SENATE BILL No. 1101
February 13, 2002, Introduced by Senators Gougeon, Schwarz, Johnson and Smith and referred to the Committee on Appropriations.
EXECUTIVE BUDGET BILL
A bill to make appropriations for the department of community health and certain state purposes related to aging, mental health, public health, and medical services for the fiscal year ending September 30, 2003; to provide for the expenditure of such appropriations; to create funds; to provide for reports; to prescribe the powers and duties of certain local and state agencies and departments; and to provide for disposition of fees and other income received by the various state agencies.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
PART 1
LINE-ITEM APPROPRIATIONS
Sec. 101. Subject to the conditions set forth in this bill, the amounts listed in this part are appropriated for the department of community health for the fiscal year ending September 30, 2003, from the funds indicated in this part. The following is a summary of the appropriations in this part:
DEPARTMENT OF COMMUNITY HEALTH
APPROPRIATION SUMMARY:
Full-time equated unclassified positions 6.0
Full-time equated classified positions 5,666.3
Average population 1,438.0
GROSS APPROPRIATION $ 9,155,663,900
Interdepartmental grant revenues:
Total interdepartmental grants and
intradepartmental transfers 69,172,900
ADJUSTED GROSS APPROPRIATION $ 9,086,491,000
Federal revenues:
Total federal revenues 4,801,713,100
Special revenue funds:
Total local revenues 1,065,265,900
Total private revenues 63,122,600
Total local and private revenues 1,128,388,500
Tobacco settlement revenue 70,768,200
Total other state restricted revenues 522,560,000
State general fund/general purpose $ 2,563,061,200
Sec. 102. DEPARTMENTWIDE ADMINISTRATION
Full-time equated unclassified positions 6.0
Full-time equated classified positions 343.5
Director and other unclassified--6.0 FTE
positions $ 581,500
Community health advisory council 28,900
Departmental administration and management--319.7
FTE positions 26,969,200
Certificate of need program administration--13.0
FTE positions 944,800
Workers' compensation program 12,448,000
Rent and building occupancy 9,020,100
Developmental disabilities council and
projects--9.0 FTE positions 2,743,600
Rural health services 726,000
Michigan essential health care provider 1,449,100
Palliative and hospice care 316,200
Primary care services--1.8 FTE positions 2,890,500
GROSS APPROPRIATION $ 58,117,900 Appropriated from:
Interdepartmental grant revenues:
Interdepartmental grant from the department of treasury,
Michigan state hospital finance authority 101,600
Federal revenues:
Total federal revenues 14,786,000
Special revenue funds:
Total private revenues 185,900
Total other state restricted revenues 3,857,100
State general fund/general purpose $ 39,187,300
Sec. 103. MENTAL HEALTH/SUBSTANCE ABUSE SERVICES ADMINISTRATION AND SPECIAL PROJECTS
Full-time equated classified positions 101.0
Mental health/substance abuse program
administration--101.0 FTE positions $ 10,172,600
Consumer involvement program 189,100
Gambling addiction 3,500,000
Protection and advocacy services support 818,300
Mental health initiatives for older persons 1,165,800
Community residential and support services 4,473,600
Highway safety projects 1,837,200
Federal and other special projects 1,977,200
GROSS APPROPRIATION $ 24,133,800
Appropriated from:
Federal revenues:
Total federal revenues: 5,813,100
Special revenue funds:
Total private revenues 190,000
Total other state restricted revenues 3,682,300
State general fund/general purpose $ 14,448,400
Sec. 104. COMMUNITY MENTAL HEALTH/SUBSTANCE ABUSE SERVICES PROGRAMS
Full-time equated classified positions 2.0
Medicaid mental health services $ 1,340,850,700
Community mental health non-Medicaid services 258,930,200
Multicultural services 3,163,800
Medicaid substance abuse services 26,127,500
Respite services 3,318,600
CMHSP, purchase of state services contracts 165,813,900 Civil service charges 2,606,400 Federal mental health block grant--2.0 FTE
positions 15,317,400
State disability assistance program substance
abuse services 6,600,000
Community substance abuse prevention, education
and treatment programs 79,740,400
GROSS APPROPRIATION $ 1,902,468,900
Appropriated from:
Federal revenues:
Total federal revenues 841,357,000
Special revenue funds:
Total other state restricted revenues 6,042,400
State general fund/general purpose $ 1,055,069,500
Sec. 105. STATE PSYCHIATRIC HOSPITALS, CENTERS FOR PERSONS WITH DEVELOPMENTAL DISABILITIES, AND FORENSIC AND PRISON MENTAL HEALTH SERVICES
Total average population 1,438.0
Full-time equated classified positions 4,289.0
Caro regional mental health center-psychiatric
hospital-adult--498.0 FTE positions $ 39,828,900
Average population 184.0
Kalamazoo psychiatric hospital-adult--402.0 FTE
positions 29,559,400
Average population 136.0
Northville psychiatric hospital-adult--844.0 FTE
positions 65,451,800
Average population 377.0
Walter P. Reuther psychiatric hospital-adult--440.0
FTE positions 35,332,500
Average population 232.0
Hawthorn center-psychiatric hospital-children
and adolescents--333.0 FTE positions 24,627,200
Average population 118.0
Mount Pleasant center-developmental disabilities--
498.0 FTE positions 36,883,300
Average population 181.0
Center for forensic psychiatry--522.0 FTE positions 41,835,500
Average population 210.0
Forensic mental health services provided to the
department of corrections---741.0 FTE positions 68,088,700
Revenue recapture 750,000
IDEA, federal special education 120,000
Special maintenance and equipment 947,800
Purchase of medical services for residents of
hospitals and centers 1,358,200
Closed site, transition, and related costs--11.0
FTE positions 1,066,900 Severance pay 216,900
Gifts and bequests for patient living and treatment
environment 500,000
GROSS APPROPRIATION $ 346,567,100
Appropriated from:
Interdepartmental grant revenues:
Interdepartmental grant from the department of
corrections 68,088,700
Federal revenues:
Total federal revenues 33,145,700
Special revenue funds:
CMHSP, purchase of state services contracts 165,813,900
Other local revenues 25,958,300 Total private revenues 500,000
Total other state restricted revenues 10,396,000
State general fund/general purpose $ 42,664,500
Sec. 106. PUBLIC HEALTH ADMINISTRATION
Full-time equated classified positions 81.3
Executive administration--12.0 FTE positions $ 1,129,200
Minority health grants and contracts 989,100
Vital records and health statistics--69.3 FTE
positions 5,610,500 GROSS APPROPRIATION $ 7,728,800
Appropriated from:
Interdepartmental grant revenues:
Interdepartmental grant from family independence
agency 447,800
Federal revenues:
Total federal revenues 2,045,100
Special revenue funds:
Total other state restricted revenues 2,432,200
State general fund/general purpose $ 2,803,700
Sec. 107. INFECTIOUS DISEASE CONTROL
Full-time equated classified positions 44.3
AIDS prevention, testing and care programs--9.8 FTE
positions $ 27,608,300
Immunization local agreements 13,990,300
Immunization program management and field
support--7.7 FTE positions 1,699,600
Sexually transmitted disease control local
agreements 3,541,700
Sexually transmitted disease control management and
field support--26.8 FTE positions 3,503,500
GROSS APPROPRIATION $ 50,343,400
Appropriated from:
Federal revenues:
Total federal revenues 36,057,700
Special revenue funds:
Total private revenues 1,847,000
Total other state restricted revenues 7,550,000
State general fund/general purpose $ 4,888,700
Sec. 108. LABORATORY SERVICES
Full-time equated classified positions 113.2
Laboratory services--113.2 FTE positions $ 13,326,700
GROSS APPROPRIATION $ 13,326,700
Appropriated from:
Interdepartmental grant revenues:
Interdepartmental grant from environmental
quality 392,100
Federal revenues:
Total federal revenues 3,411,100
Special revenue funds:
Total other state restricted revenues 3,131,300
State general fund/general purpose $ 6,392,200
Sec. 109. EPIDEMIOLOGY
Full-time equated classified positions 64.5
AIDS surveillance and prevention program--7.0 FTE
positions $ 1,772,800
Bioterrorism preparedness--33.0 FTE positions 9,503,400
Epidemiology administration--24.5 FTE positions 6,298,900
Tuberculosis control and recalcitrant AIDS
program 867,000
GROSS APPROPRIATION $ 18,442,100
Appropriated from:
Federal revenues:
Total federal revenues 15,936,100
Special revenue funds:
Total other state restricted revenues 179,000
State general fund/general purpose $ 2,327,000
Sec. 110. LOCAL HEALTH ADMINISTRATION AND GRANTS
Full-time equated classified positions 3.0
Implementation of 1933 PA 133, MCL 333.17015 $ 100,000
Lead abatement program--3.0 FTE positions 1,550,200
Local health services 462,300
Local public health operations 41,070,200
Medical services cost reimbursement to local
health departments 1,500,000
GROSS APPROPRIATION $ 44,682,700
Appropriated from:
Federal revenues:
Total federal revenues 2,952,900
Special revenue funds:
Total other state restricted revenues 340,800
State general fund/general purpose $ 41,389,000
Sec. 111. CHRONIC DISEASE AND INJURY PREVENTION AND HEALTH PROMOTION
Full-time equated classified positions 30.7
