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In the complex landscape of mental health law in Michigan, the PCM 209 form plays a critical role. It serves as a Supplemental Petition to Application for Hospitalization and Order for Examination, providing a vital process for individuals who were unable to be examined by a mental health professional after an initial application for hospitalization was made. This form outlines a petitioner's efforts to have an individual examined and requests court intervention to ensure the examination takes place. The intervention can include ordering an examination at a preadmission screening unit designated by the community mental health services program or involving a peace officer to take the individual into protective custody for transportation to the screening unit. Furthermore, the form requires the petitioner to declare the truthfulness of the petition under penalty of perjury, underscoring the seriousness of the request. The court's findings and orders are also detailed, providing clear directions on the next steps, including approvals or denials of the petition. This document encapsulates the legal framework in place to address situations where individuals may be in urgent need of mental health services but are unable to seek them voluntarily, highlighting the system's commitment to balancing individual rights with public safety.

Preview - Pcm 209 Michigan Form

Approved, SCAO

JIS CODE: SPA

STATEOFMICHIGAN PROBATECOURT COUNTYOF

SUPPLEMENTAL PETITION TO

APPLICATION FOR HOSPITALIZATION

AND ORDER FOR EXAMINATION

FILE NO.

In the matter of

PETITION

1.I executed the attached Application for Hospitalization (PCM 201). I have been unable to have the individual examined by a physician or licensed psychologist although I have made the following efforts:

2.I request the court to order

a.the individual to be examined at

the preadmission screening unit designated by the community mental health services program.

b. a peace officer to take the individual into protective custody and transport him/her to the preadmission screening unit named above for the examination.

I declare under the penalties of perjury that this petition has been examined by me and that its contents are true to the best of my information, knowledge, and belief.

Date

Attorney name (type or print)

Bar no.

 

 

Address

 

 

 

City, state, zip

Telephone no.

Signature of petitioner

Name (type or print)

Address

City, state, zip

 

 

 

 

 

 

ORDER

 

 

 

THE COURT FINDS:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3. The application

is

is not

reasonable and in full compliance with section 424 of the Mental Health Code.

4. A reasonable effort

was

was not

made to secure an examination.

 

 

5.

It is necessary that a peace officer take the individual into protective custody and immediately transport him or her to the

 

designated preadmission screening unit for the examination.

 

 

6.

There does not appear to be probable cause to take action on this petition.

 

 

IT IS ORDERED:

 

 

 

 

 

 

 

 

7.

The individual be examined at the designated preadmission screening unit.

 

 

8.

A peace officer shall take the individual into protective custody and immediately transport him or her to the designated

 

preadmission screening unit provided that the individual is presented for examination by

 

,

 

which is within 10 days of the date of execution of the application.

Date

9.

The petition is denied.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date

 

 

 

 

 

 

Judge

Bar no.

USE NOTE: If this form is being filed in the circuit court family division, please enter the court name and county in the upper left-hand corner of the form.

Do not write below this line - For court use only

MCL 330.1428, MCL 330.1429

PCM 209 (9/13) SUPPLEMENTAL PETITION TO APPLICATION FOR HOSPITALIZATION AND ORDER FOR EXAMINATION

Form Characteristics

Fact Number Description
1 The form is known as the PCM 209 – Supplemental Petition to Application for Hospitalization and Order for Examination.
2 It is used in the State of Michigan, within its Probate Court system.
3 Governing laws for this form include MCL 330.1428 and MCL 330.1429.
4 The form is designed to be filed when an individual has been unable to have another person examined by a physician or licensed psychologist for reasons related to mental health.
5 It requests the court to order an examination of the individual at a preadmission screening unit designated by the community mental health services program.
6 Additionally, it can request a peace officer to take the individual into protective custody for transportation to the screening unit for examination.
7 Petitioners must declare under penalties of perjury that the information provided in the petition is true, to the best of their information, knowledge, and belief.
8 The court has to find if the application for hospitalization is reasonable and in full compliance with Section 424 of the Mental Health Code among other considerations.
9 The form also indicates actions to be taken by the court, which can include ordering the examination, taking the individual into protective custody, or denying the petition.

