Act No. 131
Public Acts of 2009
Approved by the Governor*
October 29, 2009
Filed with the Secretary of State
October 30, 2009
EFFECTIVE DATE: October 30, 2009
*Item Vetoes
Sec. 112. CHRONIC DISEASE AND INJURY PREVENTION AND
HEALTH PROMOTION
Injury control intervention project................................................................ $ 200,000 (Page 5)
Sec. 113. FAMILY, MATERNAL, AND CHILDREN’S HEALTH SERVICES
Early childhood collaborative secondary prevention................................. $ 524,000 (Page 6)
Prenatal care outreach and service delivery support................................. $ 3,249,300
Sec. 285.
Entire Section. (Page 16)
Sec. 407. (5)
Entire Subsection. (Page 19)
Sec. 407. (6)
Entire Subsection. (Page 19)
Sec. 720.
Entire Section. (Page 25)
Sec. 1031.
Entire Section. (Page 27)
Sec. 1107.
Entire Section. (Page 28)
Sec. 1112.
Entire Section. (Page 28)
Sec. 1139.
Entire Section. (Page 29)
Sec. 1419.
Entire Section. (Page 30)
Sec. 1717. (1)
The words: “The second pool, totaling $5,000,000.00, shall be distributed to unaffiliated hospitals and hospital systems that received less than $900,000.00 in disproportionate share hospital payments in fiscal year 2007-2008 based on a formula that is weighted proportional to the product of each eligible system’s Medicaid revenue and each eligible system’s Medicaid utilization, except that no payment of less than $1,000.00 shall be made.” (Page 39)
Enrolled House Bill No. 4436
STATE OF MICHIGAN
95TH LEGISLATURE
REGULAR SESSION OF 2009
Introduced by Rep. McDowell
ENROLLED HOUSE BILL No. 4436
AN ACT 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, 2010; 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:
PART 1
LINE-ITEM APPROPRIATIONS
Sec. 101. Subject to the conditions set forth in this act, the amounts listed in this part are appropriated for the department of community health for the fiscal year ending September 30, 2010, from the funds indicated in this part. The following is a summary of the appropriations in this part:
DEPARTMENT OF COMMUNITY HEALTH
APPROPRIATION SUMMARY
Full-time equated unclassified positions............................................................................................6.0
Full-time equated classified positions..........................................................................................4,375.6
Average population.............................................................................................................................893.0
GROSS APPROPRIATION.......................................................................................................................... $ 13,092,429,800
Interdepartmental grant revenues:
Total interdepartmental grants and intradepartmental transfers.......................................................... 48,946,000
ADJUSTED GROSS APPROPRIATION.................................................................................................. $ 13,043,483,800
Federal revenues:
Total other federal revenues......................................................................................................................... 7,869,380,800
Total federal revenues (ARRA).................................................................................................................... 1,080,092,400
Special revenue funds:
Total local revenues......................................................................................................................................... 225,972,600
Total private revenues.................................................................................................................................... 72,308,500
Merit award trust fund................................................................................................................................... 22,899,900
Total other state restricted revenues.......................................................................................................... 1,464,163,500
State general fund/general purpose............................................................................................................. $ 2,308,666,100
Sec. 102. DEPARTMENTWIDE ADMINISTRATION
Full-time equated unclassified positions............................................................................................6.0
Full-time equated classified positions.............................................................................................182.2
Director and other unclassified—6.0 FTE positions................................................................................. $ 598,600
Departmental administration and management—172.2 FTE positions................................................. 22,407,300
Worker’s compensation program................................................................................................................... 8,247,100
Rent and building occupancy......................................................................................................................... 10,778,100
Developmental disabilities council and projects—10.0 FTE positions.................................................. 2,793,500
GROSS APPROPRIATION.......................................................................................................................... $ 44,824,600
Appropriated from:
Federal revenues:
Total federal revenues.................................................................................................................................... 13,605,300
Special revenue funds:
Total private revenues.................................................................................................................................... 35,200
Total other state restricted revenues.......................................................................................................... 2,366,100
State general fund/general purpose............................................................................................................. $ 28,818,000
Sec. 103. MENTAL HEALTH/SUBSTANCE ABUSE SERVICES ADMINISTRATION
AND SPECIAL PROJECTS
Full-time equated classified positions.............................................................................................118.5
Mental health/substance abuse program administration—117.5 FTE positions.................................. $ 14,691,200
Gambling addiction—1.0 FTE position........................................................................................................ 3,000,000
Protection and advocacy services support.................................................................................................. 194,400
Community residential and support services............................................................................................. 2,136,000
Highway safety projects................................................................................................................................ 400,000
Federal and other special projects............................................................................................................... 4,247,700
Family support subsidy.................................................................................................................................. 18,599,200
Housing and support services....................................................................................................................... 9,306,800
