9) is confidential, is not a public record, and is not subject to court subpoena. The
department shall use the accreditation information only as provided in this section and properly destroy the
documentation after a decision on the waiver request is made.
(11) The department shall grant a waiver under subsection (9) if the accreditation report submitted under
subsection (9)(b) is less than 3 years old or the standard federal survey submitted under subsection (9)(c) is
less than 15 months old and there is no indication of substantial noncompliance with licensure standards or of
deficiencies that represent a threat to public safety or patient care. If the accreditation report or standard
federal survey is too old, the department may deny the waiver request and conduct the visits required under
subsection (9). Denial of a waiver request by the department is not subject to appeal.
(12) This section does not prohibit the department from citing a violation of this part during a survey,
conducting investigations or inspections according to section 20156, or conducting surveys of health facilities
or agencies for the purpose of complaint investigations or federal certification. This section does not prohibit
the bureau of fire services created in section 1b of the fire prevention code, 1941 PA 207, MCL 29.1b, from
conducting annual surveys of hospitals, nursing homes, and county medical care facilities.
(13) At the request of a health facility or agency, the department may conduct a consultation engineering
survey of a health facility and provide professional advice and consultation regarding health facility
construction and design. A health facility or agency may request a voluntary consultation survey under this
subsection at any time between licensure surveys. The fees for a consultation engineering survey are the same
as the fees established for waivers under section 20161(8).
(14) If the department determines that substantial noncompliance with licensure standards exists or that
deficiencies that represent a threat to public safety or patient care exist based on a review of an accreditation
report submitted under subsection (9)(b), the department shall prepare a written summary of the substantial
noncompliance or deficiencies and the health facility's or agency's response to the department's determination.
The department's written summary and the health facility's or agency's response are public documents.
(15) The department or a local health department shall conduct investigations or inspections, other than
inspections of financial records, of a county medical care facility, home for the aged, nursing home, or
hospice residence without prior notice to the health facility or agency. An employee of a state agency charged
with investigating or inspecting the health facility or agency or an employee of a local health department who
directly or indirectly gives prior notice regarding an investigation or an inspection, other than an inspection of
the financial records, to the health facility or agency or to an employee of the health facility or agency, is
guilty of a misdemeanor. Consultation visits that are not for the purpose of annual or follow-up inspection or
survey may be announced.
(16) The department shall maintain a record indicating whether a visit and inspection is announced or
unannounced. Survey findings gathered at each health facility or agency during each visit and inspection,
whether announced or unannounced, shall be taken into account in licensure decisions.
(17) The department shall require periodic reports and a health facility or agency shall give the department
access to books, records, and other documents maintained by a health facility or agency to the extent
necessary to carry out the purpose of this article and the rules promulgated under this article. The department
shall not divulge or disclose the contents of the patient's clinical records in a manner that identifies an
individual except under court order. The department may copy health facility or agency records as required to
document findings. Surveyors shall use electronic resident information, whenever available, as a source of
survey-related data and shall request facility assistance to access the system to maximize data export.
(18) The department may delegate survey, evaluation, or consultation functions to another state agency or
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to a local health department qualified to perform those functions. The department shall not delegate survey,
evaluation, or consultation functions to a local health department that owns or operates a hospice or hospice
residence licensed under this article. The department shall delegate under this subsection by cost
reimbursement contract between the department and the state agency or local health department. The
department shall not delegate survey, evaluation, or consultation functions to nongovernmental agencies,
except as provided in this section. The voluntary inspection described in this subsection must be agreed upon
by both the licensee and the department.
(19) If, upon investigation, the department or a state agency determines that an individual licensed to
practice a profession in this state has violated the applicable licensure statute or the rules promulgated under
that statute, the department, state agency, or local health department shall forward the evidence it has to the
appropriate licensing agency.
(20) The department may consolidate all information provided for any report required under this section
and section 20155a into a single report. The department shall report to the appropriations subcommittees, the
senate and house of representatives standing committees having jurisdiction over issues involving senior
citizens, and the fiscal agencies on March 1 of each year on the initial and follow-up surveys conducted on all
nursing homes in this state. The department shall include all of the following information in the report:
(a) The number of surveys conducted.
(b) The number requiring follow-up surveys.
(c) The average number of citations per nursing home for the most recent calendar year.
(d) The number of night and weekend complaints filed.
(e) The number of night and weekend responses to complaints conducted by the department.
(f) The average length of time for the department to respond to a complaint filed against a nursing home.
(g) The number and percentage of citations disputed through informal dispute resolution and independent
informal dispute resolution.
(h) The number and percentage of citations overturned or modified, or both.
(i) The review of citation patterns developed under subsection (8).
(j) Information regarding the progress made on implementing the administrative and electronic support
structure to efficiently coordinate all nursing home licensing and certification functions.
(k) The number of annual standard surveys of nursing homes that were conducted during a period of open
survey or enforcement cycle.
(l) The number of abbreviated complaint surveys that were not conducted on consecutive surveyor
workdays.
(m) The percent of all form CMS-2567 reports of findings that were released to the nursing home within
the 10-working-day requirement.
(n) The percent of provider notifications of acceptance or rejection of a plan of correction that were
released to the nursing home within the 10-working-day requirement.
(o) The percent of first revisits that were completed within 60 days from the date of survey completion.
(p) The percent of second revisits that were completed within 85 days from the date of survey completion.
(q) The percent of letters of compliance notification to the nursing home that were released within 10
working days of the date of the completion of the revisit.
(r) A summary of the discussions from the meetings required in subsection (24).
(s) The number of nursing homes that participated in a recognized quality improvement program as
described under section 20155a(3).
(21) The department shall report March 1 of each year to the standing committees on appropriations and
the standing committees having jurisdiction over issues involving senior citizens in the senate and the house
of representatives on all of the following:
(a) The percentage of nursing home citations that are appealed through the informal dispute resolution
process.
(b) The number and percentage of nursing home citations that are appealed and supported, amended, or
deleted through the informal dispute resolution process.
(c) A summary of the quality assurance review of the amended citations and related survey retraining
efforts to improve consistency among surveyors and across the survey administrative unit that occurred in the
year being reported.
(22) Subject to subsection (23), a clarification work group comprised of the department in consultation
with a nursing home resident or a member of a nursing home resident's family, nursing home provider groups,
the American Medical Directors Association, the state long-term care ombudsman, and the federal Centers for
Medicare and Medicaid Services shall clarify the following terms as those terms are used in title XVIII and
title XIX and applied by the department to provide more consistent regulation of nursing homes in this state:
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(a) Immediate jeopardy.
(b) Harm.
(c) Potential harm.
(d) Avoidable.
(e) Unavoidable.
(23) All of the following clarifications developed under subsection (22) apply for purposes of subsection
(22):
(a) Specifically, the term "immediate jeopardy" means a situation in which immediate corrective action is
necessary because the nursing home'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 receiving care in a nursing home.
(b) The likelihood of immediate jeopardy is reasonably higher if there is evidence of a flagrant failure by
the nursing home to comply with a peer-reviewed, evidence-based, nationally recognized clinical process
guideline than if the nursing home has substantially and continuously complied with peer-reviewed,
evidence-based, nationally recognized guidelines. If federal regulations and guidelines are not clear, and if the
clinical process guidelines have been recognized, a process failure giving rise to an immediate jeopardy may
involve an egregious widespread or repeated process failure and the absence of reasonable efforts to detect
and prevent the process failure.
(c) In determining whether or not there is immediate jeopardy, the survey agency should consider at least
all of the following:
(i) Whether the nursing home could reasonably have been expected to know about the deficient practice
and to stop it, but did not stop the deficient practice.
(ii) Whether the nursing home could reasonably have been expected to identify the deficient practice and to
correct it, but did not correct the deficient practice.
(iii) Whether the nursing home could reasonably have been expected to anticipate that serious injury,
serious harm, impairment, or death might result from continuing the deficient practice, but did not so
anticipate.
(iv) Whether the nursing home could reasonably have been expected to know that a widely accepted
high-risk practice is or could be problematic, but did not know.
(v) Whether the nursing home could reasonably have been expected to detect the process problem in a
more timely fashion, but did not so detect.
(d) The existence of 1 or more of the factors described in subdivision (c), and especially the existence of 3
or more of those factors simultaneously, may lead to a conclusion that the situation is one in which the
nursing home's practice makes adverse events likely to occur if immediate intervention is not undertaken, and
therefore constitutes immediate jeopardy. If none of the factors described in subdivision (c) is present, the
situation may involve harm or potential harm that is not immediate jeopardy.
(e) Specifically, "actual harm" means a negative outcome to a resident that has compromised the resident's
ability to maintain or reach, or both, 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. Harm does not include a deficient practice that only may cause or has caused limited consequences
to the resident.
(f) For purposes of subdivision (e), in determining whether a negative outcome is of limited consequence,
if the "state operations manual" or "the guidance to surveyors" published by the federal Centers for Medicare
and Medicaid Services does not provide specific guidance, the department may consider whether most people
in similar circumstances would feel that the damage was of such short duration or impact as to be
inconsequential or trivial. In such a case, the consequence of a negative outcome may be considered more
limited if it occurs in the context of overall procedural consistency with a peer-reviewed, evidence-based,
nationally recognized clinical process guideline, as compared to a substantial inconsistency with or variance
from the guideline.
(g) For purposes of subdivision (e), if the publications described in subdivision (f) do not provide specific
guidance, the department may consider the degree of a nursing home's adherence to a peer-reviewed,
evidence-based, nationally recognized clinical process guideline in considering whether the degree of
compromise and future risk to the resident constitutes actual harm. The risk of significant compromise to the
resident may be considered greater in the context of substantial deviation from the guidelines than in the case
of overall adherence.
(h) To improve consistency and to avoid disputes over avoidable and unavoidable negative outcomes,
nursing homes and survey agencies must have a common understanding of accepted process guidelines and of
the circumstances under which it can reasonably be said that certain actions or inactions will lead to avoidable
negative outcomes. If the "state operations manual" or "the guidance to surveyors" published by the federal
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Centers for Medicare and Medicaid Services is not specific, a nursing home's overall documentation of
adherence to a peer-reviewed, evidence-based, nationally recognized clinical process guideline with a process
indicator is relevant information in considering whether a negative outcome was avoidable or unavoidable
and may be considered in the application of that term.
(24) The department shall conduct a quarterly meeting and invite appropriate stakeholders. The department
shall invite as appropriate stakeholders under this subsection at least 1 representative from each nursing home
provider organization that does not own or operate a nursing home representing 30 or more nursing homes
statewide, the state long-term care ombudsman or his or her designee, and any other clinical experts.
Individuals who participate in these quarterly meetings, jointly with the department, may designate advisory
workgroups to develop recommendations on the discussion topics that should include, at a minimum, all of
the following:
(a) Opportunities for enhanced promotion of nursing home performance, including, but not limited to,
programs that encourage and reward providers that strive for excellence.
(b) Seeking quality improvement to the survey and enforcement process, including clarifications to
process-related policies and protocols that include, but are not limited to, all of the following:
(i) Improving the surveyors' quality and preparedness.
(ii) Enhanced communication between regulators, surveyors, providers, and consumers.
(iii) Ensuring fair enforcement and dispute resolution by identifying methods or strategies that may resolve
identified problems or concerns.
(c) Promoting transparency across provider and surveyor communities, including, but not limited to, all of
the following:
(i) Applying regulations in a consistent manner and evaluating changes that have been implemented to
resolve identified problems and concerns.
(ii) Providing consumers with information regarding changes in policy and interpretation.
(iii) Identifying positive and negative trends and factors contributing to those trends in the areas of resident
care, deficient practices, and enforcement.
(d) Clinical process guidelines.
(25) A nursing home shall use peer-reviewed, evidence-based, nationally recognized clinical process
guidelines or peer-reviewed, evidence-based, best-practice resources to develop and implement resident care
policies and compliance protocols with measurable outcomes specifically in the following clinical practice
areas:
(a) Use of bed rails.
(b) Adverse drug effects.
(c) Prevention of falls.
(d) Prevention of pressure ulcers.
(e) Nutrition and hydration.
(f) Pain management.
(g) Depression and depression pharmacotherapy.
(h) Heart failure.
(i) Urinary incontinence.
(j) Dementia care.
(k) Osteoporosis.
(l) Altered mental states.
(m) Physical and chemical restraints.
(n) Person-centered care principles.
(26) In an area of clinical practice that is not listed in subsection (25), a nursing home may use
peer-reviewed, evidence-based, nationally recognized clinical process guidelines or peer-reviewed,
evidence-based, best-practice resources to develop and implement resident care policies and compliance
protocols with measurable outcomes to promote performance excellence.
(27) The department shall consider recommendations from an advisory workgroup created under
subsection (24). The department may include training on new and revised peer-reviewed, evidence-based,
nationally recognized clinical process guidelines or peer-reviewed, evidence-based, best-practice resources,
which contain measurable outcomes, in the joint provider and surveyor training sessions to assist provider
efforts toward improved regulatory compliance and performance excellence and to foster a common
understanding of accepted peer-reviewed, evidence-based, best-practice resources between providers and the
survey agency. The department shall post on its website all peer-reviewed, evidence-based, nationally
recognized clinical process guidelines and peer-reviewed, evidence-based, best-practice resources used in a
training session under this subsection for provider, surveyor, and public reference.
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(28) Representatives from each nursing home provider organization that does not own or operate a nursing
home representing 30 or more nursing homes statewide and the state long-term care ombudsman or his or her
designee are permanent members of a clinical advisory workgroup created under subsection (24). The
department shall issue survey certification memorandums to providers to announce or clarify changes in the
interpretation of regulations.
(29) The department shall maintain the process by which the director of the long-term care division or his
or her designee reviews and authorizes the issuance of a citation for immediate jeopardy or substandard
quality of care before the statement of deficiencies is made final. The review must assure the consistent and
accurate application of federal and state survey protocols and defined regulatory standards. As used in this
subsection, "immediate jeopardy" and "substandard quality of care" mean those terms as defined by the
federal Centers for Medicare and Medicaid Services.
(30) Upon availability of funds, the department shall give grants, awards, or other recognition to nursing
homes to encourage the rapid development and implementation of resident care policies and compliance
protocols that are created from peer-reviewed, evidence-based, nationally recognized clinical process
guidelines or peer-reviewed, evidence-based, best-practice resources with measurable outcomes to promote
performance excellence.
(31) A nursing home shall post the nursing home's survey report in a conspicuous place within the nursing
home for public review.
(32) Nothing in this section limits the requirements of related state and federal law.
(33) As used in this section:
(a) "Consecutive days" means calendar days, but does not include Saturday, Sunday, or state- or
federally-recognized holidays.
(b) "Form CMS-2567" means the federal Centers for Medicare and Medicaid Services' form for the
statement of deficiencies and plan of correction or a successor form serving the same purpose.
(c) "Title XVIII" means title XVIII of the social security act, 42 USC 1395 to 1395lll.
(d) "Title XIX" means title XIX of the social security act, 42 USC 1396 to 1396w-5.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1978, Act 493, Eff. Mar. 30, 1979;Am. 1981, Act 111, Imd. Eff. July 17, 1981;
Am. 1982, Act 474, Eff. Mar. 30, 1983;Am. 1992, Act 80, Imd. Eff. June 2, 1992;Am. 1996, Act 267, Imd. Eff. June 12, 1996;
Am. 2000, Act 170, Imd. Eff. June 20, 2000;Am. 2000, Act 171, Imd. Eff. June 20, 2000;Am. 2001, Act 218, Imd. Eff. Dec. 28,
2001;Am. 2006, Act 195, Imd. Eff. June 19, 2006;Am. 2012, Act 322, Imd. Eff. Oct. 9, 2012;Am. 2015, Act 104, Eff. Oct. 1,
2015;Am. 2015, Act 155, Eff. Jan. 18, 2016.
Compiler's note: For transfer of the clinical advisory committee to the department of community health, and abolishment of the
committee, see E.R.O. No. 2009-6, compiled at MCL 333.26329.
Popular name: Act 368
Administrative rules: R 325.3801 et seq. of the Michigan Administrative Code.
333.20155a Nursing home health survey tasks; electronic system; determination of open
survey cycle; grants; reports of survey findings; nursing home's plan of correction;
notifications of acceptance or rejection; revisit; evidence of substantial compliance;
informal dispute resolution; citation levels.
Sec. 20155a. (1) Nursing home health survey tasks shall be facilitated by the licensing and regulatory
affairs bureau of health systems to ensure consistent and efficient coordination of the nursing home licensing
and certification functions for standard and abbreviated surveys. The department shall develop an electronic
system to support the coordination of these activities. If funds are appropriated for the system, the department
shall implement the system within 120 days of that appropriation.
(2) When preparing to conduct an annual standard survey, the department shall determine if there is an
open survey cycle and make every reasonable effort to confirm that substantial compliance has been achieved
by implementation of the nursing home's accepted plan of correction before initiating the annual standard
survey while maintaining the federal requirement for standard annual survey interval and state survey average
of 12 months.
(3) The department shall seek approval from the Centers for Medicare and Medicaid Services to develop a
program to provide grants to nursing homes that have achieved a 5-star quality rating from the Centers for
Medicare and Medicaid Services. The department shall seek approval from the Centers for Medicare and
Medicaid Services for nursing homes to be eligible to receive a grant, up to $5,000.00 per nursing home from
the civil monetary fund for nursing homes that meet the Centers for Medicare and Medicaid Services
standards for the 5-star quality rating. Grants to nursing homes shall be used to implement evidence-based
quality improvement programs within the nursing home. Each nursing home that receives a grant shall submit
a report to the department that describes the final outcome from implementing the program.
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(4) All abbreviated complaint surveys shall be conducted on consecutive days until complete. All form
CMS-2567 reports of survey findings shall be released to the nursing home within 10 consecutive days after
completion of the survey.
(5) Departmental notifications of acceptance or rejection of a nursing home's plan of correction shall be
reviewed and released to the nursing home within 10 consecutive days of receipt of that plan of correction.
(6) A nursing-home-submitted plan of correction in response to any survey must have a completion date
not to exceed 40 days from the exit date of survey. If a nursing home has not received additional citations
before a revisit occurs, the department shall conduct the first revisit not more than 60 days from the exit date
of the survey.
(7) Letters of compliance notification to nursing homes shall be released to the nursing home within 10
consecutive days of all survey revisit completion dates.
(8) The department may accept a nursing home's evidence of substantial compliance instead of requiring a
post survey on-site first or second revisit as the department considers appropriate in accordance with the
Centers for Medicare and Medicaid Services survey protocols. A nursing home requesting consideration of
evidence of substantial compliance in lieu of an on-site revisit must include an affidavit that asserts the
nursing home is in substantial compliance as shown by the submitted evidence for that specific survey event.
There may be no deficiencies with a scope and severity originating higher than level F. Citations with a scope
and severity of level F or below may go through a desk review by the department upon thorough review of the
plan of correction. Citations with a scope and severity of level G or higher are not to be considered for a desk
review. If there is no enforcement action, the nursing home's evidence of substantial compliance may be
reviewed administratively and accepted as evidence of deficiency correction.
(9) Informal dispute resolution conducted by the Michigan peer review organization shall be given strong
consideration upon final review by the department. In the annual report to the legislature, the department shall
include the number of Michigan peer review organization-referred reviews and, of those reviews, the number
of citations that were overturned by the department.
(10) Citation levels used in this section mean citation levels as defined by the Centers for Medicare and
Medicaid Services' survey protocol grid defining scope and severity assessment of deficiency.
History: Add. 2012, Act 322, Imd. Eff. Oct. 9, 2012;Am. 2015, Act 155, Eff. Jan. 18, 2016.
Popular name: Act 368
333.20161 Fees and assessments for health facility and agency licenses and certificates of
need; schedule; fees; use of quality assurance assessment; tax levy; definitions.
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Sec. 20161. (1) The department shall assess fees and other assessments for health facility and agency
licenses and certificates of need on an annual basis as provided in this article. Until October 1, 2019, except as
otherwise provided in this article, fees and assessments shall be paid as provided in the following schedule:
(a) Freestanding surgical
outpatient facilities................$500.00 per facility
license.
(b) Hospitals...................$500.00 per facility
license and $10.00 per
licensed bed.
(c) Nursing homes, county
medical care facilities, and
hospital long-term care units........$500.00 per facility
license and $3.00 per
licensed bed over 100
licensed beds.
(d) Homes for the aged..........$6.27 per licensed bed.
(e) Hospice agencies............$500.00 per agency license.
(f) Hospice residences..........$500.00 per facility
license and $5.00 per
licensed bed.
(g) Subject to subsection
(11), quality assurance assessment
for nursing homes and hospital
long-term care units.................an amount resulting
in not more than 6%
of total industry
revenues.
(h) Subject to subsection
(12), quality assurance assessment
for hospitals........................at a fixed or variable
rate that generates
funds not more than the
maximum allowable under
the federal matching
requirements, after
consideration for the
amounts in subsection
(12)(a) and (i).
(i) Initial licensure
application fee for subdivisions
(a), (b), (c), (e), and (f)..........$2,000.00 per initial
license.
(2) If a hospital requests the department to conduct a certification survey for purposes of title XVIII or title
XIX of the social security act, the hospital shall pay a license fee surcharge of $23.00 per bed. As used in this
subsection, "title XVIII" and "title XIX" mean those terms as defined in section 20155.
(3) All of the following apply to the assessment under this section for certificates of need:
(a) The base fee for a certificate of need is $3,000.00 for each application. For a project requiring a
projected capital expenditure of more than $500,000.00 but less than $4,000,000.00, an additional fee of
$5,000.00 is added to the base fee. For a project requiring a projected capital expenditure of $4,000,000.00 or
more but less than $10,000,000.00, an additional fee of $8,000.00 is added to the base fee. For a project
requiring a projected capital expenditure of $10,000,000.00 or more, an additional fee of $12,000.00 is added
to the base fee.
(b) In addition to the fees under subdivision (a), the applicant shall pay $3,000.00 for any designated
complex project including a project scheduled for comparative review or for a consolidated licensed health
facility application for acquisition or replacement.
(c) If required by the department, the applicant shall pay $1,000.00 for a certificate of need application that
receives expedited processing at the request of the applicant.
(d) The department shall charge a fee of $500.00 to review any letter of intent requesting or resulting in a
waiver from certificate of need review and any amendment request to an approved certificate of need.
(e) A health facility or agency that offers certificate of need covered clinical services shall pay $100.00 for
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each certificate of need approved covered clinical service as part of the certificate of need annual survey at the
time of submission of the survey data.
(f) The department shall use the fees collected under this subsection only to fund the certificate of need
program. Funds remaining in the certificate of need program at the end of the fiscal year shall not lapse to the
general fund but shall remain available to fund the certificate of need program in subsequent years.
(4) A license issued under this part is effective for no longer than 1 year after the date of issuance.
(5) Fees described in this section are payable to the department at the time an application for a license,
permit, or certificate is submitted. If an application for a license, permit, or certificate is denied or if a license,
permit, or certificate is revoked before its expiration date, the department shall not refund fees paid to the
department.
(6) The fee for a provisional license or temporary permit is the same as for a license. A license may be
issued at the expiration date of a temporary permit without an additional fee for the balance of the period for
which the fee was paid if the requirements for licensure are met.
(7) The cost of licensure activities shall be supported by license fees.
(8) The application fee for a waiver under section 21564 is $200.00 plus $40.00 per hour for the
professional services and travel expenses directly related to processing the application. The travel expenses
shall be calculated in accordance with the state standardized travel regulations of the department of
technology, management, and budget in effect at the time of the travel.
(9) An applicant for licensure or renewal of licensure under part 209 shall pay the applicable fees set forth
in part 209.
(10) Except as otherwise provided in this section, the fees and assessments collected under this section
shall be deposited in the state treasury, to the credit of the general fund. The department may use the
unreserved fund balance in fees and assessments for the criminal history check program required under this
article.
(11) The quality assurance assessment collected under subsection (1)(g) and all federal matching funds
attributed to that assessment shall be used only for the following purposes and under the following specific
circumstances:
(a) The quality assurance assessment and all federal matching funds attributed to that assessment shall be
used to finance Medicaid nursing home reimbursement payments. Only licensed nursing homes and hospital
long-term care units that are assessed the quality assurance assessment and participate in the Medicaid
program are eligible for increased per diem Medicaid reimbursement rates under this subdivision. A nursing
home or long-term care unit that is assessed the quality assurance assessment and that does not pay the
assessment required under subsection (1)(g) in accordance with subdivision (c)(i) or in accordance with a
written payment agreement with this state shall not receive the increased per diem Medicaid reimbursement
rates under this subdivision until all of its outstanding quality assurance assessments and any penalties
assessed under subdivision (f) have been paid in full. This subdivision does not authorize or require the
department to overspend tax revenue in violation of the management and budget act, 1984 PA 431, MCL
18.1101 to 18.1594.
(b) Except as otherwise provided under subdivision (c), beginning October 1, 2005, the quality assurance
assessment is based on the total number of patient days of care each nursing home and hospital long-term care
unit provided to non-Medicare patients within the immediately preceding year, shall be assessed at a uniform
rate on October 1, 2005 and subsequently on October 1 of each following year, and is payable on a quarterly
basis, with the first payment due 90 days after the date the assessment is assessed.
(c) Within 30 days after September 30, 2005, the department shall submit an application to the federal
Centers for Medicare and Medicaid Services to request a waiver according to 42 CFR 433.68(e) to implement
this subdivision as follows:
(i) If the waiver is approved, the quality assurance assessment rate for a nursing home or hospital
long-term care unit with less than 40 licensed beds or with the maximum number, or more than the maximum
number, of licensed beds necessary to secure federal approval of the application is $2.00 per non-Medicare
patient day of care provided within the immediately preceding year or a rate as otherwise altered on the
application for the waiver to obtain federal approval. If the waiver is approved, for all other nursing homes
and long-term care units the quality assurance assessment rate is to be calculated by dividing the total
statewide maximum allowable assessment permitted under subsection (1)(g) less the total amount to be paid
by the nursing homes and long-term care units with less than 40 licensed beds or with the maximum number,
or more than the maximum number, of licensed beds necessary to secure federal approval of the application
by the total number of non-Medicare patient days of care provided within the immediately preceding year by
those nursing homes and long-term care units with more than 39 licensed beds, but less than the maximum
number of licensed beds necessary to secure federal approval. The quality assurance assessment, as provided
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under this subparagraph, shall be assessed in the first quarter after federal approval of the waiver and shall be
subsequently assessed on October 1 of each following year, and is payable on a quarterly basis, with the first
payment due 90 days after the date the assessment is assessed.
(ii) If the waiver is approved, continuing care retirement centers are exempt from the quality assurance
assessment if the continuing care retirement center requires each center resident to provide an initial life
interest payment of $150,000.00, on average, per resident to ensure payment for that resident's residency and
services and the continuing care retirement center utilizes all of the initial life interest payment before the
resident becomes eligible for medical assistance under the state's Medicaid plan. As used in this subparagraph,
"continuing care retirement center" means a nursing care facility that provides independent living services,
assisted living services, and nursing care and medical treatment services, in a campus-like setting that has
shared facilities or common areas, or both.
(d) Beginning May 10, 2002, the department shall increase the per diem nursing home Medicaid
reimbursement rates for the balance of that year. For each subsequent year in which the quality assurance
assessment is assessed and collected, the department shall maintain the Medicaid nursing home
reimbursement payment increase financed by the quality assurance assessment.
