HOUSE BILL No. 4413

 

March 19, 2003, Introduced by Rep. Whitmer 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 mental health, public          

                                                                                

    health, and medical services for the fiscal year ending September 30,       

                                                                                

    2004; to provide for the expenditure of those appropriations; to create     

                                                                                

    funds; to require and 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:                                  

                                                                                

1   PART 1                                                                      

                                                                                


                                                                                

1   LINE-ITEM APPROPRIATIONS                                                    

                                                                                

2       Sec. 101. Subject to the conditions set forth in this bill, the             

                                                                                

3   amounts listed in this part are appropriated for the department of          

                                                                                

4   community health for the fiscal year ending September 30, 2004, from        

                                                                                

5   the funds indicated in this part.  The following is a summary of the        

                                                                                

6   appropriations in this part:                                                

                                                                                

7   DEPARTMENT OF COMMUNITY HEALTH                                              

                                                                                

8   APPROPRIATION SUMMARY:                                                      

                                                                                

9                                                                                    Full-time equated unclassified positions     6.0                                                                         

                                                                                

10                                                                                   Full-time equated classified positions     4,666.2                                                                     

                                                                                

11                                                                                   Average population     995.0                                                                       

                                                                                

12      GROSS APPROPRIATION                                                              $    9,117,346,900                                                               

                                                                                

13  Interdepartmental grant revenues:                                           

                                                                                

14      Total interdepartmental grants and                                          

                                                                                

15                                                                                   intradepartmental transfers                                                          69,204,800                                                                  

                                                                                

16      ADJUSTED GROSS APPROPRIATION                                                     $    9,048,142,100                                                               

                                                                                

17  Federal revenues:                                                           

                                                                                

18      Total federal revenues                                                               4,890,865,600                                                               

                                                                                

19  Special revenue funds:                                                      

                                                                                

20      Total local revenues                                                                 806,552,500                                                                 

                                                                                

21      Total private revenues                                                               59,458,000                                                                  

                                                                                

22      Total other state restricted revenues                                                707,327,400                                                                 

                                                                                

23      State general fund/general purpose                                               $    2,583,938,600                                                               

                                                                                

24                                                                                   Sec. 102. DEPARTMENTWIDE ADMINISTRATION                                     

                                                                                

25                                                                                   Full-time equated unclassified positions    6.0                                                                         

                                                                                

26                                                                                   Full-time equated classified positions     343.5                                                                       

                                                                                

27      Director and other unclassified--6.0 FTE                                    


                                                                                

1                                                                                    positions                                                                        $    581,500                                                                     

                                                                                

2       Community health advisory council                                                    28,900                                                                      

                                                                                

3       Departmental administration and management--319.7                           

                                                                                

4                                                                                    FTE positions                                                                       23,695,400                                                                  

                                                                                

5       Certificate of need program administration--13.0                            

                                                                                

6                                                                                    FTE positions                                                                        944,800                                                                     

                                                                                

7       Worker's compensation program                                                        11,381,100                                                                  

                                                                                

8       Rent and building occupancy                                                          8,300,100                                                                   

                                                                                

9       Developmental disabilities council and                                      

                                                                                

10                                                                                   projects--9.0 FTE positions                                                          2,743,600                                                                   

                                                                                

11      Rural health services                                                                1,377,900                                                                   

                                                                                

12      Michigan essential health care provider program                                      1,391,700                                                                   

                                                                                

13      Primary care services--1.8 FTE positions                                             2,790,100                                                                   

                                                                                

14      GROSS APPROPRIATION                                                              $    53,235,100                                                                  

                                                                                

15                                                                                   Appropriated from:                                                          

                                                                                

16  Interdepartmental grant revenues:                                           

                                                                                

17      Interdepartmental grant from the department of treasury,                    

                                                                                

18                                                                                   Michigan state hospital finance authority                                            101,600                                                                     

                                                                                

19  Federal revenues:                                                           

                                                                                

20      Total federal revenues                                                               15,911,000                                                                  

                                                                                

21  Special revenue funds:                                                      

                                                                                

22      Total private revenues                                                               185,900                                                                     

                                                                                

23      Total other state restricted revenues                                                1,580,000                                                                   

                                                                                

24      State general fund/general purpose                                               $    35,456,600                                                                  

                                                                                

25                                                                                   Sec. 103. MENTAL HEALTH/SUBSTANCE ABUSE SERVICES                            

                                                                                

26  ADMINISTRATION AND SPECIAL PROJECTS                                         

                                                                                

27                                                                                   Full-time equated classified positions    102.5                                                                       


                                                                                

1       Mental health/substance abuse program                                       

                                                                                

2                                                                                    administration—-102.5 FTE positions                                              $    9,135,900                                                                   

                                                                                

3       Consumer involvement program                                                         189,100                                                                     

                                                                                

4       Gambling addiction                                                                   3,500,000                                                                   

                                                                                

5       Protection and advocacy services support                                             777,400                                                                     

                                                                                

6       Mental health initiatives for older persons                                          1,349,200                                                                   

                                                                                

7       Community residential and support services                                           3,838,200                                                                   

                                                                                

8       Highway safety projects                                                              1,837,200                                                                   

                                                                                

9       Federal and other special projects                                                   1,977,200                                                                   

                                                                                

10      GROSS APPROPRIATION                                                              $    22,604,200                                                                  

                                                                                

11                                                                                   Appropriated from:                                                          

                                                                                

12  Federal revenues:                                                           

                                                                                

13      Total federal revenues                                                               6,169,100                                                                   

                                                                                

14  Special revenue funds:                                                      

                                                                                

15      Total private revenues                                                               190,000                                                                     

                                                                                

16      Total other state restricted revenues                                                3,682,300                                                                   

                                                                                

17      State general fund/general purpose                                               $    12,562,800                                                                  

                                                                                

18                                                                                   Sec. 104. COMMUNITY MENTAL HEALTH/SUBSTANCE ABUSE                           

                                                                                

19  SERVICES PROGRAMS                                                           

                                                                                

20                                                                                   Full-time equated classified positions    2.0                                                                         

                                                                                

21      Medicaid mental health services                                                  $    1,433,326,600                                                               

                                                                                

22      Community mental health non-medicaid services                                        287,147,600                                                                 

                                                                                

23      Medicaid adult benefits waiver                                                       40,000,000                                                                  

                                                                                

24      Multicultural services                                                               3,163,800                                                                   

                                                                                

25      Medicaid substance abuse services                                                    27,333,700                                                                  

                                                                                

26      CMHSP, purchase of state services contracts                                          98,412,200                                                                  

                                                                                

27      Civil service charges                                                                2,065,500                                                                   


                                                                                

1       Federal mental health block grant--2.0 FTE positions                                 15,317,400                                                                  

                                                                                

2       State disability assistance program substance abuse                         

                                                                                

3                                                                                    services                                                                             2,509,800                                                                   

                                                                                

4       Community substance abuse prevention, education and                         

                                                                                

5                                                                                    treatment programs                                                                   80,548,400                                                                  

                                                                                

6       GROSS APPROPRIATION                                                              $    1,989,825,000                                                               

                                                                                

7                                                                                    Appropriated from:                                                          

                                                                                

8   Federal revenues:                                                           

                                                                                

9       Total federal revenues                                                               920,541,900                                                                 

                                                                                

10  Special revenue funds:                                                      

                                                                                

11      Total local revenues                                                                 26,000,000                                                                  

                                                                                

12      Total other state restricted revenues                                                3,042,400                                                                   

                                                                                

13      State general fund/general purpose                                               $    1,040,240,700                                                               

                                                                                

14                                                                                   Sec. 105. STATE PSYCHIATRIC HOSPITALS, CENTERS FOR                          

                                                                                

15  PERSONS WITH DEVELOPMENTAL DISABILITIES, AND FORENSIC AND                   

                                                                                

16  PRISON MENTAL HEALTH SERVICES                                               

                                                                                

17                                                                                   Total average population     995.0                                                                       

                                                                                

18                                                                                   Full-time equated classified positions     3,261.9                                                                     

                                                                                

19      Caro regional mental health center-psychiatric                              

                                                                                

20                                                                                   hospital-adult--472.8 FTE positions                                              $    36,376,400                                                                  

                                                                                

21                                                                                   Average population     208.0                                                                       

                                                                                

22      Kalamazoo psychiatric hospital-adult--316.2 FTE                             

                                                                                

23                                                                                   positions                                                                            20,568,200                                                                  

                                                                                

24                                                                                      Average population     129.0                                                                       

                                                                                

25      Walter P. Reuther psychiatric hospital-adult--552.2                         

                                                                                

26                                                                                   FTE positions                                                                        38,718,800                                                                  

                                                                                

27                                                                                      Average population     172.0                                                                       


                                                                                

1       Hawthorn center-psychiatric hospital-children                               

                                                                                

2                                                                                    and adolescents--201.6 FTE positions                                                 20,370,500                                                                  

                                                                                

3                                                                                       Average population     94.0                                                                        

                                                                                

4       Mount Pleasant center-developmental disabilities--                          

                                                                                

5                                                                                    425.5 FTE positions                                                                  29,107,100                                                                  

                                                                                

6                                                                                       Average population     164.0                                                                       

                                                                                

7       Center for forensic psychiatry--472.6 FTE positions                                  41,785,400                                                                  

                                                                                

8                                                                                       Average population 228.0                                                 

                                                                                

9       Forensic mental health services provided to the                             

                                                                                

10                                                                                   department of corrections--810.0 FTE positions                                       68,120,600                                                                  

                                                                                

11      Revenue recapture                                                                    750,000                                                                     

                                                                                

12      IDEA, federal special education                                                      120,000                                                                     

                                                                                

13      Special maintenance and equipment                                                    335,300                                                                     

                                                                                

14      Purchase of medical services for residents of                               

                                                                                

15                                                                                   hospitals and centers                                                                1,358,200                                                                   

                                                                                

16      Closed site, transition, and related costs--11.0                            

                                                                                

17                                                                                   FTE positions                                                                        1,067,200                                                                   

                                                                                

18      Severance pay                                                                        216,900                                                                     

                                                                                

19      Gifts and bequests for patient living and                                   

                                                                                

20                                                                                   treatment environment                                                                500,000                                                                     

                                                                                

21      GROSS APPROPRIATION                                                              $    259,394,600                                                                 

                                                                                

22                                                                                   Appropriated from:                                                          

                                                                                

23  Interdepartmental grant revenues:                                           

                                                                                

24      Interdepartmental grant from the department of                              

                                                                                

25                                                                                   corrections                                                                          68,120,600                                                                  

                                                                                

26  Federal revenues:                                                           

                                                                                

27      Total federal revenues                                                               28,708,500                                                                  


                                                                                

1   Special revenue funds:                                                      

                                                                                

2       CMHSP, purchase of state services contracts                                          98,412,200                                                                  

                                                                                

3       Other local revenues                                                                 15,228,300                                                                  

                                                                                

4       Total private revenues                                                               500,000                                                                     

                                                                                

5       Total other state restricted revenues                                                7,034,600                                                                   

                                                                                

6       State general fund/general purpose                                               $    41,390,400                                                                  

                                                                                

7                                                                                    Sec. 106.  PUBLIC HEALTH ADMINISTRATION                                     

                                                                                

8                                                                                    Full-time equated classified positions    81.3                                                                        

                                                                                

9       Executive administration--12.0 FTE positions                                     $    1,014,300                                                                   

                                                                                

10      Minority health grants and contracts                                                 650,000                                                                     

                                                                                

11      Vital records and health statistics--69.3 FTE                               

                                                                                

12                                                                                   positions                                                                            6,141,700                                                                   

                                                                                

13      GROSS APPROPRIATION                                                              $    7,806,000                                                                   

                                                                                

14                                                                                   Appropriated from:                                                          

                                                                                

15  Interdepartmental grant revenues:                                           

                                                                                

16      Interdepartmental grant from family independence                            

                                                                                

17                                                                                   agency                                                                               447,800                                                                     

                                                                                

18  Federal revenues:                                                           

                                                                                

19      Total federal revenues                                                               2,045,100                                                                   

                                                                                

20  Special revenue funds:                                                      

                                                                                

21      Total other state restricted revenues                                                2,963,400                                                                   

                                                                                

22      State general fund/general purpose                                               $    2,349,700                                                                   

                                                                                

23                                                                                   Sec. 107. INFECTIOUS DISEASE CONTROL                                        

                                                                                

24                                                                                   Full-time equated classified positions     44.3                                                                        

                                                                                

25      AIDS prevention, testing, and care programs--9.8 FTE                        

                                                                                

26                                                                                   positions                                                                        $    29,158,600                                                                  

                                                                                

27      Immunization local agreements                                                        13,990,300                                                                  


                                                                                

1       Immunization program management and field                                   

                                                                                

2                                                                                    support--7.7 FTE positions                                                           1,582,100                                                                   

                                                                                

3       Sexually transmitted disease control local                                  

                                                                                

4                                                                                    agreements                                                                           3,479,900    Sexually transmitted disease control management                             

                                                                                

5                                                                                    and field support--26.8 FTE positions                                                3,392,100                                                                   

                                                                                

6       GROSS APPROPRIATION                                                              $    51,603,000                                                                  

                                                                                

7                                                                                    Appropriated from:                                                          

                                                                                

8   Federal revenues:                                                           

                                                                                

9       Total federal revenues                                                               37,593,000                                                                  

                                                                                

10  Special revenue funds:                                                      

                                                                                

11      Total private revenues                                                               1,847,000                                                                   

                                                                                

12      Total other state restricted revenues                                                7,550,000                                                                   

                                                                                

13      State general fund/general purpose                                               $    4,613,000                                                                   

                                                                                

14                                                                                   Sec. 108. LABORATORY SERVICES                                               

                                                                                

15                                                                                   Full-time equated classified positions     115.2                                                                       

                                                                                

16      Laboratory services--115.2 FTE positions                                         $    12,091,600                                                                  

                                                                                

17      GROSS APPROPRIATION                                                              $    12,091,600                                                                  

                                                                                

18                                                                                   Appropriated from:                                                          

                                                                                

19  Interdepartmental grant revenues:                                           

                                                                                

20      Interdepartmental grant from environmental quality                                   392,100                                                                     

                                                                                

21  Federal revenues:                                                           

                                                                                

22      Total federal revenues                                                               2,040,100                                                                   

                                                                                

23  Special revenue funds:                                                      

                                                                                

24      Total other state restricted revenues                                                3,131,300                                                                   

                                                                                

25      State general fund/general purpose                                               $    6,528,100                                                                   

                                                                                

26                                                                                   Sec. 109. EPIDEMIOLOGY                                                      

                                                                                

27                                                                                   Full-time equated classified positions     98.0                                                                        


                                                                                

1       AIDS surveillance and prevention program--7.0 FTE                           

                                                                                

2                                                                                    positions                                                                        $    1,883,100                                                                   