Guidelines on Utilizing Pcm 209 Michigan

Filling out the PCM 209 form is an essential step in the process for those seeking additional support in Michigan for hospitalization matters. This document is specifically designed to request a court-ordered examination when voluntary examination has not been possible. It is crucial to provide accurate and detailed information to facilitate a smooth and effective evaluation process by the court. Below are the steps required to complete the PCM 209 form accurately.

  1. Start by entering the state and county information at the top of the form where it says "STATE OF MICHIGAN PROBATE COURT COUNTY OF."
  2. In the section labeled "In the matter of," insert the full name of the individual concerned.
  3. Under the "PETITION" heading, indicate that you have executed the attached Application for Hospitalization (PCM 201) by checking the appropriate box.
  4. Describe the efforts made to have the individual examined by a physician or licensed psychologist in the space provided after statement one.
  5. Select and mark the appropriate request to the court: whether it is to have the individual examined at a preadmission screening unit or to have a peace officer take the individual into protective custody for transport to the screening unit.
  6. Fill in the date at the bottom of the petition section.
  7. Provide the attorney's name, bar number, address, city, state, zip, and telephone number in the designated spaces.
  8. The petitioner should sign their name in the space provided and type or print their name, address, city, state, and zip in the lines below the signature.
  9. Review the "ORDER" section at the bottom of the form, although decisions and actions in this section are completed by a judge.
  10. Ensure all the information is accurate and true to the best of your knowledge, acknowledging the declaration under the penalties of perjury.

After the PCM 209 form is complete, it should be submitted to the appropriate probate court. This allows the court to assess the request and make necessary orders for the examination of the individual in question. Following submission, parties involved should stay informed of any court dates or further requirements, ensuring they respond promptly to any court communications.

Crucial Points on This Form

What is the PCM 209 Michigan form?

The PCM 209 form, also known as the Supplemental Petition to Application for Hospitalization and Order for Examination, is used in the state of Michigan's probate court system. It comes into play after an initial Application for Hospitalization (PCM 201) has been executed but the individual has not yet been examined by a physician or licensed psychologist despite efforts to do so. This form essentially requests the court to order an examination or take other specified actions regarding the individual in question.

Who can file a PCM 209 form?

Individuals who have already filed an Application for Hospitalization (PCM 201) and have been unable to secure an examination for the person they are concerned about can file the PCM 209 form. This includes family members, guardians, or any concerned parties who have legal standing or have been given permission by the court to file such applications.

What are the steps to complete the PCM 209 form?

Completing the PCM 209 form involves:

  • Filling in the details about the initial Application for Hospitalization (PCM 201) that was executed.
  • Describing the efforts made to have the individual examined by a healthcare professional.
  • Requesting the court to either order the individual to be examined at a preadmission screening unit designated by the community mental health services program or have a peace officer transport the individual to the screening unit.
  • Signing the form under penalty of perjury, affirming that the information provided is true to the best of one's knowledge.
  • Providing the name, contact information, and signature of the petitioner, as well as the attorney's details, if applicable.

Where should the PCM 209 form be filed?

The PCM 209 form should be filed in the probate court of the county where the individual resides or is currently located. If the case is related to the circuit court's family division, the name of the court and county should be mentioned in the upper left-hand corner of the form.

Is there a deadline for filing the PCM 209 form?

While there is no specific deadline mentioned in the form itself for filing the PCM 209, it's important to act promptly. This is especially true since the situation involves the health and safety of an individual. The form does mention that the examination should take place within 10 days of the execution of the application, indicating the urgency.

What happens after the PCM 209 form is filed?

After filing the PCM 209 form, the court will review the application and the efforts made to secure an examination. Depending on its findings, the court may:

  1. Order that the individual be examined at the designated preadmission screening unit.
  2. Instruct a peace officer to take the individual into protective custody and transport them for examination.
  3. Deny the petition if it appears there's no probable cause or if the court finds that the application is not reasonable or in compliance with the Mental Health Code.