(e) The department shall implement this section in a manner that complies with federal requirements
necessary to ensure that the quality assurance assessment qualifies for federal matching funds.
(f) If a nursing home or a hospital long-term care unit fails to pay the assessment required by subsection
(1)(g), the department may assess the nursing home or hospital long-term care unit a penalty of 5% of the
assessment for each month that the assessment and penalty are not paid up to a maximum of 50% of the
assessment. The department may also refer for collection to the department of treasury past due amounts
consistent with section 13 of 1941 PA 122, MCL 205.13.
(g) The Medicaid nursing home quality assurance assessment fund is established in the state treasury. The
department shall deposit the revenue raised through the quality assurance assessment with the state treasurer
for deposit in the Medicaid nursing home quality assurance assessment fund.
(h) The department shall not implement this subsection in a manner that conflicts with 42 USC 1396b(w).
(i) The quality assurance assessment collected under subsection (1)(g) shall be prorated on a quarterly
basis for any licensed beds added to or subtracted from a nursing home or hospital long-term care unit since
the immediately preceding July 1. Any adjustments in payments are due on the next quarterly installment due
date.
(j) In each fiscal year governed by this subsection, Medicaid reimbursement rates shall not be reduced
below the Medicaid reimbursement rates in effect on April 1, 2002 as a direct result of the quality assurance
assessment collected under subsection (1)(g).
(k) The state retention amount of the quality assurance assessment collected under subsection (1)(g) shall
be equal to 13.2% of the federal funds generated by the nursing homes and hospital long-term care units
quality assurance assessment, including the state retention amount. The state retention amount shall be
appropriated each fiscal year to the department to support Medicaid expenditures for long-term care services.
These funds shall offset an identical amount of general fund/general purpose revenue originally appropriated
for that purpose.
(l) Beginning October 1, 2019, the department shall not assess or collect the quality assurance assessment
or apply for federal matching funds. The quality assurance assessment collected under subsection (1)(g) shall
not be assessed or collected after September 30, 2011 if the quality assurance assessment is not eligible for
federal matching funds. Any portion of the quality assurance assessment collected from a nursing home or
hospital long-term care unit that is not eligible for federal matching funds shall be returned to the nursing
home or hospital long-term care unit.
(12) The quality assurance dedication is an earmarked assessment collected under subsection (1)(h). That
assessment and all federal matching funds attributed to that assessment shall be used only for the following
purpose and under the following specific circumstances:
(a) To maintain the increased Medicaid reimbursement rate increases as provided for in subdivision (c).
(b) The quality assurance assessment shall be assessed on all net patient revenue, before deduction of
expenses, less Medicare net revenue, as reported in the most recently available Medicare cost report and is
payable on a quarterly basis, with the first payment due 90 days after the date the assessment is assessed. As
used in this subdivision, "Medicare net revenue" includes Medicare payments and amounts collected for
coinsurance and deductibles.
(c) Beginning October 1, 2002, the department shall increase the hospital Medicaid reimbursement rates
for the balance of that year. For each subsequent year in which the quality assurance assessment is assessed
and collected, the department shall maintain the hospital Medicaid reimbursement rate increase financed by
the quality assurance assessments.
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(d) The department shall implement this section in a manner that complies with federal requirements
necessary to ensure that the quality assurance assessment qualifies for federal matching funds.
(e) If a hospital fails to pay the assessment required by subsection (1)(h), the department may assess the
hospital a penalty of 5% of the assessment for each month that the assessment and penalty are not paid up to a
maximum of 50% of the assessment. The department may also refer for collection to the department of
treasury past due amounts consistent with section 13 of 1941 PA 122, MCL 205.13.
(f) The hospital quality assurance assessment fund is established in the state treasury. The department shall
deposit the revenue raised through the quality assurance assessment with the state treasurer for deposit in the
hospital quality assurance assessment fund.
(g) In each fiscal year governed by this subsection, the quality assurance assessment shall only be collected
and expended if Medicaid hospital inpatient DRG and outpatient reimbursement rates and disproportionate
share hospital and graduate medical education payments are not below the level of rates and payments in
effect on April 1, 2002 as a direct result of the quality assurance assessment collected under subsection (1)(h),
except as provided in subdivision (h).
(h) The quality assurance assessment collected under subsection (1)(h) shall not be assessed or collected
after September 30, 2011 if the quality assurance assessment is not eligible for federal matching funds. Any
portion of the quality assurance assessment collected from a hospital that is not eligible for federal matching
funds shall be returned to the hospital.
(i) The state retention amount of the quality assurance assessment collected under subsection (1)(h) shall
be equal to 13.2% of the federal funds generated by the hospital quality assurance assessment, including the
state retention amount. The 13.2% state retention amount described in this subdivision does not apply to the
Healthy Michigan plan. In the fiscal year ending September 30, 2016, there is a 1-time additional retention
amount of up to $92,856,100.00. Beginning in the fiscal year ending September 30, 2017, and for each fiscal
year thereafter, there is a retention amount of $105,000,000.00 for each fiscal year for the Healthy Michigan
plan. The state retention percentage shall be applied proportionately to each hospital quality assurance
assessment program to determine the retention amount for each program. The state retention amount shall be
appropriated each fiscal year to the department to support Medicaid expenditures for hospital services and
therapy. These funds shall offset an identical amount of general fund/general purpose revenue originally
appropriated for that purpose. By May 31, 2019, the department, the state budget office, and the Michigan
Health and Hospital Association shall identify an appropriate retention amount for the fiscal year ending
September 30, 2020 and each fiscal year thereafter.
(13) The department may establish a quality assurance assessment to increase ambulance reimbursement as
follows:
(a) The quality assurance assessment authorized under this subsection shall be used to provide
reimbursement to Medicaid ambulance providers. The department may promulgate rules to provide the
structure of the quality assurance assessment authorized under this subsection and the level of the assessment.
(b) The department shall implement this subsection in a manner that complies with federal requirements
necessary to ensure that the quality assurance assessment qualifies for federal matching funds.
(c) The total annual collections by the department under this subsection shall not exceed $20,000,000.00.
(d) The quality assurance assessment authorized under this subsection shall not be collected after October
1, 2019. The quality assurance assessment authorized under this subsection shall no longer be collected or
assessed if the quality assurance assessment authorized under this subsection is not eligible for federal
matching funds.
(14) The quality assurance assessment provided for under this section is a tax that is levied on a health
facility or agency.
(15) As used in this section:
(a) "Healthy Michigan plan" means the medical assistance plan described in section 105d of the social
welfare act, 1939 PA 280, MCL 400.105d, that has a federal matching fund rate of not less than 90%.
(b) "Medicaid" means that term as defined in section 22207.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1981, Act 76, Eff. Oct. 1, 1981;Am. 1984, Act 376, Eff. Mar. 29, 1985;Am.
1987, Act 217, Imd. Eff. Dec. 22, 1987;Am. 1988, Act 332, Eff. Oct. 1, 1988;Am. 1990, Act 179, Imd. Eff. July 2, 1990;Am.
1990, Act 252, Imd. Eff. Oct. 12, 1990;Am. 1996, Act 267, Imd. Eff. June 12, 1996;Am. 2000, Act 253, Imd. Eff. June 29, 2000;
Am. 2002, Act 303, Imd. Eff. May 10, 2002;Am. 2002, Act 562, Imd. Eff. Oct. 1, 2002;Am. 2003, Act 113, Imd. Eff. July 24, 2003;
Am. 2003, Act 234, Imd. Eff. Dec. 29, 2003;Am. 2004, Act 393, Imd. Eff. Oct. 15, 2004;Am. 2004, Act 469, Imd. Eff. Dec. 28,
2004;Am. 2005, Act 187, Eff. Sept. 30, 2005;Am. 2007, Act 5, Imd. Eff. Mar. 23, 2007;Am. 2007, Act 85, Imd. Eff. Sept. 30,
2007;Am. 2008, Act 173, Imd. Eff. July 2, 2008;Am. 2008, Act 277, Imd. Eff. Sept. 29, 2008;Am. 2011, Act 144, Imd. Eff. Sept.
21, 2011;Am. 2013, Act 137, Imd. Eff. Oct. 15, 2013;Am. 2015, Act 104, Eff. Oct. 1, 2015;Am. 2016, Act 189, Imd. Eff. June 21,
2016.
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Compiler's note: Enacting section 2 of Act 234 of 2003 provides:
"Enacting section 2. (1) Section 20161 as amended by this amendatory act is curative and intended to express the original intent of the
legislature regarding the application of 2002 PA 303 and 2002 PA 562, as amended by 2003 PA 113.
"(2) Section 20161 as amended by this amendatory act is retroactive and is effective for all quality assurance assessments made after
May 9, 2002."
Enacting section 1 of Act 187 of 2005 provides:
"Enacting section 1. Section 20161 of the public health code, 1978 PA 368, MCL 333.20161, as amended by this amendatory act is
retroactive and is effective for all quality assurance assessments made after September 30, 2005."
Enacting section 1 was enacted into law as follows:
"Enacting section 1. This amendatory act takes effect October 1, 2013."
Popular name: Act 368
Administrative rules: R 325.3801 et seq. of the Michigan Administrative Code.
333.20165a Action against health facility's treatment as authorized under right to try act;
definitions.
Sec. 20165a. (1) Except in the case of gross negligence or willful misconduct as determined by the
department, a health facility's cooperation in a treatment recommended by a health professional as authorized
under the right to try act, alone, is not grounds for the department to take any action against a licensee under
section 20165.
(2) As used in this section:
(a) "Gross negligence" means conduct so reckless as to demonstrate a substantial lack of concern for
whether serious injury to a person would result.
(b) "Willful misconduct" means conduct committed with an intentional or reckless disregard for the safety
of others, as by failing to exercise reasonable care to prevent a known danger.
History: Add. 2014, Act 346, Imd. Eff. Oct. 17, 2014.
333.20166 Notice of intent to deny, limit, suspend, or revoke license or certification; service;
contents; hearing; record; transcript; determination; powers of department; judicial order
to appear and give testimony; contempt; failure to show need for health facility or agency.
Sec. 20166. (1) Notice of intent to deny, limit, suspend, or revoke a license or certification shall be given
by certified mail or personal service, shall set forth the particular reasons for the proposed action, and shall fix
a date, not less that 30 days after the date of service, on which the applicant or licensee shall be given the
opportunity for a hearing before the director or the director's authorized representative. The hearing shall be
conducted in accordance with the administrative procedures act of 1969 and rules promulgated by the
department. A full and complete record shall be kept of the proceeding and shall be transcribed when
requested by an interested party, who shall pay the cost of preparing the transcript.
(2) On the basis of a hearing or on the default of the applicant or licensee, the department may issue, deny,
limit, suspend, or revoke a license or certification. A copy of the determination shall be sent by certified mail
or served personally upon the applicant or licensee. The determination becomes final 30 days after it is mailed
or served, unless the applicant or licensee within the 30 days appeals the decision to the circuit court in the
county of jurisdiction or to the Ingham county circuit court.
(3) The department may establish procedures, hold hearings, administer oaths, issue subpoenas, or order
testimony to be taken at a hearing or by deposition in a proceeding pending at any stage of the proceeding. A
person may be compelled to appear and testify and to produce books, papers, or documents in a proceeding.
(4) In case of disobedience of a subpoena, a party to a hearing may invoke the aid of the circuit court of the
jurisdiction in which the hearing is held to require the attendance and testimony of witnesses. The circuit
court may issue an order requiring an individual to appear and give testimony. Failure to obey the order of the
circuit court may be punished by the court as a contempt.
(5) The department shall not deny, limit, suspend, or revoke a license on the basis of an applicant's or
licensee's failure to show a need for a health facility or agency unless the health facility or agency has not
obtained a certificate of need required by part 222.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1988, Act 332, Eff. Oct. 1, 1988.
Compiler's note: In paragraph (1), the words not less that 30 days evidently should read not less than 30 days.
Popular name: Act 368
333.20169 HIV infected test subject; compliance with reporting requirements; definitions.
Sec. 20169. (1) A health facility or agency licensed under this article that obtains from a test subject a test
result that indicates that the test subject is HIV infected shall comply with the reporting requirements of
section 5114.
(2) As used in this section:
(a) HIV means human immunodeficiency virus.
(b) HIV infected means that term as defined in section 5101.
History: Add. 1988, Act 489, Eff. Mar. 30, 1989.
Popular name: Act 368
333.20171 Rules implementing article; rules promulgated under MCL 333.21563; rules
subject to MCL 554.917.
Sec. 20171. (1) The department, after obtaining approval of the advisory commission, shall promulgate and
enforce rules to implement this article, including rules necessary to enable a health facility or agency to
qualify for and receive federal funds available for patient care or for projects involving new construction,
additions, modernizations, or conversions.
(2) The rules applicable to health facilities or agencies shall be uniform insofar as is reasonable.
(3) The rules shall establish standards relating to:
(a) Ownership.
(b) Reasonable disclosure of ownership interests in proprietary corporations and of financial interests of
trustees of voluntary, nonprofit corporations and owners of proprietary corporations and partnerships.
(c) Organization and function of the health facility or agency, owner, operator, and governing body.
(d) Administration.
(e) Professional and nonprofessional staff, services, and equipment appropriate to implement section
20141(3).
(f) Policies and procedures.
(g) Fiscal and medical audit.
(h) Utilization and quality control review.
(i) Physical plant including planning, construction, functional design, sanitation, maintenance,
housekeeping, and fire safety.
(j) Arrangements for the continuing evaluation of the quality of health care provided.
(k) Other pertinent organizational, operational, and procedural requirements for each type of health facility
or agency.
(4) The rules promulgated under section 21563 for the designation of rural community hospitals may also
specify all of the following:
(a) Maximum bed size.
(b) The level of services to be provided in each category as described in section 21562(2).
(c) Requirements for transfer agreements with other hospitals to ensure efficient and appropriate patient
care.
(5) Rules promulgated under this article are subject to section 17 of the continuing care community
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disclosure act, MCL 554.917.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1978, Act 493, Eff. Mar. 30, 1979;Am. 1990, Act 252, Imd. Eff. Oct. 12, 1990;
Am. 2014, Act 449, Imd. Eff. Jan. 2, 2015.
Popular name: Act 368
Administrative rules: R 325.1001 et seq.; R 325.1801 et seq.; R 325.2301 et seq.; R 325.3801 et seq.; R 325.6001 et seq.; R
325.20101 et seq.; and R 325.23101 et seq. of the Michigan Administrative Code.
333.20175a Agreement with another health facility to protect, maintain, and provide access
to records; closure of health facility; noncompliance; fine; definitions.
Sec. 20175a. (1) If a health facility or agency is unable to comply with section 20175, the health facility or
agency shall employ or contract, arrange, or enter into an agreement with another health facility or agency or
a medical records company to protect, maintain, and provide access to those records required under section
20175(1).
(2) If a health facility or agency closes or otherwise ceases operation, the health facility or agency shall not
abandon the records required to be maintained under section 20175(1) and shall send a written notice to the
department that specifies who will have custody of the medical records and how a patient may request access
to or copies of his or her medical records and shall do either of the following:
(a) Transfer the records required under section 20175(1) to any of the following:
(i) A successor health facility or agency.
(ii) If designated by the patient or his or her authorized representative, to the patient or a specific health
facility or agency or a health care provider licensed or registered under article 15.
(iii) A health facility or agency or a medical records company with which the health facility or agency had
contracted or entered into an agreement to protect, maintain, and provide access to those records required
under section 20175(1).
(b) In accordance with section 20175(1), as long as the health facility or agency sends a written notice to
the last known address of each patient for whom he or she has provided medical services and receives written
authorization from the patient or his or her authorized representative, destroy the records required under
section 20175(1). The notice shall provide the patient with 30 days to request a copy of his or her record or to
designate where he or she would like his or her medical records transferred and shall request from the patient
within 30 days written authorization for the destruction of his or her medical records. If the patient fails to
request a copy or transfer of his or her medical records or to provide the health facility or agency with written
authorization for the destruction, then the health facility or agency shall not destroy those records that are less
than 7 years old but may destroy, in accordance with section 20175(1), those that are 7 years old or older.
(3) Nothing in this section shall be conducted to create or change the ownership rights to any medical
records.
(4) A person that fails to comply with this section is subject to an administrative fine of not more than
$10,000.00 if the failure was the result of gross negligence or willful and wanton misconduct.
(5) As used in this section:
(a) "Medical record" or "record" means information, oral or recorded in any form or medium, that pertains
to a patient's health care, medical history, diagnosis, prognosis, or medical condition and that is maintained by
a licensee in the process of providing medical services.
(b) "Medical records company" means a person who contracts for or agrees to protect, maintain, and
provide access to medical records for a health facility or agency in accordance with section 20175.
(c) "Patient" means an individual who receives or has received health care from a health care provider or
health facility or agency. Patient includes a guardian, if appointed, and a parent, guardian, or person acting in
loco parentis, if the individual is a minor, unless the minor lawfully obtained health care without the consent
or notification of a parent, guardian, or other person acting in loco parentis, in which case the minor has the
exclusive right to exercise the rights of a patient under this section with respect to his or her medical records
relating to that care.
History: Add. 2006, Act 481, Imd. Eff. Dec. 22, 2006.
Popular name: Act 368
333.20178 Nursing home, home for the aged, or county medical care facility; description of
services to patients or residents with Alzheimer's disease; contents; represents to the
public defined.
Sec. 20178. (1) Beginning not more than 90 days after the effective date of the amendatory act that added
this section, a health facility or agency that is a nursing home, home for the aged, or county medical care
facility that represents to the public that it provides inpatient care or services or residential care or services, or
both, to persons with Alzheimer's disease or a related condition shall provide to each prospective patient,
resident, or surrogate decision maker a written description of the services provided by the health facility or
agency to patients or residents with Alzheimer's disease or a related condition. A written description shall
include, but not be limited to, all of the following:
(a) The overall philosophy and mission reflecting the needs of patients or residents with Alzheimer's
disease or a related condition.
(b) The process and criteria for placement in or transfer or discharge from a program for patients or
residents with Alzheimer's disease or a related condition.
(c) The process used for assessment and establishment of a plan of care and its implementation.
(d) Staff training and continuing education practices.
(e) The physical environment and design features appropriate to support the function of patients or
residents with Alzheimer's disease or a related condition.
(f) The frequency and types of activities for patients or residents with Alzheimer's disease or a related
condition.
(g) Identification of supplemental fees for services provided to patients or residents with Alzheimer's
disease or a related condition.
(2) As used in this section, represents to the public means advertises or markets the facility as providing
specialized Alzheimer's or dementia care services.
History: Add. 2000, Act 500, Imd. Eff. Jan. 11, 2001.
Popular name: Act 368
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333.20179 Artificial insemination services on anonymous basis; use of frozen sperm; testing
sperm donor for presence of HIV or antibody to HIV; violation; liability; definitions.
Sec. 20179. (1) A health facility or agency licensed under this article that provides artificial insemination
services on an anonymous basis shall use only frozen sperm, and shall test each potential sperm donor for the
presence in the donor of HIV or an antibody to HIV. The donated sperm shall be frozen, stored, and
quarantined for not less than 6 months. Before frozen sperm is used for artificial insemination, and not less
than 6 months after the date of the donation, the health facility or agency shall take a second blood sample
from the donor and have that blood sample tested for HIV or an antibody to HIV. If at any time the test results
are positive, the health facility or agency licensed under this article shall not use the sperm of the donor for
artificial insemination purposes.
(2) A health facility or agency licensed under this article that violates this section shall be liable in a civil
action for damages for the loss or damage resulting from the violation.
(3) As used in this section:
(a) Anonymous basis means that the recipient of the sperm does not know the identity of the donor, but
the health facility or agency licensed under this article that provides the artificial insemination services or
collects the sperm from the donor does know the identity of the donor.
(b) HIV means human immunodeficiency virus.
History: Add. 1988, Act 487, Eff. July 1, 1989.
Popular name: Act 368
333.20181 Abortion; admitting patient not required; refusal to perform, participate in, or
allow; immunity.
Sec. 20181. A hospital, clinic, institution, teaching institution, or other health facility is not required to
admit a patient for the purpose of performing an abortion. A hospital, clinic, institution, teaching institution,
or other health facility or a physician, member, or associate of the staff, or other person connected therewith,
may refuse to perform, participate in, or allow to be performed on its premises an abortion. The refusal shall
be with immunity from any civil or criminal liability or penalty.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.20184 Rights of individuals, staff members, and employees previously participating in,
or expressing willingness to participate in, termination of pregnancy.
Sec. 20184. A hospital, clinic, institution, teaching institution, or other health facility which refuses to
allow abortions to be performed on its premises shall not deny staff privileges or employment to an individual
for the sole reason that the individual previously participated in, or expressed a willingness to participate in, a
termination of pregnancy. A hospital, clinic, institution, teaching institution, or other health facility shall not
discriminate against its staff members or other employees for the sole reason that the staff members or
employees have participated in, or have expressed a willingness to participate in, a termination of pregnancy.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
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333.20188 Repealed. 2004, Act 119, Eff. Nov. 27, 2005.
Compiler's note: The repealed section pertained to creation of commission on patient safety.
Popular name: Act 368
333.20191 Emergency patient; test for presence of infectious agent; positive test results;
duties of health facility; notice; request for testing; confidentiality; rules; disclosure as
misdemeanor; liability; definitions.
Sec. 20191. (1) If a police officer, fire fighter, individual licensed under section 20950 or 20952, or another
individual assists an emergency patient who is subsequently transported to a health facility or transports an
emergency patient to a health facility, and if the emergency patient, as part of the treatment rendered by the
health facility or pursuant to a request made under subsection (2), is tested for the presence in the emergency
patient of an infectious agent and the test results are positive, or is tested pursuant to a request made under
subsection (2) for the presence in the emergency patient of the infectious agent of HIV or HBV and the test
results are positive or negative, the health facility shall do all of the following:
(a) Subject to subsection (4) and subdivision (b), if the test results are positive for an infectious agent and
the individual meets 1 of the following requirements, notify the individual on a form provided by the
department that he or she may have been exposed to an infectious agent and, if the test results of a test
conducted pursuant to subsection (2) are negative for the infectious agent of HIV or HBV, notify the
individual of that fact:
(i) The individual is a police officer, fire fighter, or individual licensed under section 20950 or 20952.
(ii) The individual demonstrates in writing to the health facility that he or she was exposed to the blood,
body fluids, or airborne agents of the emergency patient or participated in providing assistance to the
emergency patient or transportation of the emergency patient to the health facility. An individual who makes a
request under subsection (2) is exempt from the requirements of this subparagraph.
(b) Subject to subsection (4), if the test results indicate that the emergency patient is HIV infected, the
health facility shall not reveal that the infectious agent is HIV unless the health facility has received a written
request for notification from an individual described in subdivision (a)(i) or (ii). This subdivision does not
apply if the test results indicate that the emergency patient is not HIV infected.
(c) Subject to subsection (4), on a form provided by the department, notify the individual described in
subdivision (a), at a minimum, of the appropriate infection control precautions to be taken and the
approximate date of the potential exposure. If the emergency patient is tested pursuant to a request made
under subsection (2) for the presence in the emergency patient of the infectious agent of HIV or HBV, or
both, and if the test results are positive or negative, the health facility also shall notify the individual described
in subdivision (a) on the form provided by the department that he or she should be tested for HIV infection or
HBV infection, or both, and counseled regarding both infectious agents.
(2) A police officer, fire fighter, individual licensed under section 20950 or 20952, or other individual who
assists an emergency patient who is subsequently transported to a health facility or who transports an
emergency patient to a health facility and who sustains a percutaneous, mucous membrane, or open wound
exposure to the blood or body fluids of the emergency patient may request that the emergency patient be
tested for HIV infection or HBV infection, or both, pursuant to this subsection. The police officer, fire fighter,
individual licensed under section 20950 or 20952, or other individual shall make a request to a health facility
under this subsection in writing on a form provided by the department and before the emergency patient is
discharged from the health facility. The request form shall be dated and shall contain at a minimum the name
and address of the individual making the request and a description of the individual's exposure to the
emergency patient's blood or other body fluids. The request form shall contain a space for the information
required under subsection (3) and a statement that the requester is subject to the confidentiality requirements
of subsection (5) and section 5131. The request form shall not contain information that would identify the
emergency patient by name. A health facility that receives a request under this subsection shall accept as fact
the requester's description of his or her exposure to the emergency patient's blood or other body fluids, unless
the health facility has reasonable cause to believe otherwise. The health facility shall make a determination as
to whether or not the exposure described in the request was a percutaneous, mucous membrane, or open
wound exposure pursuant to R 325.70001 to R 325.70018 of the Michigan administrative code. If the health
facility determines that the exposure described in the request was a percutaneous, mucous membrane, or open
wound exposure, the health facility shall test the emergency patient for HIV infection or HBV infection, or
both, as indicated in the request. A health facility that performs a test under this subsection may charge the
individual requesting the test for the reasonable and customary charges of the test. The individual requesting
the test is responsible for the payment of the charges if the charges are not payable by the individual's
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employer, pursuant to an agreement between the individual and the employer, or by the individual's health
care payment or benefits plan. A health facility is not required to provide HIV counseling pursuant to section
5133(1) to an individual who requests that an emergency patient be tested for HIV under this subsection,
unless the health facility tests the requesting individual for HIV.
(3) A health facility shall comply with this subsection if the health facility receives a request under
subsection (2) and determines either that there is reasonable cause to disbelieve the requester's description of
his or her exposure or that the exposure was not a percutaneous, mucous membrane, or open wound exposure
and as a result of the determination the health facility is not required to test the emergency patient for HIV
infection or HBV infection, or both. A health facility shall also comply with this subsection if the health
facility receives a request under subsection (2) and determines that the exposure was a percutaneous, mucous
membrane, or open wound exposure, but is unable to test the emergency patient for HIV infection or HBV
infection, or both. The health facility shall state in writing on the request form the reasons for disbelieving the
requester's description of his or her exposure, the health facility's exposure determination, or the inability to
test the emergency patient, as applicable. The health facility shall transmit a copy of the completed request
form to the requesting individual within 2 days after the date the determination is made that the health facility
has reasonable cause to disbelieve the requester's description of his or her exposure or that the exposure was
not a percutaneous, mucous membrane, or open wound exposure or within 2 days after the date the health
facility determines that it is unable to test the emergency patient for HIV infection or HBV infection, or both.
(4) The notification required under subsection (1) shall occur within 2 days after the test results are
obtained by the health facility or after receipt of a written request under subsection (1)(b). The notification
shall be transmitted to the potentially exposed individual or, upon request of the individual, to the individual's
primary care physician or other health professional designated by the individual, as follows:
(a) If the potentially exposed individual provides his or her name and address or the name and address of
the individual's primary care physician or other health professional designated by the individual to the health
facility or if the health facility has a procedure that allows the health facility in the ordinary course of its
business to determine the individual's name and address or the name and address of the individual's primary
care physician or other health professional designated by the individual, the health facility shall notify the
individual or the individual's primary care physician or other health professional designated by the individual
directly at that address.
(b) If the potentially exposed individual is a police officer, fire fighter, or individual licensed under section
20950 or 20952, and if the health facility does not have the name of the potentially exposed individual or the
individual's primary care physician or other health professional designated by the individual, the health
facility shall notify the appropriate police department, fire department, or life support agency that employs or
dispatches the individual. If the health facility is unable to determine the employer of an individual described
in this subdivision, the health facility shall notify the medical control authority or chief elected official of the
governmental unit that has jurisdiction over the transporting vehicle.