Anti-drug abuse grants.................................................................................................................................. 8,575,000
Interdepartmental grant to judiciary for drug treatment courts........................................................... 1,800,000
GROSS APPROPRIATION.......................................................................................................................... $ 62,950,300
Appropriated from:
Federal revenues:
Total federal revenues.................................................................................................................................... 47,800,000
Special revenue funds:
Total private revenues.................................................................................................................................... 190,000
Total other state restricted revenues.......................................................................................................... 3,000,000
State general fund/general purpose............................................................................................................. $ 11,960,300
Sec. 104. COMMUNITY MENTAL HEALTH/SUBSTANCE ABUSE SERVICES
PROGRAMS
Full-time equated classified positions.................................................................................................9.5
Medicaid mental health services................................................................................................................... $ 1,970,775,800
Community mental health non-Medicaid services..................................................................................... 287,468,000
Medicaid adult benefits waiver..................................................................................................................... 40,000,000
Multicultural services..................................................................................................................................... 6,823,800
Medicaid substance abuse services............................................................................................................... 41,676,500
CMHSP, purchase of state services contracts............................................................................................ 120,833,400
Civil service charges....................................................................................................................................... 1,499,300
Federal mental health block grant—2.5 FTE positions........................................................................... 15,374,900
State disability assistance program substance abuse services............................................................... 2,243,100
Community substance abuse prevention, education, and treatment programs................................... 82,592,300
Children’s waiver home care program......................................................................................................... 19,549,800
Nursing home PAS/ARR-OBRA—7.0 FTE positions.............................................................................. 12,116,000
Children with serious emotional disturbance waiver................................................................................ 7,188,000
GROSS APPROPRIATION.......................................................................................................................... $ 2,608,140,900
Appropriated from:
Interdepartmental grant revenues:
Interdepartmental grant from the department of human services........................................................ 1,769,000
Federal revenues:
Total other federal revenues......................................................................................................................... $ 1,411,168,100
Federal FMAP stimulus (ARRA)................................................................................................................ 203,370,900
Special revenue funds:
Total local revenues......................................................................................................................................... 25,228,900
Total other state restricted revenues.......................................................................................................... 10,753,200
State general fund/general purpose............................................................................................................. $ 955,850,800
Sec. 105. STATE PSYCHIATRIC HOSPITALS, CENTERS FOR PERSONS WITH
DEVELOPMENTAL DISABILITIES, AND FORENSIC AND PRISON MENTAL
HEALTH SERVICES
Total average population...................................................................................................................893.0
Full-time equated classified positions..........................................................................................2,590.5
Caro Regional Mental Health Center - psychiatric hospital - adult—468.3 FTE positions.............. $ 52,809,300
Average population.............................................................................................................................185.0
Kalamazoo Psychiatric Hospital - adult—483.1 FTE positions............................................................... 51,065,700
Average population.............................................................................................................................189.0
Walter P. Reuther Psychiatric Hospital - adult—433.3 FTE positions................................................. 46,659,000
Average population.............................................................................................................................234.0
Hawthorn Center - psychiatric hospital - children and adolescents—230.9 FTE positions.............. 24,834,000
Average population...............................................................................................................................75.0
Mount Pleasant Center - developmental disabilities................................................................................ 2,465,000
Center for forensic psychiatry—578.6 FTE positions.............................................................................. 61,286,800
Average population.............................................................................................................................210.0
Forensic mental health services provided to the department of corrections—396.3 FTE
positions......................................................................................................................................................... 45,489,700
Revenue recapture.......................................................................................................................................... 750,000
IDEA, federal special education................................................................................................................... 120,000
Special maintenance........................................................................................................................................ 332,500
Purchase of medical services for residents of hospitals and centers..................................................... 445,600
Closed site, transition, and related costs.................................................................................................... 2,050,100
Gifts and bequests for patient living and treatment environment......................................................... 1,000,000