AIDS and risk reduction clearinghouse and media
campaign $ 1,576,000
Alzheimer's information network 440,000 Cancer prevention and control program--13.6
FTE positions 13,581,400
Chronic disease prevention 1,767,400
Diabetes and kidney program--8.0 FTE positions 4,305,700
Health education, promotion, and research
programs--2.9 FTE positions 1,352,800
Injury control intervention project 925,000
Morris Hood Wayne State University diabetes
outreach 500,000
Physical fitness, nutrition, and health 1,500,000
Public health traffic safety coordination 650,000
Smoking prevention program--6.2 FTE positions 5,544,700
Tobacco tax collection and enforcement 810,000 Violence prevention 1,446,900
GROSS APPROPRIATION $ 34,399,900
Appropriated from:
Federal revenues:
Total federal funds 15,203,200
Special revenue funds:
Total other state restricted revenues 17,882,300
State general fund/general purpose $ 1,314,400
Sec. 112. COMMUNITY LIVING, CHILDREN, AND FAMILIES
Full-time equated classified positions 84.0
Abstinence and pregnancy prevention program $ 9,146,100
Childhood lead program--5.0 FTE positions 1,412,200
Children's waiver home care program 22,828,400
Community living, children and families
administration--68.5 FTE positions 7,285,100
Dental programs 510,400
Dental programs for persons with developmental
disabilities 151,000
Family planning local agreements 8,393,900
Family support subsidy 14,737,100
Housing and support services--1.0 FTE position 5,579,300
Local MCH services 15,050,200
Medicaid outreach and service delivery support 6,488,600
Migrant health care 200,000
Newborn screening follow-up and treatment
services 2,428,000
Omnibus budget reconciliation act
implementation--9.0 FTE positions 12,770,500
Pediatric AIDS prevention and control 1,026,300
Prenatal care outreach and service
delivery support 4,299,300
Southwest community partnership 1,547,300
Special projects--0.5 FTE position 2,532,500
Sudden infant death syndrome program 321,300
GROSS APPROPRIATION $ 116,707,500 Appropriated from:
Federal revenues:
Total federal revenues 73,009,800
Special revenue funds:
Total private revenues 261,100
Total other state restricted revenues 12,990,000
State general fund/general purpose $ 30,446,600
Sec. 113. WOMEN, INFANTS, AND CHILDREN FOOD AND NUTRITION PROGRAM
Full-time equated classified positions 42.0
Women, infants, and children program administration
and special projects--42.0 FTE positions $ 4,951,300
Women, infants, and children program local
agreements and food costs 164,311,000
GROSS APPROPRIATION $ 169,262,300
Appropriated from:
Federal revenues:
Total federal revenues 121,386,400
Special revenue funds:
Total private revenues 47,875,900
State general fund/general purpose $ 0
Sec. 114. CHILDREN'S SPECIAL HEALTH CARE SERVICES
Full-time equated classified positions 66.6
Children's special health care services
administration--66.6 FTE positions $ 5,058,500
Amputee program 184,600
Bequests for care and services 1,579,600
Case management services 3,923,500
Conveyor contract 559,100
Medical care and treatment 128,018,000
GROSS APPROPRIATION $ 139,323,300
Appropriated from:
Federal revenues:
Total federal revenues 66,335,700
Special revenue funds:
Total private revenues 750,000
Total other state restricted revenues 650,000
State general fund/general purpose $ 71,587,600
Sec. 115. OFFICE OF DRUG CONTROL POLICY
Full-time equated classified positions 17.0
Drug control policy--17.0 FTE positions $ 1,973,400
Anti-drug abuse grants 28,659,200
GROSS APPROPRIATION $ 30,632,600
Appropriated from:
Federal revenues:
Total federal revenues 30,246,600
State general fund/general purpose $ 386,000
Sec. 116. CRIME VICTIM SERVICES COMMISSION
Full-time equated classified positions 9.0
Grants administration services--9.0 FTE
positions $ 1,040,500
Justice assistance grants 15,000,000
Crime victim rights services grants 7,655,300
GROSS APPROPRIATION $ 23,695,800
Appropriated from:
Federal revenues:
Total federal revenues: 15,939,900
Special revenue funds:
Total other state restricted revenues 7,240,900
State general fund/general purpose $ 515,000
Sec. 117. OFFICE OF SERVICES TO THE AGING
Full-time equated classified positions 41.5
Commission (per diem $50.00) $ 10,500
Office of services to aging administration--38.5
FTE positions 4,201,200
Long-term care advisor--3.0 FTE positions 761,000
Community services 34,589,900
Nutrition services 37,289,300
Senior volunteer services 5,970,000
Senior citizen centers staffing and equipment 1,130,000
Employment assistance 2,818,300
Respite care program 7,100,000
GROSS APPROPRIATION $ 93,870,200
Appropriated from:
Federal revenues:
Total federal revenues 48,813,400
Special revenue funds:
Tobacco settlement revenue 5,761,000
Total other state restricted revenues 2,600,000
State general fund/general purpose $ 36,695,800
Sec. 118. MEDICAL SERVICES ADMINISTRATION
Full-time equated classified positions 333.7
Medical services administration--333.7 FTE
positions $ 46,747,500
Facility inspection contract-state police 132,800
GROSS APPROPRIATION $ 46,880,300
Appropriated from:
Federal revenues:
Total federal revenues 30,639,700
Special revenue funds:
State general fund/general purpose $ 16,240,600
Sec. 119. MEDICAL SERVICES
Hospital services and therapy $ 708,300,200
Hospital disproportionate share payments 45,000,000
Medicare premium payments 153,456,600
Physician services 147,397,900
Pharmaceutical services 593,178,300
Health maintenance organizations 1,353,831,800
Home health services 28,734,500
Transportation 7,634,200
Auxiliary medical services 89,618,200
Long-term care services 1,368,444,900
Elder prescription insurance coverage 145,000,000
MIChild program 57,067,100
MIFamily plan 191,091,900
Personal care services 20,816,200
Maternal and child health 9,234,500
Social services to the physically disabled 1,344,900
Subtotal basic medical services program 4,920,151,200
School based services 65,094,200
Special adjustor payments 1,014,000,900
Subtotal special medical services payments 1,079,095,100
GROSS APPROPRIATION $ 5,999,246,300
Appropriated from:
Federal revenues:
Total federal revenues 3,425,948,500
Special revenue funds:
Total local revenues 873,493,700
Total private revenues 11,512,700
Tobacco settlement revenue 65,007,200
Total other state restricted revenues 441,791,900
State general fund/general purpose $ 1,181,492,300
Sec. 120. INFORMATION TECHNOLOGY
Information technology services and projects $ 35,834,300
GROSS APPROPRIATION $ 35,834,300
Appropriated from:
Interdepartmental grant revenues:
Interdepartmental grant from the department
of corrections 142,700
Federal revenues:
Total federal revenues 18,685,200
Special revenue funds:
Total other state restricted revenues 1,793,800
State general fund/general purpose $ 15,212,600
PART 2
PROVISIONS CONCERNING APPROPRIATIONS
GENERAL SECTIONS
Sec. 201. (1) Pursuant to section 30 of article IX of the state constitution of 1963, total state spending from state resources under part 1 for fiscal year 2002-2003 is $3,156,389,400.00 and state spending from state resources to be paid to local units of government for fiscal year 2002-2003 is $1,001,418,200.00. The itemized statement below identifies appropriations from which spending to units of local government will occur:
DEPARTMENT OF COMMUNITY HEALTH
DEPARTMENTWIDE ADMINISTRATION
Departmental administration and management $ 15,520,500
Rural health services 35,000
MENTAL HEALTH/SUBSTANCE ABUSE SERVICES ADMINISTRATION AND SPECIAL PROJECTS
Mental health initiatives for older persons 1,165,800
COMMUNITY MENTAL HEALTH/SUBSTANCE ABUSE SERVICES PROGRAMS
State disability assistance program substance abuse
services 6,600,000
Community substance abuse prevention, education,
and treatment programs 17,673,500
Medicaid mental health services 589,897,800
Community mental health non-Medicaid services 258,930,200
Multicultural services 3,163,800
Medicaid substance abuse services 11,647,600
Respite services 3,318,600
INFECTIOUS DISEASE CONTROL
AIDS prevention, testing, and care programs 1,342,000
Immunization local agreements 2,973,900
Sexually transmitted disease control local
agreements 452,900
LOCAL HEALTH ADMINISTRATION AND GRANTS
Local public health operations 41,070,200
CHRONIC DISEASE AND INJURY PREVENTION AND HEALTH PROMOTION
Cancer prevention and control program 722,400
Diabetes and kidney program 909,000
Smoking prevention program 1,380,800
COMMUNITY LIVING, CHILDREN, AND FAMILIES
Childhood lead program 85,000
Family planning local agreements 1,301,400
Local MCH services 246,100
Omnibus budget reconciliation act
implementation 2,152,700
Abstinence and pregnancy prevention program 3,169,600
Prenatal care outreach and service
delivery support 1,235,000
CHILDREN'S SPECIAL HEALTH CARE SERVICES
Case management services 3,319,900
MEDICAL SERVICES
Transportation 1,406,800
OFFICE OF SERVICES TO THE AGING
Community services 13,133,900
Nutrition services 12,731,100
Senior volunteer services 781,400
CRIME VICTIM SERVICES COMMISSION
Crime victim rights services grants 5,051,300
TOTAL OF PAYMENTS TO LOCAL UNITS OF GOVERNMENT $ 1,001,418,200
Sec. 202. (1) The appropriations authorized under this bill are subject to the management and budget act, 1984, PA 431, MCL 18.1101 to 18.1594.