                                                                                

3       Asthma prevention and control                                                        1,032,300                                                                   

                                                                                

4       Bioterrorism preparedness--59.5 FTE positions                                        34,157,700                                                                  

                                                                                

5       Epidemiology administration--31.5 FTE positions                                      6,071,100                                                                   

                                                                                

6       Tuberculosis control and recalcitrant AIDS program                                   867,000                                                                     

                                                                                

7       GROSS APPROPRIATION                                                              $    44,011,200                                                                  

                                                                                

8                                                                                    Appropriated from:                                                          

                                                                                

9   Federal revenues:                                                           

                                                                                

10      Total federal revenues                                                               41,892,800                                                                  

                                                                                

11  Special revenue funds:                                                      

                                                                                

12      Total other state restricted revenues                                                179,000                                                                     

                                                                                

13      State general fund/general purpose                                               $    1,939,400                                                                   

                                                                                

14                                                                                   Sec. 110. LOCAL HEALTH ADMINISTRATION AND GRANTS                            

                                                                                

15                                                                                   Full-time equated classified positions     3.0                                                                         

                                                                                

16      Implementation of 1993 PA 133, MCL 333.17015                                     $    100,000                                                                     

                                                                                

17      Lead abatement program--3.0 FTE positions                                            1,550,200                                                                   

                                                                                

18      Local health services                                                                220,000                                                                     

                                                                                

19      Local public health operations                                                       40,618,400                                                                  

                                                                                

20      Medical services cost reimbursement to local                                

                                                                                

21                                                                                   health departments                                                                   1,800,000                                                                   

                                                                                

22      GROSS APPROPRIATION                                                              $    44,288,600                                                                  

                                                                                

23                                                                                   Appropriated from:                                                          

                                                                                

24  Federal revenues:                                                           

                                                                                

25      Total federal revenues                                                               3,249,100                                                                   

                                                                                

26  Special revenue funds:                                                      

                                                                                

27      Total other state restricted revenues                                                344,600                                                                     


                                                                                

1       State general fund/general purpose                                               $    40,694,900                                                                  

                                                                                

2                                                                                    Sec. 111. CHRONIC DISEASE AND INJURY PREVENTION AND                         

                                                                                

3   HEALTH PROMOTION                                                            

                                                                                

4                                                                                    Full-time equated classified positions     30.7                                                                        

                                                                                

5       AIDS and risk reduction clearinghouse and media                             

                                                                                

6                                                                                    campaign                                                                         $    1,576,000                                                                   

                                                                                

7       Alzheimer's information network                                                      440,000                                                                     

                                                                                

8       Cancer prevention and control program--13.6                                 

                                                                                

9                                                                                    FTE positions                                                                        11,043,100                                                                  

                                                                                

10      Chronic disease prevention                                                           1,572,400                                                                   

                                                                                

11      Diabetes and kidney program--8.0 FTE positions                                       2,953,900                                                                   

                                                                                

12      Health education, promotion, and research                                   

                                                                                

13                                                                                   programs--2.9 FTE positions                                                          992,100                                                                     

                                                                                

14      Injury control intervention project                                                  714,900                                                                     

                                                                                

15      Obesity program                                                                      196,700                                                                     

                                                                                

16      Public health traffic safety coordination                                            350,000                                                                     

                                                                                

17      Smoking prevention program--6.2 FTE positions                                        4,852,700                                                                   

                                                                                

18      Tobacco tax collection and enforcement                                               810,000                                                                     

                                                                                

19      Violence prevention                                                                  1,446,900                                                                   

                                                                                

20      GROSS APPROPRIATION                                                              $    26,948,700                                                                  

                                                                                

21                                                                                   Appropriated from:                                                          

                                                                                

22  Federal revenues:                                                           

                                                                                

23      Total federal revenues                                                               15,493,200                                                                  

                                                                                

24  Special revenue funds:                                                      

                                                                                

25      Total other state restricted revenues                                                9,891,800                                                                   

                                                                                

26      State general fund/general purpose                                               $    1,563,700                                                                   

                                                                                

27                                                                                   Sec. 112. COMMUNITY LIVING, CHILDREN, AND FAMILIES                          


                                                                                

1                                                                                    Full-time equated classified positions     84.0                                                                        

                                                                                

2       Childhood lead program--5.0 FTE positions                                        $    1,470,700                                                                   

                                                                                

3       Children's waiver home care program                                                  19,549,800                                                                  

                                                                                

4       Community living, children, and families                                    

                                                                                

5                                                                                    administration--68.5 FTE positions                                                   7,074,100                                                                   

                                                                                

6       Dental programs                                                                      485,400                                                                     

                                                                                

7       Dental program for persons with developmental                                    

                                                                                

8                                                                                    disabilities                                                                         151,000                                                                     

                                                                                

9       Family planning local agreements                                                     11,318,100                                                                  

                                                                                

10      Family support subsidy                                                               15,593,500                                                                  

                                                                                

11      Housing and support services--1.0 FTE positions                                      5,579,300                                                                   

                                                                                

12      Local MCH services                                                                   13,050,200                                                                  

                                                                                

13      Migrant health care                                                                  200,000                                                                     

                                                                                

14      Newborn screening follow-up and treatment services                                   2,428,000                                                                   

                                                                                

15      Omnibus budget reconciliation act                                           

                                                                                

16                                                                                   implementation--9.0 FTE positions                                                    12,770,500                                                                  

                                                                                

17      Pediatric AIDS prevention and control                                                1,026,300                                                                   

                                                                                

18      Pregnancy prevention program                                                         5,846,100                                                                   

                                                                                

19      Prenatal care outreach and service delivery support                                  3,049,300                                                                   

                                                                                

20      Southwest community partnership                                                      996,700                                                                     

                                                                                

21      Special projects--0.5 FTE positions                                                  5,274,500                                                                   

                                                                                

22      Sudden infant death syndrome program                                                 221,300                                                                     

                                                                                

23      GROSS APPROPRIATION                                                              $    106,084,800                                                                 

                                                                                

24                                                                                   Appropriated from:                                                          

                                                                                

25  Federal revenues:                                                           

                                                                                

26      Total federal revenues                                                               75,704,200                                                                  

                                                                                

27  Special revenue funds:                                                      


                                                                                

1       Total private revenues                                                               261,100                                                                     

                                                                                

2       Total other state restricted revenues                                                10,540,000                                                                  

                                                                                

3       State general fund/general purpose                                               $    19,579,500                                                                  

                                                                                

4                                                                                    Sec. 113. WOMEN, INFANTS, AND CHILDREN FOOD AND NUTRITION                   

                                                                                

5   PROGRAMS                                                                    

                                                                                

6                                                                                    Full-time equated classified positions     42.0                                                                        

                                                                                

7       Women, infants, and children program administration                         

                                                                                

8                                                                                    and special projects--42.0 FTE positions                                         $    5,600,100                                                                   

                                                                                

9       Women, infants, and children program local agreements                       

                                                                                

10                                                                                   and food costs                                                                       181,392,100                                                                 

                                                                                

11      GROSS APPROPRIATION                                                              $    186,992,200                                                                 

                                                                                

12                                                                                   Appropriated from:                                                          

                                                                                

13  Federal revenues:                                                           

                                                                                

14      Total federal revenues                                                               136,644,900                                                                 

                                                                                

15  Special revenue funds:                                                      

                                                                                

16      Total private revenues                                                               50,347,300                                                                  

                                                                                

17      State general fund/general purpose                                               $                                                                            0    

                                                                                

18                                                                                   Sec. 114. CHILDREN'S SPECIAL HEALTH CARE SERVICES                           

                                                                                

19                                                                                   Full-time equated classified positions     66.6                                                                        

                                                                                

20      Children's special health care services administration--66.6                

                                                                                

21                                                                                   FTE positions                                                                    $    4,478,800                                                                   

                                                                                

22      Amputee program                                                                      184,600                                                                     

                                                                                

23      Bequests for care and services                                                       1,829,600                                                                   

                                                                                

24      Case management services                                                             3,773,500                                                                   

                                                                                

25      Conveyor contract                                                                    513,500                                                                     

                                                                                

26      Medical care and treatment                                                           156,247,200    GROSS APPROPRIATION                                                              $    167,027,200                                                                 

                                                                                

27                                                                                   Appropriated from:                                                          


                                                                                

1   Federal revenues:                                                           

                                                                                

2       Total federal revenues                                                               79,815,600                                                                  

                                                                                

3   Special revenue funds:                                                      

                                                                                

4       Total private revenues                                                               1,000,000                                                                   

                                                                                

5       Total other state restricted revenues                                                650,000                                                                     

                                                                                

6       State general fund/general purpose                                               $    85,561,600                                                                  

                                                                                

7                                                                                    Sec. 115. OFFICE OF DRUG CONTROL POLICY                                     

                                                                                

8                                                                                    Full-time equated classified positions     17.0                                                                        

                                                                                

9       Drug control policy--17.0 FTE positions                                          $    1,973,400                                                                   

                                                                                

10      Anti-drug abuse grants                                                               26,859,200                                                                  

                                                                                

11      IDG to Judiciary for drug treatment courts                                           1,800,000                                                                   

                                                                                

12      GROSS APPROPRIATION                                                              $    30,632,600                                                                  

                                                                                

13                                                                                   Appropriated from:                                                          

                                                                                

14  Federal revenues:                                                           

                                                                                

15      Total federal revenues                                                               30,246,600                                                                  

                                                                                

16      State general fund/general purpose                                               $    386,000                                                                     

                                                                                

17                                                                                   Sec. 116. CRIME VICTIM SERVICES COMMISSION                                  

                                                                                

18                                                                                   Full-time equated classified positions    9.0                                                                         

                                                                                

19      Grants administration services--9.0 FTE positions                                $    1,080,500                                                                   

                                                                                

20      Justice assistance grants                                                            13,000,000                                                                  

                                                                                

21      Crime victim rights services grants                                                  8,265,300                                                                   

                                                                                

22      GROSS APPROPRIATION                                                              $    22,345,800                                                                  

                                                                                

23                                                                                   Appropriated from:                                                          

                                                                                

24  Federal revenues:                                                           

                                                                                

25      Total federal revenues                                                               13,946,900                                                                  

                                                                                

26  Special revenue funds:                                                      

                                                                                

27      Total other state restricted revenues                                                7,984,400                                                                   


                                                                                

1       State general fund/general purpose                                               $    414,500                                                                     

                                                                                

2                                                                                    Sec. 117. OFFICE OF SERVICES TO THE AGING                                   

                                                                                

3                                                                                    Full-time equated classified positions     31.5                                                                        

                                                                                

4       Commission (per diem $50.00)                                                     $    10,500                                                                      

                                                                                

5       Office of services to aging administration--31.5                            

                                                                                

6                                                                                    FTE positions                                                                        4,167,800                                                                   

                                                                                

7       Community services                                                                   35,286,100                                                                  

                                                                                

8       Nutrition services                                                                   38,191,200                                                                  

                                                                                

9       Senior volunteer services                                                            5,645,900                                                                   

                                                                                

10      Senior citizen centers staffing and equipment                                        1,068,700                                                                   

                                                                                

11      Employment assistance                                                                2,818,300                                                                   

                                                                                

12      Respite care program                                                                 7,100,000                                                                   

                                                                                

13      GROSS APPROPRIATION                                                              $    94,288,500                                                                  

                                                                                

14                                                                                   Appropriated from:                                                          

                                                                                

15  Federal revenues:                                                           

                                                                                

16      Total federal revenues                                                               52,094,300                                                                  

                                                                                

17  Special revenue funds:                                                      

                                                                                

18      Tobacco settlement revenue                                                           5,000,000                                                                   

                                                                                

19      Total other state restricted revenues                                                2,267,000                                                                   

                                                                                

20      State general fund/general purpose                                               $    34,927,200                                                                  

                                                                                

21                                                                                   Sec. 118. MEDICAL SERVICES ADMINISTRATION                                   

                                                                                

22                                                                                   Full-time equated classified positions     333.7                                                                       

                                                                                

23      Medical services administration--333.7 FTE positions                             $    39,319,900                                                                  

                                                                                

24      Facility inspection contract - state police                                          132,800                                                                     

                                                                                

25      MIChild administration                                                               4,327,800                                                                   

                                                                                

26      GROSS APPROPRIATION                                                              $    43,780,500                                                                  

                                                                                

27                                                                                   Appropriated from:                                                          


                                                                                

1   Federal revenues:                                                           

                                                                                

2       Total federal revenues                                                               29,512,300                                                                  

                                                                                

3   Special revenue funds:                                                      

                                                                                

4       State general fund/general purpose                                               $    14,268,200                                                                  

                                                                                

5                                                                                    Sec. 119. MEDICAL SERVICES                                                  

                                                                                

6       Hospital services and therapy                                                    $    831,709,400                                                                 

                                                                                

7       Hospital disproportionate share payments                                             45,000,000                                                                  

                                                                                

8       Physician services                                                                   207,735,800                                                                 

                                                                                

9       Medicare premium payments                                                            166,046,600                                                                 

                                                                                

10      Pharmaceutical services                                                              479,705,800                                                                 

                                                                                

11      Home health services                                                                 28,887,900                                                                  

                                                                                

12      Transportation                                                                       8,918,200                                                                   

                                                                                

13      Auxiliary medical services                                                           73,676,800                                                                  

                                                                                

14      Long-term care services                                                              1,490,390,400                                                               

                                                                                

15      Elder prescription insurance coverage                                                68,011,800                                                                  

                                                                                

16      Health plan services                                                                 1,437,028,400                                                               

                                                                                

17      MIChild program                                                                      36,875,600                                                                  

                                                                                

18      Maternal and child health                                                            9,234,500                                                                   

                                                                                

19      Social services to the physically disabled                                           1,344,900                                                                   

                                                                                

20      Medicaid adult benefits waiver                                                       178,707,600                                                                 

                                                                                

21      Subtotal basic medical services program                                              5,063,273,700                                                               

                                                                                

22      School-based services                                                                69,159,500                                                                  

                                                                                

23      Special adjustor payments                                                            791,338,100                                                                 

                                                                                

24      Subtotal special medical services payments                                           860,497,600                                                                 

                                                                                

25      GROSS APPROPRIATION                                                              $    5,923,771,300                                                               

                                                                                

26                                                                                   Appropriated from:                                                          

                                                                                

27  Federal revenues:                                                           


                                                                                

1       Total federal revenues                                                               3,381,952,800                                                               

                                                                                

2   Special revenue funds:                                                      

                                                                                

3       Total local revenues                                                                 666,912,000                                                                 

                                                                                

4       Total private revenues                                                               5,126,700                                                                   

                                                                                

5       Tobacco settlement revenue                                                           192,316,000                                                                 

                                                                                

6       Total other state restricted revenues                                                447,376,800                                                                 

                                                                                

7       State general fund/general purpose                                               $    1,230,087,000                                                               

                                                                                