GROSS APPROPRIATION.......................................................................................................................... $ 289,307,700
Appropriated from:
Interdepartmental grant revenues:
Interdepartmental grant from the department of corrections................................................................ 45,489,700
Federal revenues:
Total other federal revenues......................................................................................................................... 30,633,400
Federal FMAP stimulus (ARRA)................................................................................................................ 3,382,200
Special revenue funds:
CMHSP, purchase of state services contracts............................................................................................ 120,833,400
Other local revenues....................................................................................................................................... 16,928,200
Total private revenues.................................................................................................................................... 1,000,000
Total other state restricted revenues.......................................................................................................... 12,331,700
State general fund/general purpose............................................................................................................. $ 58,709,100
Sec. 106. PUBLIC HEALTH ADMINISTRATION
Full-time equated classified positions...............................................................................................92.7
Public health administration—8.3 FTE positions...................................................................................... $ 1,631,300
Minority health grants and contracts—3.0 FTE positions...................................................................... 1,100,400
Promotion of healthy behaviors.................................................................................................................... 2,375,900
Vital records and health statistics—81.4 FTE positions.......................................................................... 10,392,000
GROSS APPROPRIATION.......................................................................................................................... $ 15,499,600
Appropriated from:
Interdepartmental grant revenues:
Interdepartmental grant from the department of human services........................................................ 1,123,900
Federal revenues:
Total federal revenues.................................................................................................................................... 5,236,900
Special revenue funds:
Total private revenues.................................................................................................................................... $ 1,700,000
Total other state restricted revenues.......................................................................................................... 6,116,000
State general fund/general purpose............................................................................................................. $ 1,322,800
Sec. 107. HEALTH POLICY, REGULATION, AND PROFESSIONS
Full-time equated classified positions.............................................................................................420.6
Health systems administration—193.6 FTE positions............................................................................. $ 20,644,300
Emergency medical services program state staff—8.5 FTE positions................................................. 1,495,000
Radiological health administration—21.4 FTE positions......................................................................... 2,947,400
Emergency medical services grants and services..................................................................................... 660,000
Health professions—147.0 FTE positions................................................................................................... 24,598,200
Background check program—5.5 FTE positions....................................................................................... 2,681,000
Health policy, regulation, and professions administration—25.2 FTE positions................................. 2,985,800
Nurse scholarship, education, and research program—3.0 FTE positions........................................... 1,718,300
Certificate of need program administration—14.0 FTE positions......................................................... 1,955,700
Rural health services—1.0 FTE position.................................................................................................... 1,405,700
Michigan essential health provider............................................................................................................... 1,325,100
Primary care services—1.4 FTE positions................................................................................................. 2,318,800
Primary care services (ARRA)..................................................................................................................... 130,000
GROSS APPROPRIATION.......................................................................................................................... $ 64,865,300
Appropriated from:
Interdepartmental grant revenues:
Interdepartmental grant from the department of treasury, Michigan state hospital finance
authority........................................................................................................................................................ 116,300
Federal revenues:
Total other federal revenues......................................................................................................................... 23,123,000
Federal revenues (ARRA)............................................................................................................................. 130,000
Special revenue funds:
Total local revenues......................................................................................................................................... 227,700
Total private revenues.................................................................................................................................... 455,000
Total other state restricted revenues.......................................................................................................... 31,606,600
State general fund/general purpose............................................................................................................. $ 9,206,700
Sec. 108. INFECTIOUS DISEASE CONTROL
Full-time equated classified positions...............................................................................................51.7
AIDS prevention, testing, and care programs—12.7 FTE positions..................................................... $ 41,367,600
Immunization local agreements.................................................................................................................... 13,990,300
Immunization program management and field support—15.0 FTE positions..................................... 2,035,500
Pediatric AIDS prevention and control—1.0 FTE position.................................................................... 1,226,400