Can the court deny a PCM 209 petition?

Yes, the court can deny a PCM 209 petition. This can occur if the court finds that the application is not reasonable or does not comply with section 424 of the Mental Health Code, among other reasons such as the lack of probable cause.

Is an attorney required to file a PCM 209 form?

While having an attorney is not strictly required to file a PCM 209 form, consulting with one can be beneficial. An attorney who is experienced in mental health law can provide advice on the filing process, help ensure that all necessary information and documentation are provided, and assist with any legal proceedings that may follow.

How does one ensure the PCM 209 form is in full compliance with the Mental Health Code?

Ensuring compliance with the Mental Health Code when filling out the PCM 209 form involves:

  • Providing accurate and complete information about the efforts made to secure an examination.
  • Making sure the request aligns with the guidelines and requirements stipulated in section 424 of the Mental Health Code.
  • Possibly consulting with an attorney or legal advisor familiar with mental health laws in Michigan to review the petition before filing.

What is section 424 of the Mental Health Code?

Section 424 of the Mental Health Code outlines the legal framework and requirements for involuntary hospitalization for mental health treatment in Michigan. It details the conditions under which an individual can be hospitalized against their will, including the necessary procedures and protections to ensure that the individual's rights are respected throughout the process.

Common mistakes

Filling out the PCM 209 Michigan form, used for supplemental petitions relating to the application for hospitalization and orders for examination, often involves complex and detailed information. A common error made while completing this form is inaccurately describing the efforts made to have the individual examined by a physician or licensed psychologist. It's vital that these efforts are documented thoroughly and accurately to satisfy legal requirements and to provide the court with a clear understanding of the circumstances.

Another frequent mistake is not specifically requesting the court's intervention in a clear and legally sound manner. This form allows the petitioner to request that the court orders an examination by a preadmission screening unit or that a peace officer takes the individual into protective custody for an examination. If these requests are not made correctly or are vague, it could lead to delays or the denial of the petition.

A critical yet often overlooked detail is the proper completion of the declaration section, where the petitioner affirms under the penalties of perjury that the information given in the petition is true to the best of their knowledge. Neglecting to sign or inaccurately filling out this section can invalidate the entire petition. Similarly, ensuring that the attorney’s name, bar number, and contact information are filled out correctly is essential for the legal process to proceed smoothly.

In the order section of the form, there is an opportunity for misstep if one does not accurately reflect the court's findings regarding the reasonableness and compliance of the application, as well as the necessity of a peace officer's intervention. Failing to echo the court's findings accurately can lead to unnecessary confusion or a disconnection between the petition's request and the court's decision.

Finally, a common mistake is not adhering to the form's submission guidelines, including missing the deadline for presenting the individual for examination. The form specifies that the examination must occur within 10 days of the application's execution. Overlooking this timeframe could lead to the petition being dismissed or delayed, impacting the individual's well-being and the petitioner’s intentions.

Understanding and avoiding these mistakes can make the legal process more efficient and ensure those in need receive the appropriate care and examination in accordance with Michigan’s Mental Health Code. Proper attention to detail, strict adherence to procedural requirements, and clear communication with the court are pivotal in successfully navigating this legal process.

Documents used along the form

When dealing with the complexities of legal processes related to mental health in Michigan, the PCM 209 form—Supplemental Petition to Application for Hospitalization and Order for Examination—is just one of several documents that might be utilized. This form supplements the initial application when an individual has not been examined by a physician or licensed psychologist despite efforts to do so. To better navigate these procedures, it's beneficial to be aware of other forms and documents that often accompany PCM 209, each serving its unique purpose in the process.