8                                                                                    Sec. 120. INFORMATION TECHNOLOGY                                            

                                                                                

9       Information technology services and projects                                     $    30,616,000                                                                  

                                                                                

10      GROSS APPROPRIATION                                                              $    30,616,000                                                                  

                                                                                

11                                                                                   Appropriated from:                                                          

                                                                                

12  Interdepartmental grant revenues:                                           

                                                                                

13      IDG from the department of corrections                                               142,700                                                                     

                                                                                

14  Federal revenues:                                                           

                                                                                

15      Total federal revenues                                                               17,304,200                                                                  

                                                                                

16  Special revenue funds:                                                      

                                                                                

17      Total other state restricted revenues                                                1,793,800                                                                   

                                                                                

18      State general fund/general purpose                                               $    11,375,300                                                                  

                                                                                

19  PART 2                                                                      

                                                                                

20  PROVISIONS CONCERNING APPROPRIATIONS                                        

                                                                                

21  GENERAL SECTIONS                                                            

                                                                                

22      Sec. 201. Pursuant to section 30 of article IX of the state                 

                                                                                

23  constitution of 1963, total state spending from state resources under       

                                                                                

24  part 1 for fiscal year 2003-2004 is $3,291,266,000.00 and state             

                                                                                

25  spending from state resources to be paid to units of local government       

                                                                                

26  for fiscal year 2003-2004 is $1,187,922,600.00. The itemized statement      

                                                                                

27  below identifies appropriations from which spending to units of local       


                                                                                

1   government will occur:                                                      

                                                                                

2   DEPARTMENT OF COMMUNITY HEALTH                                              

                                                                                

3   DEPARTMENTWIDE ADMINISTRATION                                               

                                                                                

4       Departmental administration and management                                       $    11,657,700                                                                  

                                                                                

5       Rural health services                                                                35,000                                                                      

                                                                                

6   MENTAL HEALTH/SUBSTANCE ABUSE SERVICES ADMINISTRATION AND SPECIAL           

                                                                                

7   PROJECTS    Mental health initiatives for older persons                                          1,049,200                                                                   

                                                                                

8   COMMUNITY MENTAL HEALTH/SUBSTANCE ABUSE SERVICES PROGRAMS                   

                                                                                

9       State disability assistance program substance abuse                         

                                                                                

10                                                                                   services                                                                             2,509,800                                                                   

                                                                                

11      Community substance abuse prevention, education, and                        

                                                                                

12                                                                                   treatment programs                                                                   19,133,500                                                                  

                                                                                

13      Medicaid mental health services                                                      764,074,800                                                                 

                                                                                

14      Community mental health non-Medicaid services                                        287,147,600                                                                 

                                                                                

15      Multicultural services                                                               3,163,800                                                                   

                                                                                

16      Medicaid substance abuse services                                                    12,179,700                                                                  

                                                                                

17  INFECTIOUS DISEASE CONTROL                                                  

                                                                                

18      AIDS prevention, testing and care programs                                           1,466,800                                                                   

                                                                                

19      Immunization local agreements                                                        2,973,900                                                                   

                                                                                

20      Sexually transmitted disease control local agreements                                406,100                                                                     

                                                                                

21  LOCAL HEALTH ADMINISTRATION AND GRANTS                                      

                                                                                

22      Local public health operations                                                       40,618,400                                                                  

                                                                                

23  CHRONIC DISEASE AND INJURY PREVENTION AND HEALTH PROMOTION                  

                                                                                

24      Smoking prevention program                                                           1,898,400                                                                   

                                                                                

25  COMMUNITY LIVING, CHILDREN, AND FAMILIES                                    

                                                                                

26      Childhood lead program                                                               85,000                                                                      

                                                                                

27      Family planning local agreements                                                     1,142,200                                                                   


                                                                                

1       Local MCH services                                                                   246,100                                                                     

                                                                                

2       Omnibus budget reconciliation act implementation                                     2,030,800                                                                   

                                                                                

3       Prenatal care outreach and service delivery support                                  610,000                                                                     

                                                                                

4   CHILDREN'S SPECIAL HEALTH CARE SERVICES                                     

                                                                                

5       Case management services                                                             3,169,900                                                                   

                                                                                

6   MEDICAL SERVICES                                                            

                                                                                

7       Transportation                                                                       1,175,300                                                                   

                                                                                

8   OFFICE OF SERVICES TO THE AGING                                             

                                                                                

9       Community services                                                                   12,530,300                                                                  

                                                                                

10      Nutrition services                                                                   12,439,500                                                                  

                                                                                

11      Senior volunteer services                                                            517,500                                                                     

                                                                                

12  CRIME VICTIM SERVICES COMMISSION                                            

                                                                                

13      Crime victim rights services grants                                                  5,661,300                                                                   

                                                                                

14  TOTAL OF PAYMENTS TO LOCAL UNITS OF GOVERNMENT                                   $    1,187,922,600                                                               

                                                                                

15      Sec. 202. The appropriations authorized under this bill are subject         

                                                                                

16  to the management and budget act, 1984 PA 431, MCL 18.1101 to 18.1594.      

                                                                                

17      Sec. 203. As used in this bill:                                             

                                                                                

18      (a) "AIDS" means acquired immunodeficiency syndrome.                        

                                                                                

19      (b) "CMHSP" means a community mental health services program as             

                                                                                

20  that term is defined in section 100a of the mental health code, 1974 PA     

                                                                                

21  258, MCL 330.1100a.                                                         

                                                                                

22      (c) "Disease management" means a comprehensive system that                  

                                                                                

23  incorporates the patient, physician, and health plan into 1 system with     

                                                                                

24  the common goal of achieving desired outcomes for patients.                 

                                                                                

25      (d) "Department" means the Michigan department of community                 

                                                                                

26  health.                                                                     

                                                                                

27      (e) "DSH" means disproportionate share hospital.                            


                                                                                

1       (f) "EPIC" means elder prescription insurance coverage program.             

                                                                                

2       (g) "EPSDT" means early and periodic screening, diagnosis, and              

                                                                                

3   treatment.                                                                  

                                                                                

4       (h) "FTE" means full-time equated.                                          

                                                                                

5       (i) "GME" means graduate medical education.                                 

                                                                                

6       (j) "Health plan" means, at a minimum, an organization that meets           

                                                                                

7   the criteria for delivering the comprehensive package of services under     

                                                                                

8   the department's comprehensive health plan.                                 

                                                                                

9       (k) "HMO" means health maintenance organization.                            

                                                                                

10      (l) "IDEA" means individual disability education act.                       

                                                                                

11      (m) "IDG" means interdepartmental grant.                                    

                                                                                

12      (n) "MCH" means maternal and child health.                                  

                                                                                

13      (o) "MIChild" means a state and federally funded health insurance           

                                                                                

14  program for children under age 19, living in families with incomes up       

                                                                                

15  to 200% of federal poverty level.                                           

                                                                                

16      (p) "MSS/ISS" means maternal and infant support services.                   

                                                                                

17      (q) "Title XVIII" means title XVIII of the social security act,             

                                                                                

18  chapter 531, 49 Stat. 620, 42 U.S.C. 1395 to 1395b, 1395b-2, 1395b-6 to     

                                                                                

19  1395b-7, 1395c to 1395i, 1395i-2 to 1395i-5, 1395j to 1395t, 1395u to       

                                                                                

20  1395w, 1395w-2 to 1395w-4, 1395w-21 to 1395w-28, 1395x to 1395yy, and       

                                                                                

21  1395bbb to 1395ggg.                                                         

                                                                                

22      (r) "Title XIX" means title XIX of the social security act,                 

                                                                                

23  chapter 531, 49 Stat. 620, 42 U.S.C. 1396 to 1396r-6 and 1396r-8 to         

                                                                                

24  1396v.                                                                      

                                                                                

25      (s) "Title XX" means title XX of the social security act, chapter           

                                                                                

26  531, 49 U.S.C. 1397 to 1397f.                                               

                                                                                

27      (t) "WIC" means women, infants, and children supplemental                   


                                                                                

1   nutrition program.                                                          

                                                                                

2       Sec. 204. The department of civil service shall bill departments and        

                                                                                

3   agencies at the end of the first fiscal quarter for the 1% charge           

                                                                                

4   authorized by section 5 of article XI of the state constitution of          

                                                                                

5   1963.  Payments shall be made for the total amount of the billing by        

                                                                                

6   the end of the second fiscal quarter.                                       

                                                                                

7       Sec. 205. (1) A hiring freeze is imposed on the state classified            

                                                                                

8   civil service.  State departments and agencies are prohibited from          

                                                                                

9   hiring any new state classified civil service employees and prohibited      

                                                                                

10  from filling any vacant state classified civil service positions.  This     

                                                                                

11  hiring freeze does not apply to internal transfers of classified            

                                                                                

12  employees from 1 position to another within a department.                   

                                                                                

13      (2) The state budget director shall grant exceptions to this                

                                                                                

14  hiring freeze when the state budget director believes that the hiring       

                                                                                

15  freeze will result in rendering a state department or agency unable to      

                                                                                

16  deliver basic services, cause a loss of revenue to the state, result in     

                                                                                

17  the inability of the state to receive federal funds, or necessitate         

                                                                                

18  additional expenditures that exceed any savings from maintaining the        

                                                                                

19  vacancy.  The state budget director shall report quarterly to the           

                                                                                

20  chairpersons of the senate and house of representatives standing            

                                                                                

21  committees on appropriations the number of exceptions to the hiring         

                                                                                

22  freeze approved during the previous quarter and the reasons to justify      

                                                                                

23  the exception.                                                              

                                                                                

24      Sec. 206. Unless otherwise specified, the department shall use the          

                                                                                

25  Internet to fulfill the reporting requirements of this bill.  This          

                                                                                

26  requirement may include transmission of reports via electronic mail to      

                                                                                

27  the recipients identified for each reporting requirement, or it may         


                                                                                

1   include placement of reports on an Internet or Intranet site.               

                                                                                

2       Sec. 207. From the funds appropriated in part 1 for information             

                                                                                

3   technology, the department shall pay user fees to the department of         

                                                                                

4   information technology for technology-related services and projects.        

                                                                                

5   Such user fees shall be subject to provisions of an interagency             

                                                                                

6   agreement between the departments and agencies and the department of        

                                                                                

7   information technology.                                                     

                                                                                

8       Sec. 208. Amounts appropriated in part 1 for information technology         

                                                                                

9   may be designated as work projects and carried forward to support           

                                                                                

10  department of community health projects under the direction of the          

                                                                                

11  department of information technology.  Funds designated in this manner      

                                                                                

12  are not available for expenditure until approved as work projects under     

                                                                                

13  section 451a of the management and budget act, 1984 PA 431, MCL             

                                                                                

14  18.1451a.                                                                   

                                                                                

15      Sec. 209. (1) In addition to the funds appropriated in part 1, there        

                                                                                

16  is appropriated an amount not to exceed $100,000,000.00 for federal         

                                                                                

17  contingency funds.  These funds are not available for expenditure until     

                                                                                

18  they have been transferred to another line item in this bill under          

                                                                                

19  section 393(2) of the management and budget act, 1984 PA 431, MCL           

                                                                                

20  18.1393.                                                                    

                                                                                

21      (2) In addition to the funds appropriated in part 1, there is               

                                                                                

22  appropriated an amount not to exceed $50,000,000.00 for state-              

                                                                                

23  restricted contingency funds.  These funds are not available for            

                                                                                

24  expenditure until they have been transferred to another line item in        

                                                                                

25  this bill under section 393(2) of the management and budget act, 1984       

                                                                                

26  PA 431, MCL 18.1393.                                                        

                                                                                

27      (3) In addition to the funds appropriated in part 1, there is               


                                                                                

1   appropriated an amount not to exceed $50,000,000.00 for local               

                                                                                

2   contingency funds.  These funds are not available for expenditure until     

                                                                                

3   they have been transferred to another line item in this bill under          

                                                                                

4   section 393(2) of the management and budget act, 1984 PA 431, MCL           

                                                                                

5   18.1393.                                                                    

                                                                                

6       (4) In addition to the funds appropriated in part 1, there is               

                                                                                

7   appropriated an amount not to exceed $10,000,000.00 for private             

                                                                                

8   contingency funds.  These funds are not available for expenditure until     

                                                                                

9   they have been transferred to another line item in this bill under          

                                                                                

10  section 393(2) of the management and budget act, 1984 PA 431, MCL           

                                                                                

11  18.1393.                                                                    

                                                                                

12      Sec. 211. If the revenue collected by the department from fees and          

                                                                                

13  collections exceeds the amount appropriated in part 1, the revenue may      

                                                                                

14  be carried forward with the approval of the state budget director into      

                                                                                

15  the subsequent fiscal year.  The revenue carried forward under this         

                                                                                

16  section shall be used as the first source of funds in the subsequent        

                                                                                

17  fiscal year.                                                                

                                                                                

18      Sec. 212. (1) On or before February 1, 2004, the department shall           

                                                                                

19  report to the house of representatives and senate appropriations            

                                                                                

20  subcommittees on community health, the house and senate fiscal              

                                                                                

21  agencies, and the state budget director on the detailed name and            

                                                                                

22  amounts of federal, restricted, private, and local sources of revenue       

                                                                                

23  that support the appropriations in each of the line items in part 1 of      

                                                                                

24  this bill.                                                                  

                                                                                

25      (2) Upon the release of the fiscal year 2004-2005 executive                 

                                                                                

26  budget recommendation, the department shall report to the same parties      

                                                                                

27  in subsection (2) on the amounts and detailed sources of federal,           


                                                                                

1   restricted, private, and local revenue proposed to support the total        

                                                                                

2   funds appropriated in each of the line items in part 1 of the fiscal        

                                                                                

3   year 2004-2005 executive budget proposal.                                   

                                                                                

4       (3) The department shall provide to the same parties in                     

                                                                                

5   subsection (1) all revenue source detail for consolidated revenue line      

                                                                                

6   item detail upon request to the department.                                 

                                                                                

7       Sec. 213. The state departments, agencies, and commissions receiving        

                                                                                

8   tobacco tax funds from part 1 shall report by January 1, 2004, to the       

                                                                                

9   senate and house of representatives appropriations committees, the          

                                                                                

10  senate and house fiscal agencies, and the state budget director on the      

                                                                                

11  following:                                                                  

                                                                                

12      (a) Detailed spending plan by appropriation line item including             

                                                                                

13  description of programs.                                                    

                                                                                

14      (b) Description of allocations or bid processes including need or           

                                                                                

15  demand indicators used to determine allocations.                            

                                                                                

16      (c) Eligibility criteria for program participation and maximum              

                                                                                

17  benefit levels where applicable.                                            

                                                                                

18      (d) Outcome measures to be used to evaluate programs.                       