Sexually transmitted disease control local agreements............................................................................ 3,360,700
Sexually transmitted disease control management and field support—23.0 FTE positions............. 3,716,500
Infectious disease control (ARRA)............................................................................................................... 2,822,700
GROSS APPROPRIATION.......................................................................................................................... $ 68,519,700
Appropriated from:
Federal revenues:
Total other federal revenues......................................................................................................................... 42,128,500
Federal revenues (ARRA)............................................................................................................................. 2,822,700
Special revenue funds:
Total private revenues.................................................................................................................................... 10,873,600
Total other state restricted revenues.......................................................................................................... 9,535,200
State general fund/general purpose............................................................................................................. $ 3,159,700
Sec. 109. LABORATORY SERVICES
Full-time equated classified positions.............................................................................................122.0
Laboratory services—122.0 FTE positions................................................................................................ $ 18,439,100
GROSS APPROPRIATION.......................................................................................................................... $ 18,439,100
Appropriated from:
Interdepartmental grant revenues:
Interdepartmental grant from the department of environmental quality............................................ 447,100
Federal revenues:
Total federal revenues.................................................................................................................................... $ 1,683,600
Special revenue funds:
Total other state restricted revenues.......................................................................................................... 9,048,100
State general fund/general purpose............................................................................................................. $ 7,260,300
Sec. 110. EPIDEMIOLOGY
Full-time equated classified positions.............................................................................................131.0
AIDS surveillance and prevention program............................................................................................... $ 2,254,100
Asthma prevention and control—2.6 FTE positions................................................................................. 843,500
Bioterrorism preparedness—68.6 FTE positions...................................................................................... 48,905,100
Epidemiology administration—42.3 FTE positions................................................................................... 8,112,400
Lead abatement program—7.0 FTE positions........................................................................................... 2,191,300
Newborn screening follow-up and treatment services—10.5 FTE positions....................................... 4,692,100
Tuberculosis control and prevention............................................................................................................ 867,000
GROSS APPROPRIATION.......................................................................................................................... $ 67,865,500
Appropriated from:
Federal revenues:
Total federal revenues.................................................................................................................................... 60,390,800
Special revenue funds:
Total private revenues.................................................................................................................................... 25,000
Total other state restricted revenues.......................................................................................................... 5,295,200
State general fund/general purpose............................................................................................................. $ 2,154,500
Sec. 111. LOCAL HEALTH ADMINISTRATION AND GRANTS
Implementation of 1993 PA 133, MCL 333.17015...................................................................................... $ 20,000
Local health services....................................................................................................................................... 100,000
Local public health operations....................................................................................................................... 40,082,800
Medicaid outreach cost reimbursement to local health departments.................................................... 9,000,000
GROSS APPROPRIATION.......................................................................................................................... $ 49,202,800
Appropriated from:
Federal revenues:
Total federal revenues.................................................................................................................................... 9,000,000
Special revenue funds:
Total local revenues......................................................................................................................................... 5,150,000
Total other state restricted revenues.......................................................................................................... 100,000
State general fund/general purpose............................................................................................................. $ 34,952,800
Sec. 112. CHRONIC DISEASE AND INJURY PREVENTION AND HEALTH
PROMOTION
Full-time equated classified positions...............................................................................................75.3
Alzheimer’s information network.................................................................................................................. $ 99,500
Cancer prevention and control program—12.0 FTE positions............................................................... 14,304,400
Chronic disease prevention—27.7 FTE positions...................................................................................... 5,285,700
Diabetes and kidney program—12.2 FTE positions................................................................................. 2,512,700
Health education, promotion, and research programs—6.5 FTE positions.......................................... 829,600
Injury control intervention project.............................................................................................................. 200,000
Public health traffic safety coordination—1.0 FTE position................................................................... 445,100
Smoking prevention program—14.0 FTE positions.................................................................................. 4,662,400
Violence prevention—1.9 FTE positions..................................................................................................... 1,892,900
