Petition For Second Or Continuing Treatment Order {PCM 219} | Pdf Fpdf Doc Docx | Michigan

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Petition For Second Or Continuing Treatment Order {PCM 219} | Pdf Fpdf Doc Docx | Michigan

Petition For Second Or Continuing Treatment Order {PCM 219}

This is a Michigan form that can be used for Mental Health within Statewide.

Alternate TextLast updated: 5/16/2016

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Approved, SCAO JIS CODE: OFC STATE OF MICHIGAN PROBATE COURT COUNTY OF In the matter of 1. Date of hearing: 2. A petition has been filed by FILE NO. SECOND CONTINUING ORDER FOR TREATMENT Judge: Bar no. asserting that the individual Petitioner name (type or print) named above continues to be a person requiring treatment. 3. The initial order for mental health treatment was made pursuant to a petition filed under MCL 330.1434. 4. The court finds that notice of hearing has been given according to law. was present in court. 5. The individual was not present for reasons stated on the record. Present were The hearing was with without a jury. , the attorney for the individual, and , the attorney for the petitioner. 6. Testimony of a physician or licensed psychologist was waived by the individual and the individual's attorney. 7. Testimony was given by Testimony was not given because the parties stipulated to entry of the order. . THE COURT FINDS: 8. By clear and convincing evidence, the individual continues to be a person requiring treatment because the individual has a mental illness, and as a result of that mental illness a. can be reasonably expected within the near future to intentionally or unintentionally seriously physically injure self or others, and has engaged in an act or acts or made significant threats that are substantially supportive of the expectation. b. is unable to attend to those basic physical needs that must be attended to in order to avoid serious harm in the near future, and has demonstrated that inability by failing to attend to those basic physical needs. c. whose judgment is so impaired the individual is unable to understand the need for treatment. Continued behavior as the result of this mental illness can be reasonably expected, on the basis of competent clinical opinion, to result in significant physical harm to self or others. 9. There is is not an available treatment program that is an alternative to hospitalization or that follows an initial period of hospitalization adequate to meet the individual's treatment needs and is sufficient to prevent harm that the individual may inflict upon self or others within the near future. 10. that is adequate and appropriate to the individual's condition. (SEE SECOND PAGE) hospital can provide treatment Do not write below this line - For court use only American LegalNet, Inc. www.FormsWorkFlow.com PCM 219 (9/14) SECOND OR CONTINUING ORDER FOR TREATMENT MCL 330.1401, MCL 330.1464a, MCL 330.1469a, MCL 330.1472a 11. The individual is not a person requiring treatment. 12. The individual has been hospitalized involuntarily two or more times within the two-year period immediately preceding the filing of the petition and has rejected aftercare programs and treatment. IT IS ORDERED that the individual: 13. Undergo a second order of treatment and be hospitalized in the hospital noted above for a period not to exceed 90 days. 14. Undergo a continuing order of treatment and be hospitalized in the hospital noted above for a period not to exceed one year. 15. Undergo a second or continuing order of combined hospitalization and alternative/assisted outpatient treatment for a period not to exceed one year. Hospitalization in the hospital noted above shall not exceed 90 days. Alternative/assisted outpatient treatment shall be under the supervision of a community mental health services program a mental health agency or professional as follows: An initial hospitalization period shall not exceed days. 16. Is discharged from the hospital and shall undergo an alternative/assisted outpatient treatment program under the a community mental health services program supervision of a mental health agency or professional for a period not to exceed one year. Case management services shall be as follows: Additionally, one or more of the following is ordered: (See MCL 330.1433[3] for specific provisions that may be ordered.) 17. If the individual refuses to comply with a psychiatrist's order to return to the hospital, a peace officer shall take the individual into protective custody and transport the individual to the hospital designated by the psychiatrist. 18. Is discharged and the petition is denied. 19. If felony charges have been previously dismissed under MCL 330.2044(1)(b) and the time for petitioning to refile charges has not elapsed, a. not less than 30 days before the scheduled release or discharge, the director of the treating facility shall notify the prosecutor's office in the county in which charges against the person were originally brought that the patient's release or discharge is pending. b. not less than 30 days before the scheduled release or discharge, the patient to be released or discharged shall undergo a competency examination as described in MCL 330.2026. A copy of the written report of the examination along with the notice required in item 19.a. above shall be submitted to the prosecutor's office in the county in which the charges against the patient were originally brought. The written report is admissible as provided in MCL 330.2030(3). Date Judge American LegalNet, Inc. www.FormsWorkFlow.com

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