                                                                                

19      (e) Any other information considered necessary by the house of              

                                                                                

20  representatives or senate appropriations committees or the state budget     

                                                                                

21  director.                                                                   

                                                                                

22      Sec. 214. The use of state-restricted tobacco tax revenue received          

                                                                                

23  for the purpose of tobacco prevention, education, and reduction efforts     

                                                                                

24  and deposited in the healthy Michigan fund shall not be used for            

                                                                                

25  lobbying as defined in 1978 PA472, MCL 4.411 to 4.431.                      

                                                                                

26      Sec. 216. (1) In addition to funds appropriated in part 1 for all           

                                                                                

27  programs and services, there is appropriated for write-offs of accounts     


                                                                                

1   receivable, deferrals, and for prior year obligations in excess of          

                                                                                

2   applicable prior year appropriations, an amount equal to total write-       

                                                                                

3   offs and prior year obligations, but not to exceed amounts available in     

                                                                                

4   prior year revenues.                                                        

                                                                                

5       (2) The department's ability to satisfy appropriation deductions            

                                                                                

6   in part 1 shall not be limited to collections and accruals pertaining       

                                                                                

7   to services provided in fiscal year 2003-2004, but shall also include       

                                                                                

8   reimbursements, refunds, adjustments, and settlements from prior years.     

                                                                                

9       Sec. 218. Basic health services for the purpose of part 23 of the           

                                                                                

10  public health code, 1978 PA 368, MCL 333.2301 to 333.2321, are:             

                                                                                

11  immunizations, communicable disease control, sexually transmitted           

                                                                                

12  disease control, tuberculosis control, prevention of gonorrhea eye          

                                                                                

13  infection in newborns, screening newborns for the 7 conditions listed       

                                                                                

14  in section 5431(1)(a) through (g) of the public health code, 1978 PA        

                                                                                

15  368, MCL 333.5431, community health annex of the Michigan emergency         

                                                                                

16  management plan, and prenatal care.                                         

                                                                                

17      Sec. 219. (1) The department may contract with the Michigan public          

                                                                                

18  health institute for the design and implementation of projects and for      

                                                                                

19  other public health related activities prescribed in section 2611 of        

                                                                                

20  the public health code, 1978 PA 368, MCL 333.2611.  The department may      

                                                                                

21  develop a master agreement with the institute to carry out these            

                                                                                

22  purposes for up to a 3-year period.  The department shall report to the     

                                                                                

23  house of representatives and senate appropriations subcommittees on         

                                                                                

24  community health, the house and senate fiscal agencies, and the state       

                                                                                

25  budget director on or before November 1, 2003 and May 1, 2004 all of        

                                                                                

26  the following:                                                              

                                                                                

27      (a) A detailed description of each funded project.                          


                                                                                

1       (b) The amount allocated for each project, the appropriation line           

                                                                                

2   item from which the allocation is funded, and the source of financing       

                                                                                

3   for each project.                                                           

                                                                                

4       (c) The expected project duration.                                          

                                                                                

5       (d) A detailed spending plan for each project, including a list             

                                                                                

6   of all subgrantees and the amount allocated to each subgrantee.             

                                                                                

7       (2) If a report required under subsection (1) is not received by            

                                                                                

8   the house of representatives and senate appropriations subcommittees on     

                                                                                

9   community health, the house and senate fiscal agencies, and the state       

                                                                                

10  budget director on or before the date specified for that report, the        

                                                                                

11  disbursement of funds to the Michigan public health institute under         

                                                                                

12  this section shall stop.  The disbursement of those funds shall             

                                                                                

13  recommence when the overdue report is received.                             

                                                                                

14      (3) On or before September 30, 2004, the department shall provide           

                                                                                

15  to the same parties listed in subsection (1) a copy of all reports,         

                                                                                

16  studies, and publications produced by the Michigan public health            

                                                                                

17  institute, its subcontractors, or the department with the funds             

                                                                                

18  appropriated in part 1 and allocated to the Michigan public health          

                                                                                

19  institute.                                                                  

                                                                                

20      Sec. 220. All contracts with the Michigan public health institute           

                                                                                

21  funded with appropriations in part 1 shall include a requirement that       

                                                                                

22  the Michigan public health institute submit to financial and                

                                                                                

23  performance audits by the state auditor general of projects funded with     

                                                                                

24  state appropriations.                                                       

                                                                                

25      Sec. 223. The department of community health may establish and              

                                                                                

26  collect fees for publications, videos and related materials,                

                                                                                

27  conferences, and workshops. Collected fees shall be used to offset          


                                                                                

1   expenditures to pay for printing and mailing costs of the publications,     

                                                                                

2   videos and related materials, and costs of the workshops and                

                                                                                

3   conferences. The costs shall not exceed fees collected.                     

                                                                                

4       Sec. 224. (1) In addition to the amounts appropriated in part 1, in         

                                                                                

5   order to encourage administrative efficiencies, there is appropriated       

                                                                                

6   to the department of community health, an amount not to exceed one-half     

                                                                                

7   of the unexpended, unreserved general fund portions of fiscal year          

                                                                                

8   2002-2003 appropriations made to the department for salaries and wages      

                                                                                

9   expenses, contractual services, supplies and materials expenses,            

                                                                                

10  information technology expenses and program operations costs.               

                                                                                

11      (2)     The appropriations contained in subsection 1 are subject to                 

                                                                                

12  the approval of the state budget director and shall be spent for the        

                                                                                

13  same purposes for which the original appropriation was made in fiscal       

                                                                                

14  year 2002-2003.                                                             

                                                                                

15  DEPARTMENTWIDE ADMINISTRATION                                               

                                                                                

16      Sec. 301. From funds appropriated for worker's compensation, the            

                                                                                

17  department may make payments in lieu of worker's compensation payments      

                                                                                

18  for wage and salary and related fringe benefits for employees who           

                                                                                

19  return to work under limited duty assignments.                              

                                                                                

20      Sec. 303. The department is prohibited from requiring first-party           

                                                                                

21  payment from individuals or families with a taxable income of               

                                                                                

22  $10,000.00 or less for mental health services for determinations made       

                                                                                

23  in accordance with section 818 of the mental health code, 1974 PA 258,      

                                                                                

24  MCL 330.1818.                                                               

                                                                                

25      Sec. 304. The funds appropriated in part 1 for the Michigan                 

                                                                                

26  essential health care provider program may also provide loan repayment      

                                                                                

27  for dentists that fit the criteria established by part 27 of the public     


                                                                                

1   health code, 1978 PA 368, MCL 333.2701 to 333.2727.                         

                                                                                

2   COMMUNITY MENTAL HEALTH/SUBSTANCE ABUSE SERVICES PROGRAM                    

                                                                                

3       Sec. 401. Funds appropriated in part 1 are intended to support a            

                                                                                

4   system of comprehensive community mental health services under the full     

                                                                                

5   authority and responsibility of local CMHSPs/specialty prepaid health       

                                                                                

6   plans.  The department shall ensure that each CMHSP/specialty prepaid       

                                                                                

7   health plan provides all of the following:                                  

                                                                                

8       (a) A system of single entry and single exit.                               

                                                                                

9       (b) A complete array of mental health services which shall                  

                                                                                

10  include, but shall not be limited to, all of the following services:        

                                                                                

11  residential and other individualized living arrangements, outpatient        

                                                                                

12  services, acute inpatient services, and long-term, 24-hour inpatient        

                                                                                

13  care in a structured, secure environment.                                   

                                                                                

14      (c) The coordination of inpatient and outpatient hospital                   

                                                                                

15  services through agreements with state-operated psychiatric hospitals,      

                                                                                

16  units, and centers in facilities owned or leased by the state, and          

                                                                                

17  privately-owned hospitals, units, and centers licensed by the state         

                                                                                

18  pursuant to sections 134 through 149b of the mental health code, 1974       

                                                                                

19  PA 258, MCL 330.1134 to 330.1149b.                                          

                                                                                

20      (d) Individualized plans of service that are sufficient to meet             

                                                                                

21  the needs of individuals, including those discharged from psychiatric       

                                                                                

22  hospitals or centers, and that ensure the full range of recipient needs     

                                                                                

23  is addressed through the CMHSP's/specialty prepaid health plan’s            

                                                                                

24  program or through assistance with locating and obtaining services to       

                                                                                

25  meet these needs.                                                           

                                                                                

26      (e) A system of case management to monitor and ensure the                   

                                                                                

27  provision of services consistent with the individualized plan of            


                                                                                

1   services or supports.                                                       

                                                                                

2       (f) A system of continuous quality improvement.                             

                                                                                

3       (g) A system to monitor and evaluate the mental health services             

                                                                                

4   provided.                                                                   

                                                                                

5       (h) A system that serves at-risk and delinquent youth as required           

                                                                                

6   under the provisions of the mental health code, 1974 PA 258, MCL            

                                                                                

7   330.1001 to 330.2106.                                                       

                                                                                

8       Sec. 402. (1) From funds appropriated in part 1, final                      

                                                                                

9   authorizations to CMHSPs/specialty prepaid health plans shall be made       

                                                                                

10  upon the execution of contracts between the department and                  

                                                                                

11  CMHSPs/specialty prepaid health plans.  The contracts shall contain an      

                                                                                

12  approved plan and budget as well as policies and procedures governing       

                                                                                

13  the obligations and responsibilities of both parties to the contracts.      

                                                                                

14  Each contract with a CMHSP/specialty prepaid health plan that the           

                                                                                

15  department is authorized to enter into under this subsection shall          

                                                                                

16  include a provision that the contract is not valid unless the total         

                                                                                

17  dollar obligation for all of the contracts between the department and       

                                                                                

18  the CMHSPs/specialty prepaid health plans entered into under this           

                                                                                

19  subsection for fiscal year 2003-2004 does not exceed the amount of          

                                                                                

20  money appropriated in part 1 for the contracts authorized under this        

                                                                                

21  subsection.                                                                 

                                                                                

22      (2) The department shall immediately report to the senate and               

                                                                                

23  house of representatives appropriations subcommittees on community          

                                                                                

24  health, the senate and house fiscal agencies, and the state budget          

                                                                                

25  director if either of the following occurs:                                 

                                                                                

26      (a) Any new contracts with CMHSPs/specialty prepaid health plans            

                                                                                

27  that would affect rates or expenditures are enacted.                        


                                                                                

1       (b) Any amendments to contracts with CMHSPs/specialty prepaid               

                                                                                

2   health plans that would affect rates or expenditures are enacted.           

                                                                                

3       (3) The report required by subsection (2) shall include                     

                                                                                

4   information about the changes and their effects on rates and                

                                                                                

5   expenditures.                                                               

                                                                                

6       Sec. 404. (1) Not later than May 31 of each fiscal year, the                

                                                                                

7   department shall provide a report on the community mental health            

                                                                                

8   services programs to the members of the house of representatives and        

                                                                                

9   senate appropriations subcommittees on community health, the house and      

                                                                                

10  senate fiscal agencies, and the state budget director that includes the     

                                                                                

11  information required by this section.                                       

                                                                                

12      (2) The report shall contain information for each CMHSP/specialty           

                                                                                

13  prepaid health plan and a statewide summary, each of which shall            

                                                                                

14  include at least the following information:                                 

                                                                                

15      (a) A demographic description of service recipients which,                  

                                                                                

16  minimally, shall include reimbursement eligibility, client population,      

                                                                                

17  age, ethnicity, housing arrangements, and diagnosis.                        

                                                                                

18      (b) When the encounter data is available, a breakdown of clients            

                                                                                

19  served, by diagnosis. As used in this subdivision, "diagnosis" means a      

                                                                                

20  recipient's primary diagnosis, stated as a specifically named mental        

                                                                                

21  illness, emotional disorder, or developmental disability corresponding      

                                                                                

22  to terminology employed in the latest edition of the American               

                                                                                

23  psychiatric association's diagnostic and statistical manual.                

                                                                                

24      (c) Per capita expenditures by client population group.                     

                                                                                

25      (d) Financial information which, minimally, shall include a                 

                                                                                

26  description of funding authorized; expenditures by client group and         

                                                                                

27  fund source; and cost information by service category, including            


                                                                                

1   administration.  Service category shall include all department approved     

                                                                                

2   services.                                                                   

                                                                                

3       (e) Data describing service outcomes which shall include, but not           

                                                                                

4   be limited to, an evaluation of consumer satisfaction, consumer choice,     

                                                                                

5   and quality of life concerns including, but not limited to, housing and     

                                                                                

6   employment.                                                                 

                                                                                

7       (f) Information about access to community mental health services            

                                                                                

8   programs which shall include, but not be limited to, the following:         

                                                                                

9                                                                                (i) The number of people receiving requested services.                              

                                                                                

10      (ii) The number of people who requested services but did not                 

                                                                                

11  receive services.                                                           

                                                                                

12      (iii) The number of people requesting services who are on waiting            

                                                                                

13  lists for services.                                                         

                                                                                

14      (iv) The average length of time that people remained on waiting              

                                                                                

15  lists for services.                                                         

                                                                                

16      (g) The number of second opinions requested under the code and              

                                                                                

17  the determination of any appeals.                                           

                                                                                

18      (h) An analysis of information provided by community mental                 

                                                                                

19  health service programs in response to the needs assessment                 

                                                                                

20  requirements of the mental health code, including information about the     

                                                                                

21  number of persons in the service delivery system who have requested and     

                                                                                

22  are clinically appropriate for different services.                          

                                                                                

23      (i) An estimate of the number of FTEs employed by the                       

                                                                                

24  CMHSPs/specialty prepaid health plans or contracted with directly by        

                                                                                

25  the CMHSPs/specialty prepaid health plans as of September 30, 2003 and      

                                                                                

26  an estimate of the number of FTEs employed through contracts with           

                                                                                

27  provider organizations as of September 30, 2003.                            


                                                                                

1       (j) Lapses and carryforwards during fiscal year 2002-2003 for               

                                                                                

2   CMHSPs/specialty prepaid health plans.                                      

                                                                                

3       (k) Contracts for mental health services entered into by                    

                                                                                

4   CMHSPs/specialty prepaid health plans with providers, including amount      

                                                                                

5   and rates, organized by type of service provided.                           

