Criminal background checks for psychiatry? Michigan's mental health exceptionalism.

The Medicare Prescription Drug, Improvement, and Modernization Act of 2003, § 307 (MMA) requires the establishment of a pilot program for background checks of new employees of long-term care (LTC) facilities. Michigan was the only participating state to single out psychiatric facilities and employees under laws designed to comply with the program specified in § 307. The program was a demonstration project from the Centers for Medicare and Medicaid Services (CMS). This three-year pilot (2005–2007) was designed to evaluate the effectiveness of conducting national criminal background checks on prospective employees with direct access to patients in LTC facilities, defined as nursing facilities, long-term care hospitals, intermediate care facilities, home health agencies, certain group homes, and personal care agencies. We examined the history of the CMS criminal background check program, Michigan’s approach, potential implications for public health and public policy, and the possible ramifications of singling out psychiatric facilities.