(c) A medical control authority or chief elected official described in subdivision (b) shall notify the
potentially exposed individual or the individual's primary care physician or other health professional
designated by the individual or, if unable to notify the potentially exposed individual or the individual's
primary care physician or other health professional designated by the individual, shall document in writing the
notification efforts and reasons for being unable to make the notification.
(5) The notice required under subsection (1) shall not contain information that would identify the
emergency patient who tested positive for an infectious agent or who tested positive or negative for the
presence in the emergency patient of the infectious agent of HIV or HBV. The information contained in the
notice is confidential and is subject to this section, the rules promulgated under section 5111, and section
5131. A person who receives confidential information under this section shall disclose the information to
others only to the extent consistent with the authorized purpose for which the information was obtained.
(6) The department shall promulgate rules to administer this section. The department shall develop and
distribute the forms required under subsections (1)(a) and (c) and (2).
(7) Except as otherwise provided in this subsection, a person who discloses information regarding an
infectious agent in violation of subsection (5) is guilty of a misdemeanor. This subsection does not apply to
the disclosure of information regarding a serious communicable disease or infection, if the disclosure is
subject to rules promulgated under section 5111 or to section 5131.
(8) A person or governmental entity that makes a good faith effort to comply with subsection (1), (2), (3),
or (4) is immune from any civil liability or criminal penalty based on compliance or the failure to comply.
(9) As used in this section:
(a) "Emergency patient" means an individual who is transported to an organized emergency department
located in and operated by a hospital licensed under this article or a facility other than a hospital that is
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routinely available for the general care of medical patients.
(b) "HBV" means hepatitis B virus.
(c) "HBV infected" or "HBV infection" means the status of an individual who is tested as HBsAg-positive.
(d) "Health facility" means a health facility or agency as defined in section 20106.
(e) "HIV" means human immunodeficiency virus.
(f) "HIV infected" means that term as defined in section 5101.
(g) "Infectious agent" means that term as defined in R 325.9031 of the Michigan administrative code.
(h) "Life support agency" means that term as defined in section 20906.
(i) "Serious communicable disease or infection" means that term as defined in section 5101.
History: Add. 1988, Act 490, Eff. Mar. 30, 1989;Am. 1990, Act 179, Imd. Eff. July 2, 1990;Am. 1994, Act 419, Eff. Mar 30,
1995;Am. 2010, Act 119, Imd. Eff. July 13, 2010.
Popular name: Act 368
333.20193 Compliance.
Sec. 20193. A health facility or agency shall comply with part 138.
History: Add. 1990, Act 21, Eff. June 4, 1990.
Popular name: Act 368
333.20198 Health facility, agency inpatient facility, or residential facility; prohibited conduct;
violation as misdemeanor; penalty; nonapplicability of subsections (1) and (2).
Sec. 20198. (1) Subject to subsection (3), an individual shall not enter upon the premises of a health
facility or agency that is an inpatient facility, an outpatient facility, or a residential facility for the purpose of
engaging in an activity that would cause a reasonable person to feel terrorized, frightened, intimidated,
threatened, harassed, or molested and that actually causes a health facility or agency employee, patient,
resident, or visitor to feel terrorized, frightened, intimidated, threatened, harassed, or molested. This
subsection does not prohibit constitutionally protected activity or conduct that serves a legitimate purpose.
(2) An individual who violates subsection (1) is guilty of a misdemeanor, punishable by imprisonment for
not more than 1 year or a fine of not less than $1,000.00 or more than $10,000.00, or both.
(3) Subsections (1) and (2) do not apply to a nursing home covered under sections 21763(5) and
21799c(1)(c).
History: Add. 1998, Act 270, Eff. Mar. 23, 1999.
Popular name: Act 368
***** 333.20201 THIS SECTION IS AMENDED EFFECTIVE AUGUST 1, 2017: See 333.20201.amended
*****
333.20201 Policy describing rights and responsibilities of patients or residents; adoption;
posting and distribution; contents; additional requirements; discharging, harassing,
retaliating, or discriminating against patient exercising protected right; exercise of rights
by patient's representative; informing patient or resident of policy; designation of person
to exercise rights and responsibilities; additional patients' rights; definitions.
Sec. 20201. (1) A health facility or agency that provides services directly to patients or residents and is
licensed under this article shall adopt a policy describing the rights and responsibilities of patients or residents
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admitted to the health facility or agency. Except for a licensed health maintenance organization, which shall
comply with chapter 35 of the insurance code of 1956, 1956 PA 218, MCL 500.3501 to 500.3580, the policy
shall be posted at a public place in the health facility or agency and shall be provided to each member of the
health facility or agency staff. Patients or residents shall be treated in accordance with the policy.
(2) The policy describing the rights and responsibilities of patients or residents required under subsection
(1) shall include, as a minimum, all of the following:
(a) A patient or resident shall not be denied appropriate care on the basis of race, religion, color, national
origin, sex, age, disability, marital status, sexual preference, or source of payment.
(b) An individual who is or has been a patient or resident is entitled to inspect, or receive for a reasonable
fee, a copy of his or her medical record upon request in accordance with the medical records access act, 2004
PA 47, MCL 333.26261 to 333.26271. Except as otherwise permitted or required under the health insurance
portability and accountability act of 1996, Public Law 104-191, or regulations promulgated under that act, 45
CFR parts 160 and 164, a third party shall not be given a copy of the patient's or resident's medical record
without prior authorization of the patient or resident.
(c) A patient or resident is entitled to confidential treatment of personal and medical records, and may
refuse their release to a person outside the health facility or agency except as required because of a transfer to
another health care facility, as required by law or third party payment contract, or as permitted or required
under the health insurance portability and accountability act of 1996, Public Law 104-191, or regulations
promulgated under that act, 45 CFR parts 160 and 164.
(d) A patient or resident is entitled to privacy, to the extent feasible, in treatment and in caring for personal
needs with consideration, respect, and full recognition of his or her dignity and individuality.
(e) A patient or resident is entitled to receive adequate and appropriate care, and to receive, from the
appropriate individual within the health facility or agency, information about his or her medical condition,
proposed course of treatment, and prospects for recovery, in terms that the patient or resident can understand,
unless medically contraindicated as documented in the medical record by the attending physician or a
physician's assistant to whom the physician has delegated the performance of medical care services.
(f) A patient or resident is entitled to refuse treatment to the extent provided by law and to be informed of
the consequences of that refusal. If a refusal of treatment prevents a health facility or agency or its staff from
providing appropriate care according to ethical and professional standards, the relationship with the patient or
resident may be terminated upon reasonable notice.
(g) A patient or resident is entitled to exercise his or her rights as a patient or resident and as a citizen, and
to this end may present grievances or recommend changes in policies and services on behalf of himself or
herself or others to the health facility or agency staff, to governmental officials, or to another person of his or
her choice within or outside the health facility or agency, free from restraint, interference, coercion,
discrimination, or reprisal. A patient or resident is entitled to information about the health facility's or
agency's policies and procedures for initiation, review, and resolution of patient or resident complaints.
(h) A patient or resident is entitled to information concerning an experimental procedure proposed as a part
of his or her care and has the right to refuse to participate in the experimental procedure without jeopardizing
his or her continuing care.
(i) A patient or resident is entitled to receive and examine an explanation of his or her bill regardless of the
source of payment and to receive, upon request, information relating to financial assistance available through
the health facility or agency.
(j) A patient or resident is entitled to know who is responsible for and who is providing his or her direct
care, is entitled to receive information concerning his or her continuing health needs and alternatives for
meeting those needs, and to be involved in his or her discharge planning, if appropriate.
(k) A patient or resident is entitled to associate and have private communications and consultations with
his or her physician or a physician's assistant to whom the physician has delegated the performance of medical
care services, attorney, or any other person of his or her choice and to send and receive personal mail
unopened on the same day it is received at the health facility or agency, unless medically contraindicated as
documented in the medical record by the attending physician or a physician's assistant to whom the physician
has delegated the performance of medical care services. A patient's or resident's civil and religious liberties,
including the right to independent personal decisions and the right to knowledge of available choices, shall
not be infringed and the health facility or agency shall encourage and assist in the fullest possible exercise of
these rights. A patient or resident may meet with, and participate in, the activities of social, religious, and
community groups at his or her discretion, unless medically contraindicated as documented in the medical
record by the attending physician or a physician's assistant to whom the physician has delegated the
performance of medical care services.
(l) A patient or resident is entitled to be free from mental and physical abuse and from physical and
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chemical restraints, except those restraints authorized in writing by the attending physician or a physician's
assistant to whom the physician has delegated the performance of medical care services for a specified and
limited time or as are necessitated by an emergency to protect the patient or resident from injury to self or
others, in which case the restraint may only be applied by a qualified professional who shall set forth in
writing the circumstances requiring the use of restraints and who shall promptly report the action to the
attending physician or physician's assistant. In case of a chemical restraint, a physician shall be consulted
within 24 hours after the commencement of the chemical restraint.
(m) A patient or resident is entitled to be free from performing services for the health facility or agency
that are not included for therapeutic purposes in the plan of care.
(n) A patient or resident is entitled to information about the health facility or agency rules and regulations
affecting patient or resident care and conduct.
(o) A patient or resident is entitled to adequate and appropriate pain and symptom management as a basic
and essential element of his or her medical treatment.
(3) The following additional requirements for the policy described in subsection (2) apply to licensees
under parts 213 and 217:
(a) The policy shall be provided to each nursing home patient or home for the aged resident upon
admission, and the staff of the facility shall be trained and involved in the implementation of the policy.
(b) Each nursing home patient may associate and communicate privately with persons of his or her choice.
Reasonable, regular visiting hours, which shall be not less than 8 hours per day, and which shall take into
consideration the special circumstances of each visitor, shall be established for patients to receive visitors. A
patient may be visited by the patient's attorney or by representatives of the departments named in section
20156, during other than established visiting hours. Reasonable privacy shall be afforded for visitation of a
patient who shares a room with another patient. Each patient shall have reasonable access to a telephone. A
married nursing home patient or home for the aged resident is entitled to meet privately with his or her spouse
in a room that assures privacy. If both spouses are residents in the same facility, they are entitled to share a
room unless medically contraindicated and documented in the medical record by the attending physician or a
physician's assistant to whom the physician has delegated the performance of medical care services.
(c) A nursing home patient or home for the aged resident is entitled to retain and use personal clothing and
possessions as space permits, unless to do so would infringe upon the rights of other patients or residents, or
unless medically contraindicated as documented in the medical record by the attending physician or a
physician's assistant to whom the physician has delegated the performance of medical care services. Each
nursing home patient or home for the aged resident shall be provided with reasonable space. At the request of
a patient, a nursing home shall provide for the safekeeping of personal effects, funds, and other property of a
patient in accordance with section 21767, except that a nursing home is not required to provide for the
safekeeping of a property that would impose an unreasonable burden on the nursing home.
(d) A nursing home patient or home for the aged resident is entitled to the opportunity to participate in the
planning of his or her medical treatment. The attending physician or a physician's assistant to whom the
physician has delegated the performance of medical care services shall fully inform the nursing home patient
of the patient's medical condition unless medically contraindicated as documented in the medical record by a
physician or a physician's assistant to whom the physician has delegated the performance of medical care
services. Each nursing home patient shall be afforded the opportunity to discharge himself or herself from the
nursing home.
(e) A home for the aged resident may be transferred or discharged only for medical reasons, for his or her
welfare or that of other residents, or for nonpayment of his or her stay, except as provided by title XVIII or
title XIX. A nursing home patient may be transferred or discharged only as provided in sections 21773 to
21777. A nursing home patient or home for the aged resident is entitled to be given reasonable advance notice
to ensure orderly transfer or discharge. Those actions shall be documented in the medical record.
(f) A nursing home patient or home for the aged resident is entitled to be fully informed before or at the
time of admission and during stay of services available in the facility, and of the related charges including any
charges for services not covered under title XVIII, or not covered by the facility's basic per diem rate. The
statement of services provided by the facility shall be in writing and shall include those required to be offered
on an as-needed basis.
(g) A nursing home patient or home for the aged resident is entitled to manage his or her own financial
affairs, or to have at least a quarterly accounting of personal financial transactions undertaken in his or her
behalf by the facility during a period of time the patient or resident has delegated those responsibilities to the
facility. In addition, a patient or resident is entitled to receive each month from the facility an itemized
statement setting forth the services paid for by or on behalf of the patient and the services rendered by the
facility. The admission of a patient to a nursing home does not confer on the nursing home or its owner,
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administrator, employees, or representatives the authority to manage, use, or dispose of a patient's property.
(h) A nursing home patient or a person authorized by the patient in writing may inspect and copy the
patient's personal and medical records. The records shall be made available for inspection and copying by the
nursing home within a reasonable time, not exceeding 1 week, after the receipt of a written request.
(i) If a nursing home patient desires treatment by a licensed member of the healing arts, the treatment shall
be made available unless it is medically contraindicated, and the medical contraindication is justified in the
patient's medical record by the attending physician or a physician's assistant to whom the physician has
delegated the performance of medical care services.
(j) A nursing home patient has the right to have his or her parents, if a minor, or his or her spouse, next of
kin, or patient's representative, if an adult, stay at the facility 24 hours a day if the patient is considered
terminally ill by the physician responsible for the patient's care or a physician's assistant to whom the
physician has delegated the performance of medical care services.
(k) Each nursing home patient shall be provided with meals that meet the recommended dietary allowances
for that patient's age and sex and that may be modified according to special dietary needs or ability to chew.
(l) Each nursing home patient has the right to receive representatives of approved organizations as
provided in section 21763.
(4) A nursing home, its owner, administrator, employee, or representative shall not discharge, harass, or
retaliate or discriminate against a patient because the patient has exercised a right protected under this section.
(5) In the case of a nursing home patient, the rights enumerated in subsection (2)(c), (g), and (k) and
subsection (3)(d), (g), and (h) may be exercised by the patient's representative.
(6) A nursing home patient or home for the aged resident is entitled to be fully informed, as evidenced by
the patient's or resident's written acknowledgment, before or at the time of admission and during stay, of the
policy required by this section. The policy shall provide that if a patient or resident is adjudicated incompetent
and not restored to legal capacity, the rights and responsibilities set forth in this section shall be exercised by a
person designated by the patient or resident. The health facility or agency shall provide proper forms for the
patient or resident to provide for the designation of this person at the time of admission.
(7) This section does not prohibit a health facility or agency from establishing and recognizing additional
patients' rights.
(8) As used in this section:
(a) "Patient's representative" means that term as defined in section 21703.
(b) "Title XVIII" means title XVIII of the social security act, 42 USC 1395 to 1395kkk-1.
(c) "Title XIX" means title XIX of the social security act, 42 USC 1396 to 1396w-5.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1978, Act 493, Eff. Mar. 30, 1979;Am. 1982, Act 354, Imd. Eff. Dec. 21, 1982;
Am. 1998, Act 88, Imd. Eff. May 13, 1998;Am. 2001, Act 240, Imd. Eff. Jan. 8, 2002;Am. 2006, Act 38, Imd. Eff. Mar. 2, 2006;
Am. 2011, Act 210, Imd. Eff. Nov. 8, 2011.
Popular name: Act 368
Popular name: Patient Rights
333.20203 Guidelines; immunity; other remedies at law neither expanded nor diminished.
Sec. 20203. (1) The rights and responsibilities prescribed in sections 20201 and 20202 are guidelines for
health facilities, facility staff, facility employees, patients, and residents. An individual shall not be civilly or
criminally liable for failure to comply with those sections.
(2) Sections 20201 and 20202 shall not be construed to expand or diminish other remedies at law available
to a patient or resident under this code or the statutory and common law of this state.
(3) The department shall develop guidelines to assist health facilities and agencies in the implementation of
sections 20201 and 20202.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
PART 203
AMBULANCE OPERATIONS AND ADVANCED MOBILE EMERGENCY CARE SERVICES
333.20301-333.20382 Repealed. 1981, Act 79, Imd. Eff. June 30, 1981.
Popular name: Act 368
PART 204
MEDICAL GOOD-FAITH PROVISIONS
333.20401 Short title of part.
Sec. 20401. This part shall be known and may be cited as the "medical good-faith provisions act".
History: Add. 2013, Act 57, Eff. Sept. 10, 2013.
Popular name: Act 368
PART 205
CLINICAL AND OTHER LABORATORIES
333.20501 "Laboratory" defined; principles of construction.
Sec. 20501. (1) As used in this part, "laboratory" means a facility for the biological, microbiological,
serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other
examination of materials derived from the human body for the purpose of providing information for the
diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of the health of, human
beings.
(2) In addition, article 1 contains general definitions and principles of construction applicable to all articles
in this code.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2015, Act 104, Eff. Oct. 1, 2015.
Compiler's note: For transfer of powers and duties of the division of health facility licensing and certification in the bureau of health
systems, division of federal support services, and the division of emergency medical services, with the exception of the division of
managed care and division of health facility development, from the department of public health to the director of the department of
commerce, see E.R.O. No. 1996-1, compiled at MCL 330.3101 of the Michigan Compiled Laws.
For transfer of powers and duties of the bureau of health services from the department of consumer and industry services to the
director of the department of community health by Type II transfer, see E.R.O. No. 2003-1, compiled at MCL 445.2011.
Popular name: Act 368
333.20521 Authorization to order laboratory test classified by Food and Drug Administration.
Sec. 20521. Only a physician, dentist, or other person authorized by law can order a laboratory test that has
been classified by the Food and Drug Administration as moderate or high complexity. A laboratory test that is
classified by the Food and Drug Administration as waived does not require an order.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2015, Act 104, Eff. Oct. 1, 2015.
Popular name: Act 368
333.20554 Sale, gift, or other distribution of live pathogenic microorganisms and cultures or
recombinant deoxyribonucleic acid materials; contents of label on container; record.
Sec. 20554. Live pathogenic bacteria, fungi, mycoplasma, parasites, viruses, or other microorganisms or
cultures of the microorganisms when sold, given away, or shipped by a laboratory or other person, shall bear a
label on the container showing the registration number of the laboratory or other person sending the
specimens and the name and address of the person to whom sent. A laboratory or person shall not sell or
convey a live pathogenic microorganism or recombinant deoxyribonucleic acid materials to any other
laboratory or person in this state without permission of the department unless each is registered under section
20551 or 20552. The laboratory or person shall keep a record of each sale, gift, or other distribution of live
pathogenic microorganisms and cultures or recombinant deoxyribonucleic acid materials containing the name
and laboratory address of the recipient or purchaser. The record shall be at all times open to examination and
copying by a representative of the department.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
PART 206
COUNTY MEDICAL CARE FACILITIES
333.20601-333.20621 Repealed. 1978, Act 493, Eff. Mar. 30, 1979.
Popular name: Act 368
PART 207
EMERGENCY MEDICAL SERVICES
333.20701-333.20773 Expired. 1981, Act 79, Eff. Sept. 30, 1989;Repealed, 1990, Act 179,
Imd. Eff. July 2, 1990.
Popular name: Act 368
PART 208
FREESTANDING SURGICAL OUTPATIENT FACILITIES
333.20801 General definitions and principles of construction.
Sec. 20801. Article 1 contains general definitions and principles of construction applicable to all articles in
this code and part 201 contains definitions applicable to this part.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Compiler's note: For transfer of powers and duties of the division of health facility licensing and certification in the bureau of health
systems, division of federal support services, and the division of emergency medical services, with the exception of the division of
managed care and division of health facility development, from the department of public health to the director of the department of
commerce, see E.R.O. No. 1996-1, compiled at MCL 330.3101 of the Michigan Compiled Laws.
For transfer of powers and duties of the bureau of health services from the department of consumer and industry services to the
director of the department of community health by Type II transfer, see E.R.O. No. 2003-1, compiled at MCL 445.2011.
Popular name: Act 368
333.20813 Owner, operator, and governing body of freestanding surgical outpatient facility;
responsibilities and duties.
Sec. 20813. The owner, operator, and governing body of a freestanding surgical outpatient facility licensed
under this article:
(a) Are responsible for all phases of the operation of the facility, selection of medical staff, and quality of
care rendered in the facility.
(b) Shall cooperate with the department in the enforcement of this article and require that the physicians
and other personnel working in the facility and for whom a state license or registration is required be currently
licensed or registered.
(c) Shall assure that physicians admitted to practice in the facility are granted professional privileges
consistent with the capability of the facility and with the physicians' individual training, experience, and other
qualifications.
(d) Shall assure that physicians admitted to practice in the facility are organized into a medical staff to
enable an effective review of the professional practices of the facility for the purpose of reducing morbidity
and mortality and improving the care provided in the facility for patients.
(e) Shall assure that the facility does not pay a fee to compensate or reimburse a medical referral agency or
other person that refers or recommends an individual to a facility for any form of medical or surgical care or
treatment.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
PART 209
EMERGENCY MEDICAL SERVICES
333.20901 Meanings of words and phrases; general definitions and principles of
construction.
Sec. 20901. (1) For purposes of this part, the words and phrases defined in sections 20902 to 20908 have
the meanings ascribed to them in those sections.
(2) In addition, article 1 contains general definitions and principles of construction applicable to all articles
in this code, and part 201 contains definitions applicable to this part.
History: Add. 1990, Act 179, Imd. Eff. July 2, 1990.
Compiler's note: For transfer of powers and duties of the division of health facility licensing and certification in the bureau of health
systems, division of federal support services, and the division of emergency medical services, with the exception of the division of
managed care and division of health facility development, from the department of public health to the director of the department of
commerce, see E.R.O. No. 1996-1, compiled at MCL 330.3101 of the Michigan Compiled Laws.
For transfer of powers and duties of the bureau of health services from the department of consumer and industry services to the
director of the department of community health by Type II transfer, see E.R.O. No. 2003-1, compiled at MCL 445.2011.
For transfer of powers and duties of department of licensing and regulatory affairs relative to registration, licensing, or regulation of
professional occupations arising from part 209 of the Michigan public health code, including any board, commission, council, or similar
entity providing regulation of health professionals licensed, registered, or certified under part 209 of article 17 of the Michigan public
health code, to the department of community health, see E.R.O. No. 2014-2, compiled at MCL 333.26253.
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Popular name: Act 368
333.20902 Definitions; A to D.
Sec. 20902. (1) Advanced life support means patient care that may include any care a paramedic is
qualified to provide by paramedic education that meets the educational requirements established by the
department under section 20912 or is authorized to provide by the protocols established by the local medical
control authority under section 20919 for a paramedic.
(2) Aircraft transport operation means a person licensed under this part to provide patient transport, for
profit or otherwise, between health facilities using an aircraft transport vehicle.
(3) Aircraft transport vehicle means an aircraft that is primarily used or designated as available to
provide patient transportation between health facilities and that is capable of providing patient care according
to orders issued by the patient's physician.
(4) Ambulance means a motor vehicle or rotary aircraft that is primarily used or designated as available
to provide transportation and basic life support, limited advanced life support, or advanced life support.
(5) Ambulance operation means a person licensed under this part to provide emergency medical services
and patient transport, for profit or otherwise.
(6) Basic life support means patient care that may include any care an emergency medical technician is
qualified to provide by emergency medical technician education that meets the educational requirements
established by the department under section 20912 or is authorized to provide by the protocols established by
the local medical control authority under section 20919 for an emergency medical technician.
(7) Clinical preceptor means an individual who is designated by or under contract with an education
program sponsor for purposes of overseeing the students of an education program sponsor during the
participation of the students in clinical training.
(8) Disaster means an occurrence of imminent threat of widespread or severe damage, injury, or loss of
life or property resulting from a natural or man-made cause, including but not limited to, fire, flood, snow,
ice, windstorm, wave action, oil spill, water contamination requiring emergency action to avert danger or
damage, utility failure, hazardous peacetime radiological incident, major transportation accident, hazardous
materials accident, epidemic, air contamination, drought, infestation, or explosion. Disaster does not include a
riot or other civil disorder unless it directly results from and is an aggravating element of the disaster.
History: Add. 1990, Act 179, Imd. Eff. July 2, 1990;Am. 2000, Act 375, Imd. Eff. Jan. 2, 2001.
Popular name: Act 368
333.20904 Definitions; E.
Sec. 20904. (1) Education program sponsor means a person, other than an individual, that meets the
standards of the department to conduct training at the following levels:
(a) Medical first responder.
(b) Emergency medical technician.
(c) Emergency medical technician specialist.
(d) Paramedic.
(e) Emergency medical services instructor-coordinator.
(2) Emergency means a condition or situation in which an individual declares a need for immediate
medical attention for any individual, or where that need is declared by emergency medical services personnel
or a public safety official.
(3) Emergency medical services instructor-coordinator means an individual licensed under this part to
conduct and instruct emergency medical services education programs.
(4) Emergency medical services means the emergency medical services personnel, ambulances,
nontransport prehospital life support vehicles, aircraft transport vehicles, medical first response vehicles, and
equipment required for transport or treatment of an individual requiring medical first response life support,
basic life support, limited advanced life support, or advanced life support.
(5) Emergency medical services personnel means a medical first responder, emergency medical
technician, emergency medical technician specialist, paramedic, or emergency medical services
instructor-coordinator.
(6) Emergency medical services system means a comprehensive and integrated arrangement of the
personnel, facilities, equipment, services, communications, medical control, and organizations necessary to
provide emergency medical services and trauma care within a particular geographic region.
(7) Emergency medical technician means an individual who is licensed by the department to provide
basic life support.
(8) Emergency medical technician specialist means an individual who is licensed by the department to
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provide limited advanced life support.
(9) Emergency patient means an individual with a physical or mental condition that manifests itself by
acute symptoms of sufficient severity, including, but not limited to, pain such that a prudent layperson,
possessing average knowledge of health and medicine, could reasonably expect to result in 1 or all of the
following:
(a) Placing the health of the individual or, in the case of a pregnant woman, the health of the patient or the
unborn child, or both, in serious jeopardy.
(b) Serious impairment of bodily function.
(c) Serious dysfunction of a body organ or part.
(10) Examination means a written and practical evaluation approved or developed by the national
registry of emergency medical technicians or other organization with equivalent national recognition and
expertise in emergency medical services personnel testing and approved by the department.
History: Add. 1990, Act 179, Imd. Eff. July 2, 1990;Am. 2000, Act 375, Imd. Eff. Jan. 2, 2001.
Popular name: Act 368
333.20906 Definitions; L, M.
Sec. 20906. (1) "Life support agency" means an ambulance operation, nontransport prehospital life support
operation, aircraft transport operation, or medical first response service.
(2) "Life support vehicle" means an ambulance, nontransport prehospital life support vehicle, aircraft
transport vehicle, or medical first response vehicle.
(3) "Limited advanced life support" means patient care that may include any care an emergency medical
technician specialist is qualified to provide by emergency medical technician specialist education that meets
the educational requirements established by the department under section 20912 or is authorized to provide by
the protocols established by the local medical control authority under section 20919 for an emergency medical
technician specialist.
(4) "Local governmental unit" means a county, city, village, charter township, or township.
(5) "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.
(6) "Medical control authority" means an organization designated by the department under section
20910(1)(g) to provide medical control.
(7) "Medical director" means a physician who is appointed to that position by a medical control authority
under section 20918.
(8) "Medical first responder" means an individual who has met the educational requirements of a
department approved medical first responder course and who is licensed to provide medical first response life
support as part of a medical first response service or as a driver of an ambulance that provides basic life
support services only. Medical first responder does not include a police officer solely because his or her
police vehicle is equipped with an automated external defibrillator.