                                                                                

6       (l) Information on the community mental health Medicaid managed             

                                                                                

7   care program, including, but not limited to, both of the following:         

                                                                                

8                                                                                (i) Expenditures by each CMHSP/specialty prepaid health plan                        

                                                                                

9   organized by Medicaid eligibility group, including per eligible             

                                                                                

10  individual expenditure averages.                                            

                                                                                

11      (ii) Performance indicator information required to be submitted              

                                                                                

12  to the department in the contracts with CMHSPs/specialty prepaid health     

                                                                                

13  plans.                                                                      

                                                                                

14      (3) The department shall include data reporting requirements                

                                                                                

15  listed in subsection (2) in the annual contract with each individual        

                                                                                

16  CMHSP/specialty prepaid health plan.                                        

                                                                                

17      (4) The department shall take all reasonable actions to ensure              

                                                                                

18  that the data required are complete and consistent among all                

                                                                                

19  CMHSPs/specialty prepaid health plans.                                      

                                                                                

20      Sec. 406. (1) The funds appropriated in part 1 for the state                

                                                                                

21  disability assistance substance abuse services program shall be used to     

                                                                                

22  support per diem room and board payments in substance abuse residential     

                                                                                

23  facilities.  Eligibility of clients for the state disability assistance     

                                                                                

24  substance abuse services program shall include needy persons 18 years       

                                                                                

25  of age or older, or emancipated minors, who reside in a substance abuse     

                                                                                

26  treatment center.                                                           

                                                                                

27      (2) The department shall reimburse all licensed substance abuse             


                                                                                

1   programs eligible to participate in the program at a rate equivalent to     

                                                                                

2   that paid by the family independence agency to adult foster care            

                                                                                

3   providers. Programs accredited by department-approved accrediting           

                                                                                

4   organizations shall be reimbursed at the personal care rate, while all      

                                                                                

5   other eligible programs shall be reimbursed at the domiciliary care         

                                                                                

6   rate.                                                                       

                                                                                

7       Sec. 408. (1) By April 15, 2004 the department shall report the             

                                                                                

8   following data from fiscal year 2002-2003 on substance abuse                

                                                                                

9   prevention, education, and treatment programs to the senate and house       

                                                                                

10  of representatives appropriations subcommittees on community health,        

                                                                                

11  the senate and house fiscal agencies, and the state budget office:          

                                                                                

12      (a) Expenditures stratified by coordinating agency, by central              

                                                                                

13  diagnosis and referral agency, by fund source, by subcontractor, by         

                                                                                

14  population served, and by service type. Additionally, data on               

                                                                                

15  administrative expenditures by coordinating agency and by subcontractor     

                                                                                

16  shall be reported.                                                          

                                                                                

17      (b) Expenditures per state client, with data on the distribution            

                                                                                

18  of expenditures reported using a histogram approach.                        

                                                                                

19      (c) Number of services provided by central diagnosis and referral           

                                                                                

20  agency, by subcontractor, and by service type. Additionally, data on        

                                                                                

21  length of stay, referral source, and participation in other state           

                                                                                

22  programs.                                                                   

                                                                                

23      (d) Collections from other first- or third-party payers, private            

                                                                                

24  donations, or other state or local programs, by coordinating agency, by     

                                                                                

25  subcontractor, by population served, and by service type.                   

                                                                                

26      (2) The department shall take all reasonable actions to ensure              

                                                                                

27  that the required data reported are complete and consistent among all       


                                                                                

1   coordinating agencies.                                                      

                                                                                

2       Sec. 409. The funding in part 1 for substance abuse services shall          

                                                                                

3   be distributed in a manner that provides priority to service providers      

                                                                                

4   that furnish child care services to clients with children.                  

                                                                                

5       Sec. 410. The department shall assure that substance abuse treatment        

                                                                                

6   is provided to applicants and recipients of public assistance through       

                                                                                

7   the family independence agency who are required to obtain substance         

                                                                                

8   abuse treatment as a condition of eligibility for public assistance.        

                                                                                

9       Sec. 411. (1) The department shall ensure that each contract with a         

                                                                                

10  CMHSP/specialty prepaid health plan requires the CMHSP/specialty            

                                                                                

11  prepaid health plan to implement programs to encourage diversion of         

                                                                                

12  persons with serious mental illness, serious emotional disturbance, or      

                                                                                

13  developmental disability from possible jail incarceration when              

                                                                                

14  appropriate.                                                                

                                                                                

15      (2) Each CMHSP/specialty prepaid health plan shall have jail                

                                                                                

16  diversion services and shall work toward establishing working               

                                                                                

17  relationships with representative staff of local law enforcement            

                                                                                

18  agencies, including county prosecutors' offices, county sheriffs'           

                                                                                

19  offices, county jails, municipal police agencies, municipal detention       

                                                                                

20  facilities, and the courts.  Written interagency agreements describing      

                                                                                

21  what services each participating agency is prepared to commit to the        

                                                                                

22  local jail diversion effort and the procedures to be used by local law      

                                                                                

23  enforcement agencies to access mental health jail diversion services        

                                                                                

24  are strongly encouraged.                                                    

                                                                                

25      Sec. 414. Medicaid substance abuse treatment services shall be              

                                                                                

26  managed by selected CMHSPs/specialty prepaid health plans pursuant to       

                                                                                

27  the centers for Medicare and Medicaid services' approval of Michigan's      


                                                                                

1   1915(b) waiver request to implement a managed care plan for specialized     

                                                                                

2   substance abuse services.  The selected CMHSPs/specialty prepaid health     

                                                                                

3   plans shall receive a capitated payment on a per eligible per month         

                                                                                

4   basis to assure provision of medically necessary substance abuse            

                                                                                

5   services to all beneficiaries who require those services.  The selected     

                                                                                

6   CMHSPs/specialty prepaid health plans shall be responsible for the          

                                                                                

7   reimbursement of claims for specialized substance abuse services.  The      

                                                                                

8   CMHSPs/specialty prepaid health plans that are not coordinating             

                                                                                

9   agencies may continue to contract with a coordinating agency.  Any          

                                                                                

10  alternative arrangement must be based on client service needs and have      

                                                                                

11  prior approval from the department.                                         

                                                                                

12      Sec. 418. On or before the tenth of each month, the department shall        

                                                                                

13  report to the senate and house of representatives appropriations            

                                                                                

14  subcommittees on community health, the senate and house fiscal              

                                                                                

15  agencies, and the state budget director on the amount of funding paid       

                                                                                

16  to the CMHSPs/specialty prepaid health plans to support the Medicaid        

                                                                                

17  managed mental health care program in that month.  The information          

                                                                                

18  shall include the total paid to each CMHSP/specialty prepaid health         

                                                                                

19  plan, per capita rate paid for each eligibility group for each CMHSP        

                                                                                

20  /specialty prepaid health plan, and number of cases in each eligibility     

                                                                                

21  group for each CMHSP/specialty prepaid health plan, and year-to-date        

                                                                                

22  summary of eligibles and expenditures for the Medicaid managed mental       

                                                                                

23  health care program.                                                        

                                                                                

24      Sec. 424. Each community mental health services program/specialty           

                                                                                

25  prepaid health plan that contracts with the department to provide           

                                                                                

26  services to the Medicaid population shall adhere to the following           

                                                                                

27  timely claims processing and payment procedure for claims submitted by      


                                                                                

1   health professionals and facilities:                                        

                                                                                

2       (a) A "clean claim" as described in section 111i of the social              

                                                                                

3   welfare act, 1939 PA 280, MCL 400.111i, must be paid within 45 days         

                                                                                

4   after receipt of the claim by the community mental health services          

                                                                                

5   program/specialty prepaid health plan. A clean claim that is not paid       

                                                                                

6   within this time frame shall bear simple interest at a rate of 12% per      

                                                                                

7   annum.                                                                      

                                                                                

8       (b) A community mental health services program/specialty prepaid            

                                                                                

9   health plan must state in writing to the health professional or             

                                                                                

10  facility any defect in the claim within 30 days after receipt of the        

                                                                                

11  claim.                                                                      

                                                                                

12      (c) A health professional and a health facility have 30 days                

                                                                                

13  after receipt of a notice that a claim or a portion of a claim is           

                                                                                

14  defective within which to correct the defect.  The community mental         

                                                                                

15  health services program shall pay the claim within 30 days after the        

                                                                                

16  defect is corrected.                                                        

                                                                                

17      Sec. 435. A county required under the provisions of the mental              

                                                                                

18  health code, 1974 PA 258, MCL 330.1001 to 330.2106, to provide matching     

                                                                                

19  funds to a CMHSP for mental health services rendered to residents in        

                                                                                

20  its jurisdiction shall pay the matching funds in equal installments on      

                                                                                

21  not less than a quarterly basis throughout the fiscal year, with the        

                                                                                

22  first payment being made by October 1, 2003.                                

                                                                                

23      Sec. 439. (1) It is the intent of the legislature that the                  

                                                                                

24  department, in conjunction with CMHSPs, support pilot projects that         

                                                                                

25  facilitate the movement of adults with mental illness from state            

                                                                                

26  psychiatric hospitals to community residential settings.                    

                                                                                

27      (2) The purpose of the pilot projects is to encourage the                   


                                                                                

1   placement of persons with mental illness in community residential           

                                                                                

2   settings who may require any of the following:                              

                                                                                

3       (a) A secured and supervised living environment.                            

                                                                                

4       (b) Assistance in taking prescribed medications.                            

                                                                                

5       (c) Intensive case management services.                                     

                                                                                

6       (d) Assertive community treatment team services.                            

                                                                                

7       (e) Alcohol or substance abuse treatment and counseling.                    

                                                                                

8       (f) Individual or group therapy.                                            

                                                                                

9       (g) Day or partial day programming activities.                              

                                                                                

10      (h) Vocational, educational, or self-help training or activities.           

                                                                                

11      (i) Other services prescribed to treat a person's mental illness            

                                                                                

12  to prevent the need for hospitalization.                                    

                                                                                

13      (3) The pilot projects described in this section shall be                   

                                                                                

14  completely voluntary.                                                       

                                                                                

15  STATE PSYCHIATRIC HOSPITALS, CENTERS FOR PERSONS WITH DEVELOPMENTAL         

                                                                                

16  DISABILITLIES, AND FORENSIC AND PRISON MENTAL HEALTH SERVICES               

                                                                                

17      Sec. 601. (1) In funding of staff in the financial support division,        

                                                                                

18  reimbursement, and billing and collection sections, priority shall be       

                                                                                

19  given to obtaining third-party payments for services.  Collection from      

                                                                                

20  individual recipients of services and their families shall be handled       

                                                                                

21  in a sensitive and nonharassing manner.                                     

                                                                                

22      (2) The department shall continue a revenue recapture project to            

                                                                                

23  generate additional revenues from third parties related to cases that       

                                                                                

24  have been closed or are inactive.  Revenues collected through project       

                                                                                

25  efforts are appropriated to the department for departmental costs and       

                                                                                

26  contractual fees associated with these retroactive collections and to       

                                                                                

27  improve ongoing departmental reimbursement management functions.            


                                                                                

1       Sec. 602. Unexpended and unencumbered amounts and accompanying              

                                                                                

2   expenditure authorizations up to $500,000.00 remaining on September 30,     

                                                                                

3   2004 from pay telephone revenues and the amounts appropriated in part 1     

                                                                                

4   for gifts and bequests for patient living and treatment environments        

                                                                                

5   shall be carried forward for 1 fiscal year.  The purpose of gifts and       

                                                                                

6   bequests for patient living and treatment environments is to use            

                                                                                

7   additional private funds to provide specific enhancements for               

                                                                                

8   individuals residing at state-operated facilities.  Use of the gifts        

                                                                                

9   and bequests shall be consistent with the stipulation of the donor.         

                                                                                

10  The expected completion date for the use of gifts and bequests              

                                                                                

11  donations is within 3 years unless otherwise stipulated by the donor.       

                                                                                

12      Sec. 603. The funds appropriated in part 1 for forensic mental              

                                                                                

13  health services provided to the department of corrections are in            

                                                                                

14  accordance with the interdepartmental plan developed in cooperation         

                                                                                

15  with the department of corrections.  The department is authorized to        

                                                                                

16  receive and expend funds from the department of corrections in addition     

                                                                                

17  to the appropriations in part 1 to fulfill the obligations outlined in      

                                                                                

18  the interdepartmental agreements.                                           

                                                                                

19      Sec. 604. (1) The CMHSPs/specialty prepaid health plans shall               

                                                                                

20  provide semiannual reports to the department on the following               

                                                                                

21  information:                                                                

                                                                                

22      (a) The number of days of care purchased from state hospitals and           

                                                                                

23  centers.                                                                    

                                                                                

24      (b) The number of days of care purchased from private hospitals             

                                                                                

25  in lieu of purchasing days of care from state hospitals and centers.        

                                                                                

26      (c) The number and type of alternative placements to state                  

                                                                                

27  hospitals and centers other than private hospitals.                         


                                                                                

1       (d) Waiting lists for placements in state hospitals and centers.            

                                                                                

2       (2) The department shall semiannually report the information in             

                                                                                

3   subsection (1) to the house of representatives and senate                   

                                                                                

4   appropriations subcommittees on community health, the house and senate      

                                                                                

5   fiscal agencies, and the state budget director.                             

                                                                                

6       Sec. 605. (1) The department shall not implement any closures or            

                                                                                

7   consolidations of state hospitals, centers, or agencies until               

                                                                                

8   CMHSPs/specialty prepaid health plans have programs and services in         

                                                                                

9   place for those persons currently in those facilities and a plan for        

                                                                                

10  service provision for those persons who would have been admitted to         

                                                                                

11  those facilities.                                                           

                                                                                

12      (2) All closures or consolidations are dependent upon adequate              

                                                                                

13  department-approved CMHSP plans that include a discharge and aftercare      

                                                                                

14  plan for each person currently in the facility.  A discharge and            

                                                                                

15  aftercare plan shall address the person's housing needs.  A homeless        

                                                                                

16  shelter or similar temporary shelter arrangements are inadequate to         

                                                                                

17  meet the person's housing needs.                                            

                                                                                

18      (3) Four months after the certification of closure required in              

                                                                                

19  section 19(6) of the state employees' retirement act, 1943 PA 240, MCL      

                                                                                

20  38.19, the department shall provide a closure plan to the house of          

                                                                                

21  representatives and senate appropriations subcommittees on community        

                                                                                

22  health.                                                                     

                                                                                

23      (4) Upon the closure of state-run operations and after                      

                                                                                

24  transitional costs have been paid, the remaining balances of funds          

                                                                                

25  appropriated for that operation shall be transferred to                     

                                                                                

26  CMHSPs/specialty prepaid health plans responsible for providing             

                                                                                

27  services for persons previously served by the operations.                   


                                                                                

1       Sec. 606. The department may collect revenue for patient                    

                                                                                

2   reimbursement from first- and third-party payers, including Medicaid,       

                                                                                

3   to cover the cost of placement in state hospitals and centers.  The         

                                                                                

4   department is authorized to adjust financing sources for patient            

                                                                                

5   reimbursement based on actual revenues earned.  If the revenue              

                                                                                

6   collected exceeds current year expenditures, the revenue may be carried     

                                                                                

7   forward with approval of the state budget director.  The revenue            

                                                                                

8   carried forward shall be used as a first source of funds in the             

                                                                                

9   subsequent year.                                                            

                                                                                

10  INFECTIOUS DISEASE CONTROL                                                  

                                                                                

11      Sec. 801. In the expenditure of funds appropriated in part 1 for            

                                                                                

12  AIDS programs, the department and its subcontractors shall ensure that      

                                                                                

13  adolescents receive priority for prevention, education, and outreach        

                                                                                

14  services.                                                                   

                                                                                

15      Sec. 802. In developing and implementing AIDS provider education            

                                                                                

16  activities, the department may provide funding to the Michigan state        

                                                                                

17  medical society to serve as lead agency to convene a consortium of          

                                                                                

18  health care providers, to design needed educational efforts, to fund        

                                                                                

19  other statewide provider groups, and to assure implementation of these      

                                                                                

20  efforts, in accordance with a plan approved by the department.              