  • PCM 201 - Application for Hospitalization: This is the initial document filed by an individual seeking the hospitalization of a person for mental health treatment. It outlines the reasons why hospitalization is deemed necessary and requests an examination by a medical professional.
  • PCM 202 - Certificate of Need for Hospitalization: Completed by a physician or licensed psychologist, this certificate confirms the professional's opinion that the individual in question requires hospitalization for mental health treatment based on their assessment.
  • PCM 203 - Order for Hospitalization: This legal document is issued by the court ordering the hospitalization of the individual. It is based on the findings and recommendations presented in the Application for Hospitalization and the Certificate of Need for Hospitalization.
  • PCM 210 - Notice of Hospitalization: This notice form is used to inform relevant parties, including family members and legal guardians, about the individual's pending or ongoing hospitalization for mental health treatment.
  • PCM 211 - Objection to Hospitalization: If the individual in question or any relevant party objects to the hospitalization, this form allows them to formally express their disagreement and request a court hearing on the matter.
  • PCM 212 - Report on Condition and Status: Used by the treating facility or professional, this report provides the court with an update on the individual's mental health condition and treatment progress, aiding in the decision-making process for continued treatment or release.

These documents collectively streamline the legal and administrative processes associated with the mental health care system in Michigan. Each one plays a critical role in ensuring that individuals receive appropriate care while also respecting their legal rights and the concerns of their families or guardians. Whether you're a legal professional, healthcare provider, or a family member involved in the process, understanding these documents and how they interconnect can be crucial in navigating the complexities of mental health law and advocacy in Michigan.

Similar forms

  • The Application for Hospitalization (PCM 201) form is closely related to the PCM 209 form. Both documents are integral to the process of involuntary hospitalization for mental health treatment in Michigan. While the PCM 201 form serves as the initial application indicating the need for hospitalization, the PCM 209 acts as a supplemental petition when the initial efforts to examine the individual by a physician or licensed psychologist were unsuccessful. Essentially, the PCM 209 seeks judicial intervention to ensure the examination is carried out.

  • The Order for Examination form pairs with the PCM 209 form by legally enforcing the examination of the individual in question. After the PCM 209 is submitted, detailing the petitioner's attempts to have the individual examined and requesting court intervention, the Order for Examination is the court's directive that mandates this examination, specifying the involvement of law enforcement if necessary. Together, they ensure that the individual receives an evaluation essential for determining the need for hospitalization.

  • Similar in purpose, the Commitment Order may be considered a subsequent step following the processes initiated by the PCM 209 form. After an individual has been examined through the provisions outlined in PCM 209 and the related orders, a Commitment Order could be issued as a formal decision for hospitalization if deemed necessary. This document formalizes the court's determination on involuntary hospitalization, directly linking it to the outcomes initiated by the PCM 209's requests.

  • The Petition for Discharge from Hospitalization can be seen as a counterpart to the PCM 209 form. While PCM 209 facilitates the process towards involuntary hospitalization due to mental health concerns, the Petition for Discharge serves the opposite purpose. It is used when an individual or an advocate believes that the individual no longer requires involuntary hospitalization and seeks their release. This document underscores the dynamic and responsive nature of mental health care and legal oversight.

Dos and Don'ts

When filling out the PCM 209 Michigan form, a supplemental petition to application for hospitalization and order for examination, it's important to follow certain guidelines to ensure the process is smooth and effective. Here are several dos and don'ts to keep in mind:

  • Do review the attached Application for Hospitalization (PCM 201) before starting the PCM 209 to ensure consistency and accuracy in the information provided.
  • Do clearly document the efforts made to have the individual examined by a physician or licensed psychologist. Specific details and dates provide clarity and support your request.
  • Do accurately fill in all required fields, including personal information about the petitioner and the individual concerned, to avoid any processing delays.
  • Do use clear, concise language to detail the necessity of court-ordered examination, making it easier for the court to understand and act upon your request.
  • Do sign and date the form, acknowledging the declaration under the penalties of perjury. This step is crucial for the legal validity of the petition.
  • Don't leave any sections incomplete. If a section does not apply, consider noting it as "N/A" or "Not Applicable" to indicate it was not overlooked.
  • Don't hesitate to consult with a legal professional if there are any uncertainties or questions about how to properly complete the form. This can prevent potential legal issues.
  • Don't underestimate the importance of the timing in filing the PCM 209. Note the date constraints, especially the requirement that the individual be presented for examination within 10 days of the execution of the application.
  • Don't disregard the instructions regarding the submission of the form, especially if it needs to be filed in a specific division of the circuit court. Properly addressing and submitting the form ensures it reaches the right hands without unnecessary delays.