(2) Funds for which the state is acting as the custodian or agent are not subject to annual appropriation.
Sec. 203. As used in this bill:
(a) "AIDS" means acquired immunodeficiency syndrome.
(b) "CMHSP" means a community mental health service program as that term is defined in section 100a of the mental health code, 1974 PA 258, MCL 330.1100a.
(c) "Department" means the Michigan department of community health.
(d) "DSH" means disproportionate share hospital.
(e) "EPSDT" means early and periodic screening, diagnosis, and treatment.
(f) "FTE" means full-time equated.
(g) "GME" means graduate medical education.
(h) "Health plan" means, at a minimum, an organization that meets the criteria for delivering the comprehensive package of services under the department's comprehensive health plan.
(i) "HIV" means human immunodeficiency virus.
(j) "HMO" means health maintenance organization.
(k) "IDEA" means individuals with disabilities education act.
(l) "MCH" means maternal and child health.
(m) "MSS/ISS" means maternal and infant support services.
(n) "Title XVIII" means title XVIII of the social security act, chapter 531, 49 Stat. 620, 42 U.S.C. 1395 to 1395b,1395b-2, 1395b-6 to 1395b-7, 1395c to 1395i, 1395i-2 to 1395i-5, 1395j to 1395t, 1395u to 1395w, 1395w-2 to 1395w-4,1395w-21 to 1395w-28, 1395x to 1395yy, and 1395bbb to 1395ggg.
(o) "Title XIX" means title XIX of the social security act, chapter 531, 49 Stat. 620, 42 U.S.C. 1396 to 1396r-6 and 1396r-8 to 1396v.
(p) "Title XX" means title XX of the social security act,
chapter 531, 49 Stat. 620, 42 U.S.C. 1397 - 1397f.
(q) "WIC" means women, infants, and children supplemental nutrition program.
Sec. 204. The department of civil service shall bill departments and agencies at the end of the first fiscal quarter for the 1% charge authorized by section 5 of article XI of the state constitution of 1963. Payments shall be made for the total amount of the billing by the end of the second fiscal quarter.
Section 205. (1) A hiring freeze is imposed on the state classified civil service. State departments and agencies are prohibited from hiring any new full-time state classified civil service employees and prohibited from filling any vacant state classified civil service positions. This hiring freeze does not apply to internal transfers of classified employees from one position to another within a department.
(2) The state budget director shall grant exceptions to this hiring freeze when the state budget director believes that the hiring freeze will result in rendering a state department or agency unable to deliver basic services, cause loss of revenue to the state, result in the inability of the state to receive federal funds, or would necessitate additional expenditures that exceed any savings from maintaining a vacancy. The state budget director shall report quarterly to the chairpersons of the senate and house standing committees on appropriations the number of exceptions to the hiring freeze approved during the previous quarter and the reasons to justify the exception.
Sec. 206. (1) In addition to the funds appropriated in part 1, there is appropriated an amount not to exceed $100,000,000.00 for federal contingency funds. These funds are not available for expenditure until they have been transferred to another line item in this bill under section 393(2) of the management and budget act, 1984 PA 431, MCL 18.1393.
(2) In addition to the funds appropriated in part 1, there is appropriated an amount not to exceed $50,000,000.00 for state restricted contingency funds. These funds are not available for expenditure until they have been transferred to another line item in this bill under section 393(2) of the management and budget act, 1984 PA 431, MCL 18.1393.
(3) In addition to the funds appropriated in part 1, there is appropriated an amount not to exceed $50,000,000.00 for local contingency funds. These funds are not available for expenditure until they have been transferred to another line item in this bill under section 393(2) of the management and budget act, 1984 PA 431, MCL 18.1393.
(4) In addition to the funds appropriated in part 1, there is appropriated an amount not to exceed $10,000,000.00 for private contingency funds. These funds are not available for expenditure until they have been transferred to another line item in this bill under section 393(2) of the management and budget act, 1984 PA 431, MCL 18.1393.
Sec. 208. Unless otherwise specified, the department shall use the Internet to fulfill the reporting requirements of this bill. This may include transmission of reports via electronic mail to the recipients identified for each reporting requirement or it may include placement of reports on an Internet or Intranet site.
Sec. 211. If the revenue collected by the department from fees and collections exceeds the amount appropriated in part 1, the revenue may be carried forward with the approval of the state budget director into the subsequent fiscal year. The revenue carried forward under this section shall be used as the first source of funds in the subsequent fiscal year.
Sec. 212. (1) From the amounts appropriated in part 1, no greater than the following amounts are supported with federal maternal and child health block grant, preventive health and health services block grant, substance abuse block grant, healthy Michigan fund, and Michigan health initiative funds:
(a) Maternal and child health block grant $ 20,627,000
(b) Preventive health and health services
block grant 6,115,300
(c) Substance abuse block grant 61,694,100
(d) Healthy Michigan fund 34,365,900 (e) Michigan health initiative 9,060,200
(2) On or before February 1, 2003, the department shall report to the house of representatives and senate appropriations subcommittees on community health, the house and senate fiscal agencies, and the state budget director on the detailed name and amounts of federal, restricted, private, and local sources of revenue that support the appropriations in each of the line items in part 1 of this bill.
(3) Upon the release of the fiscal year 2003-2004 executive budget recommendation, the department shall report to the same parties in subsection (2) on the amounts and detailed sources of federal, restricted, private, and local revenue proposed to support the total funds appropriated in each of the line items in part 1 of the fiscal year 2003-2004 executive budget proposal.
(4) The department shall provide to the same parties in subsection (2) all revenue source detail for consolidated revenue line item detail upon request to the department.
Sec. 213. The state departments, agencies, and commissions receiving tobacco tax funds from part 1 shall report by January 1, 2003, to the senate and house of representatives appropriations committees, the senate and house fiscal agencies, and the state budget director on the following:
(a) Detailed spending plan by appropriation line item including description of programs.
(b) Description of allocations or bid processes including need or demand indicators used to determine allocations.
(c) Eligibility criteria for program participation and maximum benefit levels where applicable.
(d) Outcome measures to be used to evaluate programs.
(e) Any other information considered necessary by the house of representatives or senate appropriations committees or the state budget director.
Sec. 214. The use of state restricted tobacco tax revenue received for the purpose of tobacco prevention, education, and reduction efforts and deposited in the healthy Michigan fund shall not be used for lobbying as defined in 1978 PA 472, MCL 4.411 to 4.431.
Sec. 216. (1) In addition to funds appropriated in part 1 for all programs and services, there is appropriated for write-offs of accounts receivable, deferrals, and for prior year obligations in excess of applicable prior year appropriations, an amount equal to total write-offs and prior year obligations, but not to exceed amounts available in prior year revenues.
(2) The department's ability to satisfy appropriation deductions in part 1 shall not be limited to collections and accruals pertaining to services provided in fiscal year 2002-2003, but shall also include reimbursements, refunds, adjustments, and settlements from prior years.
Sec. 218. Basic health services for the purpose of part 23 of the public health code, 1978 PA 368, MCL 333.2301 to 333.2321, are: immunizations, communicable disease control, sexually transmitted disease control, tuberculosis control, prevention of gonorrhea eye infection in newborns, screening newborns for the 7 conditions listed in section 5431(1)(a) through (g) of the public health code, 1978 PA 368, MCL 333.5431, community health annex of the Michigan emergency management plan, and prenatal care.
Sec. 219. (1) The department may contract with the Michigan public health institute for the design and implementation of projects and for other public health related activities prescribed in section 2611 of the public health code, 1978 PA 368, MCL 333.2611. The department may develop a master agreement with the institute to carry out these purposes for up to a 3-year period. The department shall report to the house of representatives and senate appropriations subcommittees on community health, the house and senate fiscal agencies, and the state budget director on or before November 1, 2002, and May 1, 2003, all of the following:
(a) A detailed description of each funded project.
(b) The amount allocated for each project, the appropriation line item from which the allocation is funded, and the source of financing for each project.
(c) The expected project duration.
(d) A detailed spending plan for each project, including a list of all subgrantees and the amount allocated to each subgrantee.