                                                                                

21      Sec. 803. The department shall continue the AIDS drug assistance            

                                                                                

22  program maintaining the prior year eligibility criteria and drug            

                                                                                

23  formulary.  This section is not intended to prohibit the department         

                                                                                

24  from providing assistance for improved AIDS treatment medications.          

                                                                                

25  LOCAL HEALTH ADMINISTRATION AND GRANTS                                      

                                                                                

26      Sec. 901. The amount appropriated in part 1 for implementation of           

                                                                                

27  the 1993 amendments to sections 9161, 16221, 16226, 17014, 17015, and       


                                                                                

1   17515 of the public health code, 1978 PA 368, MCL 333.9161, 333.16221,      

                                                                                

2   333.16226, 333.17014, 333.17015, and 333.17515, shall reimburse local       

                                                                                

3   health departments for costs incurred related to implementation of          

                                                                                

4   section 17015(15) of the public health code, 1978 PA 368, MCL               

                                                                                

5   333.17015.                                                                  

                                                                                

6       Sec. 902. If a county that has participated in a district health            

                                                                                

7   department or an associated arrangement with other local health             

                                                                                

8   departments takes action to cease to participate in such an arrangement     

                                                                                

9   after October 1, 2003, the department shall have the authority to           

                                                                                

10  assess a penalty from the local health department's operational             

                                                                                

11  accounts in an amount equal to no more than 5% of the local health          

                                                                                

12  department's local public health operations funding.  This penalty          

                                                                                

13  shall only be assessed to the local county that requests the                

                                                                                

14  dissolution of the health department.                                       

                                                                                

15      Sec. 903. The department shall provide a report annually to the             

                                                                                

16  house of representatives and senate appropriations subcommittees on         

                                                                                

17  community health, the senate and house fiscal agencies, and the state       

                                                                                

18  budget director on the expenditures and activities undertaken by the        

                                                                                

19  lead abatement program.  The report shall include, but is not limited       

                                                                                

20  to, a funding allocation schedule, expenditures by category of              

                                                                                

21  expenditure and by subcontractor, revenues received, description of         

                                                                                

22  program elements, and description of program accomplishments and            

                                                                                

23  progress.                                                                   

                                                                                

24      Sec. 904. (1) Funds appropriated in part 1 for local public health          

                                                                                

25  operations shall be prospectively allocated to local health departments     

                                                                                

26  to support immunizations, infectious disease control, sexually              

                                                                                

27  transmitted disease control and prevention, hearing screening, vision       


                                                                                

1   services, food protection, public water supply, private groundwater         

                                                                                

2   supply, and on-site sewage management.  Food protection shall be            

                                                                                

3   provided in consultation with the Michigan department of agriculture.       

                                                                                

4   Public water supply, private groundwater supply, and on-site sewage         

                                                                                

5   management shall be provided in consultation with the Michigan              

                                                                                

6   department of environmental quality.                                        

                                                                                

7       (2) Local public health departments will be held to contractual             

                                                                                

8   standards for the services in subsection (1).                               

                                                                                

9       (3) Distributions in subsection (1) shall be made only to                   

                                                                                

10  counties that maintain local spending in fiscal year 2003-2004 of at        

                                                                                

11  least the amount expended in fiscal year 1992-1993 for the services         

                                                                                

12  described in subsection (1).                                                

                                                                                

13      (4) By April 1, 2004, the department shall make available upon              

                                                                                

14  request a report to the senate or house of representatives                  

                                                                                

15  appropriations subcommittee on community health, the senate or house        

                                                                                

16  fiscal agency, or the state budget director on the planned allocation       

                                                                                

17  of the funds appropriated for local public health operations.               

                                                                                

18  CHRONIC DISEASE AND INJURY PREVENTION AND HEALTH PROMOTION                  

                                                                                

19      Sec. 1001. From the state funds appropriated in part 1, the                 

                                                                                

20  department shall allocate funds to promote awareness, education, and        

                                                                                

21  early detection of breast, cervical, prostate, and colorectal cancer,       

                                                                                

22  and provide for other health promotion media activities.                    

                                                                                

23      Sec. 1002. (1) Provision of the school health education curriculum,         

                                                                                

24  such as the Michigan model or another comprehensive school health           

                                                                                

25  education curriculum, shall be in accordance with the health education      

                                                                                

26  goals established by the Michigan model for the comprehensive school        

                                                                                

27  health education state steering committee.  The state steering              


                                                                                

1   committee shall be comprised of a representative from each of the           

                                                                                

2   following offices and departments:                                          

                                                                                

3       (a) The department of education.                                            

                                                                                

4       (b) The department of community health.                                     

                                                                                

5       (c) The health administration in the department of community                

                                                                                

6   health.                                                                     

                                                                                

7       (d) The bureau of mental health and substance abuse services in             

                                                                                

8   the department of community health.                                         

                                                                                

9       (e) The family independence agency.                                         

                                                                                

10      (f) The department of state police.                                         

                                                                                

11      (2) Upon written or oral request, a pupil not less than 18 years            

                                                                                

12  of age or a parent or legal guardian of a pupil less than 18 years of       

                                                                                

13  age, within a reasonable period of time after the request is made,          

                                                                                

14  shall be informed of the content of a course in the health education        

                                                                                

15  curriculum and may examine textbooks and other classroom materials that     

                                                                                

16  are provided to the pupil or materials that are presented to the pupil      

                                                                                

17  in the classroom.  This subsection does not require a school board to       

                                                                                

18  permit pupil or parental examination of test questions and answers,         

                                                                                

19  scoring keys, or other examination instruments or data used to              

                                                                                

20  administer an academic examination.                                         

                                                                                

21      Sec. 1003. Funds appropriated in part 1 for the Alzheimer's                 

                                                                                

22  information network shall be used to provide information and referral       

                                                                                

23  services through regional networks for persons with Alzheimer's disease     

                                                                                

24  or related disorders, their families, and health care providers.            

                                                                                

25      Sec. 1006. In spending the funds appropriated in part 1 for the             

                                                                                

26  smoking prevention program, priority shall be given to prevention and       

                                                                                

27  smoking cessation programs for pregnant women, women with young             


                                                                                

1   children, and adolescents.                                                  

                                                                                

2       Sec. 1007. (1) The funds appropriated in part 1 for violence                

                                                                                

3   prevention shall be used for, but not be limited to, the following:         

                                                                                

4       (a) Programs aimed at the prevention of spouse, partner, or child           

                                                                                

5   abuse and rape.                                                             

                                                                                

6       (b) Programs aimed at the prevention of workplace violence.                 

                                                                                

7       (2) In awarding grants from the amounts appropriated in part 1              

                                                                                

8   for violence prevention, the department shall give equal consideration      

                                                                                

9   to public and private nonprofit applicants.                                 

                                                                                

10      (3) From the funds appropriated in part 1 for violence                      

                                                                                

11  prevention, the department may include local school districts as            

                                                                                

12  recipients of the funds for family violence prevention programs.            

                                                                                

13      Sec. 1009. From the funds appropriated in part 1 for the diabetes           

                                                                                

14  and kidney program, a portion of the funds may be allocated to the          

                                                                                

15  National Kidney Foundation of Michigan for kidney disease prevention        

                                                                                

16  programming including early identification and education programs and       

                                                                                

17  kidney disease prevention demonstration projects.                           

                                                                                

18      Sec. 1019. From the funds appropriated in part 1 for chronic disease        

                                                                                

19  prevention, $50,000.00 shall be allocated for stroke prevention,            

                                                                                

20  education, and outreach.  The objectives of the program shall include       

                                                                                

21  education to assist persons in identifying risk factors, and education      

                                                                                

22  to assist persons in the early identification of the occurrence of a        

                                                                                

23  stroke in order to minimize stroke damage.                                  

                                                                                

24      Sec. 1020. From the funds appropriated in part 1 for chronic disease        

                                                                                

25  prevention, $55,000.00 shall be allocated for a childhood and adult         

                                                                                

26  arthritis program.                                                          

                                                                                

27  COMMUNITY LIVING, CHILDREN, AND FAMILIES                                    


                                                                                

1       Sec. 1101. The department shall review the basis for the                    

                                                                                

2   distribution of funds to local health departments and other public and      

                                                                                

3   private agencies for the women, infants, and children food supplement       

                                                                                

4   program; family planning; and prenatal care outreach and service            

                                                                                

5   delivery support program and indicate the basis upon which any              

                                                                                

6   projected underexpenditures by local public and private agencies shall      

                                                                                

7   be reallocated to other local agencies that demonstrate need.               

                                                                                

8       Sec. 1104. Before April 1, 2004, the department shall submit a              

                                                                                

9   report to the house and senate fiscal agencies and the state budget         

                                                                                

10  director on planned allocations from the amounts appropriated in part 1     

                                                                                

11  for local MCH services, prenatal care outreach and service delivery         

                                                                                

12  support, family planning local agreements, and pregnancy prevention         

                                                                                

13  programs.  Using applicable federal definitions, the report shall           

                                                                                

14  include information on all of the following:                                

                                                                                

15      (a) Funding allocations.                                                    

                                                                                

16      (b) Actual number of women, children, and/or adolescents served and         

                                                                                

17  amounts expended for each group for the fiscal year 2002-2003.              

                                                                                

18      Sec. 1105. For all programs for which an appropriation is made in           

                                                                                

19  part 1, the department shall contract with those local agencies best        

                                                                                

20  able to serve clients.  Factors to be used by the department in             

                                                                                

21  evaluating agencies under this section shall include ability to serve       

                                                                                

22  high-risk population groups; ability to serve low-income clients, where     

                                                                                

23  applicable; availability of, and access to, service sites; management       

                                                                                

24  efficiency; and ability to meet federal standards, when applicable.         

                                                                                

25      Sec. 1106. Each family planning program receiving federal title X           

                                                                                

26  family planning funds shall be in compliance with all performance and       

                                                                                

27  quality assurance indicators that the United States bureau of community     

                                                                                

28  health services specifies in the family planning annual report.  An         


                                                                                

1   agency not in compliance with the indicators shall not receive              

                                                                                

2   supplemental or reallocated funds.                                          

                                                                                

3       Sec. 1106a. (1) Federal abstinence money expended in part 1 for the         

                                                                                

4   purpose of promoting abstinence education shall provide abstinence          

                                                                                

5   education to teenagers most likely to engage in high-risk behavior as       

                                                                                

6   their primary focus, and may include programs that include 9- to 17-        

                                                                                

7   year-olds. Programs funded must meet all of the following guidelines:       

                                                                                

8       (a) Teaches the gains to be realized by abstaining from sexual              

                                                                                

9   activity.                                                                   

                                                                                

10      (b) Teaches abstinence from sexual activity outside of marriage             

                                                                                

11  as the expected standard for all school-age children.                       

                                                                                

12      (c) Teaches that abstinence is the only certain way to avoid out-           

                                                                                

13  of-wedlock pregnancy, sexually transmitted diseases, and other health       

                                                                                

14  problems.                                                                   

                                                                                

15      (d) Teaches that a monogamous relationship in the context of                

                                                                                

16  marriage is the expected standard of human sexual activity.                 

                                                                                

17      (e) Teaches that sexual activity outside of marriage is likely to           

                                                                                

18  have harmful effects.                                                       

                                                                                

19      (f) Teaches that bearing children out of wedlock is likely to               

                                                                                

20  have harmful consequences.                                                  

                                                                                

21      (g) Teaches young people how to avoid sexual advances and how               

                                                                                

22  alcohol and drug use increases vulnerability to sexual advances.            

                                                                                

23      (h) Teaches the importance of attaining self-sufficiency before             

                                                                                

24  engaging in sexual activity.                                                

                                                                                

25      (2) Coalitions, organizations, and programs that do not provide             

                                                                                

26  contraceptives to minors and demonstrate efforts to include parental        

                                                                                

27  involvement as a means of reducing the risk of teens becoming pregnant      


                                                                                

1   shall be given priority in the allocations of funds.                        

                                                                                

2       (3) Programs and organizations that meet the guidelines of                  

                                                                                

3   subsection (1) and criteria of subsection (2) shall have the option of      

                                                                                

4   receiving all or part of their funds directly from the department of        

                                                                                

5   community health.                                                           

                                                                                

6       Sec. 1107. Of the amount appropriated in part 1 for prenatal care           

                                                                                

7   outreach and service delivery support, not more than 10% shall be           

                                                                                

8   expended for local administration, data processing, and evaluation.         

                                                                                

9       Sec. 1108. The funds appropriated in part 1 for pregnancy prevention        

                                                                                

10  programs shall not be used to provide abortion counseling, referrals,       

                                                                                

11  or services.                                                                

                                                                                

12      Sec. 1109. (1) From the amounts appropriated in part 1 for dental           

                                                                                

13  programs, funds shall be allocated to the Michigan dental association       

                                                                                

14  for the administration of a volunteer dental program that would provide     

                                                                                

15  dental services to the uninsured in an amount that is no less than the      

                                                                                

16  amount allocated to that program in fiscal year 1996-1997.                  

                                                                                

17      (2) Not later than December 1 of the current fiscal year, the               

                                                                                

18  department shall make available upon request a report to the senate or      

                                                                                

19  house of representatives appropriations subcommittee on community           

                                                                                

20  health or the senate or house of representatives standing committee on      

                                                                                

21  health policy the number of individual patients treated, number of          

                                                                                

22  procedures performed, and approximate total market value of those           

                                                                                

23  procedures through September 30, 2003.                                      

                                                                                

24      Sec. 1110. Agencies that currently receive pregnancy prevention             

                                                                                

25  funds and either receive or are eligible for other family planning          

                                                                                

26  funds shall have the option of receiving all of their family planning       

                                                                                

27  funds directly from the department of community health and be               


                                                                                

1   designated as delegate agencies.                                            

                                                                                

2       Sec. 1111. The department shall allocate no less than 87% of the            

                                                                                

3   funds appropriated in part 1 for family planning local agreements and       

                                                                                

4   the pregnancy prevention program for the direct provision of family         

                                                                                

5   planning/pregnancy prevention services.                                     

                                                                                

6       Sec. 1112. From the funds appropriated for prenatal care outreach           

                                                                                

7   and service delivery support, the department shall allocate at least        

                                                                                

8   $1,000,000.00 to communities with high infant mortality rates.              

