Summary of Bill SB 928 (2025-2026) – Michigan Health: Licensing; Behavioral Health Transport Licensing Requirements
Purpose and broad intent
- SB 928 proposes to create a new regulatory framework, codified as Chapter 9B of the Mental Health Code (amending 1974 PA 258), to establish licensure, standards, and oversight for Behavioral Health Transport (BHT) agencies, vehicles, and personnel.
- The bill ties enactment to SB 927; it would take effect only if SB 927 becomes law.
- The overarching goal is to standardize the provision of emergency transportation for individuals experiencing a mental health crisis, ensuring safety, accountability, and compliance with medical control authorities and best practices.
Key provisions and changes
- Definitions (Sec. 981):
- Establishes terms for the regime: attendant, behavioral health transport (BHT), behavioral health transport agency (operator), BHT vehicle (BHTV), and eligible individual (a person meeting specific crisis, transport, medical stability, and mobility criteria).
- Medical control authority is defined (per existing Public Health Code).
Authorized uses and travel rules (Sec. 983):
- BHT must be used for: interfacility transfers of individuals requiring different care levels; voluntary or involuntary admission to a psychiatric hospital; mental health evaluation or treatment.
- BHTV should transport the eligible individual to the closest facility able to meet immediate mental health needs (with caveats for longer distances if medically necessary).
Eligibility criteria for transport (Sec. 985):
- Eligible individuals must be in an acute mental health crisis, require urgent transport, be medically stable, and physically able to enter/exit the vehicle.
- Agencies may require:
- Consent/awareness of transport.
- Clothing restrictions (no pockets or strings).
- Facility staff/security accompaniment to mitigate elopement.
- If medical interventions, ongoing monitoring, or physical/chemical restraints are needed, ambulance transport is required (not BHT).
Agency responsibilities and reporting (Sec. 987):
- Minimum one BHT vehicle available for emergency response.
- Must respond to requests during normal operating hours.
- Operate under medical control authority (possible multi-authority approvals).
- Protect patient privacy and confidentiality; comply with abuse reporting laws.
- Maintain detailed logs and annually report to the Legislature, covering:
- Number of individuals served, police interventions, investigations, and license revocations.
- Maintain policies following national best practices, addressing:
- Assessment of higher-level transport needs, medical contingencies, receiving facility acceptance, pickup/drop-off criteria, safety measures, infection control, extended transport needs, documentation, and abuse investigations.
- Rights policy: provide written policy outlining eligible individuals’ rights (dignity, privacy, access to basic items, freedom from discrimination/abuse, ability to discontinue transport, complaint rights, and disclosure of privacy protections).
Prohibitions and compliance (Sec. 987(2)):
- Prohibits false or misleading statements about response times/locations.
- Prohibits certain advertising on BHT vehicles (e.g., attorney, investigators, hospital branding in certain ways), operating outside licensed parameters, and the use of physical or chemical restraints.
Operating hours and back-up arrangements (Sec. 987(3)):
- If not 24/7, agencies must provide after-hours back-up contact information for other providers.
Licensing regime (Sec. 989):
- Licensure required to establish or operate a BHT.
- Application requires:
- Completed forms, policies/procedures manuals, insurance certificates, and proof of annual vehicle inspections.
- Licenses: non-transferable; new owners must obtain a new license.
- License term: 2 years; renewal requires proof of vehicle inspections and payment of renewal fees ($100 application; $25 per vehicle).
- Site visit within 15 days of complete application; incomplete applications receive notice within 15 days.
- Late renewal fees: $300 if submitted within 60 days post-expiration; $400 if more than 60 days, plus requirement to meet initial licensure standards.
- Exceptions: Ambulance services licensed under Public Health Code or law enforcement agencies may operate without a BHT license.
- Event changes: notify Department within 30 days of significant changes.
Complaints and enforcement (Sec. 991):
- Complaints regarding violations trigger Department investigations and documentation of results to complainant and subject.
- Department may suspend, revoke, or refuse renewal after a hearing under the Administrative Procedures Act.
Vehicle safety and equipment standards (Sec. 993):
- Vehicles must meet applicable federal safety standards (49 CFR Part 567) and manufacturer recommendations.
- Vehicle types allowed: SUV, sedan, limousine, or passenger van.
- Required features include: four doors, triple-pane windows, secure seating, video monitoring and real-time supervisor visibility if used, ligature-minimization measures, restricted door/window access, GPS, occupant protection systems, climate control, no contraband items, observation mirror, and a safety partition separating attendant and patient.
- Equipment: first aid kit, fire extinguisher, biohazard bag, PPE per public health guidance, service area map.
Staffing requirements (Sec. 997):
- Attendants must meet minimum criteria (age 18+, high school diploma or equivalent, pass background check, valid Michigan driver license, and commercial driver license).
- Training must cover mental health first aid, CPR/first aid, cultural competence, de-escalation, trauma-informed care, internal policies, patient rights, and privacy laws (including CFR 42 Part 2).
- Training must be completed before transport and annually thereafter; documentation of compliance must be maintained and available to the Department.
Transport limitations (Sec. 998):
- Vehicles transport one individual at a time; attendants generally single-occupant transport unless:
- The patient is under 18, or
- Transport distance is 300 miles or more (two attendants required).
Regulatory rulemaking (Sec. 999):
- The Department will promulgate rules to implement the chapter under the Administrative Procedures Act.
Enacting and timeline details
- Enacting section notes:
- The act does not take effect unless SB 927 is enacted into law.
- Administrative timelines:
- License application: site visit within 15 days of complete application; incomplete apps notified within 15 days.
- Licenses expire every 2 years; renewals due at least 30 days before expiration.
- Renewal late fees structured by timing of renewal submission.
Potential impacts and who is affected
- Affects:
- Behavioral health transport agencies and their vehicles and staff.
- Individuals experiencing mental health crises who rely on transport to appropriate facilities.
- Receiving facilities and medical control authorities involved in oversight and coordination.
- The Michigan Department of Health or relevant licensing authority implementing and enforcing these provisions.
- Impacts include:
- New licensure and ongoing compliance requirements, with associated fees and periodic inspections.
- Standardized vehicle and staffing safety/operational protocols.
- Increased transparency via annual reporting and formal complaint processes.
- Enhanced patient rights protections and privacy safeguards.
- Potential consolidation or exit of non-conforming providers due to licensure requirements.
This summary covers the substantive elements of SB 928 as introduced, outlining purpose, key requirements, affected parties, and regulatory timelines.