(2) If a report required under subsection (1) is not received by the house of representatives and senate appropriations subcommittees on community health, the house and senate fiscal agencies, and the state budget director on or before the date specified for that report, the disbursement of funds to the Michigan public health institute under this section shall stop. The disbursement of those funds shall recommence when the overdue report is received.
(3) On or before September 30, 2003, the department shall provide to the same parties listed in subsection (1) a copy of all reports, studies, and publications produced by the Michigan public health institute, its subcontractors, or the department with the funds appropriated in part 1 and allocated to the Michigan public health institute.
Sec. 220. All contracts with the Michigan public health institute funded with appropriations in part 1 shall include a requirement that the Michigan public health institute submit to financial and performance audits by the state auditor general of projects funded with state appropriations.
Sec. 223. The department of community health may establish and collect fees for publications, videos and related materials, conferences, and workshops. Collected fees shall be used to offset expenditures to pay for printing and mailing costs of the publications, videos and related materials, and costs of the workshops and conferences. The costs shall not exceed fees collected.
Sec. 259. From the funds appropriated in part 1 for information technology, the department shall pay user fees to the department of information technology for technology related services and projects. Such user fees shall be subject to provisions of an interagency agreement between the department and the department of information technology.
Sec. 260. Amounts appropriated in part 1 for information technology may be designated as work projects and carried forward to support technology projects under the direction of the department of information technology. Funds designated in this manner are not available for expenditure until approved as work projects under section 451a of the management and budget act, 1984 PA 431, MCL 18.1451a.
DEPARTMENTWIDE ADMINISTRATION
Sec. 301. From funds appropriated for worker's compensation, the department may make payments in lieu of worker's compensation payments for wage and salary and related fringe benefits for employees who return to work under limited duty assignments.
Sec. 302. Funds appropriated in part 1 for the community health advisory council may be used for member per diems of $50.00 and other council expenditures.
Sec. 303. The department is prohibited from requiring first-party payment from individuals or families with a taxable income of $10,000.00 or less for mental health services for determinations made in accordance with section 818 of the mental health code, 1974 PA 258, MCL 330.1818.
Sec 304. The funds appropriated in part 1 for the Michigan essential health care provider program may also provide loan repayment for dentists that fit the criteria established by part 27 of the public health code, 1978 PA 368, MCL 333.2701 to 333.2727.
Sec 305. The department is directed to continue support of multicultural agencies that provide primary care services from the funds appropriated in part 1.
COMMUNITY MENTAL HEALTH/SUBSTANCE ABUSE SERVICES PROGRAMS
Sec. 401. (1) Funds appropriated in part 1 are intended to support a system of comprehensive community mental health services under the full authority and responsibility of local CMHSPs. The department shall ensure that each CMHSP provides all of the following:
(a) A system of single entry and single exit.
(b) A complete array of mental health services which shall include, but shall not be limited to, all of the following services: residential and other individualized living arrangements, outpatient services, acute inpatient services, and long-term, 24-hour inpatient care in a structured, secure environment.
(c) The coordination of inpatient and outpatient hospital services through agreements with state-operated psychiatric hospitals, units, and centers in facilities owned or leased by the state, and privately-owned hospitals, units, and centers licensed by the state pursuant to sections 134 through 149b of the mental health code, 1974 PA 258, MCL 330.1134 to 330.1149b.
(d) Individualized plans of service that are sufficient to meet the needs of individuals, including those discharged from psychiatric hospitals or centers, and that ensure the full range of recipient needs is addressed through the CMHSP's program or through assistance with locating and obtaining services to meet these needs.
(e) A system of case management to monitor and ensure the provision of services consistent with the individualized plan of services or supports.
(f) A system of continuous quality improvement.
(g) A system to monitor and evaluate the mental health services provided.
(h) A system that serves at-risk and delinquent youth as required under the provisions of the mental health code, 1974 PA 258, MCL 330.1001 to 330.2106.
Sec. 402. (1) From funds appropriated in part 1, final authorizations to CMHSPs shall be made upon the execution of contracts between the department and CMHSPs. The contracts shall contain an approved plan and budget as well as policies and procedures governing the obligations and responsibilities of both parties to the contracts. Each contract with a CMHSP that the department is authorized to enter into under this subsection shall include a provision that the contract is not valid unless the total dollar obligation for all of the contracts between the department and the CMHSPs entered into under this subsection for the current fiscal year does not exceed the amount of money appropriated in part 1 for the contracts authorized under this subsection.
(2) The department shall immediately report to the senate and house of representatives appropriations subcommittees on community health, the senate and house fiscal agencies, and the state budget director if either of the following occurs:
(a) Any new contracts with CMHSPs that would affect rates or expenditures are enacted.
(b) Any amendments to contracts with CMHSPs that would affect rates or expenditures are enacted.
(3) The report required by subsection (2) shall include information about the changes and their effects on rates and expenditures.
Sec. 403. From the funds appropriated in part 1 for multicultural services, the department shall ensure that CMHSPs continue contracts with multicultural services providers.
Sec. 404. (1) Not later than May 31 of each fiscal year, the department shall provide a report on the community mental health services programs to the members of the house of representatives and senate appropriations subcommittees on community health, the house and senate fiscal agencies, and the state budget director that includes the information required by this section.
(2) The report shall contain information for each CMHSP and a statewide summary, each of which shall include at least the following information:
(a) A demographic description of service recipients which, minimally, shall include reimbursement eligibility, client population, age, ethnicity, housing arrangements, and diagnosis.
(b) When the encounter data is available, a breakdown of clients served, by diagnosis. As used in this subdivision, "diagnosis" means a recipient's primary diagnosis, stated as a specifically named mental illness, emotional disorder, or developmental disability corresponding to terminology employed in the latest edition of the American psychiatric association's diagnostic and statistical manual.
(c) Per capita expenditures by client population group.
(d) Financial information which, minimally, shall include a description of funding authorized; expenditures by client group and fund source; and cost information by service category, including administration. Service category shall include all department approved services.
(e) Data describing service outcomes which shall include, but not be limited to, an evaluation of consumer satisfaction, consumer choice, and quality of life concerns including, but not limited to, housing and employment.
(f) Information about access to community mental health services programs which shall include, but not be limited to, the following:
(i) The number of people receiving requested services.
(ii) The number of people who requested services but did not receive services.
(iii) The number of people requesting services who are on waiting lists for services.
(iv) The average length of time that people remained on waiting lists for services.
(g) The number of second opinions requested under the code and the determination of any appeals.
(h) An analysis of information provided by community mental health service programs in response to the needs assessment requirements of the mental health code, including information about the number of persons in the service delivery system who have requested and are clinically appropriate for different services.
(i) An estimate of the number of FTEs employed by the CMHSPs or contracted with directly by the CMHSPs as of September 30, 2002 and an estimate of the number of FTEs employed through contracts with provider organizations as of September 30, 2002.
(j) Lapses and carryforwards during fiscal year 2001-2002 for CMHSPs.
(k) Information on the community mental health Medicaid managed care program, including, but not limited to, both of the following:
(i) Expenditures by each CMHSP organized by Medicaid eligibility group, including per eligible individual expenditure averages.
(ii) Performance indicator information required to be submitted to the department in the contracts with CMHSPs.
(3) The department shall include data reporting requirements listed in subsection (2) in the annual contract with each individual CMHSP.
(4) The department shall take all reasonable actions to ensure that the data required are complete and consistent among all CMHSPs.
Sec. 406. (1) The funds appropriated in part 1 for the state disability assistance substance abuse services program shall be used to support per diem room and board payments in substance abuse residential facilities. Eligibility of clients for the state disability assistance substance abuse services program shall include needy persons 18 years of age or older, or emancipated minors, who reside in a substance abuse treatment center.
(2) The department shall reimburse all licensed substance abuse programs eligible to participate in the program at a rate equivalent to that paid by the family independence agency to adult foster care providers. Programs accredited by department-approved accrediting organizations shall be reimbursed at the personal care rate, while all other eligible programs shall be reimbursed at the domiciliary care rate.
Sec. 408. (1) By April 15 of the current fiscal year, the department shall report the following data from the prior fiscal year on substance abuse prevention, education, and treatment programs to the senate and house of representatives appropriations subcommittees on community health, the senate and house fiscal agencies, and the state budget office:
(a) Expenditures stratified by administering entity, by central diagnosis and referral agency, by fund source, by subcontractor, by population served, and by service type. Additionally, data on administrative expenditures by administering entity and by subcontractor shall be reported.
(b) Expenditures per state client, with data on the distribution of expenditures reported using a histogram approach.
(c) Number of services provided by central diagnosis and referral agency, by subcontractor, and by service type. Additionally, data on length of stay, referral source, and participation in other state programs.
(d) Collections from other first- or third-party payers, private donations, or other state or local programs, by administering entity, by subcontractor, by population served, and by service type.
(2) The department shall take all reasonable actions to ensure that the required data reported are complete and consistent among all administering entities.
Sec. 409. The funding in part 1 for substance abuse services shall be distributed in a manner that provides priority to service providers that furnish child care services to clients with children.