                                                                                

9       Sec. 1128. The department shall make every effort to maximize the           

                                                                                

10  receipt of federal Medicaid funds to support the activities of the          

                                                                                

11  migrant health care line item.                                              

                                                                                

12      Sec. 1133. The department shall release infant mortality rate data          

                                                                                

13  to all local public health departments no later than 48 hours prior to      

                                                                                

14  releasing infant mortality rate data to the public.                         

                                                                                

15      Sec. 1151. The department may work with local participating agencies        

                                                                                

16  to define local annual contributions for the farmer's market nutrition      

                                                                                

17  program, project FRESH, to enable the department to request federal         

                                                                                

18  matching funds by April 1, 2004 based on local commitment of funds.         

                                                                                

19  CHILDREN’S SPECIAL HEALTH CARE SERVICES                                     

                                                                                

20      Sec. 1201. Funds appropriated in part 1 for medical care and                

                                                                                

21  treatment of children with special health care needs shall be paid          

                                                                                

22  according to reimbursement policies determined by the Michigan medical      

                                                                                

23  services program.  Exceptions to these policies may be made with the        

                                                                                

24  prior approval of the state budget director.                                

                                                                                

25      Sec. 1202. The department may do 1 or more of the following:                

                                                                                

26      (a) Provide special formula for eligible clients with specified             

                                                                                

27  metabolic and allergic disorders.                                           


                                                                                

1       (b) Provide medical care and treatment to eligible patients with            

                                                                                

2   cystic fibrosis who are 21 years of age or older.                           

                                                                                

3       (c) Provide genetic diagnostic and counseling services for                  

                                                                                

4   eligible families.                                                          

                                                                                

5       (d) Provide medical care and treatment to eligible patients with            

                                                                                

6   hereditary coagulation defects, commonly known as hemophilia, who are       

                                                                                

7   21 years of age or older.                                                   

                                                                                

8   OFFICE OF DRUG CONTROL POLICY                                               

                                                                                

9       Sec. 1300. In addition to the $1.8 million in Byrne Formula Grant           

                                                                                

10  Program funding the department provides to local drug treatment courts,     

                                                                                

11  the department shall provide $1.8 million in Byrne Formula Grant            

                                                                                

12  Program funding to the Judiciary by interdepartmental grant.                

                                                                                

13  OFFICE OF SERVICES TO THE AGING                                             

                                                                                

14      Sec. 1401. The appropriation in part 1 to the office of services to         

                                                                                

15  the aging, for community and nutrition services and home services,          

                                                                                

16  shall be restricted to eligible individuals at least 60 years of age        

                                                                                

17  who fail to qualify for home care services under title XVIII, XIX, or       

                                                                                

18  XX.                                                                         

                                                                                

19      Sec. 1403. The office of services to the aging shall require each           

                                                                                

20  region to report to the office of services to the aging home delivered      

                                                                                

21  meals waiting lists based upon standard criteria.  Determining criteria     

                                                                                

22  shall include all of the following:                                         

                                                                                

23      (a) The recipient's degree of frailty.                                      

                                                                                

24      (b) The recipient's inability to prepare his or her own meals               

                                                                                

25  safely.                                                                     

                                                                                

26      (c) Whether the recipient has another care provider available.              

                                                                                

27      (d) Any other qualifications normally necessary for the recipient           


                                                                                

1   to receive home delivered meals.                                            

                                                                                

2       Sec. 1404. The area agencies and local providers may receive and            

                                                                                

3   expend fees for the provision of day care, care management, respite         

                                                                                

4   care, and certain eligible home and community-based services.  The fees     

                                                                                

5   shall be based on a sliding scale, taking client income into                

                                                                                

6   consideration.  The fees shall be used to expand services.                  

                                                                                

7       Sec. 1406. The appropriation of $5,000,000.00 of tobacco settlement         

                                                                                

8   funds to the office of services to the aging for the respite care           

                                                                                

9   program shall be allocated in accordance with a long-term care plan         

                                                                                

10  developed by the long-term care working group established in section        

                                                                                

11  1657 of 1998 PA 336 upon implementation of the plan.  The use of the        

                                                                                

12  funds shall be for direct respite care or adult respite care center         

                                                                                

13  services.  Not more than 10% of the amount allocated under this section     

                                                                                

14  shall be expended for administration and administrative purposes.           

                                                                                

15      Sec. 1408. The office of services to the aging shall provide that           

                                                                                

16  funds appropriated under this bill shall be awarded on a local level in     

                                                                                

17  accordance with locally determined needs.                                   

                                                                                

18  MEDICAL SERVICES                                                            

                                                                                

19      Sec. 1601. The cost of remedial services incurred by residents of           

                                                                                

20  licensed adult foster care homes and licensed homes for the aged shall      

                                                                                

21  be used in determining financial eligibility for the medically needy.       

                                                                                

22  Remedial services include basic self-care and rehabilitation training       

                                                                                

23  for a resident.                                                             

                                                                                

24      Sec. 1602. Medical services shall be provided to elderly and                

                                                                                

25  disabled persons with incomes less than or equal to 100% of the             

                                                                                

26  official poverty line, pursuant to the state's option to elect such         

                                                                                

27  coverage set out at section 1902(a)(10)(A)(ii) and (m) of title XIX, 42     


                                                                                

1   U.S.C. 1396a.                                                               

                                                                                

2       Sec. 1603. (1) The department may establish a program for persons to        

                                                                                

3   purchase medical coverage at a rate determined by the department.           

                                                                                

4       (2) The department may receive and expend premiums for the buy-in           

                                                                                

5   of medical coverage in addition to the amounts appropriated in part 1.      

                                                                                

6       (3) The premiums described in this section shall be classified as           

                                                                                

7   private funds.                                                              

                                                                                

8       Sec. 1605. (1) The protected income level for Medicaid coverage             

                                                                                

9   determined pursuant to section 106(1)(b)(iii) of the social welfare         

                                                                                

10  act, 1939 PA 280, MCL 400.106, shall be 100% of the related public          

                                                                                

11  assistance standard.                                                        

                                                                                

12      (2) The department shall notify the senate and house of                     

                                                                                

13  representatives appropriations subcommittees on community health and        

                                                                                

14  the state budget director of any proposed revisions to the protected        

                                                                                

15  income level for Medicaid coverage related to the public assistance         

                                                                                

16  standard 90 days prior to implementation.                                   

                                                                                

17      Sec. 1606. For the purpose of guardian and conservator charges, the         

                                                                                

18  department of community health may deduct up to $60.00 per month as an      

                                                                                

19  allowable expense against a recipient's income when determining medical     

                                                                                

20  services eligibility and patient pay amounts.                               

                                                                                

21      Sec. 1607. (1) An applicant for Medicaid, whose qualifying condition        

                                                                                

22  is pregnancy, shall immediately be presumed to be eligible for Medicaid     

                                                                                

23  coverage unless the preponderance of evidence in her application            

                                                                                

24  indicates otherwise.                                                        

                                                                                

25      (2) An applicant qualified as described in subsection (1) shall             

                                                                                

26  be given a letter of authorization to receive Medicaid covered services     

                                                                                

27  related to her pregnancy.  In addition, the applicant shall receive a       


                                                                                

1   listing of Medicaid physicians and managed care plans in the immediate      

                                                                                

2   vicinity of the applicant's residence.                                      

                                                                                

3       (3) An applicant that selects a Medicaid provider, other than a             

                                                                                

4   managed care plan, from which to receive pregnancy services, shall not      

                                                                                

5   be required to enroll in a managed care plan until the end of the           

                                                                                

6   second month postpartum.                                                    

                                                                                

7       (4) In the event that an applicant, presumed to be eligible                 

                                                                                

8   pursuant to subsection (1), is subsequently found to be ineligible, a       

                                                                                

9   Medicaid physician or managed care plan that has been providing             

                                                                                

10  pregnancy services to an applicant under this section is entitled to        

                                                                                

11  reimbursement for those services until such time as they are notified       

                                                                                

12  by the department that the applicant was found to be ineligible for         

                                                                                

13  Medicaid.                                                                   

                                                                                

14      (5) If the preponderance of evidence in an application indicates            

                                                                                

15  that the applicant is not eligible for Medicaid, the department shall       

                                                                                

16  refer that applicant to the nearest public health clinic or similar         

                                                                                

17  entity as a potential source for receiving pregnancy-related services.      

                                                                                

18      Sec. 1611. (1) For care provided to medical services recipients with        

                                                                                

19  other third-party sources of payment, medical services reimbursement        

                                                                                

20  shall not exceed, in combination with such other resources, including       

                                                                                

21  Medicare, those amounts established for medical services-only patients.     

                                                                                

22  The medical services payment rate shall be accepted as payment in full.     

                                                                                

23  Other than an approved medical services copayment, no portion of a          

                                                                                

24  provider's charge shall be billed to the recipient or any person acting     

                                                                                

25  on behalf of the recipient.  Nothing in this section shall be               

                                                                                

26  considered to affect the level of payment from a third-party source         

                                                                                

27  other than the medical services program.  The department shall require      


                                                                                

1   a nonenrolled provider to accept medical services payments as payment       

                                                                                

2   in full.                                                                    

                                                                                

3       (2) Notwithstanding subsection (1), medical services                        

                                                                                

4   reimbursement for hospital services provided to dual Medicare/medical       

                                                                                

5   services recipients with Medicare Part B coverage only shall equal,         

                                                                                

6   when combined with payments for Medicare and other third-party              

                                                                                

7   resources, if any, those amounts established for medical services-only      

                                                                                

8   patients, including capital payments.                                       

                                                                                

9       Sec. 1615. Unless prohibited by federal or state law or regulation,         

                                                                                

10  the department may require enrolled Medicaid providers to submit their      

                                                                                

11  billings for services electronically and have a program that provides a     

                                                                                

12  mechanism for Medicaid providers to submit their billings for services      

                                                                                

13  over the Internet.                                                          

                                                                                

14      Sec. 1620. (1) For fee-for-service recipients, the pharmaceutical           

                                                                                

15  dispensing fee shall be $3.77 or the pharmacy's usual or customary cash     

                                                                                

16  charge, whichever is less.                                                  

                                                                                

17      (2) The department shall require a prescription copayment for               

                                                                                

18  Medicaid recipients except as prohibited by federal or state law or         

                                                                                

19  regulation.                                                                 

                                                                                

20      Sec. 1627. (1) The department shall use procedures and rebates              

                                                                                

21  amounts specified under section 1927 of title XIX, 42 U.S.C. 1396r-8,       

                                                                                

22  to secure quarterly rebates from pharmaceutical manufacturers for           

                                                                                

23  outpatient drugs dispensed to participants in MIChild programs,             

                                                                                

24  maternal outpatient medical services program state medical program,         

                                                                                

25  children's special health care services, and EPIC.                          

                                                                                

26      (2) For products distributed by pharmaceutical manufacturers not            

                                                                                

27  providing quarterly rebates as listed in subsection (1), the department     


                                                                                

1   may require preauthorization.                                               

                                                                                

2       Sec. 1641. An institutional provider that is required to submit a           

                                                                                

3   cost report under the medical services program shall submit cost            

                                                                                

4   reports completed in full within 5 months after the end of its fiscal       

                                                                                

5   year.                                                                       

                                                                                

6       Sec. 1648. The department shall maintain an automated toll-free             

                                                                                

7   phone line to enable medical providers to verify the eligibility status     

                                                                                

8   of Medicaid recipients.  There shall be no charge to providers for the      

                                                                                

9   use of the toll-free phone line.                                            

                                                                                

10      Sec. 1649. From the funds appropriated in part 1 for medical                

                                                                                

11  services, the department shall continue breast and cervical cancer          

                                                                                

12  treatment coverage for women up to 250% of the federal poverty level,       

                                                                                

13  who are under age 65, and who are not otherwise covered by insurance.       

                                                                                

14  This coverage shall be provided to women who have been screened through     

                                                                                

15  the centers for disease control breast and cervical cancer early            

                                                                                

16  detection program, and are found to have breast or cervical cancer,         

                                                                                

17  pursuant to the breast and cervical cancer prevention and treatment act     

                                                                                

18  of 2000, Public Law 106-354, 114 Stat.1381.                                 

                                                                                

19      Sec. 1650. (1) The department may require medical services                  

                                                                                

20  recipients residing in counties offering managed care options to choose     

                                                                                

21  the particular managed care plan in which they wish to be enrolled.         

                                                                                

22  Persons not expressing a preference may be assigned to a managed care       

                                                                                

23  provider.                                                                   

                                                                                

24      (2) Persons to be assigned a managed care provider shall be                 

                                                                                

25  informed in writing of the criteria for exceptions to capitated managed     

                                                                                

26  care enrollment, their right to change HMOs for any reason within the       

                                                                                

27  initial 90 days of enrollment, the toll-free telephone number for           


                                                                                

1   problems and complaints, and information regarding grievance and            

                                                                                

2   appeals rights.                                                             

                                                                                

3       (3) The criteria for medical exceptions to HMO enrollment shall             

                                                                                

4   be based on submitted documentation that indicates a recipient has a        

                                                                                

5   serious medical condition, and is undergoing active treatment for that      

                                                                                

6   condition with a physician who does not participate in 1 of the HMOs.       

                                                                                

7   If the person meets the criteria established by this subsection, the        

                                                                                

8   department shall grant an exception to mandatory enrollment at least        

                                                                                

9   through the current prescribed course of treatment, subject to periodic     

                                                                                

10  review of continued eligibility.                                            

                                                                                

11      Sec. 1655. (1) The department may require a 12-month lock-in to the         

                                                                                

12  HMO selected by the recipient during the initial and subsequent open        

                                                                                

13  enrollment periods, but allow for good cause exceptions during the          

                                                                                

14  lock-in period.                                                             

                                                                                

15      (2) Medicaid recipients shall be allowed to change HMOs for any             

                                                                                

16  reason within the initial 90 days of enrollment.                            

                                                                                

17      Sec. 1656. (1) The department shall provide an expedited complaint          

                                                                                

18  review procedure for Medicaid eligible persons enrolled in HMOs for         

                                                                                

19  situations in which failure to receive any health care service would        

                                                                                

20  result in significant harm to the enrollee.                                 

                                                                                

21      (2) The department shall provide for a toll-free telephone number           

                                                                                

22  for Medicaid recipients enrolled in managed care to assist with             

                                                                                

23  resolving problems and complaints.  If warranted, the department shall      

                                                                                

24  immediately disenroll persons from managed care and approve fee-for-        

                                                                                

25  service coverage.                                                           

                                                                                

26      (3) Annual reports summarizing the problems and complaints                  

                                                                                

27  reported and their resolution shall be provided to the house of             


                                                                                

1   representatives and senate appropriations subcommittees on community        

                                                                                

2   health, the house and senate fiscal agencies, the state budget office,      

                                                                                

3   and the department's health plans advisory council.                         