GROSS APPROPRIATION.......................................................................................................................... $ 30,232,300
Appropriated from:
Federal revenues:
Total federal revenues.................................................................................................................................... 22,388,600
Special revenue funds:
Total private revenues.................................................................................................................................... 146,600
Total other state restricted revenues.......................................................................................................... 5,896,800
State general fund/general purpose............................................................................................................. $ 1,800,300
Sec. 113. FAMILY, MATERNAL, AND CHILDREN’S HEALTH SERVICES
Full-time equated classified positions...............................................................................................56.3
Childhood lead program—6.0 FTE positions............................................................................................. $ 1,766,600
Dental programs—3.0 FTE positions.......................................................................................................... 1,094,400
Dental program for persons with developmental disabilities.................................................................. 151,000
Early childhood collaborative secondary prevention................................................................................ 524,000
Family, maternal, and children’s health services administration—43.6 FTE positions...................... 5,631,200
Family planning local agreements................................................................................................................ 9,085,700
Local MCH services........................................................................................................................................ 7,018,100
Pregnancy prevention program.................................................................................................................... 1,747,200
Prenatal care outreach and service delivery support............................................................................... 3,249,300
School health and education programs—1.0 FTE position...................................................................... 400,000
Special projects—2.7 FTE positions............................................................................................................ 3,032,400
Sudden infant death syndrome program..................................................................................................... 321,300
GROSS APPROPRIATION.......................................................................................................................... $ 34,021,200
Appropriated from:
Federal revenues:
Total federal revenues.................................................................................................................................... 27,293,700
Special revenue funds:
Total local revenues......................................................................................................................................... 75,000
Total other state restricted revenues.......................................................................................................... 1,545,100
State general fund/general purpose............................................................................................................. $ 5,107,400
Sec. 114. WOMEN, INFANTS, AND CHILDREN FOOD AND NUTRITION
PROGRAM
Full-time equated classified positions...............................................................................................43.0
Women, infants, and children program administration and special projects—
43.0 FTE positions....................................................................................................................................... $ 9,554,800
Women, infants, and children program local agreements and food costs.............................................. 236,506,700
GROSS APPROPRIATION.......................................................................................................................... $ 246,061,500
Appropriated from:
Federal revenues:
Total federal revenues.................................................................................................................................... 192,815,400
Special revenue funds:
Total private revenues.................................................................................................................................... 53,246,100
State general fund/general purpose............................................................................................................. $ 0
Sec. 115. CHILDREN’S SPECIAL HEALTH CARE SERVICES
Full-time equated classified positions...............................................................................................47.8
Children’s special health care services administration—45.0 FTE positions....................................... $ 4,902,100
Bequests for care and services—2.8 FTE positions.................................................................................. 1,514,600
Outreach and advocacy................................................................................................................................... 3,773,500
Nonemergency medical transportation........................................................................................................ 1,527,600
Medical care and treatment........................................................................................................................... 231,455,100
GROSS APPROPRIATION.......................................................................................................................... $ 243,172,900
Appropriated from:
Federal revenues:
Total other federal revenues......................................................................................................................... 141,515,900
Federal FMAP stimulus (ARRA)................................................................................................................ 19,218,200
Special revenue funds:
Total private revenues.................................................................................................................................... 1,000,000
Total other state restricted revenues.......................................................................................................... 3,837,000
State general fund/general purpose............................................................................................................. $ 77,601,800
Sec. 116. CRIME VICTIM SERVICES COMMISSION
Full-time equated classified positions...............................................................................................11.0
Grants administration services—11.0 FTE positions............................................................................... $ 1,498,200
Justice assistance grants................................................................................................................................ $ 13,000,000
Crime victim rights services grants............................................................................................................. 12,500,000