Sec. 410. The department shall assure that substance abuse treatment is provided to applicants and recipients of public assistance through the family independence agency who are required to obtain substance abuse treatment as a condition of eligibility for public assistance.
Sec. 411. (1) The department shall ensure that each contract with a CMHSP requires the CMHSP to implement programs to encourage diversion of persons with serious mental illness, serious emotional disturbance, or developmental disability from possible jail incarceration when appropriate.
(2) Each CMHSP shall have jail diversion services and shall work toward establishing working relationships with representative staff of local law enforcement agencies, including county prosecutors' offices, county sheriffs' offices, county jails, municipal police agencies, municipal detention facilities, and the courts. Written interagency agreements describing what services each participating agency is prepared to commit to the local jail diversion effort and the procedures to be used by local law enforcement agencies to access mental health jail diversion services are strongly encouraged.
Sec. 414. Medicaid substance abuse treatment services shall be managed by selected CMHSPs pursuant to the health care financing administration's approval of Michigan's 1915(b) waiver request to implement a managed care plan for specialized substance abuse services. The selected CMHSPs shall receive a capitated payment on a per eligible per month basis to assure provision of medically necessary substance abuse services to all beneficiaries who require those services. The selected CMHSPs shall be responsible for the reimbursement of claims for specialized substance abuse services.
Sec. 418. On or before the tenth of each month, the department shall report to the senate and house of representatives appropriations subcommittees on community health, the senate and house fiscal agencies, and the state budget director on the amount of funding paid to the CMHSPs to support the Medicaid managed mental health care program in that month. The information shall include the total paid to each CMHSP, per capita rate paid for each eligibility group for each CMHSP, and number of cases in each eligibility group for each CMHSP, and year-to-date summary of eligibles and expenditures for the Medicaid managed mental health care program.
Sec. 424. Each community mental health services program that contracts with the department to provide services to the Medicaid population shall adhere to the following timely claims processing and payment procedure for claims submitted by health professionals and facilities:
(a) A "clean claim" as described in 2000 PA 187 must be paid within 45 days after receipt of the claim by the community mental health services program. A clean claim that is not paid within this time frame shall bear simple interest at a rate of 12% per annum.
(b) A community mental health services program must state in writing to the health professional or facility any defect in the claim within 30 days after receipt of the claim.
(c) A health professional and a health facility have 30 days after receipt of a notice that a claim or a portion of a claim is defective within which to correct the defect. The community mental health services program shall pay the claim within 30 days after the defect is corrected.
Sec. 435. A county required under the provisions of the mental health code, 1974 PA 258, MCL 330.1110 to 330.2106, to provide matching funds to a CMHSP for mental health services rendered to residents in its jurisdiction shall pay the matching funds in equal installments on not less than a quarterly basis throughout the fiscal year, with the first payment being made by October 1, 2002.
STATE PSYCHIATRIC HOSPITALS, CENTERS FOR PERSONS WITH DEVELOPMENTAL DISABILITIES, AND FORENSIC AND PRISON MENTAL HEALTH SERVICES
Sec. 601. (1) In funding of staff in the financial support division, reimbursement, and billing and collection sections, priority shall be given to obtaining third-party payments for services. Collection from individual recipients of services and their families shall be handled in a sensitive and nonharassing manner.
(2) The department shall continue a revenue recapture project to generate additional revenues from third parties related to cases that have been closed or are inactive. Revenues collected through project efforts are appropriated to the department for departmental costs and contractual fees associated with these retroactive collections and to improve ongoing departmental reimbursement management functions so that the need for retroactive collections will be reduced or eliminated.
Sec. 602. Unexpended and unencumbered amounts and accompanying expenditure authorizations up to $2,000,000.00 remaining on September 30, 2003 from pay telephone revenues and the amounts appropriated in part 1 for gifts and bequests for patient living and treatment environments shall be carried forward for 1 fiscal year. The purpose of gifts and bequests for patient living and treatment environments is to use additional private funds to provide specific enhancements for individuals residing at state-operated facilities. Use of the gifts and bequests shall be consistent with the stipulation of the donor. The expected completion date for the use of gifts and bequests donations is within 3 years unless otherwise stipulated by the donor.
Sec. 603. The funds appropriated in part 1 for forensic mental health services provided to the department of corrections are in accordance with the interdepartmental plan developed in cooperation with the department of corrections. The department is authorized to receive and expend funds from the department of corrections in addition to the appropriations in part 1 to fulfill the obligations outlined in the interdepartmental agreements.
Sec. 604. (1) The CMHSPs shall provide semiannual reports to the department on the following information:
(a) The number of days of care purchased from state hospitals and centers.
(b) The number of days of care purchased from private hospitals in lieu of purchasing days of care from state hospitals and centers.
(c) The number and type of alternative placements to state hospitals and centers other than private hospitals.
(d) Waiting lists for placements in state hospitals and centers.
(2) The department shall semiannually report the information in subsection (1) to the house of representatives and senate appropriations subcommittees on community health, the house and senate fiscal agencies, and the state budget director.
Sec. 605. (1) The department shall not implement any closures or consolidations of state hospitals, centers, or agencies until CMHSPs have programs and services in place for those persons currently in those facilities and a plan for service provision for those persons who would have been admitted to those facilities.
(2) All closures or consolidations are dependent upon adequate department-approved CMHSP plans that include a discharge and aftercare plan for each person currently in the facility. A discharge and aftercare plan shall address the person's housing needs. A homeless shelter or similar temporary shelter arrangements are inadequate to meet the person's housing needs.
(3) Four months after the certification of closure required in section 19(6) of the state employees' retirement act, 1943 PA 240, MCL 38.19, the department shall provide a closure plan to the house of representatives and senate appropriations subcommittees on community health, and the state budget director.
(4) Upon the closure of state-run operations and after transitional costs have been paid, the remaining balances of funds appropriated for that operation shall be transferred to CMHSPs responsible for providing services for persons previously served by the operations.
Section 606. The department may collect revenue for patient reimbursement from first- and third-party providers, including Medicaid, and local counties and/or CMHSPs to cover the cost of placement in state hospitals and centers. The department is authorized to adjust financing sources for patient reimbursement based on actual revenues earned. If the revenue collected exceeds current year expenditures, the revenue may be carried forward with approval of the state budget director. The revenue carried forward shall be used as a first source of funds in the subsequent year.
INFECTIOUS DISEASE CONTROL
Sec. 801. In the expenditure of funds appropriated in part 1 for AIDS programs, the department and its subcontractors shall ensure that adolescents receive priority for prevention, education, and outreach services.
Sec. 803. The department shall continue the AIDS drug assistance program maintaining the prior year eligibility criteria and drug formulary. This section is not intended to prohibit the department from providing assistance for improved AIDS treatment medications.
LOCAL HEALTH ADMINISTRATION AND GRANTS
Sec. 901. The amount appropriated in part 1 for implementation of the 1993 amendments to sections 9161, 16221, 16226, 17014, 17015, and 17515 of the public health code, 1978 PA 368, MCL 333.9161, 333.16221, 333.16226, 333.17014, 333.17015, and 333.17515, shall reimburse local health departments for costs incurred related to implementation of section 17015(15) of the public health code, 1978 PA 368, MCL 333.17015.
Sec. 902. If a county that has participated in a district health department or an associated arrangement with other local health departments takes action to cease to participate in such an arrangement after October 1, 2002, the department shall have the authority to assess a penalty from the local health department's operational accounts in an amount equal to no more than 5% of the local health department's local public health operations funding. This penalty shall only be assessed to the local county that requests the dissolution of the health department.
Sec. 904. (1) Funds appropriated in part 1 for local public health operations shall be prospectively allocated to local health departments to support immunizations, infectious disease control, sexually transmitted disease control and prevention, hearing screening, vision services, food protection, public water supply, private groundwater supply, and on-site sewage management. Food protection shall be provided in consultation with the Michigan department of agriculture. Public water supply, private groundwater supply, and on-site sewage management shall be provided in consultation with the Michigan department of environmental quality.
(2) Local public health departments will be held to contractual standards for the services in subsection (1).
(3) Distributions in subsection (1) shall be made only to counties that maintain local spending in fiscal year 2002-2003 of at least the amount expended in fiscal year 1992-1993 for the services described in subsection (1).
CHRONIC DISEASE AND INJURY PREVENTION AND HEALTH PROMOTION
Sec. 1002. (1) Provision of a school health education curriculum, such as the Michigan model or another comprehensive school health education curriculum, shall be in accordance with the health education goals established by the Michigan model for the comprehensive school health education state steering committee. The state steering committee shall be comprised of a representative from each of the following offices and departments:
(a) The department of education.
(b) The department of community health.
(c) The health administration in the department of community health.
(d) The bureau of mental health and substance abuse services in the department of community health.
(e) The family independence agency.
(f) The department of state police.
(2) Upon written or oral request, a pupil not less than 18 years of age or a parent or legal guardian of a pupil less than 18 years of age, within a reasonable period of time after the request is made, shall be informed of the content of a course in the health education curriculum and may examine textbooks and other classroom materials that are provided to the pupil or materials that are presented to the pupil in the classroom. This subsection does not require a school board to permit pupil or parental examination of test questions and answers, scoring keys, or other examination instruments or data used to administer an academic examination.