                                                                                

4       Sec. 1657. (1) Reimbursement for medical services to screen and             

                                                                                

5   stabilize a Medicaid recipient, including stabilization of a                

                                                                                

6   psychiatric crisis, in a hospital emergency room shall not be made          

                                                                                

7   contingent on obtaining prior authorization from the recipient's HMO.       

                                                                                

8   If the recipient is discharged from the emergency room, the hospital        

                                                                                

9   shall notify the recipient's HMO within 24 hours of the diagnosis and       

                                                                                

10  treatment received.                                                         

                                                                                

11      (2) If the treating hospital determines that the recipient will             

                                                                                

12  require further medical service or hospitalization beyond the point of      

                                                                                

13  stabilization, that hospital must receive authorization from the            

                                                                                

14  recipient's HMO prior to admitting the recipient.                           

                                                                                

15      (3) Subsections (1) and (2) shall not be construed as a                     

                                                                                

16  requirement to alter an existing agreement between an HMO and their         

                                                                                

17  contracting hospitals nor as a requirement that an HMO must reimburse       

                                                                                

18  for services that are not considered to be medically necessary.             

                                                                                

19      Sec. 1659. The following sections are the only ones that shall apply        

                                                                                

20  to the following Medicaid managed care programs, including the              

                                                                                

21  comprehensive plan, children's special health care services plan, MI        

                                                                                

22  Choice long-term care plan, and the mental health, substance abuse, and     

                                                                                

23  developmentally disabled services program: 402, 404, 414, 418, 424,         

                                                                                

24  1650, 1655, 1656, 1657, 1660, 1661, 1662, 1699, and 1704.                   

                                                                                

25      Sec. 1660. (1) The department shall assure that all Medicaid                

                                                                                

26  children have timely access to EPSDT services as required by federal        

                                                                                

27  law.  Medicaid HMOs shall provide EPSDT services to their child members     


                                                                                

1   in accordance with Medicaid EPSDT policy.                                   

                                                                                

2       (2) The primary responsibility of assuring a child's hearing and            

                                                                                

3   vision screening is with the child's primary care provider.  The            

                                                                                

4   primary care provider shall provide age appropriate screening or            

                                                                                

5   arrange for these tests through referrals to local health departments.      

                                                                                

6   Local health departments shall provide preschool hearing and vision         

                                                                                

7   screening services and accept referrals for these tests from physicians     

                                                                                

8   or from Head Start programs in order to assure all preschool children       

                                                                                

9   have appropriate access to hearing and vision screening.  Local health      

                                                                                

10  departments shall be reimbursed for the cost of providing these tests       

                                                                                

11  for Medicaid eligible children by the Medicaid program.                     

                                                                                

12      (3) The department shall require Medicaid HMOs to provide EPSDT             

                                                                                

13  utilization data through the encounter data system, and health employer     

                                                                                

14  data and information set well child health measures in accordance with      

                                                                                

15  the National Committee on Quality Assurance prescribed methodology.         

                                                                                

16      (4) The department shall require HMOs to be responsible for well            

                                                                                

17  child visits and maternal and infant support services as described in       

                                                                                

18  Medicaid policy.  These responsibilities shall be specified in the          

                                                                                

19  information distributed by the HMOs to their members.                       

                                                                                

20      (5) The department shall provide, on an annual basis, budget                

                                                                                

21  neutral incentives to Medicaid HMOs and local health departments to         

                                                                                

22  improve performance on measures related to the care of children and         

                                                                                

23  pregnant women.                                                             

                                                                                

24      Sec. 1661. (1) The department shall assure that all Medicaid                

                                                                                

25  eligible children and pregnant women have timely access to MSS/ISS          

                                                                                

26  services.  Medicaid HMOs shall assure that maternal support service         

                                                                                

27  screening is available to their pregnant members and that those women       


                                                                                

1   found to meet the maternal support service high-risk criteria are           

                                                                                

2   offered maternal support services.  Local health departments shall          

                                                                                

3   assure that maternal support service screening is available for             

                                                                                

4   Medicaid pregnant women not enrolled in an HMO and that those women         

                                                                                

5   found to meet the maternal support service high-risk criteria are           

                                                                                

6   offered maternal support services or are referred to a certified            

                                                                                

7   maternal support service provider.                                          

                                                                                

8       (2) The department shall assure the coordination of MSS/ISS                 

                                                                                

9   services with the WIC program, state-supported substance abuse, smoking     

                                                                                

10  prevention, and violence prevention programs, the family independence       

                                                                                

11  agency, and any other state or local program with a focus on preventing     

                                                                                

12  adverse birth outcomes and child abuse and neglect.                         

                                                                                

13      Sec. 1662. (1) The department shall require the external quality            

                                                                                

14  review contractor to conduct a review of all EPSDT components provided      

                                                                                

15  to children from a statistically valid sample of health plan medical        

                                                                                

16  records.                                                                    

                                                                                

17      (2) The department shall provide a copy of the analysis of the              

                                                                                

18  Medicaid HMO annual audited health employer data and information set        

                                                                                

19  reports and the annual external quality review report to the senate and     

                                                                                

20  house of representatives appropriations subcommittees on community          

                                                                                

21  health, the senate and house fiscal agencies, and the state budget          

                                                                                

22  director, within 30 days of the department's receipt of the final           

                                                                                

23  reports from the contractors.                                               

                                                                                

24      (3) The department shall work with the Michigan association of              

                                                                                

25  health plans and the Michigan association for local public health to        

                                                                                

26  improve service delivery and coordination in the MSS/ISS and EPSDT          

                                                                                

27  programs.                                                                   


                                                                                

1       (4) The department shall provide training and technical                     

                                                                                

2   assistance workshops on EPSDT and MSS/ISS for Medicaid health plans,        

                                                                                

3   local health departments, and MSS/ISS contractors.                          

                                                                                

4       Sec. 1670. (1) The appropriation in part 1 for the MIChild program          

                                                                                

5   is to be used to provide comprehensive health care to all children          

                                                                                

6   under age 19 who reside in families with income at or below 200% of the     

                                                                                

7   federal poverty level, who are uninsured and have not had coverage by       

                                                                                

8   other comprehensive health insurance within 6 months of making              

                                                                                

9   application for MIChild benefits, and who are residents of this state.      

                                                                                

10  The department shall develop detailed eligibility criteria through the      

                                                                                

11  medical services administration public concurrence process, consistent      

                                                                                

12  with the provisions of this bill.  Health care coverage for children in     

                                                                                

13  families below 150% of the federal poverty level shall be provided          

                                                                                

14  through expanded eligibility under the state's Medicaid program.            

                                                                                

15  Health coverage for children in families between 150% and 200% of the       

                                                                                

16  federal poverty level shall be provided through a state-based private       

                                                                                

17  health care program.                                                        

                                                                                

18      (2) The department shall enter into a contract to obtain MIChild            

                                                                                

19  services from any HMO, dental care corporation, or any other entity         

                                                                                

20  that offers to provide the managed health care benefits for MIChild         

                                                                                

21  services at the MIChild capitated rate. As used in this subsection:         

                                                                                

22      (a) "Dental care corporation", "health care corporation",                   

                                                                                

23  "insurer", and "prudent purchaser agreement" mean those terms as            

                                                                                

24  defined in section 2 of the prudent purchaser act, 1984 PA 233, MCL         

                                                                                

25  550.52.                                                                     

                                                                                

26      (b) "Entity" means a health care corporation or insurer operating           

                                                                                

27  in accordance with a prudent purchaser agreement.                           


                                                                                

1       (3) The department may enter into contracts to obtain certain               

                                                                                

2   MIChild services from community mental health service programs.             

                                                                                

3       (4) The department may make payments on behalf of children                  

                                                                                

4   enrolled in the MIChild program from the line-item appropriation            

                                                                                

5   associated with the program as described in the MIChild state plan          

                                                                                

6   approved by the United States department of health and human services,      

                                                                                

7   or from other medical services line-item appropriations providing for       

                                                                                

8   specific health care services.                                              

                                                                                

9       Sec. 1671. From the funds appropriated in part 1, the department            

                                                                                

10  shall continue a comprehensive approach to the marketing and outreach       

                                                                                

11  of the MIChild program.  The marketing and outreach required under this     

                                                                                

12  section shall be coordinated with current outreach, information             

                                                                                

13  dissemination, and marketing efforts and activities conducted by the        

                                                                                

14  department.                                                                 

                                                                                

15      Sec. 1672. The department may provide up to 1 year of continuous            

                                                                                

16  eligibility to children eligible for the MIChild program unless the         

                                                                                

17  family fails to pay the monthly premium, a child reaches age 19, or the     

                                                                                

18  status of the children's family changes and its members no longer meet      

                                                                                

19  the eligibility criteria as specified in the federally approved MIChild     

                                                                                

20  state plan.                                                                 

                                                                                

21      Sec. 1673. The department may establish premiums for MIChild                

                                                                                

22  eligible persons in families with income above 150% of the federal          

                                                                                

23  poverty level.  The monthly premiums shall not exceed $5.00 for a           

                                                                                

24  family.                                                                     

                                                                                

25      Sec. 1674. The department shall not require copayments under the            

                                                                                

26  MIChild program.                                                            

                                                                                

27      Sec. 1675. Children whose category of eligibility changes between           


                                                                                

1   the Medicaid and MIChild programs shall be assured of keeping their         

                                                                                

2   current health care providers through the current prescribed course of      

                                                                                

3   treatment for up to 1 year, subject to periodic reviews by the              

                                                                                

4   department if the beneficiary has a serious medical condition and is        

                                                                                

5   undergoing active treatment for that condition.                             

                                                                                

6       Sec. 1676. To be eligible for the MIChild program, a child must be          

                                                                                

7   residing in a family with an adjusted gross income of less than or          

                                                                                

8   equal to 200% of the federal poverty level. The department's                

                                                                                

9   verification policy shall be used to determine eligibility.                 

                                                                                

10      Sec. 1682. (1) The department shall implement enforcement actions as        

                                                                                

11  specified in the nursing facility enforcement provisions of section         

                                                                                

12  1919 of title XIX, 42 U.S.C. 1396r.                                         

                                                                                

13      (2) The department is authorized to receive and spend penalty               

                                                                                

14  money received as the result of noncompliance with medical services         

                                                                                

15  certification regulations.  Penalty money, characterized as private         

                                                                                

16  funds, received by the department shall increase authorizations and         

                                                                                

17  allotments in the long-term care accounts.                                  

                                                                                

18      (3) Any unexpended penalty money, at the end of the year, shall             

                                                                                

19  carry forward to the following year.                                        

                                                                                

20      Sec. 1683. The department shall promote activities that preserve the        

                                                                                

21  dignity and rights of terminally ill and chronically ill individuals.       

                                                                                

22  Priority shall be given to programs, such as hospice, that focus on         

                                                                                

23  individual dignity and quality of care provided persons with terminal       

                                                                                

24  illness and programs serving persons with chronic illnesses that reduce     

                                                                                

25  the rate of suicide through the advancement of the knowledge and use of     

                                                                                

26  improved, appropriate pain management for these persons; and                

                                                                                

27  initiatives that train health care practitioners and faculty in             


                                                                                

1   managing pain, providing palliative care, and suicide prevention.           

                                                                                

2       Sec. 1685. All nursing home rates, class I and class III, must have         

                                                                                

3   their respective fiscal year rate set 30 days prior to the beginning of     

                                                                                

4   their rate year.  Rates may take into account the most recent cost          

                                                                                

5   report prepared and certified by the preparer, provider corporate owner     

                                                                                

6   or representative as being true and accurate, and filed timely, within      

                                                                                

7   5 months of the fiscal year end in accordance with Medicaid policy.  If     

                                                                                

8   the audited version of the last report is available, it shall be used.      

                                                                                

9   Any rate factors based on the filed cost report may be retroactively        

                                                                                

10  adjusted upon completion of the audit of that cost report.                  

                                                                                

11      Sec. 1692. (1) The department of community health is authorized to          

                                                                                

12  pursue reimbursement for eligible services provided in Michigan schools     

                                                                                

13  from the federal Medicaid program.  The department and the state budget     

                                                                                

14  director are authorized to negotiate and enter into agreements,             

                                                                                

15  together with the department of education, with local and intermediate      

                                                                                

16  school districts regarding the sharing of federal Medicaid services         

                                                                                

17  funds received for these services.  The department is authorized to         

                                                                                

18  receive and disburse funds to participating school districts pursuant       

                                                                                

19  to such agreements and state and federal law.                               

                                                                                

20      (2) From the funds appropriated in part 1 for medical services              

                                                                                

21  school services payments, the department is authorized to do all of the     

                                                                                

22  following:                                                                  

                                                                                

23      (a) Finance activities within the medical services administration           

                                                                                

24  related to this project.                                                    

                                                                                

25      (b) Reimburse participating school districts pursuant to the fund           

                                                                                

26  sharing ratios negotiated in the state-local agreements authorized in       

                                                                                

27  subsection (1).                                                             


                                                                                

1       (c) Offset general fund costs associated with the medical                   

                                                                                

2   services program.                                                           

                                                                                

3       Sec. 1693. The special adjustor payments appropriation in part 1 may        

                                                                                

4   be increased if the department submits a medical services state plan        

                                                                                

5   amendment pertaining to this line item at a level higher than the           

                                                                                

6   appropriation.  The department is authorized to appropriately adjust        

                                                                                

7   financing sources in accordance with the increased appropriation.           

                                                                                

8       Sec. 1697. (1) As may be allowed by federal law or regulation, the          

                                                                                

9   department may use funds provided by a local or intermediate school         

                                                                                

10  district, which have been obtained from a qualifying health system, as      

                                                                                

11  the state match required for receiving federal Medicaid or children         

                                                                                

12  health insurance program funds.  Any such funds received shall be used      

                                                                                

13  only to support new school-based or school-linked health services.          

                                                                                

14      (2) A qualifying health system is defined as any health care                

                                                                                

15  entity licensed to provide health care services in the state of             

                                                                                

16  Michigan, that has entered into a contractual relationship with a local     

                                                                                

17  or intermediate school district to provide or manage school-based or        

                                                                                

18  school-linked health services.                                              

                                                                                

19      Sec. 1699. The department may make separate payments directly to            

                                                                                

20  qualifying hospitals serving a disproportionate share of indigent           

                                                                                

21  patients, and to hospitals providing graduate medical education             

                                                                                

22  training programs.  If direct payment for GME and DSH is made to            

                                                                                

23  qualifying hospitals for services to Medicaid clients, hospitals will       

                                                                                

24  not include GME costs or DSH payments in their contracts with HMOs.         

                                                                                

25. Sec. 1700. The department is authorized to increase the Long-term               

...                                                                             

26 care services, Hospital services and therapy, Pharmaceutical services,        

...                                                                             

27 and Health plan services appropriations to the extent that Quality            


...                                                                             

1 Assurance Assessment Program revenues are available to finance provider        

...                                                                             

2 rate increases.