(9) "Medical first response life support" means patient care that may include any care a medical first
responder is qualified to provide by medical first responder education that meets the educational requirements
established by the department under section 20912 or is authorized to provide by the protocols established by
the local medical control authority under section 20919 for a medical first responder.
(10) "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 an ambulance, and includes a fire suppression agency only if it is dispatched for medical
first response life support. Medical first response service does not include a law enforcement agency, as
defined in section 8 of 1968 PA 319, MCL 28.258, unless the law enforcement agency holds itself out as a
medical first response service and the unit responding was dispatched to provide medical first response life
support.
(11) "Medical first response vehicle" means a motor vehicle staffed by at least 1 medical first responder
and meeting equipment requirements of the department. Medical first response vehicle does not include a
vehicle solely because it is staffed with a medical first responder.
History: Add. 1990, Act 179, Imd. Eff. July 2, 1990;Am. 2000, Act 375, Imd. Eff. Jan. 2, 2001;Am. 2004, Act 6, Imd. Eff. Feb.
20, 2004;Am. 2006, Act 582, Imd. Eff. Jan. 3, 2007.
Popular name: Act 368
333.20908 Definitions; N to V.
Sec. 20908. (1) "Nonemergency patient" means an individual who is transported by stretcher, isolette, cot,
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or litter but whose physical or mental condition is such that the individual may reasonably be suspected of not
being in imminent danger of loss of life or of significant health impairment.
(2) "Nontransport prehospital life support operation" means a person licensed under this part to provide,
for profit or otherwise, basic life support, limited advanced life support, or advanced life support at the scene
of an emergency.
(3) "Nontransport prehospital life support vehicle" means a motor vehicle that is used to provide basic life
support, limited advanced life support, or advanced life support, and is not intended to transport patients.
(4) "Ongoing education program sponsor" means an education program sponsor that provides continuing
education for emergency medical services personnel.
(5) "Paramedic" means an individual licensed under this part to provide advanced life support.
(6) "Patient" means an emergency patient or a nonemergency patient.
(7) "Person" means a person as defined in section 1106 or a governmental entity other than an agency of
the United States.
(8) "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.
(9) "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.
(10) "Statewide emergency medical services communications system" means a system that integrates each
emergency medical services system with a centrally coordinated dispatch and resource coordination facility
utilizing the universal emergency telephone number, 9-1-1, when that number is appropriate, or any other
designated emergency telephone number, a statewide emergency medical 2-way radio communications
network, and linkages with the statewide emergency preparedness communications system.
(11) "Statewide trauma care system" means a comprehensive and integrated arrangement of the 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.
(12) "Volunteer" means an individual who provides services regulated under this part without expecting or
receiving money, goods, or services in return for providing those services, except for reimbursement for
expenses necessarily incurred in providing those services.
History: Add. 1990, Act 179, Imd. Eff. July 2, 1990;Am. 2000, Act 375, Imd. Eff. Jan. 2, 2001;Am. 2004, Act 581, Imd. Eff.
Jan. 4, 2005.
Popular name: Act 368
333.20919 Protocols for practice of life support agencies and licensed emergency medical
services personnel; development and adoption; procedures; conflict with Michigan
do-not-resuscitate procedure act prohibited; requirements; appeal; standards for
equipment and personnel; negative medical or economic impacts; epinephrine
auto-injector; availability of medical and economic information; review; findings.
Sec. 20919. (1) A medical control authority shall establish written protocols for the practice of life support
agencies and licensed emergency medical services personnel within its region. The medical control authority
shall develop and adopt the protocols required under this section in accordance with procedures established by
the department and shall include all of the following:
(a) The acts, tasks, or functions that may be performed by each type of emergency medical services
personnel licensed under this part.
(b) Medical protocols to ensure the appropriate dispatching of a life support agency based upon medical
need and the capability of the emergency medical services system.
(c) Protocols for complying with the Michigan do-not-resuscitate procedure act, 1996 PA 193, MCL
333.1051 to 333.1067.
(d) Protocols defining the process, actions, and sanctions a medical control authority may use in holding a
life support agency or personnel accountable.
(e) Protocols to ensure that if the medical control authority determines that an immediate threat to the
public health, safety, or welfare exists, appropriate action to remove medical control can immediately be
taken until the medical control authority has had the opportunity to review the matter at a medical control
authority hearing. The protocols must require that the hearing is held within 3 business days after the medical
control authority's determination.
(f) Protocols to ensure that if medical control has been removed from a participant in an emergency
medical services system, the participant does not provide prehospital care until medical control is reinstated,
and that the medical control authority that removed the medical control notifies the department within 1
business day of the removal.
(g) Protocols to ensure that a quality improvement program is in place within a medical control authority
and provides data protection as provided in 1967 PA 270, MCL 331.531 to 331.534.
(h) Protocols to ensure that an appropriate appeals process is in place.
(i) Protocols to ensure that each life support agency that provides basic life support, limited advanced life
support, or advanced life support is equipped with epinephrine or epinephrine auto-injectors and that each
emergency services personnel authorized to provide those services is properly trained to recognize an
anaphylactic reaction, to administer the epinephrine, and to dispose of the epinephrine auto-injector or vial.
(j) Protocols to ensure that each life support vehicle that is dispatched and responding to provide medical
first response life support, basic life support, or limited advanced life support is equipped with an automated
external defibrillator and that each emergency services personnel is properly trained to utilize the automated
external defibrillator.
(k) Except as otherwise provided in this subdivision, within 12 months after the effective date of the
amendatory act that added this subdivision, protocols to ensure that each life support vehicle that is dispatched
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and responding to provide medical first response life support, basic life support, or limited advanced life
support is equipped with opioid antagonists and that each emergency services personnel is properly trained to
administer opioid antagonists. Beginning 3 years after the effective date of the amendatory act that added this
subdivision, a medical control authority, at its discretion, may rescind or continue the protocol adopted under
this subdivision.
(2) A medical control authority shall not establish a protocol under this section that conflicts with the
Michigan do-not-resuscitate procedure act, 1996 PA 193, MCL 333.1051 to 333.1067.
(3) The department shall establish procedures for the development and adoption of written protocols under
this section. The procedures must include at least all of the following requirements:
(a) At least 60 days before adoption of a protocol, the medical control authority shall circulate a written
draft of the proposed protocol to all significantly affected persons within the emergency medical services
system served by the medical control authority and submit the written draft to the department for approval.
(b) The department shall review a proposed protocol for consistency with other protocols concerning
similar subject matter that have already been established in this state and shall consider any written comments
received from interested persons in its review.
(c) Within 60 days after receiving a written draft of a proposed protocol from a medical control authority,
the department shall provide a written recommendation to the medical control authority with any comments or
suggested changes on the proposed protocol. If the department does not respond within 60 days after
receiving the written draft, the proposed protocol is considered to be approved by the department.
(d) After department approval of a proposed protocol, the medical control authority may formally adopt
and implement the protocol.
(e) A medical control authority may establish an emergency protocol necessary to preserve the health or
safety of individuals within its region in response to a present medical emergency or disaster without
following the procedures established by the department under this subsection for an ordinary protocol. An
emergency protocol established under this subdivision is effective only for a limited period and does not take
permanent effect unless it is approved according to the procedures established by the department under this
subsection.
(4) A medical control authority shall provide an opportunity for an affected participant in an emergency
medical services system to appeal a decision of the medical control authority. Following appeal, the medical
control authority may affirm, suspend, or revoke its original decision. After appeals to the medical control
authority have been exhausted, the affected participant in an emergency medical services system may appeal
the medical control authority's decision to the state emergency medical services coordination committee
created in section 20915. The state emergency medical services coordination committee shall issue an opinion
on whether the actions or decisions of the medical control authority are in accordance with the
department-approved protocols of the medical control authority and state law. If the state emergency medical
services coordination committee determines in its opinion that the actions or decisions of the medical control
authority are not in accordance with the medical control authority's department-approved protocols or with
state law, the state emergency medical services coordination committee shall recommend that the department
take any enforcement action authorized under this code.
(5) If adopted in protocols approved by the department, a medical control authority may require life
support agencies within its region to meet reasonable additional standards for equipment and personnel, other
than medical first responders, that may be more stringent than are otherwise required under this part. If a
medical control authority proposes a protocol that establishes additional standards for equipment and
personnel, the medical control authority and the department shall consider the medical and economic impact
on the local community, the need for communities to do long-term planning, and the availability of personnel.
If either the medical control authority or the department determines that negative medical or economic
impacts outweigh the benefits of those additional standards as they affect public health, safety, and welfare,
the medical control authority shall not adopt and the department shall not approve protocols containing those
additional standards.
(6) If adopted in protocols approved by the department, a medical control authority may require medical
first response services and licensed medical first responders within its region to meet additional standards for
equipment and personnel to ensure that each medical first response service is equipped with an epinephrine
auto-injector, and that each licensed medical first responder is properly trained to recognize an anaphylactic
reaction and to administer and dispose of the epinephrine auto-injector, if a life support agency that provides
basic life support, limited advanced life support, or advanced life support is not readily available in that
location.
(7) If a decision of the medical control authority under subsection (5) or (6) is appealed by an affected
person, the medical control authority shall make available, in writing, the medical and economic information
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it considered in making its decision. On appeal, the state emergency medical services coordination committee
shall review this information under subsection (4) and shall issue its findings in writing.
History: Add. 1990, Act 179, Imd. Eff. July 2, 1990;Am. 1996, Act 192, Eff. Aug. 1, 1996;Am. 2000, Act 375, Imd. Eff. Jan. 2,
2001;Am. 2003, Act 233, Imd. Eff. Dec. 22, 2003;Am. 2006, Act 582, Imd. Eff. Jan. 3, 2007;Am. 2014, Act 312, Imd. Eff. Oct.
14, 2014.
Popular name: Act 368
***** 333.20921a.added THIS SECTION IS REPEALED BY ACT 413 OF 2014 EFFECTIVE JANUARY 1,
2018 *****
333.20921a County or micropolitan area; population 10,000 or less and population density
less than 7 people per square mile; ambulance availability; "micropolitan area" defined.
Sec. 20921a. (1) A limited or advanced ambulance operation whose primary service area is in a county or
micropolitan area with a population of 10,000 or less and whose primary service area has a population density
of less than 7 people per square mile may have an ambulance available at less than the limited or advanced
level of licensure if both of the following conditions are met:
(a) The medical control authority under which the ambulance operation operates authorizes the lesser
availability.
(b) The advanced ambulance operation has departmentapproved local medical control authority protocols
in place.
(2) A basic ambulance operation whose primary service area is in a county or micropolitan area with a
population of 10,000 or less and whose primary service area has a population density of less than 7 people per
square mile may operate at an increased level of licensure when staffed with an EMT-specialist or
EMT-paramedic, if all of the following conditions are met:
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(a) The basic ambulance is equipped at the greater licensure level.
(b) The medical control authority under which the ambulance operation operates authorizes the conditional
increased level of licensure.
(c) The basic ambulance operation has departmentapproved local medical control authority protocols in
place.
(3) As used in this section, "micropolitan area" means a micropolitan statistical area as most recently
delineated by the United States office of management and budget.
History: Add. 2014, Act 413, Eff. Mar. 30, 2015.
Popular name: Act 368
333.20926 Nontransport prehospital life support operation; license required; application; fee;
contents of license and application; renewal; compliance.
Sec. 20926. (1) A person shall not establish, operate, or cause to be operated a nontransport prehospital life
support operation unless it is licensed under this section.
(2) The department, upon proper application and payment of a $100.00 fee, shall issue a license for a
nontransport prehospital life support operation to a person meeting the requirements of this part and rules
promulgated under this part.
(3) A nontransport prehospital life support operation license shall specify the level of life support the
operation is licensed to provide. A nontransport prehospital life support operation shall operate in accordance
with this part, rules promulgated under this part, and approved local medical control authority protocols and
shall not provide life support at a level that exceeds its license or violates approved local medical control
authority protocols.
(4) An applicant for a nontransport prehospital life support operation license shall specify in the
application for licensure each nontransport prehospital life support vehicle to be operated.
(5) A nontransport prehospital life support operation license shall specify the nontransport prehospital life
support vehicles licensed to be operated.
(6) A nontransport prehospital life support operation license may be renewed annually upon application to
the department and payment of a $100.00 renewal fee. Before issuing a renewal license, the department shall
determine that the nontransport prehospital life support operation is in compliance with this part, rules
promulgated under this part, and local medical control authority protocols.
History: Add. 1990, Act 179, Imd. Eff. July 2, 1990.
Popular name: Act 368
333.20931 Air transport operation; license required; application; fee; issuance and contents
of license; renewal; compliance.
Sec. 20931. (1) A person shall not establish, operate, or cause to be operated an aircraft transport operation
unless it is licensed under this section.
(2) The department, upon proper application and payment of a $100.00 fee, shall issue a license for an
aircraft transport operation to a person meeting the requirements of this part and rules promulgated under this
part.
(3) An aircraft transport operation license shall specify the level of life support the operation is licensed to
provide. An aircraft transport operation shall operate in accordance with this part, rules promulgated under
this part, and orders established by the patient's physician and shall not provide life support at a level that
exceeds its license or violates those orders.
(4) An applicant for an aircraft transport operation license shall specify in the application for licensure each
aircraft transport vehicle to be operated and licensed.
(5) An aircraft transport operation license may be renewed annually upon application to the department
and payment of a $100.00 renewal fee. Before issuing a renewal license, the department shall determine that
the aircraft transport operation is in compliance with this part and rules promulgated under this part.
History: Add. 1990, Act 179, Imd. Eff. July 2, 1990.
Popular name: Act 368
333.20934 Operation of aircraft transport vehicle; conditions; application for and issuance of
license or annual renewal; fee; certificate of insurance; communications system;
equipment; amount of liability coverage; determination.
Sec. 20934. (1) A person shall not operate an aircraft transport vehicle unless the vehicle is licensed by the
department under this section and is operated as part of a licensed aircraft transport operation.
(2) Upon proper application and payment of a $100.00 fee, the department shall issue an aircraft transport
vehicle license or annual renewal to the applicant aircraft transport operation. Receipt of the application by
the department serves as attestation to the department by the aircraft transport operation that the vehicle is in
compliance with the minimum standards required by the department. The inspection of an aircraft transport
vehicle by the department is not required as a basis for licensure renewal, unless otherwise determined by the
department.
(3) An aircraft transport operation shall submit an application and required fee to the department for each
vehicle in service. Except as provided in subsection (6), each application shall include a certificate of
insurance for the vehicle in the amount and coverage required by the department.
(4) An aircraft transport vehicle shall be equipped with a communications system utilizing frequencies and
procedures consistent with the statewide emergency medical services communications system developed by
the department.
(5) An aircraft transport vehicle shall be equipped according to the department's minimum equipment list
based upon the level of life support the vehicle and personnel are licensed to provide.
(6) When determining the amount of liability coverage required by the department under subsection (3), an
aircraft transport operation that transports patients less than an average of 45 times a year over the 5-year
period preceding the date coverage begins, is not required to have more than $2,000,000.00 in liability
coverage on each aircraft transport vehicle in that aircraft transport operation. An aircraft transport operator
described under this subsection that has a valid federal aviation regulation part 135 air carrier certificate
issued by the federal aviation administration shall have its base of operation and primary business address on
an island in the Great Lakes more than 20 miles from the nearest mainland airport. The aircraft transport
operator's primary business address is the address shown in the operations specifications and on the air carrier
certificate.
History: Add. 1990, Act 179, Imd. Eff. July 2, 1990;Am. 2000, Act 375, Imd. Eff. Jan. 2, 2001;Am. 2012, Act 269, Imd. Eff.
July 3, 2012.
Compiler's note: For transfer of powers and duties of department of licensing and regulatory affairs relative to registration, licensing,
or regulation of professional occupations arising from part 209 of the Michigan public health code, including any board, commission,
council, or similar entity providing regulation of health professionals licensed, registered, or certified under part 209 of article 17 of the
Michigan public health code, to the department of community health, see E.R.O. No. 2014-2, compiled at MCL 333.26253.
Popular name: Act 368
333.20935 Receipt of completed license application; issuance of license within certain period
of time; report; completed application defined.
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Sec. 20935. (1) Subject to subsection (3), beginning on the effective date of the amendatory act that added
this section, the department shall approve or reject an initial license application for an ambulance operation,
nontransport prehospital life support operation, aircraft transport operation, or medical first response service
within 6 months after the applicant files a completed application as required under this part. Receipt of the
application is considered the date the application is received by any agency or department of this state.
(2) If an initial license application for an ambulance operation, nontransport prehospital life support
operation, aircraft transport operation, or medical first response service is considered incomplete by the
department, the department shall notify the applicant in writing or make the notice electronically available
within 30 days after receipt of the incomplete application, describing the deficiency and requesting additional
information.
(3) If the department identifies a deficiency or requires the fulfillment of a corrective action plan, the
6-month period is tolled until either of the following occurs:
(a) Upon notification by the department of a deficiency, until the date the requested information is received
by the department.
(b) Upon notification by the department that a corrective action plan is required, until the date the
department determines the requirements of the corrective action plan have been met.
(4) The determination of the completeness of an application does not operate as an approval of the
application for the license and does not confer eligibility of an applicant determined otherwise ineligible for
issuance of a license.
(5) If the department fails to approve or reject an initial license application within the time period required
under this section, the department shall return the license fee and shall reduce the license fee for the
applicant's next licensure application, if any, by 15%. Failure to issue or deny a license within the time period
required under this section does not allow the department to otherwise delay processing an application. The
completed application shall be placed in sequence with other completed applications received at that same
time. The department shall not discriminate against an applicant in the processing of the application based
upon the fact that the application fee was refunded or discounted under this subsection.
(6) Beginning October 1, 2005, the director of the department shall submit a report by December 1 of each
year to the standing committees and appropriations subcommittees of the senate and house of representatives
concerned with public health issues. The director shall include all of the following information in the report
concerning the preceding fiscal year:
(a) The number of initial applications the department received and completed within the 6-month time
period required under subsection (1).
(b) The number of applications requiring a request for additional information.
(c) The number of applications denied.
(d) The average processing time for initial licenses granted after the 6-month period.
(e) The number of initial license applications not issued within the 6-month period and the amount of
money returned to applicants under subsection (5).
(7) As used in this section, completed application means an application complete on its face and
submitted with any applicable licensing fees as well as any other information, records, approval, security, or
similar item required by law or rule from a local unit of government, a federal agency, or a private entity but
not from another department or agency of this state.
History: Add. 2004, Act 284, Imd. Eff. July 23, 2004.
Popular name: Act 368
333.20936 Application for license renewal received after expiration date of license; late fee;
completing requirements for initial licensure.
Sec. 20936. (1) If an application for renewal of an ambulance operation, nontransport prehospital life
support operation, or aircraft transport operation license is received by the department after the expiration date
of the license, the applicant shall pay a late fee in the amount of $300.00 in addition to the renewal fee. If an
application for renewal is not received by the department within 60 days after the license expires, the
department shall not issue a renewal license unless the licensee completes the requirements for initial
licensure and pays the late fee.
(2) If an application for renewal of an ambulance or nontransport prehospital life support vehicle, or
aircraft transport vehicle license is received by the department after the expiration date of the license, the
applicant shall pay a late fee in the amount of $100.00 in addition to the renewal fee. If an application for
renewal is not received by the department within 60 days after the license expires, the department shall not
issue a renewal license unless the licensee completes the requirements for initial licensure and pays the late
fee.
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History: Add. 1990, Act 179, Imd. Eff. July 2, 1990.
Popular name: Act 368
333.20941 Medical first response service; license required; issuance; requirements; duties;
renewal of license; advertising or disseminating information; availability of vehicle; ability
of patient to pay; police or fire suppression agency.
Sec. 20941. (1) A person shall not establish, operate, or cause to be operated a medical first response
service unless the service is licensed by the department.
(2) Upon proper application, the department shall issue a license as a medical first response service to a
person who meets the requirements of this part and rules promulgated under this part. The department shall
not charge a fee for licensing a medical first response service.
(3) A medical first response service shall provide life support in accordance with approved local medical
control authority protocols and shall not provide life support at a level that exceeds its license or violates
approved local medical control authority protocols.
(4) A medical first response service license may be renewed annually upon the application to the
department.
(5) A person shall not advertise or disseminate information leading the public to believe that the person
provides a medical first response service unless that person does in fact provide that service and has been
licensed by the department.
(6) A medical first response service shall have at least 1 medical first response vehicle available on a
24-hour-a-day, 7-day-a-week basis, to provide a medical first response capability. Each medical first response
vehicle shall be equipped and staffed as required by this part or rules promulgated under this part.
(7) A medical first response service shall provide life support consistent with its license and approved local
medical control authority protocols to all patients without prior inquiry into ability to pay or source of
payment.
(8) To the extent that a police or fire suppression agency is dispatched to provide medical first response life
support, that agency is subject to this section and the other provisions of this part relating to medical first
response services.
History: Add. 1990, Act 179, Imd. Eff. July 2, 1990.
Compiler's note: For transfer of powers and duties of department of licensing and regulatory affairs relative to registration, licensing,
or regulation of professional occupations arising from part 209 of the Michigan public health code, including any board, commission,
council, or similar entity providing regulation of health professionals licensed, registered, or certified under part 209 of article 17 of the
Michigan public health code, to the department of community health, see E.R.O. No. 2014-2, compiled at MCL 333.26253.
Popular name: Act 368
333.20945 Life support agency license; nonrenewable conditional license in lieu of denial,
suspension, or revocation; duration; conditions.
Sec. 20945. If the department determines that grounds exist under section 20165 for denial, suspension, or
revocation of a life support agency license but that the denial, suspension, or revocation of the license may be
detrimental to the health, safety, and welfare of the residents served by the life support agency or applicant,
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the department may issue a nonrenewable conditional license effective for not more than 1 year and may
prescribe such conditions as the department determines to be necessary to protect the public health, safety,
and welfare.
History: Add. 1990, Act 179, Imd. Eff. July 2, 1990.
Popular name: Act 368
333.20948 Operations and services furnished by local governmental unit; costs; ordinance.
Sec. 20948. (1) A local governmental unit or combination of local governmental units may operate an
ambulance operation or a nontransport prehospital life support operation, or contract with a person to furnish
any of those services for the use and benefit of its residents, and may pay for any or all of the cost from
available funds. A local governmental unit may receive state or federal funds or private funds for the purpose
of providing emergency medical services.
(2) A local governmental unit that operates an ambulance operation or a nontransport prehospital life
support operation or is a party to a contract or an interlocal agreement may defray any or all of its share of the
cost by either or both of the following methods:
(a) Collection of fees for services.
(b) Special assessments created, levied, collected, and annually determined pursuant to a procedure
conforming as nearly as possible to the procedure set forth in section 1 of Act No. 33 of the Public Acts of
1951, being section 41.801 of the Michigan Compiled Laws. This procedure does not prohibit the right of
referendum set forth under Act No. 33 of the Public Acts of 1951, being sections 41.801 to 41.811 of the
Michigan Compiled Laws.
(3) A local governmental unit may enact an ordinance regulating ambulance operations, nontransport
prehospital life support operations, or medical first response services. The standards and procedures
established under the ordinance shall not be in conflict with or less stringent than those required under this
part or the rules promulgated under this part.
History: Add. 1990, Act 179, Imd. Eff. July 2, 1990.
Popular name: Act 368
333.20954 Renewal license; renewal fees; procedures for late renewal; volunteers.
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Sec. 20954. (1) Upon proper application to the department and payment of the renewal fee under
subsection (2), the department may renew an emergency medical services personnel license if the applicant
meets the requirements of this part and provides, upon request of the department, verification of having met
ongoing education requirements established by the department. If an applicant for renewal fails to provide the
department with a change of address, the applicant shall pay a $20.00 fee in addition to the renewal and late
fees required under subsections (2) and (3).
(2) Except as otherwise provided in subsection (5), an applicant for renewal of a license under section
20950 shall pay a renewal fee as follows:
(a) Medical first responder - no fee.
(b) Emergency medical technician - $25.00.
(c) Emergency medical technician specialist - $25.00.
(d) Paramedic - $25.00.
(e) Emergency medical services instructor-coordinator - $25.00.
(3) Except as otherwise provided in subsection (5), if an application for renewal under subsection (1) is
postmarked after the date the license expires, the applicant shall pay a late fee in addition to the renewal fee
under subsection (2) as follows:
(a) Medical first responder - $50.00.
(b) Emergency medical technician - $50.00.
(c) Emergency medical technician specialist - $50.00.
(d) Paramedic - $50.00.
(e) Emergency medical services instructor-coordinator - $50.00.
(4) A license or registration shall be renewed by the licensee on or before the expiration date as prescribed
by rule. The department shall mail a notice to the licensee at the last known address on file with the
department advising of the time, procedure, and fee for renewal. Failure of the licensee to receive notice
under this subsection does not relieve the licensee of the responsibility for renewing his or her license. A
license not renewed by the expiration date may be renewed within 60 days of the expiration date upon
application, payment of renewal and late renewal fees, and fulfillment of any continued continuing education
requirements set forth in rules promulgated under this article. The licensee may continue to practice and use
the title during the 60-day period. If a license is not so renewed within 60 days of the expiration date, the
license is void. The licensee shall not practice or use the title. An individual may be relicensed within 3 years
of the expiration date upon application, payment of the application processing, renewal, and late renewal fees,
and fulfillment of any continuing education requirements in effect at the time of the expiration date, or that
would have been required had the individual renewed his or her license pursuant to subsection (1). An
individual may be relicensed more than 3 years after the expiration date upon application as a new applicant,
meeting all licensure requirements in effect at the time of application, taking or retaking and passing any
examinations required for initial licensure, and payment of fees required of new applicants.
(5) If a life support agency certifies to the department that an applicant for renewal under this section is a
volunteer and if the life support agency does not charge for its services, the department shall not require the
applicant to pay the fee required under subsection (2) or a late fee under subsection (3). If the applicant for
renewal ceases to meet the definition of a volunteer under this part at any time during the effective period of
his or her license renewal and is employed as a licensee under this part, the applicant for renewal shall at that
time pay the fee required under subsection (2).
(6) An individual seeking renewal under this section is not required to maintain national registry status as a
condition of license renewal.
History: Add. 1990, Act 179, Imd. Eff. July 2, 1990;Am. 2000, Act 314, Eff. Jan. 1, 2001;Am. 2000, Act 375, Imd. Eff. Jan. 2,
2001.
Popular name: Act 368
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Popular name: Act 368
333.20961 Reciprocity.
Sec. 20961. (1) The department may grant a license under this part to a person who is licensed in another
state at the time of application if the applicant provides evidence satisfactory to the department as to all of the
following:
(a) The applicant meets the requirements of this part and rules promulgated by the department for
licensure.
(b) There are no pending disciplinary proceedings against the applicant before a similar licensing agency
of this or any other state or country.
(c) If sanctions have been imposed against the applicant by a similar licensing agency of this or any other
state or country based upon grounds that are substantially similar to those set forth in section 20165 or 20958,
as determined by the department, the sanctions are not in force at the time of the application.
(d) The other state maintains licensure standards equivalent to or more stringent than those of this state.
(2) The department may make an independent inquiry to determine whether an applicant meets the
requirements described in subsection (1)(b) and (c).
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History: Add. 1990, Act 179, Imd. Eff. July 2, 1990.
Popular name: Act 368
333.20971 Emergency preparedness act and MCL 30.261 not affected by part; references to
former laws.