Sec. 1005. From the funds appropriated in part 1 for physical fitness, nutrition, and health, up to $1,000,000.00 may be allocated to the Michigan physical fitness and sports foundation. The allocation to the Michigan physical fitness and sports foundation is contingent upon the foundation providing at least a 20% cash match.
Sec. 1006. In spending the funds appropriated in part 1 for the smoking prevention program, priority shall be given to prevention and smoking cessation programs for pregnant women, women with young children, and adolescents.
Sec. 1009. From the funds appropriated in part 1 for the diabetes and kidney program, a portion of the funds may be allocated to the National Kidney Foundation of Michigan for kidney disease prevention programming including early identification and education programs and kidney disease prevention demonstration projects.
Sec. 1011. From the funds appropriated in part 1 for the diabetes and kidney program, $320,000.00 shall be allocated for improving the health of African-American men in Michigan. The funds shall be used for screening and patient self-care activities for diabetes, hypertension, stroke, and glaucoma and other eye diseases.
COMMUNITY LIVING, CHILDREN, AND FAMILIES
Sec. 1106a. (1) Federal abstinence money expended in part 1 for the purpose of promoting abstinence education shall provide abstinence education to teenagers most likely to engage in high- risk behavior as their primary focus, and may include programs that include 9- to 17-year-olds. Programs funded must meet all of the following guidelines:
(a) Teaches the gains to be realized by abstaining from sexual activity.
(b) Teaches abstinence from sexual activity outside of marriage as the expected standard for all school age children.
(c) Teaches that abstinence is the only certain way to avoid out-of-wedlock pregnancy, sexually transmitted diseases, and other health problems.
(d) Teaches that a monogamous relationship in the context of marriage is the expected standard of human sexual activity.
(e) Teaches that sexual activity outside of marriage is likely to have harmful effects.
(f) Teaches that bearing children out of wedlock is likely to have harmful consequences.
(g) Teaches young people how to avoid sexual advances and how alcohol and drug use increases vulnerability to sexual advances.
(h) Teaches the importance of attaining self-sufficiency before engaging in sexual activity.
(2) Programs and organizations that meet the guidelines of subsection (1) shall have the option of receiving all or part of their funds directly from the department of community health.
Sec. 1107. Of the amount appropriated in part 1 for prenatal care outreach and service delivery support, not more than 10% shall be expended for local administration, data processing, and evaluation.
Sec. 1108. The funds appropriated in part 1 for abstinence and pregnancy prevention programs shall not be used to provide abortion counseling, referrals, or services.
Sec. 1109. From the amounts appropriated in part 1 for dental programs, funds shall be allocated to the Michigan dental association for the administration of a volunteer dental program that would provide dental services to the uninsured in an amount that is no less than the amount allocated to that program in fiscal year 1996-1997.
Sec. 1110. Agencies that currently receive pregnancy prevention funds and either receive or are eligible for other family planning funds shall have the option of receiving all of their family planning funds directly from the department of community health and be designated as delegate agencies.
Sec. 1112. From the funds appropriated for prenatal care outreach and service delivery support, the department shall allocate at least $1,000,000.00 to communities with high infant mortality rates.
Sec. 1113. From the funds appropriated in part 1 for special projects, the department shall allocate no less than $200,000.00 to provide education and outreach to targeted populations on the dangers of drug use during pregnancy, neonatal addiction, and fetal alcohol syndrome and further develop its infant support services to target families with infants with fetal alcohol syndrome or suffering from drug addiction.
CHILDREN'S SPECIAL HEALTH CARE SERVICES
Sec. 1201. Funds appropriated in part 1 for medical care and treatment of children with special health care needs shall be paid according to reimbursement policies determined by the Michigan medical services program. Exceptions to these policies may be taken with the prior approval of the state budget director.
Sec. 1202. The department may do 1 or more of the following:
(a) Provide special formula for eligible clients with specified metabolic and allergic disorders.
(b) Provide medical care and treatment to eligible patients with cystic fibrosis who are 21 years of age or older.
(c) Provide genetic diagnostic and counseling services for eligible families.
(d) Provide medical care and treatment to eligible patients with hereditary coagulation defects, commonly known as hemophilia, who are 21 years of age or older.
CRIME VICTIM SERVICES COMMISSION
Sec. 1301. The per diem amount authorized for the crime victim services commission is $50.00.
OFFICE OF SERVICES TO THE AGING
Sec. 1401. The appropriation in part 1 to the office of services to the aging, for community and nutrition services and home services, shall be restricted to eligible individuals at least 60 years of age who fail to qualify for home care services under title XVIII, XIX, or XX of the social security act, chapter 531, 49 Stat. 620.
Sec. 1403. The office of services to the aging shall require each region to report to the office of services to the aging home delivered meals waiting lists based upon standard criteria. Determining criteria shall include all of the following:
(a) The recipient's degree of frailty.
(b) The recipient's inability to prepare his or her own meals safely.
(c) Whether the recipient has another care provider available.
(d) Any other qualifications normally necessary for the recipient to receive home delivered meals.
Sec. 1404. The area agencies and local providers may receive and expend fees for the provision of day care, care management, respite care, and certain eligible home and community based services. The fees shall be based on a sliding scale, taking client income into consideration. The fees shall be used to expand services.
Sec. 1407. (1) The amount appropriated in part 1 of tobacco settlement revenue to the office of services to the aging for the long-term care advisor shall be allocated in accordance with a long-term care plan developed by the long-term care working group established in section 1657 of 1998 PA 336 upon implementation of the plan.
(2) Activities of the long-term care advisor shall support awareness for a continuum of care for older adults including assisted living arrangements, and shall promote and support family involvement.
MEDICAL SERVICES
Sec. 1601. The cost of remedial services incurred by residents of licensed adult foster care homes and licensed homes for the aged shall be used in determining financial eligibility for the medically needy. Remedial services include basic self-care and rehabilitation training for a resident.
Sec. 1602. Medical services shall be provided to elderly and disabled persons with incomes less than or equal to 100% of the official poverty line, pursuant to the state's option to elect such coverage set out at section 1902(a)(10)(A)(ii) and (m) of title XIX, chapter 531, 49 Stat. 620, 42 U.S.C. 1396a.
Sec. 1603. (1) The department may establish a program for persons to purchase medical coverage at a rate determined by the department.
(2) The department may receive and expend premiums for the buy-in of medical coverage in addition to the amounts appropriated in part 1.
(3) The premiums described in this section shall be classified as private funds.
Sec. 1605. (1) The protected income level for Medicaid coverage determined pursuant to section 106(1)(b)(iii) of the social welfare act, 1939 PA 280, MCL 400.106, shall be 100% of the related public assistance standard.
(2) The department shall notify the senate and house of representatives appropriations subcommittees on community health and the state budget office of any proposed revisions to the protected income level for Medicaid coverage related to the public assistance standard 90 days prior to implementation.
Sec. 1606. For the purpose of guardian and conservator charges, the department of community health may deduct up to $60.00 per month as an allowable expense against a recipient's income when determining medical services eligibility and patient pay amounts.
Sec. 1607. (1) An applicant for Medicaid, whose qualifying condition is pregnancy, shall immediately be presumed to be eligible for Medicaid coverage unless the preponderance of evidence in her application indicates otherwise.
(2) An applicant qualified as described in subsection (1) shall be given a letter of authorization to receive Medicaid covered services related to her pregnancy. In addition, the applicant shall receive a listing of Medicaid physicians and managed care plans in the immediate vicinity of the applicant's residence.
(3) An applicant that selects a Medicaid provider, other than a managed care plan, from which to receive pregnancy services, shall not be required to enroll in a managed care plan until the end of the second month postpartum.
(4) In the event that an applicant, presumed to be eligible pursuant to subsection (1), is subsequently found to be ineligible, a Medicaid physician or managed care plan that has been providing pregnancy services to an applicant under this section is entitled to reimbursement for those services until such time as they are notified by the department that the applicant was found to be ineligible for Medicaid.
(5) If the preponderance of evidence in an application indicates that the applicant is not eligible for Medicaid, the department shall refer that applicant to the nearest public health clinic or similar entity as a potential source for receiving pregnancy related services.
Sec. 1611. (1) For care provided to medical services recipients with other third-party sources of payment, medical services reimbursement shall not exceed, in combination with such other resources, including Medicare, those amounts established for medical services-only patients. The medical services payment rate shall be accepted as payment in full. Other than an approved medical services copayment, no portion of a provider's charge shall be billed to the recipient or any person acting on behalf of the recipient. Nothing in this section shall be considered to affect the level of payment from a third-party source other than the medical services program. The department shall require a nonenrolled provider to accept medical services payments as payment in full.
(2) Notwithstanding subsection (1), medical services reimbursement for hospital services provided to dual Medicare/medical services recipients with Medicare Part B coverage only shall equal, when combined with payments for Medicare and other third-party resources, if any, those amounts established for medical services-only patients, including capital payments.