Crime victim’s rights fund revenue to Michigan state police.................................................................. 1,053,300
Crime victim’s rights fund revenue to department of human services................................................. 1,300,000
GROSS APPROPRIATION.......................................................................................................................... $ 29,351,500
Appropriated from:
Federal revenues:
Total federal revenues.................................................................................................................................... 15,055,300
Special revenue funds:
Total other state restricted revenues.......................................................................................................... 14,296,200
State general fund/general purpose............................................................................................................. $ 0
Sec. 117. OFFICE OF SERVICES TO THE AGING
Full-time equated classified positions...............................................................................................44.5
Commission (per diem $50.00)....................................................................................................................... $ 10,500
Office of services to aging administration—44.5 FTE positions............................................................. 6,760,500
Community services........................................................................................................................................ 34,496,600
Nutrition services............................................................................................................................................ 36,170,500
Foster grandparent volunteer program...................................................................................................... 2,427,600
Retired and senior volunteer program........................................................................................................ 681,800
Senior companion volunteer program.......................................................................................................... 1,743,800
Employment assistance.................................................................................................................................. 3,449,500
Respite care program..................................................................................................................................... 6,268,700
GROSS APPROPRIATION.......................................................................................................................... $ 92,009,500
Appropriated from:
Federal revenues:
Total federal revenues.................................................................................................................................... 55,203,900
Special revenue funds:
Total private revenues.................................................................................................................................... 537,000
Merit award trust fund................................................................................................................................... 4,468,700
Total other state restricted revenues.......................................................................................................... 1,800,000
State general fund/general purpose............................................................................................................. $ 29,999,900
Sec. 118. MEDICAL SERVICES ADMINISTRATION
Full-time equated classified positions.............................................................................................379.0
Medical services administration—379.0 FTE positions............................................................................ $ 59,977,300
Facility inspection contract............................................................................................................................ 132,800
MIChild administration.................................................................................................................................. 4,327,800
GROSS APPROPRIATION.......................................................................................................................... $ 64,437,900
Appropriated from:
Federal revenues:
Total federal revenues.................................................................................................................................... 44,509,600
Special revenue funds:
Total local revenues......................................................................................................................................... 5,000
Total other state restricted revenues.......................................................................................................... 97,800
State general fund/general purpose............................................................................................................. $ 19,825,500
Sec. 119. MEDICAL SERVICES
Hospital services and therapy....................................................................................................................... $ 1,335,404,600
Hospital disproportionate share payments................................................................................................. 50,000,000
Physician services............................................................................................................................................ 341,317,300
Medicare premium payments........................................................................................................................ 341,408,400
Pharmaceutical services................................................................................................................................. 315,359,600
Home health services...................................................................................................................................... 6,044,700
Hospice services............................................................................................................................................... 103,153,700
Transportation.................................................................................................................................................. 13,000,000
Auxiliary medical services............................................................................................................................. 7,599,500
Dental services................................................................................................................................................. 126,426,400
Ambulance services......................................................................................................................................... $ 11,734,700
Long-term care services................................................................................................................................. 1,593,808,300
Medicaid home- and community-based services waiver........................................................................... 176,426,800
Adult home help services............................................................................................................................... 264,057,900