Following these guidelines can greatly assist in the successful submission and processing of the PCM 209 form, contributing to a more efficient handling of a sensitive matter such as hospitalization and examination orders within Michigan's legal framework.

Misconceptions

Understanding the PCM 209 Michigan form, a Supplemental Petition to Application for Hospitalization and Order for Examination, is crucial for those navigating the mental health and legal systems in Michigan. However, several misconceptions about this form can hinder its proper use. By clarifying these misconceptions, individuals can better navigate the process of securing mental health care for themselves or their loved ones.

  • Misconception 1: The PCM 209 Form Guarantees Immediate Hospitalization
    Many believe that submitting the PCM 209 form will lead to immediate hospitalization of the individual in question. In reality, this form requests the court to order an examination at a preadmission screening unit. Hospitalization may follow if deemed necessary after the examination, but is not automatic upon submission of the form.

  • Misconception 2: The Form Can Be Filed by Anyone
    There's a common misunderstanding that any concerned individual can file the PCM 209 form. However, the process typically requires the involvement of a close relative, legal guardian, or a medical or mental health professional who has observed the individual's behavior firsthand and can attest to the necessity of an examination under oath.

  • Misconception 3: No Effort is Needed Besides Filing the Form
    Filing the PCM 209 form is not a one-step solution. The petitioner must have made reasonable efforts to have the individual examined by a physician or licensed psychologist and must detail these efforts in the form. This serves as evidence of the necessity for court intervention.

  • Misconception 4: The Petitioner Decides the Outcome
    Some believe that the petitioner has the authority to decide whether the individual should be hospitalized. However, the court, based on recommendations from professionals at the preadmission screening unit, makes the final decision. The role of the petitioner is to request an evaluation, not to predetermine its outcome.

  • Misconception 5: Filing the Form Ensures Police Intervention
    While the form does include a section for a peace officer to take the individual into protective custody and transport them for examination, issuance of such orders is at the discretion of the court. It is based on whether the court finds the application reasonable and whether there is probable cause.

By clarifying these misconceptions, individuals and families seeking help through the PCM 209 Michigan form can have a more accurate understanding of the process and set their expectations accordingly. It's vital to approach this with a clear understanding of the legal processes involved and the form's actual implications for mental health intervention.

Key takeaways

Filling out and using the PCM 209 Michigan form, a supplemental petition to application for hospitalization and order for examination, requires attention to detail and an understanding of the process it entails. This form plays a crucial role in situations where an individual needs to be examined by mental health professionals but challenges arise in making it happen. Here are four key takeaways to keep in mind:

  • Thorough Documentation of Efforts: It's essential to document all attempts to have the individual examined by a physician or licensed psychologist before using the PCM 209. This documentation demonstrates to the court that due diligence was exerted, emphasizing the necessity of court intervention.
  • Clear Request for Court Action: The form allows petitioners to request specific court orders, including having a peace officer transport the individual to a preadmission screening unit. Being clear and precise in these requests helps ensure the individual gets the examination needed without unnecessary delays.
  • Understanding Legal Requirements: The form mentions compliance with section 424 of the Mental Health Code, indicating the legal framework governing the petition. Familiarity with such legal requirements is vital to ensure the petition's success and the individual's rights are respected.
  • Timeliness is Critical: The form includes instructions for presenting the individual for examination within a set timeframe—within 10 days from the date the application is executed. Adhering to this timeframe is crucial to ensure the examination is timely and relevant to the individual's current mental health needs.

Successfully navigating the PCM 209 form process contributes significantly towards ensuring individuals in need receive appropriate mental health evaluations. It underscores the critical balance between legal procedures and the imperative of safeguarding individual well-being.

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