Sec. 20971. (1) This part does not supersede, limit, or otherwise affect the emergency preparedness act,
Act No. 390 of the Public Acts of 1976, being sections 30.401 to 30.420 of the Michigan Compiled Laws, or
Act No. 151 of the Public Acts of 1953, being section 30.261 of the Michigan Compiled Laws, dealing with
licenses for professional, mechanical, or other skills for persons performing civil defense, emergency, or
disaster functions under those acts.
(2) A reference in any law to former Act No. 290 of the Public Acts of 1976; former Act No. 288 of the
Public Acts of 1976; former Act No. 330 of the Public Acts of 1976; or former part 32, 203, or 207 of this act
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shall be considered a reference to this part.
History: Add. 1990, Act 179, Imd. Eff. July 2, 1990.
Popular name: Act 368
333.20973 Emergency medical services to and cooperative agreements with other states.
Sec. 20973. This part does not deny emergency medical services to individuals outside of the boundaries of
this state, or limit, restrict, or prevent a cooperative agreement for the provision of emergency medical
services between this state or a political subdivision of this state and another state or a political subdivision of
another state, a federal agency, or another nation or a political subdivision of another nation.
History: Add. 1990, Act 179, Imd. Eff. July 2, 1990.
Popular name: Act 368
PART 209A
CRITICAL INCIDENT STRESS MANAGEMENT SERVICES
333.20981 Definitions.
Sec. 20981. As used in this part:
(a) "Critical incident" means an actual or perceived event or situation that involves crisis, disaster, trauma,
or emergency.
(b) "Critical incident stress" means the acute or cumulative psychological stress or trauma that an
emergency service provider may experience in providing emergency services in response to a critical incident.
The stress or trauma is an unusually strong emotional, cognitive, behavioral, or physical reaction that may
interfere with normal functioning, including, but not limited to, 1 or more of the following:
(i) Physical and emotional illness.
(ii) Failure of usual coping mechanisms.
(iii) Loss of interest in the job or normal life activities.
(iv) Personality changes.
(v) Loss of ability to function.
(vi) Psychological disruption of personal life, including his or her relationship with a spouse, child, or
friend.
(c) "Critical incident stress management services" or "CISM services" means services provided by a
critical incident stress management team or a critical incident stress management team member to an
emergency service provider affected by a critical incident. Critical incident stress management services are
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designed to assist an emergency service provider affected by a critical incident to cope with critical incident
stress or to mitigate reactions to critical incident stress. Critical incident stress management services include 1
or more of the following:
(i) Precrisis education.
(ii) Critical incident stress defusings.
(iii) Critical incident stress debriefings.
(iv) On-scene support services.
(v) One-on-one support services.
(vi) Consultation.
(vii) Referral services.
(d) "Critical incident stress management team" or "CISM team" means an organized community or local
crisis response team that is a member of the Michigan Crisis Response Association Network.
(e) "Critical incident stress management team member" or "CISM team member" means an individual who
is specially trained to provide critical incident stress management services as a member of a critical incident
stress management team.
(f) "Emergency service provider" means an individual who provides emergency response services,
including a law enforcement officer, corrections officer, firefighter, emergency medical services provider,
dispatcher, emergency response communication employee, or rescue service provider.
History: Add. 2016, Act 40, Eff. June 13, 2016.
Compiler's note: Enacting section 1 of Act 40 of 2016 provides:
"Enacting section 1. This amendatory act applies only to critical incident stress management services provided in relation to a critical
incident that occurs on or after 90 days after the date this amendatory act is enacted into law."
Popular name: Act 368
333.20983 Liability.
Sec. 20983. (1) Except as otherwise provided in subsection (2), a CISM team or a CISM team member
providing CISM services is not liable for damages, including personal injury, wrongful death, property
damage, or other loss related to the CISM team's or CISM team member's act, error, or omission in
performing CISM services, unless the act, error, or omission constitutes wanton, willful, or intentional
misconduct.
(2) Subsection (1) does not apply to an action for medical malpractice.
History: Add. 2016, Act 40, Eff. June 13, 2016.
Compiler's note: Enacting section 1 of Act 40 of 2016 provides:
"Enacting section 1. This amendatory act applies only to critical incident stress management services provided in relation to a critical
incident that occurs on or after 90 days after the date this amendatory act is enacted into law."
Popular name: Act 368
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PART 210
HEALTH MAINTENANCE ORGANIZATIONS
333.21001-333.21099 Repealed. 1982, Act 354, Imd. Eff. Dec. 21, 1982;1987, Act 149, Imd.
Eff. Oct. 26, 1987;1988, Act 315, Eff. Mar. 30, 1989;1996, Act 472, Eff. Oct. 1,
1997;2000, Act 252, Imd. Eff. June 29, 2000.
Popular name: Act 368
Popular name: HMO
PART 213
HOMES FOR THE AGED
333.21301 Definitions and principles of construction.
Sec. 21301. Article 1 contains general definitions and principles of construction applicable to all articles in
this code and part 201 contains definitions applicable to this part.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Compiler's note: For transfer of powers and duties of the division of health facility licensing and certification in the bureau of health
systems, division of federal support services, and the division of emergency medical services, with the exception of the division of
managed care and division of health facility development, from the department of public health to the director of the department of
commerce, see E.R.O. No. 1996-1, compiled at MCL 330.3101 of the Michigan Compiled Laws.
For transfer of powers and duties of the bureau of health services from the department of consumer and industry services to the
director of the department of community health by Type II transfer, see E.R.O. No. 2003-1, compiled at MCL 445.2011.
Popular name: Act 368
333.21307 Exemptions.
Sec. 21307. This part does not authorize the medical supervision, regulation, or control of the remedial
care or treatment of residents in a home for the aged operated for the adherents of a bona fide church or
religious denomination who rely on treatment by prayer or spiritual means only in accordance with the creed
or tenets of that church or denomination. The residents, personnel, or employees, other than food handlers, of
the home are not required to submit to a medical or physical examination.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.21311 License required; use of home for aged or similar term or abbreviation;
minimum age for admission; waiver of age limitation; documentation; determination by
director.
Sec. 21311. (1) A home for the aged shall be licensed under this article.
(2) Home for the aged or a similar term or abbreviation shall not be used to describe or refer to a health
facility or agency unless the health facility or agency is licensed as a home for the aged by the department
under this article.
(3) Except as otherwise provided in this subsection, a home for the aged shall not admit an individual
under 60 years of age. Upon the request of a home for the aged and subject to subsection (4), the director shall
waive the age limitation imposed by this subsection if the individual, the individual's guardian or other legal
representative, if appointed, and the owner, operator, and governing body of the home for the aged, upon
consultation with the individual's physician, agree on each of the following:
(a) The home for the aged is capable of meeting all of the individual's medical, social, and other needs as
determined in the individual's plan of service.
(b) The individual will be compatible with the other residents of that home for the aged.
(c) The placement in that home for the aged is in the best interests of the individual.
(4) The owner, operator, and governing body of the home for the aged shall submit, with its request for a
waiver, documentation to the director that supports each of the points of agreement necessary under
subsection (3). Within 5 days after receipt of the information required under this subsection, the director shall
determine if that documentation collectively substantiates each of the points of agreement necessary under
subsection (3) and approve or deny the waiver. If denied, the director shall send a written notice of the denial
and the reasons for denial to the requesting party.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1984, Act 311, Eff. Mar. 29, 1985;Am. 2004, Act 74, Imd. Eff. Apr. 21, 2004.
Popular name: Act 368
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333.21313 Owner, operator, and governing body of home for aged; responsibilities and
duties; good moral character; issuance of license by department; criminal history check
and criminal records check required; renewal of license; storage of fingerprints in
automated fingerprint identification system database; convictions.
Sec. 21313. (1) The owner, operator, and governing body of a home for the aged are responsible for all
phases of the operation of the home and shall assure that the home maintains an organized program to provide
room and board, protection, supervision, assistance, and supervised personal care for its residents.
(2) The owner, operator, and governing body shall assure the availability of emergency medical care
required by a resident.
(3) The owner, operator, or member of the governing body of a home for the aged and the authorized
representative shall be of good moral character.
(4) The department of human services shall not issue a license to or renew the license of an owner,
operator, or member of the governing body, who has regular direct access to residents or who has on-site
facility operational responsibilities, or an applicant, if an individual or the authorized representative, if any of
those individuals have been convicted of 1 or more of the following:
(a) A felony under this act or under chapter XXA of the Michigan penal code, 1931 PA 328, MCL
750.145m to 750.145r.
(b) A misdemeanor under this act or under chapter XXA of the Michigan penal code, 1931 PA 328, MCL
750.145m to 750.145r, within the 10 years immediately preceding the application.
(c) A misdemeanor involving abuse, neglect, assault, battery, or criminal sexual conduct or involving fraud
or theft against a vulnerable adult as that term is defined in section 145m of the Michigan penal code, 1931
PA 328, MCL 750.145m, or a state or federal crime that is substantially similar to a misdemeanor described in
this subdivision within the 10 years immediately preceding the application.
(5) The applicant for a license for a home for the aged, if an individual, shall give written consent at the
time of license application and the authorized representative shall give written consent at the time of
appointment, for the department of state police to conduct both of the following:
(a) A criminal history check.
(b) A criminal records check through the federal bureau of investigation.
(6) Unless already submitted under subsection (5), an owner, operator, or member of the governing body
who has regular direct access to residents or who has on-site facility operational responsibilities for a home
for the aged shall give written consent at the time of license application for the department of state police to
conduct both of the following:
(a) A criminal history check.
(b) A criminal records check through the federal bureau of investigation.
(7) The department of human services shall require the applicant, authorized representative, owner,
operator, or member of the governing body who has regular direct access to residents or who has on-site
facility operational responsibilities to submit his or her fingerprints to the department of state police for the
criminal history check and criminal records check described in subsections (5) and (6).
(8) Not later than 1 year after the effective date of the 2012 amendatory act that amended this subsection,
all owners, operators, and members of the governing body of homes for the aged who have regular direct
access to residents or who have on-site facility operational responsibilities and all authorized representatives
shall comply with the requirements of this section.
(9) The department of human services shall request a criminal history check and criminal records check in
the manner prescribed by the department of state police. The department of state police shall conduct the
criminal history check and provide a report of the results to the licensing or regulatory bureau of the
department of human services. The report shall contain any criminal history information on the person
maintained by the department of state police and the results of the criminal records check from the federal
bureau of investigation. The department of state police may charge the person on whom the criminal history
check and criminal records check are performed under this section a fee for the checks required under this
section that does not exceed the actual cost and reasonable cost of conducting the checks.
(10) Beginning the effective date of the 2012 amendatory act that added this subsection, if an applicant,
authorized representative, owner, operator, or member of the governing body who has regular direct access to
residents or who has on-site facility operational responsibilities applies for a license or to renew a license to
operate a home for the aged and previously underwent a criminal history check and criminal records check
required under subsection (5) or (6) or under section 134a of the mental health code, 1974 PA 258, MCL
330.1134a, and has remained continuously licensed or continuously employed under section 20173a or under
section 34b of the adult foster care facility licensing act, 1979 PA 218, MCL 400.734b, after the criminal
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history check and criminal records check have been performed, the applicant, authorized representative,
owner, operator, or member of the governing body who has regular direct access to residents or who has
on-site facility operational responsibilities is not required to submit to another criminal history check or
criminal records check upon renewal of the license obtained under this section.
(11) The department of state police shall store and maintain all fingerprints submitted under this act in an
automated fingerprint identification system database that provides for an automatic notification at the time a
subsequent criminal arrest fingerprint card submitted into the system matches a set of fingerprints previously
submitted in accordance with this act. At the time of that notification, the department of state police shall
immediately notify the department of human services. The department of human services shall take the
appropriate action upon notification by the department of state police under this subsection.
(12) An applicant, owner, operator, member of a governing body, or authorized representative of a home
for the aged shall not be present in a home for the aged if he or she has been convicted of either of the
following:
(a) Vulnerable adult abuse, neglect, or financial exploitation.
(b) A listed offense as defined in section 2 of the sex offenders registration act, 1994 PA 295, MCL
28.722.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2010, Act 381, Imd. Eff. Dec. 22, 2010;Am. 2012, Act 51, Imd. Eff. Mar. 13,
2012.
Popular name: Act 368
PART 214
HOSPICES
333.21401 Definitions; principles of construction.
Sec. 21401. (1) As used in this part:
(a) Home care means a level of care provided to a patient that is consistent with the categories routine
home care or continuous home care described in 42 C.F.R. 418.302(b)(1) and (2).
(b) Hospice residence means a facility that meets all of the following:
(i) Provides 24-hour hospice care to 2 or more patients at a single location.
(ii) Either provides inpatient care directly in compliance with this article and with the standards set forth in
42 C.F.R. 418.100 or provides home care as described in this article.
(iii) Is owned, operated, and governed by a hospice program that is licensed under this article and provides
aggregate days of patient care on a biennial basis to not less than 51% of its hospice patients in their own
homes. As used in this subparagraph, home does not include a residence established by a patient in a health
facility or agency licensed under this article or a residence established by a patient in an adult foster care
facility licensed under the adult foster care facility licensing act, Act No. 218 of the Public Acts of 1979,
being sections 400.701 to 400.737 of the Michigan Compiled Laws.
(c) Inpatient care means a level of care provided to a patient that is consistent with the categories
inpatient respite care day and general inpatient care day described in 42 C.F.R. 418.302(b)(3) and (4).
(2) Article 1 contains general definitions and principles of construction applicable to all articles in this
code and part 201 contains definitions applicable to this part.
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History: Add. 1980, Act 293, Eff. Mar. 31, 1981;Am. 1996, Act 267, Imd. Eff. June 12, 1996.
Compiler's note: For transfer of powers and duties of the division of health facility licensing and certification in the bureau of health
systems, division of federal support services, and the division of emergency medical services, with the exception of the division of
managed care and division of health facility development, from the department of public health to the director of the department of
commerce, see E.R.O. No. 1996-1, compiled at MCL 330.3101 of the Michigan Compiled Laws.
For transfer of powers and duties of the bureau of health services from the department of consumer and industry services to the
director of the department of community health by Type II transfer, see E.R.O. No. 2003-1, compiled at MCL 445.2011.
Popular name: Act 368
333.21411 License for hospice or hospice residence required; exception; use of term
hospice; representation as hospice residence; exemption from licensure; separate
license for health facility or agency; activities of health facility or agency not restricted;
inspections and concurrent issuance of licenses.
Sec. 21411. (1) Except as provided in subsection (5), a hospice or hospice residence shall be licensed as
required under this article.
(2) The term hospice shall not be used to describe or refer to a health program or agency unless that
program or agency is licensed as a hospice by the department as required under this article or is exempted
from licensure as provided in subsection (5).
(3) A person shall not represent itself as a hospice residence unless that person is licensed as a hospice
residence by the department as required under this article.
(4) A hospital, nursing home, home for the aged, county medical care facility, or any other health facility
or agency that operates a hospice or hospice residence shall be licensed as a hospice or hospice residence
under this article.
(5) A hospice is exempt from licensure under this article if the hospice meets all of the following
requirements:
(a) Provides services to not more than 7 patients per month on a yearly average.
(b) Does not charge or receive fees for goods or services provided.
(c) Does not receive third party reimbursement for goods or services provided.
(6) If a hospice provides inpatient services that meet the definition of a hospital, nursing home, home for
the aged, county medical care facility, hospice residence, or other health facility or agency, the hospice or
hospice residence shall obtain a separate license as required under this article for that hospital, nursing home,
home for the aged, county medical care facility, hospice residence, or other health facility or agency.
(7) This part does not restrict an activity of a health facility or agency if the activity is permitted under the
license held by that health facility or agency.
(8) If separate licensure is required under this section, the department may conduct inspections and issue
the required licenses concurrently.
History: Add. 1980, Act 293, Eff. Mar. 31, 1981;Am. 1984, Act 16, Imd. Eff. Mar. 1, 1984;Am. 1996, Act 267, Imd. Eff. June
12, 1996.
Popular name: Act 368
333.21413 Duties of owner, operator, and governing body of hospice or hospice residence.
Sec. 21413. (1) The owner, operator, and governing body of a hospice or hospice residence licensed under
this article:
(a) Are responsible for all phases of the operation of the hospice or hospice residence and for the quality of
care and services rendered by the hospice or hospice residence.
(b) Shall cooperate with the department in the enforcement of this part, and require that the physicians and
other personnel working in the hospice or hospice residence and for whom a license or registration is required
be currently licensed or registered.
(c) Shall not discriminate because of race, religion, color, national origin, or sex, in the operation of the
hospice or hospice residence including employment, patient admission and care, and room assignment.
(2) As a condition of licensure as a hospice residence, an applicant shall have been licensed under this
article as a hospice and in compliance with the standards set forth in 42 C.F.R. part 418 for not less than the 2
years immediately preceding the date of application for licensure. A hospice residence licensed under this
article may provide both home care and inpatient care at the same location. A hospice residence providing
inpatient care shall comply with the standards in 42 C.F.R. 418.100.
(3) In addition to the requirements of subsections (1) and (2) and section 21415, the owner, operator, and
governing body of a hospice residence that is licensed under this article and that provides care only at the
home care level shall do all of the following:
(a) Provide 24-hour nursing services for each patient in accordance with the patient's hospice care plan as
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required under 42 C.F.R. part 418.
(b) Have an approved plan for infection control that includes making provisions for isolating each patient
with an infectious disease.
(c) Obtain fire safety approval pursuant to section 20156.
(d) Equip each patient room with a device approved by the department for calling the staff member on
duty.
(e) Design and equip areas within the hospice residence for the comfort and privacy of each patient and his
or her family members.
(f) Permit patients to receive visitors at any hour, including young children.
(g) Provide individualized meal service plans in accordance with 42 C.F.R. 418.100(j).
(h) Provide appropriate methods and procedures for the storage, dispensing, and administering of drugs
and biologicals pursuant to 42 C.F.R. 418.100(k).
History: Add. 1980, Act 293, Eff. Mar. 31, 1981;Am. 1996, Act 267, Imd. Eff. June 12, 1996.
Popular name: Act 368
333.21419 Rules.
Sec. 21419. (1) Not later than 1 year after the effective date of this part, the department shall submit for a
public hearing proposed rules necessary to implement and administer this part.
(2) The rules promulgated pursuant to subsection (1) shall not establish standards related to the credentials
of an individual providing care in a hospice program, whether as an employee of a program or volunteer in a
program, unless, with respect to the type of care the individual would provide in the hospice program, a
license or other credential is required by law for an individual providing that care.
History: Add. 1980, Act 293, Eff. Mar. 31, 1981.
Popular name: Act 368
Administrative rules: R 325.13101 et seq. of the Michigan Administrative Code.
333.21420 Exemption of hospices from license fees and certificate of need fees; period.
Sec. 21420. Notwithstanding any other provision of this act, all hospices shall be exempt from license fees
and certificate of need fees for 3 years after the first hospice is licensed under this article.
History: Add. 1980, Act 293, Eff. Mar. 31, 1981;Am. 1982, Act 245, Imd. Eff. Sept. 23, 1982.
Popular name: Act 368
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333.21421 Repealed. 1987, Act 149, Imd. Eff. Oct. 26, 1987.
Compiler's note: The repealed section provided for the expiration of this part.
Popular name: Act 368
PART 215
HOSPITALS
333.21501 Definitions and principles of construction.
Sec. 21501. Article 1 contains general definitions and principles of construction applicable to all articles in
this code and part 201 contains definitions applicable to this part.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Compiler's note: For transfer of powers and duties of the division of health facility licensing and certification in the bureau of health
systems, division of federal support services, and the division of emergency medical services, with the exception of the division of
managed care and division of health facility development, from the department of public health to the director of the department of
commerce, see E.R.O. No. 1996-1, compiled at MCL 330.3101 of the Michigan Compiled Laws.
For transfer of powers and duties of the bureau of health services from the department of consumer and industry services to the
director of the department of community health by Type II transfer, see E.R.O. No. 2003-1, compiled at MCL 445.2011.
Popular name: Act 368
333.21513 Owner, operator, and governing body of hospital; responsibilities and duties
generally.
Sec. 21513. The owner, operator, and governing body of a hospital licensed under this article:
(a) Are responsible for all phases of the operation of the hospital, selection of the medical staff, and quality
of care rendered in the hospital.
(b) Shall cooperate with the department in the enforcement of this part, and require that the physicians,
dentists, and other personnel working in the hospital who are required to be licensed or registered are in fact
currently licensed or registered.
(c) Shall assure that physicians and dentists admitted to practice in the hospital are granted hospital
privileges consistent with their individual training, experience, and other qualifications.
(d) Shall assure that physicians and dentists admitted to practice in the hospital are organized into a
medical staff to enable an effective review of the professional practices in the hospital for the purpose of
reducing morbidity and mortality and improving the care provided in the hospital for patients. The review
shall include the quality and necessity of the care provided and the preventability of complications and deaths
occurring in the hospital.
(e) Shall not discriminate because of race, religion, color, national origin, age, or sex in the operation of the
hospital including employment, patient admission and care, room assignment, and professional or
nonprofessional selection and training programs, and shall not discriminate in the selection and appointment
of individuals to the physician staff of the hospital or its training programs on the basis of licensure or
registration or professional education as doctors of medicine, osteopathic medicine and surgery, or podiatry.
(f) Shall assure that the hospital adheres to medical control authority protocols according to section 20918.
(g) Shall assure that the hospital develops and maintains a plan for biohazard detection and handling.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1984, Act 327, Imd. Eff. Dec. 26, 1984;Am. 1986, Act 174, Imd. Eff. July 7,
1986;Am. 1987, Act 178, Imd. Eff. Nov. 19, 1987;Am. 1989, Act 27, Eff. Dec. 31, 1989;Am. 1990, Act 179, Imd. Eff. July 2,
1990;Am. 1993, Act 79, Eff. Apr. 1, 1994;Am. 2002, Act 125, Imd. Eff. Apr. 1, 2002.
Compiler's note: Section 3 of Act 174 of 1986 provides: This amendatory act shall only apply to contested cases filed on or after
July 1, 1986.
Popular name: Act 368
333.21561 Application for designation as rural community hospital; use of term rural
community hospital; definition.
Sec. 21561. (1) After the effective date of the rules required under section 21563, a hospital with fewer
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than 100 licensed beds located in a nonurbanized area that is either licensed on or before the effective date of
this section or is licensed after the effective date of this section and is located in a county that did not have a
hospital on the effective date of this section may apply to the department for designation as a rural community
hospital.
(2) The term rural community hospital shall not be used to describe or refer to a health facility or agency
unless the health facility or agency is designated as a rural community hospital by the department.
(3) As used in this section, nonurbanized area means that term as defined in section 21551.
History: Add. 1990, Act 252, Imd. Eff. Oct. 12, 1990.
Popular name: Act 368
333.21562 Rural community hospital as limited service hospital; delivery of basic acute care
services; rules implementing part; agreement to participate in medicaid program;
definition; participation in federal medicare program; appointment, membership, and
purpose of ad hoc advisory committee; transfer agreement.
Sec. 21562. (1) A hospital designated as a rural community hospital under section 21561 shall be a limited
service hospital directed toward the delivery of not more than basic acute care services in order to assure
appropriate access in the rural area.
(2) The rules promulgated to implement this part shall require that a hospital designated as a rural
community hospital under section 21561 shall provide no more than the following services:
(a) Emergency care.
(b) Stabilization care for transfer to another facility.
(c) Inpatient care.
(d) Radiology and laboratory services.
(e) Ambulatory care.
(f) Obstetrical services.
(g) Outpatient services.
(h) Other services determined as appropriate by the ad hoc advisory committee created in subsection (5).
(3) A rural community hospital shall enter into an agreement with the department of social services to
participate in the medicaid program. As used in this subsection, medicaid means that term as defined in
section 22207.
(4) A rural community hospital shall meet the conditions for participation in the federal medicare program
under title XVIII of the social security act.
(5) Not later than 3 months after the effective date of this section, the director shall appoint an ad hoc
advisory committee to develop recommendations for rules to designate the maximum number of beds and the
services to be provided by a rural community hospital. In developing recommendations under this subsection,
the ad hoc advisory committee shall review the provisions of the code pertaining to hospital licensure in order
to determine those provisions that should apply to rural community hospitals. The director shall direct the
committee to report its recommendations to the department within 12 months after the committee is
appointed. The ad hoc advisory committee shall be appointed as follows:
(a) Twenty-five percent of the members shall be representatives from hospitals with fewer than 100
licensed beds.
(b) Twenty-five percent of the members shall be representatives from health care provider organizations
other than hospitals.
(c) Twenty-five percent of the members shall be representatives from organizations whose membership
includes consumers of rural health care services or members of local governmental units located in rural
areas.
(d) Twenty-five percent of the members shall be representatives from purchasers or payers of rural health
care services.
(6) A hospital designated as a rural community hospital under section 21561 shall develop and implement
a transfer agreement between the rural community hospital and 1 or more appropriate referral hospitals.
History: Add. 1990, Act 252, Imd. Eff. Oct. 12, 1990.
Popular name: Act 368
333.21563 Rules for designation of rural community hospital, maximum number of beds, and
services; showing designation on license; licensing and regulation of rural community
hospital; applicable provisions of part 222; differential reimbursement.
Sec. 21563. (1) The department, in consultation with the ad hoc advisory committee appointed under
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section 21562, shall promulgate rules for designation of a rural community hospital, maximum number of
beds, and the services provided by a rural community hospital. The director shall submit proposed rules,
based on the recommendations of the committee, for public hearing not later than 6 months after receiving the
report under section 21562(5).
(2) The designation as a rural community hospital shall be shown on a hospital's license and shall be for
the same term as the hospital license. Except as otherwise expressly provided in this part or in rules
promulgated under this section, a rural community hospital shall be licensed and regulated in the same
manner as a hospital otherwise licensed under this article. The provisions of part 222 applicable to hospitals
also apply to a rural community hospital and to a hospital designated by the department under federal law as
an essential access community hospital or a rural primary care hospital. This part and the rules promulgated
under this part do not preclude the establishment of differential reimbursement for rural community hospitals,
essential access community hospitals, and rural primary care hospitals.
History: Add. 1990, Act 252, Imd. Eff. Oct. 12, 1990.
Popular name: Act 368
PART 216
MOBILE DENTAL FACILITY
333.21601 Definitions.
Sec. 21601. (1) As used in this part:
(a) "Active patient" means a person who has received any type of dental care in a mobile dental facility in
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the preceding 24 months.
(b) "Assessment of a patient" means a limited clinical inspection that is performed to identify possible
signs of oral or systemic disease, malformation, or injury, and the potential need for referral for diagnosis and
treatment.
(c) "Clinical evaluation" means a diagnostic service provided by a dentist that includes a complete intra-
and extra-oral inspection, may include other modalities of examination to identify signs of oral or systemic
disease, malformation, or injury, and may include the completion of diagnosis and treatment planning to
determine the treatment needs of an individual patient.
(d) "Comprehensive dental services" means clinical evaluation, including diagnosis and treatment
planning; imagery services; and indicated treatment that may include preventative, restorative, and surgical
procedures that are considered necessary for an individual patient.
(e) "Dental home" means a network of individualized care based on risk assessment, that includes oral
health education, dental screenings, preventative dental services, diagnostic services, comprehensive dental
services, and emergency services.
(f) "Department" means the department of community health.
(g) "Imagery" means visualization of oral and facial structures using specialized instruments and
techniques for diagnostic purposes.