Sec. 1612. Health maintenance organizations that contract with the department to provide services to the Medicaid population shall adhere to the time frames for payment of clean claims as defined in section 111i(2)(a) of 2000 PA 187 submitted by health professionals and facilities and provide notice of any defect in claims submitted as specified in section 111i of 2000 PA 187.
Sec. 1620. (1) For fee-for-service recipients, the pharmaceutical dispensing fee shall be $3.77 or the pharmacy's usual or customary cash charge, whichever is less.
(2) When carved-out of the capitation rate for managed care recipients, the pharmaceutical dispensing fee shall be $3.77 or the pharmacy's usual or customary cash charge or the usual charge allowed by the recipients's medicaid HMO, whichever is less.
(3) The department shall require a prescription copayment for medicaid recipients except as prohibited by federal or state law or regulation.
Sec. 1624. An additional $20,000,000.00 in tobacco settlement funds are hereby appropriated to the elder prescription insurance coverage program if the state budget director certifies that the federal funds appropriated to that program are unavailable and that sufficient tobacco settlement revenue is available to finance this appropriation.
Sec. 1627. (1) The department shall use provisions specified under section 1927 of title XIX of the social security act, 42 U.S.C. 1396r-8, to secure quarterly rebates from pharmaceutical manufacturers for outpatient drugs dispensed to participants in state-funded programs.
2) For products distributed by pharmaceutical manufacturers not providing quarterly rebates as listed in subsection (1), the department may require preauthorization for prescriptions dispensed to participants in state-funded programs.
Sec. 1631. The department shall require copayments on dental, podiatric, chiropractic, vision, and hearing aid services provided to Medicaid recipients, except as prohibited by federal or state law or regulation.
Sec. 1641. An institutional provider that is required to submit a cost report under the medical services program shall submit cost reports completed in full within 5 months after the end of its fiscal year.
Sec. 1648. The department shall maintain an automated toll-free phone line to enable medical providers to verify the eligibility status of Medicaid recipients. There shall be no charge to providers for the use of the toll-free phone line.
Sec. 1649. From the funds appropriated in part 1 for medical services, the department shall continue breast and cervical cancer treatment coverage for women up to 250% of the federal poverty level, who are under age 65, and who are not otherwise covered by insurance. Such coverage shall be provided to women who have been screened through the centers for disease control breast and cervical cancer early detection program, and are found to have breast or cervical cancer, pursuant to the breast and cervical cancer prevention and treatment act of 2000, Public Law 106-354 of the 106th Congress.
Sec. 1650. (1) The department may require medical services recipients residing in counties offering managed care options to choose the particular managed care plan in which they wish to be enrolled. Persons not expressing a preference may be assigned to a managed care provider.
(2) Persons to be assigned a managed care provider shall be informed in writing of the criteria for exceptions to capitated managed care enrollment, their right to change HMOs for any reason within the initial 90 days of enrollment, the toll-free telephone number for problems and complaints, and information regarding grievance and appeals rights.
(3) The criteria for medical exceptions to HMO enrollment shall be based on submitted documentation that indicates a recipient has a serious medical condition, and is undergoing active treatment for that condition with a physician who does not participate in 1 of the HMOs. If the person meets the criteria established by this subsection, the department shall grant an exception to mandatory enrollment at least through the current prescribed course of treatment, subject to periodic review of continued eligibility.
Sec. 1653. Implementation and contracting for managed care by the department through HMOs are subject to the following conditions:
(a) Continuity of care is assured by allowing enrollees to continue receiving required medically necessary services from their current providers for a period not to exceed 1 year if enrollees meet the managed care medical exception criteria.
(b) The department shall require contracted HMOs to submit data determined necessary for evaluation on a timely basis.
(c) A health plans advisory council is functioning that meets all applicable federal and state requirements for a medical care advisory committee. The council shall review at least quarterly the implementation of the department's managed care plans.
(d) Mandatory enrollment of Medicaid beneficiaries living in counties defined as rural by the federal government, which is any nonurban standard metropolitan statistical area, is allowed if there is only 1 HMO serving the Medicaid population, as long as each Medicaid beneficiary is assured of having a choice of at least 2 physicians by the HMO.
(e) Enrollment of recipients of children's special health care services in HMOs shall be voluntary during fiscal year 2002-2003.
(f) The department shall develop a case adjustment to its rate methodology that considers the costs of persons with HIV/AIDS, end stage renal disease, organ transplants, epilepsy, and other high-cost diseases or conditions and shall implement the case adjustment when it is proven to be actuarially and fiscally sound. Implementation of the case adjustment must be budget neutral.
Sec. 1654. (1) Medicaid HMOs shall establish an ongoing internal quality assurance program for health care services provided to Medicaid recipients which includes all of the following:
(a) An emphasis on health outcomes.
(b) Establishment of written protocols for utilization review based on current standards of medical practice.
(c) Review by physicians and other health care professionals of the process followed in the provision of the health care services.
(d) Evaluation of the continuity and coordination of care that enrollees receive.
(e) Mechanisms to detect overutilization and underutilization of services.
(f) Actions to improve quality and assess the effectiveness of the action through systematic follow-up.
(g) Provision of information on quality and outcome measures to facilitate enrollee comparison and choice of health coverage options.
(h) Ongoing evaluation of the plans' effectiveness.
(i) Consumer involvement in the development of the quality assurance program and consideration of enrollee complaints and satisfaction survey results.
(2) Medicaid HMOs shall apply for accreditation by an appropriate external independent accrediting organization requiring standards recognized by the department once those HMOs have met the application requirements. The state shall accept accreditation of an HMO by an approved accrediting organization as proof that the HMO meets some or all of the state's requirements, if the state determines that the accrediting organization's standards meet or exceed the state's requirements.
(3) Medicaid HMOs shall report encounter data, including data on inpatient and outpatient hospital care, physician visits, pharmaceutical services, and other services specified by the department.
(4) Medicaid HMOs shall assure that all covered services are available and accessible to enrollees with reasonable promptness and in a manner that assures continuity. Medically necessary services shall be available and accessible 24 hours a day and 7 days a week. HMOs shall continue to develop procedures for determining medical necessity which may include a prior authorization process.
(5) Medicaid HMOs shall provide for reimbursement of HMO covered services delivered other than through the HMO's providers if medically necessary and approved by the HMO, immediately required, and that could not be reasonably obtained through the HMO's providers on a timely basis. Such services shall be considered approved if the HMO does not respond to a request for authorization within 24 hours of the request. Reimbursement shall not exceed the Medicaid fee-for-service payment for those services.
(6) Medicaid HMOs shall provide access to appropriate providers, including qualified specialists for all medically necessary services.
(7) Medicaid HMOs shall provide the department with a demonstration of the plan's capacity to adequately serve the HMO's expected enrollment of Medicaid enrollees.
(8) Medicaid HMOs shall provide assurances to the department that it will not deny enrollment to, expel, or refuse to reenroll any individual because of the individual's health status or need for services, and that it will notify all eligible persons of those assurances at the time of enrollment.
(9) Medicaid HMOs shall provide procedures for hearing and resolving grievances between the HMO and members enrolled in the HMO on a timely basis.
(10) Medicaid HMOs shall meet other standards and requirements contained in state laws, administrative rules, and policies promulgated by the department.
(11) Medicaid HMOs shall develop written plans for providing nonemergency medical transportation services funded through supplemental payments made to the plans by the department, and shall include information about transportation in their member handbook.
Sec. 1655. (1) The department may require a 12-month lock-in to the HMO selected by the recipient during the initial and subsequent open enrollment periods, but allow for good cause exceptions during the lock-in period.
(2) Medicaid recipients shall be allowed to change HMOs for any reason within the initial 90 days of enrollment.
Sec. 1656. (1) The department shall provide an expedited complaint review procedure for Medicaid eligible persons enrolled in HMOs for situations in which failure to receive any health care service would result in significant harm to the enrollee.
(2) The department shall provide for a toll-free telephone number for Medicaid recipients enrolled in managed care to assist with resolving problems and complaints. If warranted, the department shall immediately disenroll persons from managed care and approve fee-for-service coverage.
(3) Annual reports summarizing the problems and complaints reported and their resolution shall be provided to the house of representatives and senate appropriations subcommittees on community health, the house and senate fiscal agencies, the state budget office, and the department's health plans advisory council.
Sec. 1657. (1) Reimbursement for medical services to screen and stabilize a Medicaid recipient, including stabilization of a psychiatric crisis, in a hospital emergency room shall not be made contingent on obtaining prior authorization from the recipient's HMO. If the recipient is discharged from the emergency room, the hospital shall notify the recipient's HMO within 24 hours of the diagnosis and treatment received.
(2) If the treating hospital determines that the recipient will require further medical service or hospitalization beyond the point of stabilization, that hospital must receive authorization from the recipient's HMO prior to admitting the recipient.
(3) Subsections (1) and (2) shall not be construed as a requirement to alter an existing agreement between an HMO and their contracting hospitals nor as a requirement that an HMO must reimburse for services that are not considered to be medically necessary.
