Senate health committee advances assisted outpatient treatment bills 219–222 after testimony

LANSING — The Michigan Senate Committee on Health Policy voted unanimously on March 19 to report four related bills on assisted outpatient treatment (AOT) to the Senate floor following testimony from a retired probate judge and mental health advocates.

The package — Senate Bills 219, 220, 221 and 222 — is designed to expand outpatient options for people with serious mental illness by easing barriers to AOT, the committee was told.

The bills were introduced as a reintroduction of measures from the prior session that had cleared this committee but did not reach final enactment. Committee members voted 10–0 to recommend each bill pass and be reported to the full Senate.

Supporters said the changes would permit earlier intervention and reduce reliance on short hospital stays or incarceration. "If we make assisted outpatient treatment more readily available, we're going to help ease the impact of that shortage of beds," testified Milton Mack, a retired probate judge and chair of the governor's Mental Health Diversion Council.

Why it matters: Testimony framed the bills as tools for earlier treatment and better coordination among emergency departments, hospitals, probate courts and community mental health agencies. Proponents said the measures could reduce hospitalizations and jail time and improve recovery outcomes for people with serious mental illness.

What the bills would do

- Senate Bill 219: Expand who may testify as to a person's need for assisted outpatient treatment. Current law requires a psychiatrist to testify; SB 219 would allow a physician, psychologist, psychiatric nurse practitioner, or physician assistant working under psychiatric supervision to provide testimony when a psychiatrist is not readily available. If ordered, a psychiatrist would still supervise the AOT plan's preparation and implementation.

- Senate Bill 220: Broaden use of mediation as an alternative to court petitions in cases of treatment noncompliance. The bill builds on a 2020 legislative authorization for mediation and would allow providers and families to seek mediated agreements that can avert court petitions.

- Senate Bill 221: Allow AOT to be used as a voluntary alternative to forensic-center evaluations for some misdemeanor defendants, with dismissal of charges if the prosecutor and defendant do not object.

- Senate Bill 222: Permit family members to petition for extensions of existing AOT orders rather than leaving that authority solely to providers.

Key testimony and evidence

Judge Milton Mack described long experience conducting mental health hearings and cited the 2004 Michigan Mental Health Commission finding that mental illness is treatable and early intervention improves outcomes. Mack said prior changes to Michigan law (noted in testimony as 2016 and 2018 updates) already permit earlier outpatient intervention and that several counties, including Genesee County, have seen reductions in hospitalization where outpatient measures were embraced. "Where it has been embraced, hospitalization has been reduced by as much as 70 percent," Mack said.

Mack also said the current requirement that a psychiatrist must testify has made AOT petitions difficult to secure in practice: "Less than 5% of the petitions for treatment filed in Michigan at this time are for AOT only," he said. He testified that the bill package seeks to remove barriers so families and providers can seek earlier help.

Marianne Hough of the Mental Health Association in Michigan testified in support, describing cases where delayed treatment led to criminal justice involvement and urging greater awareness of AOT as an option. "AOT is a great tool," she said, and said expanded mediation could help families and providers reach agreements without court intervention.

Committee action and votes

The committee formally moved to report each bill to the Senate floor with the recommendation that the bill pass. Motions and final tallies were recorded as follows:

- SB 219: Motion to report to the floor made by Senator Santana; roll call 10 yeas, 0 nays. Recorded yes votes: Chairman Cameron Hertel; Senator Santana; Senator Bueno; Senator Cherry; Senator Kleinfeld; Senator Geiss; Senator Weber; Senator Hauck; Senator Huizenga; Senator Runstead.

- SB 220: Motion to report to the floor made by Senator Bueno; roll call 10 yeas, 0 nays. Recorded yes votes: Chairman Cameron Hertel; Senator Santana; Senator Bueno; Senator Cherry; Senator Kleinfeld; Senator Geiss; Senator Weber; Senator Hauck; Senator Huizenga; Senator Runstead.

- SB 221: Motion to report to the floor made by Senator Cherry; roll call 10 yeas, 0 nays. Recorded yes votes: Chairman Cameron Hertel; Senator Santana; Senator Voyno; Senator Cherry; Senator Kleinfeld; Senator Geist; Senator Weber; Senator Hauck; Senator Huizenga; Senator Runstead. (Transcript shows occasional variant spellings of several members' names.)

- SB 222: Motion to report to the floor made by Senator Kleinfeld; roll call 10 yeas, 0 nays. Recorded yes votes: Chairman Cameron Hertel; Senator Santana; Senator Bueno; Senator Cherry; Senator Kleinfeld; Senator Geiss; Senator Weber; Senator Hauck; Senator Huizenga; Senator Runstead.

Transcript notes and provenance

Committee staff recorded that these bills had been considered in the previous session and were being reintroduced. The chair opened testimony on the package and invited Judge Mack to present; committee members asked no substantive questions of Mack, and the committee proceeded to vote after additional testimony in support was entered into the record.

What the record does not show

The committee record does not show floor debate on these bills, any amendments adopted in committee, nor detailed fiscal notes in this hearing. The transcript contains no explicit estimates of statewide costs tied to implementation of the bills.

Next steps

All four bills were reported to the Senate floor with unanimous committee recommendations. The measures will proceed to further consideration by the full Senate per chamber rules.