(h) "Memorandum of agreement" means written documentation of an agreement between parties to work
together cooperatively on an agreed-upon project or meet an agreed-upon objective. The purpose of a
memorandum of agreement is to have a written understanding of the agreement between the parties. A
memorandum of agreement serves as a legal document that is binding and holds the parties responsible to
their commitment along with describing the terms and details of the cooperative agreement. A memorandum
of agreement may be used between agencies, the public, the federal or state government, communities, and
individuals.
(i) "Mobile dental facility" means either of the following:
(i) A self-contained, intact facility in which dentistry or dental hygiene is practiced that may be transported
from 1 location to another.
(ii) A site used on a temporary basis to provide dental services using portable equipment.
(j) "Operator" means either of the following:
(i) An individual with a valid, current license to practice dentistry or dental hygiene in this state who
utilizes and holds a permit under this part for a mobile dental facility.
(ii) A corporation, limited liability company, partnership, or any governmental agency contracting with
individuals licensed to practice dentistry in this state or dental hygienists licensed in this state, that utilizes
and holds a permit under this part for a mobile dental facility.
(k) "Preventative dental services" means dental services that include, but are not limited to, screening of a
patient, assessment of a patient, prophylaxis, fluoride treatments, and application of sealants. Imagery studies
are not preventative dental services.
(l) "Screening of a patient" means screening, including state- or federally mandated screening, to determine
an individual's need to be seen by a dentist for diagnosis.
(2) In addition, article 1 contains general definitions and principles of construction applicable to this part.
History: Add. 2014, Act 100, Eff. Apr. 1, 2015.
333.21603 Mobile dental facility; permit; operator; contracting or employing other dentists,
dental hygienists, or dental assistants; permit for 1 or more mobile dental facilities.
Sec. 21603. (1) An operator shall obtain a permit under this part for a mobile dental facility before offering
dental services at the facility.
(2) A mobile dental facility shall have an operator in charge at all times.
(3) An operator may contract or employ other dentists, dental hygienists, or dental assistants to work in a
mobile dental facility.
(4) An operator may hold a permit for 1 or more mobile dental facilities.
History: Add. 2014, Act 100, Eff. Apr. 1, 2015.
333.21605 Permit; application; fee; duration; renewal; late fee; compliance with
requirements; transfer; interim permit; approval or denial within 60 days of application.
Sec. 21605. (1) An individual or entity seeking a permit to operate a mobile dental facility shall submit an
application on a form provided by the department.
(2) An application submitted to the department under subsection (1) shall include a registration fee in an
amount determined by the department but not more than the cost of a dental license renewal fee.
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(3) A permit is valid for 3 years and an application for renewal may be submitted not later than the last day
of the month in which the permit expires upon submission of proof to the department of compliance with the
requirements of this part. A permit application that is not timely filed is subject to a late fee in an amount
determined by the department as the additional cost of processing the late renewal, but not more than a dental
license late renewal fee.
(4) A permit shall not be issued unless the applying individual or entity is in compliance with all applicable
requirements of this part.
(5) A permit issued under this part is not transferrable. If the operator of the mobile dental facility changes,
the permit is no longer valid. However, if an application for a new permit to continue operating the mobile
dental facility is submitted not later than 30 days after the change of operator, the former permit is valid as an
interim permit until the application is approved or denied, but not longer than 90 days.
(6) The department shall either approve or deny an application for a permit under this part not later than 60
days after receiving the application.
History: Add. 2014, Act 100, Eff. Apr. 1, 2015.
PART 217
NURSING HOMES
333.21701 Meanings of words and phrases; general definitions and principles of
construction.
Sec. 21701. (1) For purposes of this part, the words and phrases defined in sections 21702 to 21703 have
the meanings ascribed to them in those sections.
(2) In addition, article 1 contains general definitions and principles of construction applicable to all articles
in this code and part 201 contains definitions applicable to this part.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1978, Act 493, Eff. Mar. 30, 1979.
Compiler's note: For transfer of powers and duties of the division of health facility licensing and certification in the bureau of health
systems, division of federal support services, and the division of emergency medical services, with the exception of the division of
managed care and division of health facility development, from the department of public health to the director of the department of
commerce, see E.R.O. No. 1996-1, compiled at MCL 330.3101 of the Michigan Compiled Laws.
For transfer of powers and duties of the bureau of health services from the department of consumer and industry services to the
director of the department of community health by Type II transfer, see E.R.O. No. 2003-1, compiled at MCL 445.2011.
Popular name: Act 368
333.21702 Definitions; D to P.
Sec. 21702. (1) Discharge means the voluntary or involuntary movement of a patient out of a nursing
home regardless of the individual's destination or reason for the movement.
(2) Full-time means being usually present in the nursing home or conducting or participating in activities
directly related to the nursing home during the normal 40-hour business week.
(3) Involuntary transfer means a transfer not agreed to in writing by the patient or, in the case of a
plenary guardianship, by the patient's legal guardian.
(4) Medicaid means the program for medical assistance established under title XIX of the social security
act, chapter 531, 49 Stat. 620, 42 U.S.C. 1396 to 1396f, and 1396i to 1396u, and administered by the
department of social services under the social welfare act, Act No. 280 of the Public Acts of 1939, being
sections 400.1 to 400.119b of the Michigan Compiled Laws.
(5) Medical reasons means a medical justification for either of the following:
(a) The transfer or discharge of a patient in accord with the written orders of the attending physician that is
written into the patient's clinical record by the physician in the progress notes.
(b) The transfer or discharge of a patient who is a medicaid recipient due to a change in level of care
required by the patient and the fact that the nursing home or nursing care facility is not certified to provide the
needed level of care.
(6) Medicare means that term as defined in section 2701.
(7) Modification of a license means an action by the department to alter the number of beds, the levels of
care, the portions of the physical plant that may be operated or maintained by a licensee in a particular nursing
home, or to restrict the nursing home from engaging in activity that violates this article or a rule promulgated
under this article.
(8) Negative case action means an action taken by the department of social services to deny an
application for medical assistance, cancel medical assistance, or reduce medical assistance coverage.
(9) Nonpayment means:
(a) Failure to collect from the patient or any other source the full amount of the facility charges to a
nonmedicaid patient based on a written contract signed on or after that patient's admission to the facility.
(b) Failure to collect a medicaid patient's stipulated contribution toward his or her care.
(10) Private pay rate means the amount charged by a nursing home for the care of a patient who is not
entitled to state or federal benefits for that patient's nursing home care.
History: Add. 1978, Act 493, Eff. Mar. 30, 1979;Am. 1994, Act 73, Imd. Eff. Apr. 11, 1994.
Popular name: Act 368
333.21703 Definitions; P to W.
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Sec. 21703. (1) "Patient" means a resident.
(2) "Patient's representative" or "resident's representative" means a person, other than the licensee or an
employee or person having a direct or indirect ownership interest in the nursing home, designated in writing
by a resident or a resident's guardian for a specific, limited purpose or for general purposes, or, if a written
designation of a representative is not made, the guardian of the resident.
(3) "Relocation" means the movement of a resident from 1 bed to another or from 1 room to another within
the same nursing home or within a certified distinct part of a nursing home.
(4) "Resident" means an individual who receives care or services at a nursing home.
(5) "Transfer" means the movement of a resident from 1 nursing home to another nursing home or from 1
certified distinct part of a nursing home to another certified distinct part of the same nursing home.
(6) "Welfare" means, with reference to a resident, the physical, emotional, or social well-being of a
resident in a nursing home, including a resident awaiting transfer or discharge, as documented in the resident's
clinical record by a licensed or certified health care professional.
History: Add. 1978, Act 493, Eff. Mar. 30, 1979;Am. 2015, Act 155, Eff. Jan. 18, 2016.
Popular name: Act 368
333.21711 License required; prohibited terms or abbreviations; license for formal or informal
nursing care services; exception.
Sec. 21711. (1) A nursing home shall be licensed under this article.
(2) Nursing home, nursing center, convalescent center, extended care facility, or a similar term or
abbreviation shall not be used to describe or refer to a health facility or agency unless the health facility or
agency is licensed as a nursing home by the department under this article.
(3) A person shall not purport to provide formal or informal nursing care services of the kind normally
provided in a nursing home without obtaining a license as provided in this article. This subsection does not
apply to a hospital or a facility created by Act No. 152 of the Public Acts of 1885, as amended, being sections
36.1 to 36.12 of the Michigan Compiled Laws.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1978, Act 493, Eff. Mar. 30, 1979.
Popular name: Act 368
333.21712 Name of nursing home; change in name; prohibited terms; rehabilitation services.
Sec. 21712. (1) A nursing home shall use the name that appears on the license for its premises. A nursing
home shall not change its name without the approval of the department.
(2) A nursing home shall not use the terms hospital or sanitarium or a term conveying a meaning that
is substantially similar to those terms in the name of the nursing home. However, a nursing home may use the
term health center or health care center or rehabilitation center or a term conveying a meaning
substantially similar to those terms as long as those terms do not conflict with the terms prohibited by this
subsection.
(3) If a nursing home uses the term rehabilitation center in its name as allowed under subsection (2), the
nursing home shall have the capacity to provide rehabilitation services that include, at a minimum, all of the
following:
(a) Physical therapy services.
(b) Occupational therapy services.
(c) Speech therapy services.
(4) A nursing home shall not include in its name the name of a religious, fraternal, or charitable
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corporation, organization, or association unless the corporation, organization, or association is an owner of the
nursing home.
History: Add. 1978, Act 493, Eff. Mar. 30, 1979;Am. 2001, Act 273, Imd. Eff. Jan. 11, 2002.
Popular name: Act 368
333.21713 Owner, operator, and governing body of nursing home; responsibilities and duties
generally.
Sec. 21713. The owner, operator, and governing body of a nursing home licensed under this article:
(a) Are responsible for all phases of the operation of the nursing home and quality of care rendered in the
home.
(b) Shall cooperate with the department in the enforcement of this article and require that the physicians
and other personnel working in the nursing home and for whom a license or registration is required be
currently licensed or registered.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.21715 Nursing home; programs of planned and continuing nursing and medical
treatment required; employment of or contract with licensed or authorized individual;
services; dental treatment.
Sec. 21715. (1) A nursing home shall provide:
(a) A program of planned and continuing nursing care under the charge of a registered nurse.
(b) A program of planned and continuing medical treatment under the charge of physicians. A nursing
home, regardless of its status as a legal entity, may employ or contract with an individual licensed or
otherwise authorized to engage in a health profession under part 170 or 175 to provide the program of planned
and continuing nursing care and medical treatment under this subsection, which care and treatment include
direct clinical services to residents.
(2) A nursing home shall provide nursing care and medical treatment that consist of services given to
residents who are subject to prolonged suffering from illness or injury or who are recovering from illness or
injury. A nursing home shall provide the care and treatment within the ability of the nursing home to provide
and shall include the functions of medical treatment including the diagnosis and treatment of an illness;
nursing care via assessment, planning, and implementation; evaluation of a resident's health care needs; and
the carrying out of required treatment prescribed by a physician.
(3) A nursing home may provide dental treatment under the supervision of a dentist. A nursing home,
regardless of its status as a legal entity, may employ or contract with a dentist who is licensed under part 166.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 1978, Act 493, Eff. Mar. 30, 1979;Am. 2015, Act 156, Eff. Jan. 18, 2016.
Popular name: Act 368
333.21717 Care of certain individuals in nursing home; approval of area and program.
Sec. 21717. An individual shall not be admitted or retained for care in a nursing home who requires special
medical or surgical treatment, or treatment for acute mental illness, developmental disability, communicable
tuberculosis, or a communicable disease, unless the home is able to provide an area and a program for the
care. The department shall approve both the area and the program.
History: 1978, Act 368, Eff. Sept. 30, 1978;Am. 2014, Act 66, Imd. Eff. Mar. 28, 2014.
Popular name: Act 368
333.21720a Director of nursing; nursing personnel; effective date of subsection (1); natural
disaster or other emergency.
Sec. 21720a. (1) A nursing home shall not be licensed under this part unless that nursing home has on its
staff at least 1 registered nurse with specialized training or relevant experience in the area of gerontology,
who shall serve as the director of nursing and who shall be responsible for planning and directing nursing
care. The nursing home shall have at least 1 licensed nurse on duty at all times and shall employ additional
registered and licensed practical nurses in accordance with subsection (2). This subsection shall not take
effect until January 1, 1980.
(2) A nursing home shall employ nursing personnel sufficient to provide continuous 24-hour nursing care
and services sufficient to meet the needs of each patient in the nursing home. Nursing personnel employed in
the nursing home shall be under the supervision of the director of nursing. A licensee shall maintain a nursing
home staff sufficient to provide not less than 2.25 hours of nursing care by employed nursing care personnel
per patient per day. The ratio of patients to nursing care personnel during a morning shift shall not exceed 8
patients to 1 nursing care personnel; the ratio of patients to nursing care personnel during an afternoon shift
shall not exceed 12 patients to 1 nursing care personnel; and the ratio of patients to nursing care personnel
during a nighttime shift shall not exceed 15 patients to 1 nursing care personnel and there shall be sufficient
nursing care personnel available on duty to assure coverage for patients at all times during the shift. An
employee designated as a member of the nursing staff shall not be engaged in providing basic services such as
food preparation, housekeeping, laundry, or maintenance services, except in an instance of natural disaster or
other emergency reported to and concurred in by the department. In a nursing home having 30 or more beds,
the director of nursing shall not be included in counting the minimum ratios of nursing personnel required by
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this subsection.
(3) In administering this section, the department shall take into consideration a natural disaster or other
emergency.
History: Add. 1978, Act 493, Eff. Mar. 30, 1979.
Popular name: Act 368
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333.21735 Requirement of emergency generator system in nursing home.
Sec. 21735. (1) A nursing home licensed under this article shall have, at a minimum, an emergency
generator system that complies with existing state and federal law, including state and federal rules and
regulations.
(2) A nursing home that fails to comply with this section is subject to a civil penalty as provided under
existing state and federal law, including state and federal rules and regulations.
History: Add. 2004, Act 397, Eff. Apr. 15, 2005.
Popular name: Act 368
333.21741 Rules.
Sec. 21741. (1) The department of public health, after seeking advice and consultation from the department
of social services, appropriate consumer and professional organizations, and concerned agencies, shall
promulgate rules to implement and administer this part.
(2) Initial rules proposed under this part shall be submitted to a public hearing not later than 6 months after
this section is enacted into law.
(3) In addition to the rules prescribed in section 20171, rules for nursing homes shall include the
establishment of standards relating to:
(a) Complaint procedures.
(b) Discharges and transfers.
(c) Emergency procedures.
(d) Medical audit procedures.
(e) Patients' rights.
(f) Standards of patient care to be provided in nursing homes.
(g) Training, educational, and competency requirements of nursing home personnel other than licensed
personnel.
(h) Utilization and quality control review procedures.
History: Add. 1978, Act 493, Eff. Mar. 30, 1979.
Popular name: Act 368
333.21751 Emergency petition to place nursing home under control of receiver; appointment
of receiver; use of income and assets; major structural alteration; consultation;
termination of receivership; accounting; disposition of surplus funds.
Sec. 21751. (1) When the department has concluded a proceeding under sections 71 to 106 of the
administrative procedures act of 1969, as amended, being sections 24.271 to 24.306 of the Michigan
Compiled Laws, or when the department has suspended or revoked the license of a nursing home, the
department, a patient in the facility, or a patient's representative may file an emergency petition with the
circuit court to place the nursing home under the control of a receiver if necessary to protect the health or
safety of patients in the nursing home. The court may grant the petition upon a finding that the health or safety
of the patients in the nursing home would be seriously threatened if a condition existing at the time the
petition was filed is permitted to continue.
(2) The court shall appoint as receiver the director of the department of social services, the director of the
department of public health, or another state agency or person designated by the director of public health. The
receiver appointed by the court shall use the income and assets of the nursing home to maintain and operate
the home and to attempt to correct the conditions which constitute a threat to the patients. A major structural
alteration shall not be made to the nursing home, unless the alteration is necessary to bring the nursing home
into compliance with licensing requirements.
(3) To assist in the implementation of the mandate of the court, the receiver may request and receive
reasonable consultation from the available personnel of the department.
(4) The receivership shall be terminated when the receiver and the court certify that the conditions which
prompted the appointment have been corrected, when the license is restored, when a new license is issued, or,
in the case of a discontinuance of operation, when the patients are safely placed in other facilities, whichever
occurs first.
(5) Upon the termination of the receivership, the receiver shall render a complete accounting to the court
and shall dispose of surplus funds as the court directs.
History: Add. 1978, Act 493, Eff. Mar. 30, 1979.
Popular name: Act 368
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333.21761 Certification of nondiscrimination; violation of rights; giving preference to
members of religious or fraternal institution or organization.
Sec. 21761. (1) In addition to the requirements of section 20152, a licensee shall certify annually to the
department, as part of its application for licensure and certification, that all phases of its operation, including
its training program, are without discrimination against persons or groups of persons on the basis of race,
religion, color, national origin, sex, age, disability, marital status, sexual preference, or the exercise of rights
guaranteed by law, including freedom of speech and association. If the department finds a violation of rights
enumerated in this section, the department shall direct the administrator of the nursing home to take the
necessary action to assure that the nursing home is, in fact, operated in accordance with the rights listed in this
section.
(2) This section shall not be construed to prevent a nursing home operated, supervised, or controlled by a
religious or fraternal institution or organization from giving preference to applicants who are members of that
religious or fraternal institution or organization.
History: Add. 1978, Act 493, Eff. Mar. 30, 1979;Am. 1998, Act 88, Imd. Eff. May 13, 1998.
Popular name: Act 368
333.21765 Policies and procedures; copy of rights enumerated in MCL 333.20201; reading or
explaining rights; staff observance of rights, policies, and procedures.
Sec. 21765. (1) A nursing home shall establish written policies and procedures to implement the rights
protected under section 20201. The policies shall include a procedure for the investigation and resolution of
patient complaints. The policies and procedures shall be subject to approval by the department. The policies
and procedures shall be clear and unambiguous, shall be printed in not less than 12-point type, shall be
available for inspection by any person, shall be distributed to each patient and representative, and shall be
available for public inspection.
(2) Each patient shall be given a copy of the rights enumerated in section 20201 at the time of admission to
a nursing home. A patient of a nursing home at the time of the implementation of this section shall be given a
copy of the rights enumerated in section 20201 as specified by rule.
(3) A copy shall be given to a person who executes a contract pursuant to section 21766 and to any other
person who requests a copy.
(4) If a patient is unable to read the form, it shall be read to the patient in a language the patient
understands. In the case of a developmentally disabled individual, the rights shall be explained in a manner
that the person is able to understand and the explanation shall be witnessed by a third person. In the case of a
minor or a person who has a legal guardian, both the patient and the parent or legal guardian shall be fully
informed of the policies and procedures.
(5) A nursing home shall ensure that its staff is familiar with and observes the rights enumerated in section
20201 and the policies and procedures established under this section.
History: Add. 1978, Act 493, Eff. Mar. 30, 1979;Am. 2014, Act 66, Imd. Eff. Mar. 28, 2014.
Popular name: Act 368
333.21772 Interference with right to bring action or file complaint prohibited; retaliation
prohibited.
Sec. 21772. The owner, administrator, employee, or representative of a nursing home shall not interfere
with the right of a person to bring a civil or criminal action or to file a complaint with the department or other
governmental agency with respect to the operation of the nursing home, nor discharge, harass, or retaliate
against a person who does so or on whose behalf the action is taken.
History: Add. 1978, Act 493, Eff. Mar. 30, 1979.
Popular name: Act 368
333.21773 Involuntary transfer or discharge of patient; notice; form; request for hearing;
copy of notice; commencement of notice period; nonpayment; redemption; explanation
and discussion; counseling services; prohibition; notice of nonparticipation in state plan
for medicaid funding.
Sec. 21773. (1) A nursing home shall not involuntarily transfer or discharge a patient except for 1 or more
of the following purposes:
(a) Medical reasons.
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(b) The patient's welfare.
(c) The welfare of other patients or nursing home employees.
(d) Nonpayment for the patient's stay, except as prohibited by title XIX of the social security act, chapter
531, 49 Stat. 620, 42 U.S.C. 1396 to 1396r-6 and 1396r-8 to 1396v.
(2) A licensed nursing home shall provide written notice at least 30 days before a patient is involuntarily
transferred or discharged. The 30-day requirement of this subsection does not apply in any of the following
instances:
(a) If an emergency transfer or discharge is mandated by the patient's health care needs and is in accord
with the written orders and medical justification of the attending physician.
(b) If the transfer or discharge is mandated by the physical safety of other patients and nursing home
employees as documented in the clinical record.
(c) If the transfer or discharge is subsequently agreed to by the patient or the patient's legal guardian, and
notification is given to the next of kin and the person or agency responsible for the patient's placement,
maintenance, and care in the nursing home.
(3) The notice required by subsection (2) shall be on a form prescribed by the department of consumer and
industry services and shall contain all of the following:
(a) The stated reason for the proposed transfer.
(b) The effective date of the proposed transfer.
(c) A statement in not less than 12-point type that reads: You have a right to appeal the nursing home's
decision to transfer you. If you think you should not have to leave this facility, you may file a request for a
hearing with the department of consumer and industry services within 10 days after receiving this notice. If
you request a hearing, it will be held at least 7 days after your request, and you will not be transferred during
that time. If you lose the hearing, you will not be transferred until at least 30 days after you received the
original notice of the discharge or transfer. A form to appeal the nursing home's decision and to request a
hearing is attached. If you have any questions, call the department of consumer and industry services at the
number listed below.
(d) A hearing request form, together with a postage paid, preaddressed envelope to the department of
consumer and industry services.
(e) The name, address, and telephone number of the responsible official in the department of consumer and
industry services.
(4) A request for a hearing made under subsection (3) shall stay a transfer pending a hearing or appeal
decision.
(5) A copy of the notice required by subsection (3) shall be placed in the patient's clinical record and a
copy shall be transmitted to the department of consumer and industry services, the patient, the patient's next
of kin, patient's representative, or legal guardian, and the person or agency responsible for the patient's
placement, maintenance, and care in the nursing home.
(6) If the basis for an involuntary transfer or discharge is the result of a negative action by the department
of community health with respect to a medicaid client and a hearing request is filed with that department, the
21-day written notice period of subsection (2) does not begin until a final decision in the matter is rendered by
the department of community health or a court of competent jurisdiction and notice of that final decision is
received by the patient and the nursing home.
(7) If nonpayment is the basis for involuntary transfer or discharge, the patient may redeem up to the date
that the discharge or transfer is to be made and then may remain in the nursing home.
(8) The nursing home administrator or other appropriate nursing home employee designated by the nursing
home administrator shall discuss an involuntary transfer or discharge with the patient, the patient's next of kin
or legal guardian, and person or agency responsible for the patient's placement, maintenance, and care in the
nursing home. The discussion shall include an explanation of the reason for the involuntary transfer or
discharge. The content of the discussion and explanation shall be summarized in writing and shall include the
names of the individuals involved in the discussions and made a part of the patient's clinical record.
(9) The nursing home shall provide the patient with counseling services before the involuntary transfer or
discharge and the department shall assure that counseling services are available after the involuntary transfer
or discharge to minimize the possible adverse effect of the involuntary transfer or discharge.
(10) If a nursing home voluntarily withdraws from participation in the state plan for medicaid funding, but
continues to provide services, the nursing home shall not, except as provided in subsection (1), involuntarily
transfer or discharge a patient, whether or not the patient is eligible for medicaid benefits, who resided in the
nursing home on the day before the effective date of the nursing home's withdrawal from participation. The
prohibition against transfer or discharge imposed by this subsection continues unless the patient falls within 1
or more of the exceptions described in subsection (1).
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(11) If an individual becomes a patient of a nursing home after the date the nursing home withdraws from
participation in the state plan for medicaid funding, the nursing home, on or before the date the individual
signs a contract with the nursing home, shall provide to the patient oral and written notice of both of the
following:
(a) That the nursing home is not participating in the state plan for medicaid funding.
(b) That the facility may involuntarily transfer or discharge the patient for nonpayment under subsection
(1)(d) even if the patient is eligible for medicaid benefits.
History: Add. 1978, Act 493, Eff. Mar. 30, 1979;Am. 2001, Act 137, Imd. Eff. Oct. 26, 2001.
Popular name: Act 368
333.21774 Involuntary transfer or discharge; request for hearing; informal hearing; decision;
burden of proof; procedures; time for leaving facility.
Sec. 21774. (1) A patient subject to involuntary transfer or discharge from a licensed nursing home shall
have the opportunity to file a request for a hearing with the department within 10 days following receipt of the
written notice of the involuntary transfer or discharge by the nursing home.
(2) The department of public health, when the basis for involuntary transfer or discharge is other than a
negative action by the department of social services with respect to a medicaid client, shall hold an informal
hearing in the matter at the patient's facility not sooner than 7 days after a hearing request is filed, and render
a decision in the matter within 14 days after the filing of the hearing request.
(3) In a determination as to whether a transfer or discharge is authorized, the burden of proof rests on the
party requesting the transfer or discharge. The hearing shall be in accordance with fair hearing procedures
prescribed by rule.
(4) If the department determines that a transfer or discharge is authorized under section 21773, the patient
shall not be required to leave the facility before the thirty-fourth day following receipt of the notice required
under section 21773(2), or the tenth day following receipt of the department's decision, whichever is later.
History: Add. 1978, Act 493, Eff. Mar. 30, 1979.
Popular name: Act 368
333.21777 Holding bed open during temporary absence of patient; option; title 19 patients.
Sec. 21777. (1) If a patient is temporarily absent from a nursing home for emergency medical treatment,
the nursing home shall hold the bed open for 10 days for that patient in the patient's absence, if there is a
reasonable expectation that the patient will return within that period of time and the nursing home receives
payment for each day during the absent period.
(2) If a patient is temporarily absent from a nursing home for therapeutic reasons as approved by a
physician, the nursing home shall hold the bed open for 18 days, if there is a reasonable expectation that the
patient will return within that period of time and the nursing home receives payment for each day during the
absent period. Temporary absences for therapeutic reasons are limited to 18 days per year.
(3) When a patient's absence is longer than specified under subsection (1) or (2), or both, the patient has
the option to return to the nursing home for the next available bed.
(4) For title 19 patients, the department of community health shall continue funding for the temporary
absence as provided under subsections (1) and (2) if the nursing home is at 98% or more occupancy except for
any bed being held open under subsection (1) or (2).
History: Add. 1978, Act 493, Eff. Mar. 30, 1979;Am. 2004, Act 372, Imd. Eff. Oct. 11, 2004.
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Popular name: Act 368
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Popular name: Act 368
333.21794 Use of dining assistant to provide feeding assistance to nursing home patient.
Sec. 21794. (1) With the consent of the patient or the patient's representative a nursing home may use a
dining assistant to provide feeding assistance to a patient who, based on the charge nurse's assessment of the
patient and the patient's most recent plan of care, needs assistance or encouragement with eating and drinking,
but does not have complicated feeding problems, including, but not limited to, difficulty swallowing,
recurrent lung aspirations, tube or parenteral feedings, or behavioral issues that may compromise nutritional
intake. The charge nurse's assessment and plan of care must be documented in the patient's medical record.
For a patient who is assigned a dining assistant and experiences an emergent change in condition, the charge
nurse shall perform a special assessment to monitor the appropriateness of continued utilization of the dining
assistant.