Sec. 1659. The following sections are the only ones that shall apply to the following Medicaid managed care programs, including the comprehensive plan, children's special health care services plan, MI Choice long-term care plan, and the mental health, substance abuse, and developmentally disabled services program: 402, 404, 414, 418, 1612, 1650, 1653, 1654, 1655, 1656, 1657, 1660, 1661, and 1662.
Sec. 1660. (1) The department shall assure that all Medicaid children have timely access to EPSDT services as required by federal law. Medicaid HMOs shall provide EPSDT services to their child members in accordance with Medicaid EPSDT policy.
(2) The primary responsibility of assuring a child's hearing and vision screening is with the child's primary care provider. The primary care provider shall provide age appropriate screening or arrange for these tests through referrals to local health departments. Local health departments shall provide preschool hearing and vision screening services and accept referrals for these tests from physicians or from Head Start programs in order to assure all preschool children have appropriate access to hearing and vision screening. Local health departments shall be reimbursed for the cost of providing these tests for Medicaid eligible children by the Medicaid program.
(3) The department shall require Medicaid HMOs to provide EPSDT utilization data through the encounter data system, and health employer data and information on well child health measures in accordance with the National Committee on Quality Assurance prescribed methodology.
(4) The department shall require HMOs to be responsible for well child visits and maternal and infant support services as described in Medicaid policy. These responsibilities shall be specified in the information distributed by the HMOs to their members.
(5) The department shall provide, on an annual basis, budget neutral incentives to Medicaid HMOs and local health departments to improve performance on measures related to the care of children and pregnant women.
Sec. 1661. (1) The department shall assure that all Medicaid eligible children and pregnant women have timely access to MSS/ISS services. Medicaid HMOs shall assure that maternal support service screening is available to their pregnant members and that those women found to meet the maternal support service high-risk criteria are offered maternal support services. Local health departments shall assure that maternal support service screening is available for Medicaid pregnant women not enrolled in an HMO and that those women found to meet the maternal support service high-risk criteria are offered maternal support services or are referred to a certified maternal support service provider.
(2) The department shall prohibit HMOs from requiring prior authorization of their contracted providers for any EPSDT screening and diagnosis service, for any MSS/ISS screening referral, or for up to 3 MSS/ISS service visits.
(3) The department shall assure the coordination of MSS/ISS services with the WIC program, state-supported substance abuse, smoking prevention, and violence prevention programs, the family independence agency, and any other state or local program with a focus on preventing adverse birth outcomes and child abuse and neglect.
Sec. 1662. (1) The department shall require the external quality review contractor to conduct a review of all EPSDT components provided to children from a statistically valid sample of health plan medical records.
(2) The department shall provide a copy of the analysis of the Medicaid HMO annual audited health employer data and information set reports and the annual external quality review report to the senate and house of representatives appropriations subcommittees on community health, the senate and house fiscal agencies, and the state budget director, within 30 days of the department's receipt of the final reports from the contractors.
(3) The department shall work with the Michigan association of health plans and the Michigan association for local public health to improve service delivery and coordination in the MSS/ISS and EPSDT programs.
(4) The department shall provide training and technical assistance workshops on EPSDT and MSS/ISS for Medicaid health plans, local health departments, and MSS/ISS contractors.
Sec. 1670. (1) The appropriation in part 1 for the MIChild program is to be used to provide comprehensive health care to all children under age 19 who reside in families with income at or below 200% of the federal poverty level, who are uninsured and have not had coverage by other comprehensive health insurance within 6 months of making application for MIChild benefits, and who are residents of this state. The department shall develop detailed eligibility criteria through the medical services administration public concurrence process, consistent with the provisions of this bill. Health care coverage for children in families below 150% of the federal poverty level shall be provided through expanded eligibility under the state's Medicaid program. Health coverage for children in families between 150% and 200% of the federal poverty level shall be provided through a state-based private health care program.
(2) The department shall enter into a contract to obtain MIChild services from any HMO, dental care corporation, or any other entity that offers to provide the managed health care benefits for MIChild services at the MIChild capitated rate. As used in this subsection:
(a) "Dental care corporation", "health care corporation", "insurer", and "prudent purchaser agreement" mean those terms as defined in section 2 of the prudent purchaser act, 1984 PA 233, MCL 550.52.
(b) "Entity" means a health care corporation or insurer operating in accordance with a prudent purchaser agreement.
(3) The department may enter into contracts to obtain certain MIChild services from community mental health service programs.
(4) The department may make payments on behalf of children enrolled in the MIChild program from the line-item appropriation associated with the program as described in the MIChild state plan approved by the United States department of health and human services, or from other medical services line-item appropriations providing for specific health care services.
Sec. 1671. From the funds appropriated in part 1, the department shall continue a comprehensive approach to the marketing and outreach of the MIChild program. The marketing and outreach required under this section shall be coordinated with current outreach, information dissemination, and marketing efforts and activities conducted by the department.
Sec. 1673. The department may establish premiums for MIChild eligible persons in families with income above 150% of the federal poverty level. The monthly premiums shall not exceed $5.00 for a family.
Sec. 1674. The department shall not require copayments under the MIChild program.
Sec. 1675. Children whose category of eligibility changes between the Medicaid and MIChild programs shall be assured of keeping their current health care providers through the current prescribed course of treatment for up to 1 year, subject to periodic reviews by the department if the beneficiary has a serious medical condition and is undergoing active treatment for that condition.
Sec. 1676. To be eligible for the MIChild program, a child must be residing in a family with an adjusted gross income of less than or equal to 200% of the federal poverty level. The department's verification policy shall be used to determine eligibility.
Sec. 1681. (1) The department may fund personal care, home and community-based services, and other alternative long-term care services in lieu of nursing home services from the long-term care services line.
Sec. 1682. (1) The department shall implement enforcement actions as specified in the nursing facility enforcement provisions of section 1919 of title XIX, chapter 531, 49 Stat. 620, 42 U.S.C. 1396r.
(2) The department is authorized to receive and spend penalty money received as the result of noncompliance with medical services certification regulations. Penalty money, characterized as private funds, received by the department shall increase authorizations and allotments in the long-term care accounts.
(3) Any unexpended penalty money, at the end of the year, shall carry forward to the following year.
Sec. 1683. The department shall promote activities that preserve the dignity and rights of terminally ill and chronically ill individuals. Priority shall be given to programs, such as hospice, that focus on individual dignity and quality of care provided persons with terminal illness and programs serving persons with chronic illnesses that reduce the rate of suicide through the advancement of the knowledge and use of improved, appropriate pain management for these persons; and initiatives that train health care practitioners and faculty in managing pain, providing palliative care, and suicide prevention.
Sec. 1685. All nursing home rates, class I and class III, must have their respective fiscal year rate set 30 days prior to the beginning of their rate year. Rates may take into account the most recent cost report prepared and certified by the preparer, provider corporate owner or representative as being true and accurate, and filed timely, within 5 months of the fiscal year end in accordance with Medicaid policy. If the audited version of the last report is available, it shall be used. Any rate factors based on the filed cost report may be retroactively adjusted upon completion of the audit of that cost report.
Sec. 1692. (1) The department of community health is authorized to pursue reimbursement for eligible services provided in Michigan schools from the federal Medicaid program. The department and the state budget director are authorized to negotiate and enter into agreements, together with the department of education, with local and intermediate school districts regarding the sharing of federal Medicaid services funds received for these services. The department is authorized to receive and disburse funds to participating school districts pursuant to such agreements and state and federal law.
(2) From the funds appropriated in part 1 for medical services school services payments, the department is authorized to do all of the following:
(a) Finance activities within the medical services administration related to this project.
(b) Reimburse participating school districts pursuant to the fund sharing ratios negotiated in the state-local agreements authorized in subsection (1).
(c) Offset general fund costs associated with the medical services program.
Sec. 1693. The special adjustor payments appropriation in part 1 may be increased if the department submits a medical services state plan amendment pertaining to this line item at a level higher than the appropriation. The department is authorized to appropriately adjust financing sources in accordance with the increased appropriation.
Sec. 1640. The department of community health shall distribute $695,000.00 to children's hospitals that have a high indigent care volume. The amount to be distributed to any given hospital shall be based on a formula determined by the department of community health.
Sec. 1642. The department may make separate payments directly to qualifying hospitals serving a disproportionate share of indigent patients, and to hospitals providing graduate medical education training programs. If direct payment for GME and DSH is made to qualifying hospitals for services to Medicaid clients, hospitals will not include GME costs or DSH payments in their contracts with HMOs.
Sec. 1697. (1) As may be allowed by federal law or regulation, the department may use funds provided by a local or intermediate school district, which have been obtained from a qualifying health system, as the state match required for receiving federal Medicaid or children health insurance program funds. Any such funds received shall be used only to support new school-based or school-linked health services.
(2) A qualifying health system is defined as any health care entity licensed to provide health care services in the state of Michigan, that has entered into a contractual relationship with a local or intermediate school district to provide or manage school-based or school-linked health services.