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Senate health committee unanimously advances assisted outpatient treatment bill package
Summary
The Michigan Senate Committee on Health Policy voted 10-0 to report four bills that would expand and streamline assisted outpatient treatment (AOT), including widening who may testify, expanding mediation, enabling AOT in certain misdemeanor cases, and allowing family petitions to extend orders.
Lansing — On March 19, 2025, the Michigan Senate Committee on Health Policy advanced a package of four bills aimed at expanding assisted outpatient treatment, voting 10-0 to report Senate Bills 219, 220, 221 and 222 to the Senate floor with a recommendation that each bill pass.
The bills would broaden who may testify about a person's need for AOT, increase use of mediation to resolve treatment disputes, permit AOT as an alternative route for some misdemeanor defendants, and allow family members to petition to extend assisted outpatient treatment orders, supporters told the committee.
Judge Milton Mack, a retired probate judge and chair of the governor's Mental Health Diversion Council, told the committee the package builds on earlier changes to Michigan's Mental Health Code and is intended to enable earlier intervention. "If we make assisted outpatient treatment more readily available, we're going to help ease the impact of that shortage of beds," Mack said, arguing that broader access to AOT can reduce unnecessary hospitalizations and jail time and improve recovery outcomes.
Mack and other witnesses said the current requirement that only a psychiatrist testify as to the need for AOT has been a practical barrier in many counties. Mack told the panel "less than 5% of the petitions for treatment filed in Michigan at this time are for AOT only," and said Senate Bill 219 would add a physician, psychologist, psychiatric nurse practitioner, or physician assistant working under a psychiatrist's supervision as eligible to testify, while retaining a psychiatrist's role in supervising clinical decisions and the AOT plan.
Senate Bill 220, supporters said, would expand mediation that was authorized in 2020 but limited in scope. Mack said mediation can reduce petitions for involuntary treatment and encourage treatment engagement. Senate Bill 221 would allow AOT as an alternative to use of the forensic center to assess misdemeanor defendants if the prosecutor and defendant do not object. Senate Bill 222 would permit family members to petition for continuing involuntary treatment before current orders expire, addressing situations where a provider failed to file a timely extension request.
Marianne Hough of the Mental Health Association in Michigan, a clinical social worker and member of the association's board, said early intervention is key and that the bills would help families and clinicians access treatment before crises. "AOT is a great tool," Hough said, asking that families and practitioners become more aware of assisted outpatient treatment as an option.
The committee clerk read written support from multiple organizations, including the Michigan Health and Hospital Association, Disability Rights Michigan, PAAM, and the Community Mental Health Association of Michigan.
After testimony, committee members moved to report each bill to the floor. The motions were carried on recorded voice roll calls with identical tallies: 10 yeas, 0 nays. The chairman observed the bills had been heard and voted on in the prior legislative session and were being reintroduced this year.
The committee then turned to a separate presentation on behavioral health capacity. With the committee's unanimous votes, the four AOT bills were sent to the full Senate with a recommendation that each pass.
Votes at a glance: - Senate Bill 219 — Motion to report to the floor with recommendation that the bill pass; moved by Senator Santana; vote: 10 yeas, 0 nays; outcome: approved. - Senate Bill 220 — Motion to report to the floor with recommendation that the bill pass; moved by Senator Bueno; vote: 10 yeas, 0 nays; outcome: approved. - Senate Bill 221 — Motion to report to the floor with recommendation that the bill pass; moved by Senator Cherry; vote: 10 yeas, 0 nays; outcome: approved. - Senate Bill 222 — Motion to report to the floor with recommendation that the bill pass; moved by Senator Kleinfeld; vote: 10 yeas, 0 nays; outcome: approved.
The committee record shows each bill was reported to the floor by unanimous roll call votes.
The bills are promoted by the governor's Mental Health Diversion Council and supported in testimony by the Mental Health Association of Michigan and other advocacy and provider groups. Committee discussion during the hearing was limited; no committee member requested amendments before reporting the bills.