(2) A nursing home that chooses to utilize dining assistants shall provide individuals with training through
a department-approved training curriculum. The department and the long-term care stakeholder advisory
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workgroup designated under section 20155(24) shall develop a dining assistants training curriculum. The
department shall approve a dining assistants training curriculum that meets the requirements of this
subsection. In order to be approved by the department, the dining assistants training curriculum must include,
at a minimum, 8 hours of course material that covers all of the following:
(a) Dining assistants program overview.
(b) Patient rights.
(c) Communication and interpersonal skills.
(d) Appropriate responses to patient behavior.
(e) Recognizing changes in patients.
(f) Infection control.
(g) Assistance with feeding and hydration.
(h) Feeding techniques.
(i) Safety and emergency procedures.
(j) End of life.
(3) An individual shall not provide feeding assistance as a dining assistant in a nursing home unless he or
she has successfully completed a dining assistants training curriculum described in subsection (2). A nursing
home shall not employ or allow an individual who is less than 17 years of age to provide feeding assistance as
a dining assistant.
(4) A dining assistant shall work under the supervision of a nurse. A dining assistant's sole purpose is to
provide feeding assistance to patients, and he or she shall not perform any other nursing or nursing-related
services, such as toileting or transporting patients. A dining assistant is not nursing personnel and a nursing
home shall not include a dining assistant in computing the ratio of patients to nursing personnel or use a
dining assistant to supplement or replace nursing personnel. If approved by the charge nurse and subject to
subsection (1), a dining assistant may provide feeding assistance in a patient's room if the patient is unable to
go to or chooses not to dine in a designated dining area. A nurse is not required to be physically present
within the patient's room during the feeding, but a nurse must be immediately available. A dining assistant
who is providing feeding assistance to a patient in his or her room as provided under this subsection must not
be assigned to assist another patient at the same time.
(5) Dining assistants are subject to the criminal history checks required under section 20173a.
(6) A nursing home that utilizes dining assistants shall maintain a written record of each individual used as
a dining assistant. The nursing home shall include in the written record, at a minimum, the complete name and
address of the individual, the date the individual successfully completed the dining assistants training
curriculum, a copy of the written record of the satisfactory completion of the training curriculum, and
documentation of the criminal history check.
(7) This section does not prohibit a family member or friend from providing feeding assistance to a patient
within the nursing home or require a friend or family member to complete the training program prescribed
under subsection (2). However, a nursing home may offer to provide the dining assistants training curriculum
to family members and friends.
(8) As used in this section:
(a) "Dining assistant" means an individual who meets the requirements of this section and who is only paid
to provide feeding assistance to nursing home patients by the nursing home or who is used under an
arrangement with another agency or organization.
(b) "Immediately available" means being capable of responding to provide help if needed to the dining
assistant at any time either in person or by voice or call light system, radio, telephone, pager, or other method
of communication during a feeding.
(c) "Nurse" means an individual licensed as a registered professional nurse or a licensed practical nurse
under article 15 to engage in the practice of nursing.
(d) "Under the supervision of a nurse" means that a nurse who is overseeing the work of a dining assistant
is physically present in the nursing home and immediately available.
History: Add. 2014, Act 529, Imd. Eff. Jan. 14, 2015.
333.21795 Education and training for unlicensed nursing personnel; criteria; competency
examinations; rules.
Sec. 21795. (1) The department, in consultation and with the advice of the Michigan board of nursing and
appropriate consumer and professional organizations, shall develop by rule minimum criteria for the
education and training for unlicensed nursing personnel in facilities designated in this part.
(2) This section shall not be construed to be a prerequisite for employment of unlicensed nursing personnel
in a nursing home.
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(3) During the annual licensing inspection the department shall, and during other inspections the
department may, conduct random competency examinations to determine whether the requirements of this
section are being met. The department shall promulgate rules to administer this subsection.
History: Add. 1978, Act 493, Eff. Mar. 30, 1979.
Popular name: Act 368
PART 221
CERTIFICATES OF NEED
333.22101-333.22181 Repealed. 1981, Act 76, Eff. Oct. 1, 1981;1988, Act 332, Eff. Oct. 1,
1988.
Popular name: Act 368
PART 222
CERTIFICATES OF NEED
333.22201 Meanings of words and phrases; principles of construction.
Sec. 22201. (1) For purposes of this part, the words and phrases defined in sections 22203 to 22207 have
the meanings ascribed to them in those sections.
(2) In addition, article 1 contains general definitions and principles of construction applicable to all articles
in this code.
(3) The definitions in part 201 do not apply to this part.
History: Add. 1988, Act 332, Eff. Oct. 1, 1988.
Compiler's note: For transfer of certain powers and duties of the division of health facility development in the bureau of health
systems from the department of public health to the director of the department of community health, see E.R.O. No. 1996-1, compiled at
MCL 330.3101 of the Michigan Compiled Laws.
Popular name: Act 368
333.22203 Definitions; A to F.
Sec. 22203. (1) Addition means adding patient rooms, beds, and ancillary service areas, including, but
not limited to, procedure rooms or fixed equipment, surgical operating rooms, therapy rooms or fixed
equipment, or other accommodations to a health facility.
(2) Capital expenditure means an expenditure for a single project, including cost of construction,
engineering, and equipment that under generally accepted accounting principles is not properly chargeable as
an expense of operation. Capital expenditure includes a lease or comparable arrangement by or on behalf of a
health facility to obtain a health facility, licensed part of a health facility, or equipment for a health facility, if
the actual purchase of a health facility, licensed part of a health facility, or equipment for a health facility
would have been considered a capital expenditure under this part. Capital expenditure includes the cost of
studies, surveys, designs, plans, working drawings, specifications, and other activities essential to the
acquisition, improvement, expansion, addition, conversion, modernization, new construction, or replacement
of physical plant and equipment.
(3) Certificate of need means a certificate issued under this part authorizing a new health facility, a
change in bed capacity, the initiation, replacement, or expansion of a covered clinical service, or a covered
capital expenditure that is issued in accordance with this part.
(4) Certificate of need review standard or review standard means a standard approved by the
commission.
(5) Change in bed capacity means 1 or more of the following:
(a) An increase in licensed hospital beds.
(b) An increase in licensed nursing home beds or hospital beds certified for long-term care.
(c) An increase in licensed psychiatric beds.
(d) A change from 1 licensed use to a different licensed use.
(e) The physical relocation of beds from a licensed site to another geographic location.
(6) Clinical means directly pertaining to the diagnosis, treatment, or rehabilitation of an individual.
(7) Clinical service area means an area of a health facility, including related corridors, equipment rooms,
ancillary service and support areas that house medical equipment, patient rooms, patient beds, diagnostic,
operating, therapy, or treatment rooms or other accommodations related to the diagnosis, treatment, or
rehabilitation of individuals receiving services from the health facility.
(8) Commission means the certificate of need commission created under section 22211.
(9) Covered capital expenditure means a capital expenditure of $2,500,000.00 or more, as adjusted
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annually by the department under section 22221(g), by a person for a health facility for a single project,
excluding the cost of nonfixed medical equipment, that includes or involves the acquisition, improvement,
expansion, addition, conversion, modernization, new construction, or replacement of a clinical service area.
(10) Covered clinical service, except as modified by the commission under section 22215, means 1 or
more of the following:
(a) Initiation or expansion of 1 or more of the following services:
(i) Neonatal intensive care services or special newborn nursing services.
(ii) Open heart surgery.
(iii) Extrarenal organ transplantation.
(b) Initiation, replacement, or expansion of 1 or more of the following services:
(i) Extracorporeal shock wave lithotripsy.
(ii) Megavoltage radiation therapy.
(iii) Positron emission tomography.
(iv) Surgical services provided in a freestanding surgical outpatient facility, an ambulatory surgery center
certified under title XVIII, or a surgical department of a hospital licensed under part 215 and offering
inpatient or outpatient surgical services.
(v) Cardiac catheterization.
(vi) Fixed and mobile magnetic resonance imager services.
(vii) Fixed and mobile computerized tomography scanner services.
(viii) Air ambulance services.
(c) Initiation or expansion of a specialized psychiatric program for children and adolescent patients
utilizing licensed psychiatric beds.
(d) Initiation, replacement, or expansion of a service not listed in this subsection, but designated as a
covered clinical service by the commission under section 22215(1)(a).
(11) Fixed equipment means equipment that is affixed to and constitutes a structural component of a
health facility, including, but not limited to, mechanical or electrical systems, elevators, generators, pumps,
boilers, and refrigeration equipment.
History: Add. 1988, Act 331, Eff. Oct. 1, 1988;Am. 1993, Act 88, Imd. Eff. July 9, 1993;Am. 2002, Act 619, Eff. Mar. 31, 2003
.
Popular name: Act 368
333.22205 Definitions; H to M.
Sec. 22205. (1) Health facility, except as otherwise provided in subsection (2), means:
(a) A hospital licensed under part 215.
(b) A psychiatric hospital or psychiatric unit licensed under the mental health code, 1974 PA 258, MCL
330.1001 to 330.2106.
(c) A nursing home licensed under part 217 or a hospital long-term care unit as defined in section
20106(6).
(d) A freestanding surgical outpatient facility licensed under part 208.
(e) A health maintenance organization issued a license or certificate of authority in this state.
(2) Health facility does not include the following:
(a) An institution conducted by and for the adherents of a church or religious denomination for the purpose
of providing facilities for the care and treatment of the sick who depend solely upon spiritual means through
prayer for healing.
(b) A health facility or agency located in a correctional institution.
(c) A veterans facility operated by the state or federal government.
(d) A facility owned and operated by the department of community health.
(3) Initiate means the offering of a covered clinical service that has not been offered in compliance with
this part or former part 221 on a regular basis at that location within the 12-month period immediately
preceding the date the covered clinical service will be offered.
(4) Medical equipment means a single equipment component or a related system of components that is
used for clinical purposes.
History: Add. 1988, Act 332, Eff. Oct. 1, 1988;Am. 1993, Act 88, Imd. Eff. July 9, 1993;Am. 2000, Act 253, Imd. Eff. June 29,
2000;Am. 2002, Act 619, Eff. Mar. 31, 2003.
Popular name: Act 368
333.22207 Definitions; M to S.
Sec. 22207. (1) Medicaid means the program for medical assistance administered by the department of
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community health under the social welfare act, 1939 PA 280, MCL 400.1 to 400.119b.
(2) Modernization means an upgrading, alteration, or change in function of a part or all of the physical
plant of a health facility. Modernization includes, but is not limited to, the alteration, repair, remodeling, and
renovation of an existing building and initial fixed equipment and the replacement of obsolete fixed
equipment in an existing building. Modernization of the physical plant does not include normal maintenance
and operational expenses.
(3) New construction means construction of a health facility where a health facility does not exist or
construction replacing or expanding an existing health facility or a part of an existing health facility.
(4) Person means a person as defined in section 1106 or a governmental entity.
(5) Planning area means the area defined in a certificate of need review standard for determining the
need for, and the resource allocation of, a specific health facility, service, or equipment. Planning area
includes, but is not limited to, the state, a health facility service area, or a health service area or subarea within
the state.
(6) Proposed project means a proposal to acquire an existing health facility or begin operation of a new
health facility, make a change in bed capacity, initiate, replace, or expand a covered clinical service, or make
a covered capital expenditure.
(7) Rural county means a county not located in a metropolitan statistical area or micropolitan statistical
areas as those terms are defined under the standards for defining metropolitan and micropolitan statistical
areas by the statistical policy office of the office of information and regulatory affairs of the United States
office of management and budget, 65 F.R. p. 82238 (December 27, 2000).
(8) Stipulation means a requirement that is germane to the proposed project and has been agreed to by an
applicant as a condition of certificate of need approval.
History: Add. 1988, Act 332, Eff. Oct. 1, 1988;Am. 1993, Act 88, Imd. Eff. July 9, 1993;Am. 2002, Act 619, Eff. Mar. 31, 2003
.
Popular name: Act 368
333.22208 Definitions; T.
Sec. 22208. (1) "Title XVIII" means title XVIII of the social security act, 42 USC 1395 to 1395kkk-1.
(2) "Title XIX" means title XIX of the social security act, chapter 531, 49 Stat. 620, 42 USC 1396 to
1396w-5.
History: Add. 1988, Act 308, Eff. Oct. 1, 1988;Am. 1990, Act 260, Imd. Eff. Oct. 15, 1990;Am. 1993, Act 88, Imd. Eff. July 9,
1993;Am. 2011, Act 51, Eff. Dec. 6, 2011.
Popular name: Act 368
333.22210 Certificate of need for extended care services program; application; criteria;
modification; fee prohibited; compliance; discrimination prohibited; exercise of rights;
written acknowledgment; forms; additional rights; violation; penalty; certificate required;
definitions.
Sec. 22210. (1) Subject to this section, a hospital that applies to the department for a certificate of need and
meets all of the following criteria shall be granted a certificate of need for an extended care services program
with up to 10 licensed hospital beds:
(a) Is eligible to apply for certification as a provider of extended care services through the use of swing
beds under section 1883 of title XVIII, 42 USC 1395tt.
(b) Subject to subsection (2), has fewer than 100 licensed beds not counting beds excluded under section
1883 of title XVIII, 42 USC 1395tt.
(c) Does not have uncorrected licensing, certification, or safety deficiencies for which the department or
the bureau of fire services created in section 1b of the fire prevention code, 1941 PA 207, MCL 29.1b, or
both, has not accepted a plan of correction.
(d) Provides evidence satisfactory to the department that the hospital has had difficulty in placing patients
in skilled nursing home beds during the 12 months immediately preceding the date of the application.
(2) After October 1, 1990, the criteria set forth in subsection (1)(b) may be modified by the commission,
using the procedure set forth in section 22215(3). The department shall not charge a fee for processing a
certificate of need application to initiate an extended care services program.
(3) A hospital that is granted a certificate of need for an extended care services program under subsection
(1) shall comply with all of the following:
(a) Not charge for or otherwise attempt to recover the cost of a length of stay for a patient in the extended
care services program that exceeds the length of time allowed for post-hospital extended care under title
XVIII.
(b) Admit patients to the extended care services program only pursuant to an admissions contract approved
by the department.
(c) Subject to subdivision (f), not discharge or transfer a patient from a licensed hospital bed other than a
hospital long-term care unit bed and admit that patient to the extended care services program unless the
discharge or transfer and admission is determined medically appropriate by the attending physician.
(d) Permit access to a representative of an organization approved under section 21764 to patients admitted
to the extended care services program, for all of the purposes described in section 21763.
(e) Not allow the number of patient days for the extended care services program to exceed the equivalent
of 1,825 patient days for a single state fiscal year.
(f) Not provide extended care services in a swing bed if the hospital owns or operates a hospital long-term
care unit that has beds available at the time a patient requires admission for extended care services.
(g) Not charge or collect from a patient admitted to the extended care services program, for services
rendered as part of the extended care services program, an amount in excess of the reasonable charge for the
services as determined by the secretary of the United States department of health and human services under
title XVIII.
(h) Assist a patient who has been denied coverage for services received in an extended care services
program under title XVIII to file an appeal with the medicare recovery project operated by the office of
services to the aging.
(i) Operate the extended care services program pursuant to this section and the provisions of section 1883
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of title XVIII, 42 USC 1395tt, that are applicable to the extended care services program.
(j) Provide data to the department considered necessary by the department to evaluate the extended care
services program. The data shall include, but not be limited to, all of the following:
(i) The total number of patients admitted to the hospital's extended care services program during the period
specified by the department.
(ii) The total number of extended care services patient days for the period specified by the department.
(iii) Information identifying the type of care to which patients in the extended care services program are
released.
(k) As part of the hospital's policy describing the rights and responsibilities of patients admitted to the
hospital, as required under section 20201, incorporate all of the following additional rights and
responsibilities for patients in the extended care services program:
(i) A copy of the hospital's policy shall be provided to each extended care services patient upon admission,
and the staff of the hospital shall be trained and involved in the implementation of the policy.
(ii) Each extended care services patient may associate and communicate privately with persons of his or
her choice. Reasonable, regular visiting hours, which shall take into consideration the special circumstances
of each visitor, shall be established for extended care services patients to receive visitors. An extended care
services patient may be visited by the patient's attorney or by representatives of the departments named in
section 20156 during other than established visiting hours. Reasonable privacy shall be afforded for visitation
of an extended care services patient who shares a room with another extended care services patient. Each
extended care services patient shall have reasonable access to a telephone.
(iii) An extended care services patient is entitled to retain and use personal clothing and possessions as
space permits, unless medically contraindicated, as documented by the attending physician in the medical
record.
(iv) An extended care services patient is entitled to the opportunity to participate in the planning of his or
her medical treatment, including the development of the discharge plan under subdivision (m). An extended
care services patient shall be fully informed by the attending physician of the extended care services patient's
medical condition, unless medically contraindicated, as documented by a physician in the medical record.
Each extended care services patient shall be afforded the opportunity to discharge himself or herself from the
extended care services program.
(v) An extended care services patient is entitled to be fully informed either before or at the time of
admission, and during his or her stay, of services available in the hospital and of the related charges for those
services. The statement of services provided by the hospital shall be in writing and shall include those
services required to be offered on an as needed basis.
(vi) A patient in an extended care services program or a person authorized in writing by the patient may,
upon submission to the hospital of a written request, inspect and copy the patient's personal or medical
records. The hospital shall make the records available for inspection and copying within a reasonable time,
not exceeding 7 days, after the receipt of the written request.
(vii) An extended care services patient has the right to have his or her parents, if the extended care services
patient is a minor, or his or her spouse, next of kin, or patient's representative, if the extended care services
patient is an adult, stay at the hospital 24 hours a day if the extended care services patient is considered
terminally ill by the physician responsible for the extended care services patient's care.
(viii) Each extended care services patient shall be provided with meals that meet the recommended dietary
allowances for that patient's age and sex and that may be modified according to special dietary needs or
ability to chew.
(ix) Each extended care services patient has the right to receive a representative of an organization
approved under section 21764, for all of the purposes described in section 21763.
(l) Achieve and maintain medicare certification under title XVIII.
(m) Establish a discharge plan for each extended care services patient who is admitted to the extended care
services program. In the discharge plan, the hospital shall emphasize patient choice in receiving extended care
services in the most appropriate and least restrictive setting. The hospital shall provide to the patient or his or
her authorized representative a copy of the discharge plan not later than 3 days after the patient is admitted to
the extended care services program.
(4) A hospital or the owner, an administrator, an employee, or a representative of the hospital shall not
discharge, harass, or retaliate or discriminate against an extended care services patient because the extended
care services patient has exercised a right described in subsection (3)(k).
(5) In the case of an extended care services patient, the rights described in subsection (3)(k)(iv) may be
exercised by the patient's representative, as defined in section 21703(2).
(6) An extended care services patient shall be fully informed, as evidenced by the extended care services
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patient's written acknowledgment, before or at the time of admission and during stay, of the rights described
in subsection (3)(k). The written acknowledgment shall provide that if an extended care services patient is
adjudicated incompetent and not restored to legal capacity, the rights and responsibilities set forth in
subsection (3)(k) shall be exercised by a person designated by the extended care services patient. The hospital
shall provide proper forms for the extended care services patient to provide for the designation of this person
at the time of admission.
(7) Subsection (3)(k) does not prohibit a hospital from establishing and recognizing additional rights for
extended care services patients.
(8) A hospital that violates subsection (3) is subject to the penalty provisions of section 20165.
(9) A person shall not initiate an extended care services program without first obtaining a certificate of
need under this section.
(10) As used in this section:
(a) "Extended care services program" means a program by a hospital to provide extended care services to a
patient through the use of swing beds under section 1883 of title XVIII, 42 USC 1395tt.
(b) "Hospital long-term care unit" means that term as defined in section 20106.
History: Add. 1988, Act 308, Eff. Oct. 1, 1988;Am. 1990, Act 260, Imd. Eff. Oct. 15, 1990;Am. 1993, Act 88, Imd. Eff. July 9,
1993;Am. 2006, Act 195, Imd. Eff. June 19, 2006;Am. 2011, Act 51, Eff. Dec. 6, 2011;Am. 2014, Act 165, Imd. Eff. June 12,
2014.
Compiler's note: For transfer of powers and duties of state fire marshal to department of labor and economic growth, bureau of
construction codes and fire safety, by type II transfer, see E.R.O. No. 2003-1, compiled at MCL 445.2011.
Popular name: Act 368
333.22215 Duties of commission; purpose; public hearing before final action; submission of
proposed final action to joint committee; approval or disapproval; review standards;
revision of fees.
Sec. 22215. (1) The commission shall do all of the following:
(a) If determined necessary by the commission, revise, add to, or delete 1 or more of the covered clinical
services listed in section 22203. If the commission proposes to add to the covered clinical services listed in
section 22203, the commission shall develop proposed review standards and make the review standards
available to the public not less than 30 days before conducting a hearing under subsection (3).
(b) Develop, approve, disapprove, or revise certificate of need review standards that establish for purposes
of section 22225 the need, if any, for the initiation, replacement, or expansion of covered clinical services, the
acquisition or beginning the operation of a health facility, making changes in bed capacity, or making covered
capital expenditures, including conditions, standards, assurances, or information that must be met,
demonstrated, or provided by a person who applies for a certificate of need. A certificate of need review
standard may also establish ongoing quality assurance requirements including any or all of the requirements
specified in section 22225(2)(c). Except for nursing home and hospital long-term care unit bed review
standards, by January 1, 2004, the commission shall revise all certificate of need review standards to include a
requirement that each applicant participate in title XIX of the social security act, chapter 531, 49 Stat. 620,
1396r-6 and 1396r-8 to 1396v.
(c) Direct the department to prepare and submit recommendations regarding commission duties and
functions that are of interest to the commission including, but not limited to, specific modifications of
proposed actions considered under this section.
(d) Approve, disapprove, or revise proposed criteria for determining health facility viability under section
22225.
(e) Annually assess the operations and effectiveness of the certificate of need program based on periodic
reports from the department and other information available to the commission.
(f) By January 1, 2005, and every 2 years thereafter, make recommendations to the joint committee
regarding statutory changes to improve or eliminate the certificate of need program.
(g) Upon submission by the department approve, disapprove, or revise standards to be used by the
department in designating a regional certificate of need review agency, pursuant to section 22226.
(h) Develop, approve, disapprove, or revise certificate of need review standards governing the acquisition
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of new technology.
(i) In accordance with section 22255, approve, disapprove, or revise proposed procedural rules for the
certificate of need program.
(j) Consider the recommendations of the department and the department of attorney general as to the
administrative feasibility and legality of proposed actions under subdivisions (a), (b), and (c).
(k) Consider the impact of a proposed restriction on the acquisition of or availability of covered clinical
services on the quality, availability, and cost of health services in this state.
(l) If the commission determines it necessary, appoint standard advisory committees to assist in the
development of proposed certificate of need review standards. A standard advisory committee shall complete
its duties under this subdivision and submit its recommendations to the commission within 6 months unless a
shorter period of time is specified by the commission when the standard advisory committee is appointed. An
individual shall serve on no more than 2 standard advisory committees in any 2-year period. The composition
of a standard advisory committee shall not include a lobbyist registered under 1978 PA 472, MCL 4.411 to
4.431, but shall include all of the following:
(i) Experts with professional competence in the subject matter of the proposed standard, who shall
constitute a 2/3 majority of the standard advisory committee.
(ii) Representatives of health care provider organizations concerned with licensed health facilities or
licensed health professions.
(iii) Representatives of organizations concerned with health care consumers and the purchasers and payers
of health care services.
(m) In addition to subdivision (b), review and, if necessary, revise each set of certificate of need review
standards at least every 3 years.
(n) If a standard advisory committee is not appointed by the commission and the commission determines it
necessary, submit a request to the department to engage the services of private consultants or request the
department to contract with any private organization for professional and technical assistance and advice or
other services to assist the commission in carrying out its duties and functions under this part.
(o) Within 6 months after the appointment and confirmation of the 6 additional commission members
under section 22211, develop, approve, or revise certificate of need review standards governing the increase
of licensed beds in a hospital licensed under part 215, the physical relocation of hospital beds from 1 licensed
site to another geographic location, and the replacement of beds in a hospital licensed under part 215.
(2) The commission shall exercise its duties under this part to promote and assure all of the following:
(a) The availability and accessibility of quality health services at a reasonable cost and within a reasonable
geographic proximity for all people in this state.
(b) Appropriate differential consideration of the health care needs of residents in rural counties in ways that
do not compromise the quality and affordability of health care services for those residents.
(3) Not less than 30 days before final action is taken by the commission under subsection (1)(a), (b), (d),
(h), or (o), the commission shall conduct a public hearing on its proposed action. In addition, not less than 30
days before final action is taken by the commission under subsection (1)(a), (b), (d), (h), or (o), the
commission chairperson shall submit the proposed action and a concise summary of the expected impact of
the proposed action for comment to each member of the joint committee. The commission shall inform the
joint committee of the date, time, and location of the next meeting regarding the proposed action. The joint
committee shall promptly review the proposed action and submit its recommendations and concerns to the
commission.
(4) The commission chairperson shall submit the proposed final action including a concise summary of the
expected impact of the proposed final action to the governor and each member of the joint committee. The
governor or the legislature may disapprove the proposed final action within 45 days after the date of
submission. If the proposed final action is not submitted on a legislative session day, the 45 days commence
on the first legislative session day after the proposed final action is submitted. The 45 days shall include not
less than 9 legislative session days. Legislative disapproval shall be expressed by concurrent resolution which
shall be adopted by each house of the legislature. The concurrent resolution shall state specific objections to
the proposed final action. A proposed final action by the commission under subsection (1)(a), (b), (d), (h), or
(o) is not effective if it has been disapproved under this subsection. If the proposed final action is not
disapproved under this subsection, it is effective and binding on all persons affected by this part upon the
expiration of the 45-day period or on a later date specified in the proposed final action. As used in this
subsection, legislative session day means each day in which a quorum of either the house of representatives
or the senate, following a call to order, officially convenes in Lansing to conduct legislative business.
(5) The commission shall not develop, approve, or revise a certificate of need review standard that requires
the payment of money or goods or the provision of services unrelated to the proposed project as a condition
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that must be satisfied by a person seeking a certificate of need for the initiation, replacement, or expansion of
covered clinical services, the acquisition or beginning the operation of a health facility, making changes in
bed capacity, or making covered capital expenditures. This subsection does not preclude a requirement that
each applicant participate in title XIX of the social security act, chapter 531, 49 Stat. 620, 1396r-6 and
1396r-8 to 1396v, or a requirement that each applicant provide covered clinical services to all patients
regardless of his or her ability to pay.
(6) If the reports received under section 22221(f) indicate that the certificate of need application fees
collected under section 20161 have not been within 10% of 3/4 the cost to the department of implementing
this part, the commission shall make recommendations regarding the revision of those fees so that the
certificate of need application fees collected equal approximately 3/4 of the cost to the department of
implementing this part.
(7) As used in this section, joint committee means the joint committee created under section 22219.
History: Add. 1988, Act 332, Eff. Oct. 1, 1988;Am. 1993, Act 88, Imd. Eff. July 9, 1993;Am. 2002, Act 619, Eff. Mar. 31, 2003
.
Popular name: Act 368
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333.22225 Demonstration of need for proposed project; additional requirements.
Sec. 22225. (1) In order to be approved under this part, an applicant for a certificate of need shall
demonstrate to the satisfaction of the department that the proposed project will meet an unmet need in the area
proposed to be served. An applicant shall demonstrate the need for a proposed project by credible
documentation of compliance with the applicable certificate of need review standards. If no certificate of need
review standards are applicable to the proposed project or to a portion of a proposed project that is otherwise
governed by this part, the applicant shall demonstrate to the satisfaction of the department that an unmet need
for the proposed project or portion of the proposed project exists by credible documentation that the proposed
project will be geographically accessible and efficiently and appropriately utilized, in light of the type of
project and the existing health care system. Whether or not there are applicable certificate of need review
standards, in determining compliance with this subsection, the department shall consider approved projects
that are not yet operational, proposed projects under appeal from a final decision of the department, or
proposed projects that are pending final department decision.
(2) If, and only if, the requirements of subsection (1) are met, in order for an application to be approved
under this part, an applicant shall also demonstrate to the reasonable satisfaction of the department all of the
following:
(a) With respect to the method proposed to meet the unmet need identified under subsection (1), that the
applicant has considered alternatives to the proposed project and that, in light of the alternatives available for
consideration, the chosen alternative is the most efficient and effective method of meeting that unmet need.
(b) With respect to the financial aspects of the proposed project, that each of the following is met:
(i) The capital costs of the proposed project will result in the least costly total annual operating costs.
(ii) Funds are available to meet the capital and operating needs of the proposed project.
(iii) The proposed project utilizes the least costly method of financing, in light of available alternatives.
(iv) In the case of a construction project, the applicant stipulates that 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.
(c) The proposed project will be delivered in compliance with applicable operating standards and quality
assurance standards approved under section 22215(1)(b), including 1 or more of the following:
(i) Mechanisms for assuring appropriate utilization of the project.
(ii) Methods for evaluating the effectiveness of the project.
(iii) Means of assuring delivery of the project by qualified personnel and in compliance with applicable
safety and operating standards.
(iv) Evidence of the current and historical compliance with federal and state licensing and certification
requirements in this state by the applicant or the applicant's owner, or both, to the degree determined
appropriate by the commission in light of the subject of the review standard.
(v) Other criteria approved by the commission as appropriate to evaluate the quality of the project.
(d) The health services proposed in the project will be delivered in a health facility that meets the criteria,
if any, established by the commission for determining health facility viability, pursuant to this subdivision.
The criteria shall be proposed by the department and the office, and approved or disapproved by the
commission. At a minimum, the criteria shall specify, to the extent applicable to the applicant, that an
applicant shall be considered viable by demonstrating at least 1 of the following:
(i) A minimum percentage occupancy of licensed beds.
(ii) A minimum percentage of combined uncompensated discharges and discharges under title XIX in the
health facility's planning area.
(iii) A minimum percentage of the total discharges in the health facility's planning area.
(iv) Evidence that the health facility is the only provider in the health facility's planning area of a service
that is considered essential by the commission.
(v) An operating margin in an amount determined by the commission.
(vi) Other criteria approved by the commission as appropriate for statewide application to determine health
facility viability.
(e) In the case of a nonprofit health facility, the health facility is in fact governed by a body composed of a
majority consumer membership broadly representative of the population served. In the case of a health facility
sponsored by a religious organization, or if the nature of the nonprofit health facility is such that the legal
rights of its owners or sponsors might be impaired by a requirement as to the composition of its governing
body, an advisory board with majority consumer membership broadly representative of the population served
may be construed by the department to be equivalent to the governing board described in this subdivision, if
the advisory board meets all of the following requirements:
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(i) The role assigned to the advisory board is meaningful, as determined by the department.
(ii) The functions of the advisory board are clearly prescribed.
(iii) The advisory board is given an opportunity to influence policy formulation by the legally recognized
governing body, as determined by the department.
History: Add. 1988, Act 332, Eff. Oct. 1, 1988;Am. 1993, Act 88, Imd. Eff. July 9, 1993.
Popular name: Act 368
333.22226 Regional certificate of need review agency; standards; designation of person for
specific review area; requirements; duration and termination of agency; local certificate of
need review agency; application or other information; review; recommendations; decision;
convening consumers, providers, purchasers, or payers of health care; public hearing;
meetings; review area defined.
Sec. 22226. (1) The commission shall develop standards for the designation by the department of a
regional certificate of need review agency for each review area to develop advisory recommendations for
proposed projects. The standards shall be based on the requirements for a regional certificate of review
agency set forth in subsection (3).
(2) The department, with the concurrence of the commission, shall designate a person to be a regional
certificate of need review agency for a specific review area, according to procedures approved by the
commission, if the person meets the standards approved under subsection (1), and if a regional certificate of
need review agency has not already been designated for that specific review area.
(3) A regional certificate of need review agency shall meet all of the following requirements:
(a) Be an independent nonprofit organization that is not a subsidiary of, or otherwise controlled by, any
other person.
(b) Be governed by a board that is broadly representative of consumers, providers, payers, and purchasers
of health care in the review area, with a majority of the board being consumers, payers, and purchasers of
health care.
(c) Demonstrate a willingness and ability to conduct reviews of all proposed projects requiring a certificate
of need that would be located within the review area served by the regional certificate of need review agency.
(d) Avoid conflict of interest in its review of all applications for a certificate of need.
(e) Provide data to the department to enable the department to evaluate the regional certificate of need
review agency's performance. The data provided under this subdivision shall be reviewed at periodic meetings
between the department and the regional certificate of need review agency.
(f) Not receive more than a designated proportion of its financial support from health facilities and health
professionals, as determined by the commission.
(g) Meet other requirements established by the commission that are relevant to the functions of a regional
certificate of need review agency, under this part.
(4) The designation of a regional certificate of need review agency shall be operative for a period of time
approved by the commission, but not for more than 24 months. The designation of a regional certificate of
need review agency may be terminated by the department with the concurrence of the commission at any time
for noncompliance with the standards approved under subsection (1). In addition, the designation may be
terminated by the regional certificate of need review agency upon the expiration of 60 days after the
department receives written notice of the termination.
(5) A local certificate of need review agency that was designated pursuant to a designation agreement
authorized under former section 22124 and effective on October 1, 1988 is designated as the regional
certificate of need review agency for its review area until the expiration of 1 year after the date of final
approval of the standards developed under subsection (1), unless the designation is terminated by either the
department under subsection (4) or the regional certificate of need review agency before that time.
(6) A person applying for a certificate of need under this part shall simultaneously provide a copy of any
letter of intent, application, or additional information required by the department to the regional certificate of
need review agency designated by the department for the review area in which the proposed project would be
located, unless the regional certificate of need review agency determines that it will not review the application
or other information, and notifies both the applicant and the department in writing of its determination. The
regional certificate of need review agency may review the application and submit its recommendations to the
department. If the regional certificate of need review agency determines that it will not review the application,
then the regional certificate of need review agency shall notify both the applicant and the department in
writing of its determination. In developing its recommendations, the regional certificate of need review
agency shall utilize the review procedures and time frames specified for regional certificate of need review
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agencies in the rules continued or promulgated under this part, and shall also utilize certificate of need review
standards, statutory criteria, and forms identical to those used by the department.
(7) Before developing a proposed decision on an application, the department shall review the
recommendations of the regional certificate of need review agency for the review area in which the proposed
project would be located, if the recommendations are submitted to the department within the time frames
required under subsection (6). If the director makes a final decision that is inconsistent with the
recommendations of the regional certificate of need review agency, the department shall promptly provide the
regional certificate of need review agency with a detailed statement of the reasons for the director's decision.
The statement shall address each instance in which the director's decision is inconsistent with the
recommendation of the regional certificate of need review agency regarding a specific certificate of need
review standard or criterion.
(8) A regional certificate of need review agency may convene consumers, providers, purchasers, or payers
of health care, or representatives of all of those groups, related to activities in its review area for the purpose
of achieving the objectives of this part.
(9) Before developing a recommendation on a certificate of need application, a regional certificate of need
review agency shall hold a public hearing on the proposed project. If the department determines that local
interest merits a public hearing and a regional certificate of need review agency has not been designated for
the review area in which the proposed project will be located, then the department shall hold a public hearing
on the proposed project.
(10) A regional certificate of need review agency shall conduct all meetings regarding its activities for the
purpose of achieving the objectives of this part in compliance with the open meetings act, 1976 PA 267, MCL
15.261 to 15.275.
(11) As used in this section, review area means a geographic area established for a health systems
agency pursuant to former section 1511 of the public health service act, or a geographic area otherwise
established by the commission for a regional certificate of need review agency.
History: Add. 1988, Act 331, Eff. Oct. 1, 1988;Am. 2002, Act 619, Eff. Mar. 31, 2003.
Popular name: Act 368
Administrative rules: R 325.9101 et seq. of the Michigan Administrative Code.
333.22227 Health maintenance organization; purposes for which certificate of need required;
capital expenditures; considerations and criteria.
Sec. 22227. (1) A health maintenance organization is required to obtain a certificate of need only for 1 or
more of the following purposes:
(a) The acquisition of, purchase of, new construction of, modernization of, replacement of, or addition to a
hospital or other health facility providing inpatient services, if a covered capital expenditure is required.
(b) The initiation, replacement, or expansion of a covered clinical service.
(2) A covered capital expenditure proposed to be undertaken by a health maintenance organization that is
not intended principally to serve the needs of the enrollees of the health maintenance organization, as
determined by the department, is subject to this part.
(3) In making determinations and conducting reviews for certificates of need for health maintenance
organizations, the department shall consider the special needs and circumstances of health maintenance
organizations, and shall apply all of the following criteria:
(a) The availability of the proposed service from a provider of health care other than the health
maintenance organization on a long-term basis, at reasonable terms, and in a cost-effective manner consistent
with the health maintenance organization's basic method of operation.
(b) The long-term needs of the health maintenance organization, and its current and expected future
membership.
(c) The long-term impact of the proposed service on health care costs in the health maintenance
organization's service area.
History: Add. 1988, Act 332, Eff. Oct. 1, 1988;Am. 1993, Act 88, Imd. Eff. July 9, 1993.
Popular name: Act 368
333.22231 Decision to grant or deny application for certificate of need; conditions; single
decision for all applications; proposed decision; final decision; notice of reversal; hearing;
judicial review; effect of exceeding time frames.
Sec. 22231. (1) The decision to grant or deny an application for a certificate of need shall be made by the
director. A decision shall be proposed to the director by a bureau within the department designated by the
director as responsible for the certificate of need program. A decision shall be in writing and shall indicate 1
of the following:
(a) Approval of the application.
(b) Disapproval of the application.
(c) Subject to subsection (2), approval of the application with conditions.
(d) If agreed to by the department and the applicant, approval of the application with stipulations.
(2) If an application is approved with conditions under subsection (1)(c), the conditions shall be explicit,
shall be related to the proposed project or to the applicable provisions of this part, and shall specify a time, not
to exceed 1 year after the date the decision is rendered, within which the conditions shall be met.
(3) If the department is conducting a comparative review, the director shall issue only 1 decision for all of
the applications included in the comparative review.
(4) Before a final decision on an application is made, the bureau of the department designated by the
director as responsible for the certificate of need program shall issue a proposed decision with specific
findings of fact in support of the proposed decision with regard to each of the criteria listed in section 22225.
The proposed decision also shall state with specificity the reasons and authority of the department for the
proposed decision. The department shall transmit a copy of the proposed decision to the applicant.
(5) The proposed decision shall be submitted to the director on the same day the proposed decision is
issued.
(6) If the proposed decision is other than an approval without conditions or stipulations, the director shall
issue a final decision not later than 60 days after the date a proposed decision is submitted to the director
unless the applicant has filed a request for a hearing on the proposed decision. If the proposed decision is an
approval, the director shall issue a final decision not later than 5 days after the proposed decision is submitted
to the director.
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(7) The director shall review the proposed decision before a final decision is rendered.
(8) If a proposed decision is an approval, and if, upon review, the director reverses the proposed decision,
the director immediately shall notify the applicant of the reversal. Within 15 days after receipt of the notice of
reversal, the applicant may request a hearing under section 22232. After the hearing, the applicant may
request the director to reconsider the reversal of the proposed decision, based on the results of the hearing.
(9) Within 30 days after the final decision of the director, the final decision of the director may be appealed
only by the applicant and only on the record 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 the administrative procedures act of 1969, 1969 PA 306, MCL 24.201 to 24.328.
(10) If the department exceeds the time set forth in this section for other than good cause, as determined by
the commission, upon the written request of an applicant, the department shall return to the applicant all of the
certificate of need application fee paid by the applicant under section 20161.
History: Add. 1988, Act 332, Eff. Oct. 1, 1988;Am. 1993, Act 88, Imd. Eff. July 9, 1993;Am. 2002, Act 619, Eff. Mar. 31, 2003
.
Popular name: Act 368
333.22232 Hearing; written request; appointment and duties of hearing officer; governing
law.
Sec. 22232. (1) The applicant may, within 15 days after receipt by the applicant of the bureau's proposed
decision to deny the application or receipt of notice of reversal by the director of a proposed decision that is
an approval, submit a written request for a hearing to demonstrate that the application filed by the applicant
meets the requirements for approval under this part.
(2) The department shall appoint a hearing officer for a hearing held under this section. The hearing officer
shall establish a schedule for the hearing, control the presentation of proofs, and take such other action
determined by the hearing officer to be necessary to ensure that the hearing is conducted in an expeditious
manner and completed within a reasonable period of time. The hearing officer shall convene the hearing
within 90 days after receipt of a request for a hearing under this section. Upon written request by a party, a
hearing officer may issue subpoenas requiring the attendance and testimony of witnesses and the production
of evidence. The department shall establish appropriate qualifications for hearing officers appointed under
this section.
(3) If a hearing is requested under this section, chapter 4 of the administrative procedures act of 1969, Act
No. 306 of the Public Acts of 1969, being sections 24.271 to 24.287 of the Michigan Compiled Laws,
governs.
History: Add. 1988, Act 332, Eff. Oct. 1, 1988;Am. 1993, Act 88, Imd. Eff. July 9, 1993.
Popular name: Act 368
333.22235 Waiver of law and procedural requirements and criteria for review; affidavit;
emergency certificate of need.
Sec. 22235. (1) The department may waive otherwise applicable provisions of this part and procedural
requirements and criteria for review upon a showing by the applicant, by affidavit, of all of the following:
(a) The necessity for immediate or temporary relief due to natural disaster, fire, unforeseen safety
consideration, or other emergency circumstances.
(b) The serious adverse effect of delay on the applicant and the community that would be occasioned by
compliance with the otherwise applicable requirements of this part and rules promulgated under this part.
(c) The lack of substantial change in facilities or services that existed before the emergency circumstances
established under subdivision (a).
(d) The temporary nature of the construction of facilities or the services that will not preclude different
disposition of longer term determinations in a subsequent application for a certificate of need not made under
this section.
(2) The department may issue an emergency certificate of need after necessary and appropriate review. A
record of the review shall be made, including copies of affidavits and other documentation. Findings and
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conclusions shall be made as to an application for an emergency certificate of need, whether the emergency
certificate of need is issued or denied.
(3) An emergency certificate of need issued under this section is a final decision and the applicant is not
required to submit a formal application for a second review. A certificate of need issued under this section
may be subject to special limitations and restrictions, in regard to duration and right of extension or renewal
and other factors, imposed by the department.
History: Add. 1988, Act 332, Eff. Oct. 1, 1988;Am. 2002, Act 619, Eff. Mar. 31, 2003.
Popular name: Act 368
333.22239 Stipulation.
Sec. 22239. (1) If the certificate of need approval was based on a stipulation that the project would
participate in title XIX and the project has not participated in title XIX for at least 12 consecutive months
within the first 2 years of operation or continued to participate annually thereafter, the department shall
revoke the certificate of need. A stipulation described in this section is germane to all health facility projects.
(2) The department shall monitor the participation in title XIX of each certificate of need applicant
approved under this part. Except as otherwise provided in subsection (3), the department shall require each
applicant to provide verification of participation in title XIX with its application and annually thereafter.
(3) The department shall not revoke or deny a certificate of need for a nursing home licensed under part
217 if that nursing home does not participate in title XIX on the effective date of the amendatory act that
added this subsection but agrees to participate in title XIX if beds become available. This section does not
prohibit a person from applying for and obtaining a certificate of need to acquire or begin operation of a
nursing home that does not participate in title XIX.
History: Add. 1988, Act 332, Eff. Oct. 1, 1988;Am. 1993, Act 88, Imd. Eff. July 9, 1993;Am. 2002, Act 619, Eff. Mar. 31, 2003
.
Popular name: Act 368
333.22243 Acquisition of new technology before approval of federal food and drug
administration; notice; requirements; deactivation and removal of new technology from
service; conditions to utilizing new technology beyond specified period.
Sec. 22243. (1) Unless the commission provides otherwise in a standard approved under section
22215(1)(h), a person may acquire new technology before the new technology is approved by the federal food
and drug administration if the person notifies the department before acquiring the new technology, and the
acquisition of the new technology continuously meets all of the following requirements:
(a) Has been authorized by the federal food and drug administration under an investigational device
exemption and approved research project pursuant to 21 C.F.R. part 812.
(b) Is operated consistently with the research protocols established and approved by the federal food and
drug administration for the investigational device exemption.
(c) Is solely related to research and testing for purposes of determining the safety and effectiveness of the
new technology for use on human subjects.
(d) Is funded so that there will be no recovery of either capital or operating expenses for the use of the new
technology either from patients or from third party payers. However, usual and customary charges or other
payment arrangements for related services rendered to patients that are consistent with standard
nonexperimental treatment, including, but not limited to, room, board, ancillary services, and outpatient
services may be charged to patients or third party payers, or both, in accordance with normal billing practices.
Each patient upon whom the new technology is used shall be informed of the requirements of this
subdivision.
(e) Is maintained under a separate cost center that includes overhead costs, for expenditure reporting
related to the research project.
(f) Is developed so that capital funding for the research project will be obtained from sources other than the
Michigan state hospital finance authority or any other governmentally supported financing source. This
subdivision does not prohibit a person from using grants for research activities.
(g) Is operated so as to provide, upon request of the department, data obtained from the research project
that the department may use in developing certificate of need review standards relative to the new technology.
Aggregate data obtained as part of a federally approved data set shall meet the requirements of this part,
except that supplemental data may be requested by the department.
(h) Is not marketed or advertised to other health care providers or the public.
(2) A person acquiring new technology under this section shall deactivate and remove the new technology
from service on the date of notice that federal approval under the investigational device exemption for the
new technology acquired under 21 C.F.R. part 812 has expired or been withdrawn, or the date of receipt of a
department compliance order alleging a violation of this section.
(3) A person may continue to utilize new technology acquired under this section beyond the period
specified in subsection (2) if any 1 of the following applies:
(a) The continued use is in compliance with section 22243(1)(d) to (h).
(b) The department issues a notice that the new technology will not be added to the list of covered medical
equipment pursuant to section 22241(2)(a).
(c) The commission adds the new technology to the list of covered medical equipment, and the continued
use is consistent with applicable certificate of need review standards, if any.
History: Add. 1988, Act 332, Eff. Oct. 1, 1988.
Popular name: Act 368
333.22249 Agreement authorizing hospital to lease space and operate beds in another
hospital; conditions.
Sec. 22249. (1) Subject to subsection (2), if a hospital has a high occupancy rate, as determined by the
department, and if the hospital applies for and is issued a certificate of need for an increase in licensed bed
capacity, the department may enter into an agreement with the hospital that would authorize the hospital to
lease space and operate beds in another hospital in the same planning area, if the other hospital has a low
occupancy rate, as determined by the department.
(2) The department may enter into an agreement authorized under subsection (1) only if all of the
following apply:
(a) The hospital issued a certificate of need has a documented history of high occupancy.
(b) The alternative of redistributing the beds within the hospital's licensed bed capacity does not exist.
(c) The agreement will not change the overall supply of beds within the planning area.
(d) New construction is not required.
(e) The department determines that the agreement is necessary to protect the public health, safety, and
welfare.
History: Add. 1988, Act 332, Eff. Oct. 1, 1988.
Popular name: Act 368
ARTICLE 19
REPEALS, SAVINGS CLAUSES, AND EFFECTIVE DATES
PART 251
REPEALS
333.25101 Repeal of acts and parts of acts.
Sec. 25101. The following acts and parts of acts, as amended, are repealed:
(a) Public Acts:
PUBLIC ACT YEAR OF SECTION COMPILED LAW
NUMBER ACT NUMBERS NUMBERS (1970)
44 1899 9 to 10 24.9 to 24.10
327 1947 10a and 120 to 126 29.210a and 29.320 to
29.326
43 1950 (Extra Session) 30.151 to 30.153
287 1919 2 and 6 32.232 and 32.236
3 1895 47 to 54 of chapter 7 67.47 to 67.54
215 1895 1 to 8 of chapter 14 94.1 to 94.8
288 1972 123.281 to 123.287
172 1958 125.741 to 125.745
55 1915 128.21
297 1929 7 128.57
201 1911 128.91 to 128.93
330 1976 257.1221 to 257.1238
197 1970 286.611 to 286.616
289 1965 286.621 to 286.634
152 1956 287.451 to 287.474
151 1975 287.481 to 287.488
344 1917 289.201 to 289.203
58 1959 323.221 to 323.226
146 1919 325.1 to 325.14
109 1907 325.21 to 325.24
164 1915 325.31 to 325.33
105 1927 325.41 to 325.42
308 1927 325.51 to 325.53
235 1968 325.81 to 325.92
62 1941 325.101 to 325.103
15 1952 325.121 to 325.123
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39 1957 325.131 to 325.134
13 1959 325.141 to 325.147
26 1959 325.151 to 325.157
41 1959 325.161 to 325.164
346 1968 325.191 to 325.192
294 1965 325.221 to 325.239
136 1881 325.251 to 325.252
273 1939 325.271 to 325.274
210 1909 325.302 to 325.307
241 1947 325.401 to 325.406
305 1972 325.451 to 325.462
278 1949 325.501 to 325.505
341 1965 325.511
119 1965 325.521 to 325.524
335 1974 325.531 to 325.533
231 1955 325.551 to 325.556
7 1956 (Extra Session) 325.561 to 325.562
230 1966 325.601 to 325.620
218 1967 325.631 to 325.635
171 1970 325.651 to 325.665
56 1973 325.711 to 325.735
339 1974 325.751 to 325.766
269 1968 325.801 to 325.813
124 1977 325.871 to 325.877
288 1976 325.3001 to 325.3012
343 1925 1 to 8a and 326.1 to 326.8a and
9 to 21 326.9 to 326.21
35 1931 326.31 to 326.37
9 1897 326.51 to 326.52
170 1921 326.61 to 326.62
120 1903 327.101 to 327.111
137 1883 327.151 to 327.153
157 1879 327.171
306 1927 327.201 to 327.208a
248 1911 327.251 to 327.261
37 1917 327.311 to 327.315
138 1958 328.11 to 328.23
115 1925 328.101 to 328.102
95 1953 328.151
189 1969 328.261 to 328.270
95 1970 328.281 to 328.289
230 1885 329.1 to 329.7
293 1909 329.51 to 329.55
146 1879 329.81
306 1909 329.101 to 329.108
116 1903 329.121
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272 1919 329.151 to 329.158
6 1942 (Second Extra 329.201 to 329.208
Session)
238 1969 329.221
276 1941 329.251 to 329.255
353 1919 329.271 to 329.272
314 1927 329.401 to 329.405
164 1949 329.501 to 329.505
169 1966 329.521 to 329.526
96 1975 329.551 to 329.557
263 1913 331.401 to 331.406
17 1968 331.411 to 331.430
256 1972 331.451 to 331.462
274 1974 331.471 to 331.493
176 1973 331.551 to 331.556
139 1956 331.651 to 331.660
115 1929 332.1 to 332.7
254 1905 332.51 to 332.70
343 1917 332.101 to 332.118
252 1951 332.201 to 332.204
5 1951 (Extra Session) 332.231 to 332.239
139 1952 332.251 to 332.255
146 1909 335.1 to 335.10
3 1971 335.21
60 1954 335.201 to 335.214
241 1970 335.231
196 1971 335.301 to 335.367
56 1905 338.71 to 338.72
151 1899 338.81
162 1903 338.101a to 338.121
145 1933 338.151 to 338.159
122 1939 1 to 9 and 338.201 to 338.209 and
10 to 21 338.210 to 338.221
71 1909 338.251 to 338.262
115 1915 338.301 to 338.308a
164 1965 338.321 to 338.338
7 1925 338.381 to 338.385
277 1921 338.391 to 338.393
257 1959 338.1001 to 338.1019
151 1962 338.1101 to 338.1131
149 1967 338.1151 to 338.1175
147 1963 338.1301 to 338.1315
185 1973 338.1801 to 338.1827
290 1976 338.1921 to 338.1938
420 1976 338.1951 to 338.1978
119 1911 419.1 to 419.3
85 1923 446.301 to 446.306
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176 1927 469.161 to 469.165
207 1937 551.151 to 551.154
17 1963 3 691.1503
174 1967 691.1511 to 691.1512
158 1937 1 to 29 and 722.201 to 722.229 and
31 to 44 722.231 to 722.244
283 1939 722.301 to 722.325
138 1881 722.401 to 722.406
183 1972 722.591 to 722.594
328 1931 470 and 750.470 and
472 to 477 750.472 to 750.477
(b) Revised Statutes of 1846:
COMPILED
LAW
SECTION NUMBERS
CHAPTER NUMBERS (1970)
35 1 to 49 327.1 to
327.49
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
PART 252
SAVINGS CLAUSES AND EFFECTIVE DATES
333.25201 Continuation of statutory provisions and rules; submission of proposed rules to
public hearing; nomination and appointment of agency members.
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Sec. 25201. (1) Where a section of this code authorizes or directs the promulgation of rules, including rules
fixing fees, but rules dealing with the subject matter do not exist when the section takes effect, a statutory
provision covering the matter, which is repealed by this code, shall nevertheless continue in effect until rules
covering the matter take effect or for 3 years, whichever is sooner.
(2) Rules in effect on the effective date of this code shall continue to the extent that they do not conflict
with this code, and shall be considered as rules promulgated under this code.
(3) An agency which is required to promulgate rules under this code shall submit the proposed rules to
public hearing within 2 years after the effective date of this code.
(4) Rules and regulations adopted by a district or county board of health which are in effect on the
effective date prescribed in section 25211 continue to the extent that they do not conflict with this code, and
are considered as local health department regulations promulgated under this code.
(5) On the date this code is enacted into law procedures for the nomination and appointment of members of
agencies created or continued by this code may be commenced, but the appointments shall not take effect
before the effective date of the section providing for the appointment.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
333.25205 Section 8.4a inapplicable to code; action or other proceeding not abated.
Sec. 25205. Section 4a of chapter 1 of the Revised Statutes of 1846, being section 8.4a of the Michigan
Compiled Laws, is applicable to this code. In addition, an action or other proceeding lawfully commenced by
or against an agency or an officer of this state, in his or her official capacity in relation to the discharge of
official duties, including a proceeding against a licensee, registrant, or permittee, does not abate because the
agency or officer is superseded by another agency or office created by this code. The court may allow the
action or other proceeding to be maintained by or against the successor of the agency or officer.
History: 1978, Act 368, Eff. Sept. 30, 1978.
Popular name: Act 368
Rendered Friday, February 3, 2017 Page 658 Michigan Compiled Laws Complete Through PA 416 of 2016
Legislative Council, State of Michigan Courtesy of www.legislature.mi.gov