Personal care services.................................................................................................................................... 20,463,400
Program of all-inclusive care for the elderly.............................................................................................. 16,600,000
Health plan services........................................................................................................................................ 3,483,069,900
MIChild program............................................................................................................................................. 50,000,000
Plan first family planning waiver................................................................................................................. 8,782,200
Medicaid adult benefits waiver..................................................................................................................... 139,198,700
Special indigent care payments..................................................................................................................... 88,518,500
Federal Medicare pharmaceutical program................................................................................................ 183,611,800
Promotion of healthy behavior waiver........................................................................................................ 10,000,000
Maternal and child health............................................................................................................................... 20,279,500
Subtotal basic medical services program.................................................................................................... 8,706,265,900
School-based services...................................................................................................................................... 64,630,600
Special Medicaid reimbursement.................................................................................................................. 239,696,400
Subtotal special medical services payments............................................................................................... 304,327,000
GROSS APPROPRIATION.......................................................................................................................... $ 9,010,592,900
Appropriated from:
Federal revenues:
Total other federal revenues......................................................................................................................... 5,688,603,000
Federal FMAP stimulus (ARRA)................................................................................................................ 851,168,400
Special revenue funds:
Total local revenues......................................................................................................................................... 57,524,400
Total private revenues.................................................................................................................................... 3,100,000
Merit award trust fund................................................................................................................................... 18,431,200
Total other state restricted revenues.......................................................................................................... 1,342,964,600
State general fund/general purpose............................................................................................................. $ 1,048,801,300
Sec. 120. INFORMATION TECHNOLOGY
Information technology services and projects............................................................................................ $ 36,133,500
Michigan Medicaid information system....................................................................................................... 16,801,100
GROSS APPROPRIATION.......................................................................................................................... $ 52,934,600
Appropriated from:
Federal revenues:
Total federal revenues.................................................................................................................................... 37,225,800
Special revenue funds:
Total other state restricted revenues.......................................................................................................... 3,573,900
State general fund/general purpose............................................................................................................. $ 12,134,900
PART 2
PROVISIONS CONCERNING APPROPRIATIONS
GENERAL SECTIONS
Sec. 201. Pursuant to section 30 of article IX of the state constitution of 1963, total state spending from state resources under part 1 for fiscal year 2009-2010 is $3,795,729,500.00 and state spending from state resources to be paid to local units of government for fiscal year 2009-2010 is $1,217,612,600.00. The itemized statement below identifies appropriations from which spending to local units of government will occur:
DEPARTMENT OF COMMUNITY HEALTH
MENTAL HEALTH/SUBSTANCE ABUSE SERVICES ADMINISTRATION
AND SPECIAL PROJECTS
Community residential and support services............................................................................................. $ 344,600
Housing and support services....................................................................................................................... 599,800
COMMUNITY MENTAL HEALTH/SUBSTANCE ABUSE SERVICES PROGRAMS
State disability assistance program substance abuse services............................................................... $ 2,243,100
Community substance abuse prevention, education, and treatment programs................................... 16,814,800
Medicaid mental health services................................................................................................................... 501,559,400
Community mental health non-Medicaid services..................................................................................... 287,468,000
Medicaid adult benefits waiver..................................................................................................................... 10,308,000
Multicultural services..................................................................................................................................... 6,823,800
Medicaid substance abuse services............................................................................................................... 11,140,100
Children’s waiver home care program......................................................................................................... 5,225,700
Nursing home PASARR................................................................................................................................. 2,688,400
STATE PSYCHIATRIC HOSPITALS, CENTERS FOR PERSONS WITH DEVELOPMENTAL
DISABILITIES, AND FORENSIC AND PRISON MENTAL HEALTH SERVICES
Center for forensic psychiatry...................................................................................................................... $ 290,300
PUBLIC HEALTH ADMINISTRATION
Minority health grants and contracts.......................................................................................................... $ 241,000
Public health administration.......................................................................................................................... 61,500
HEALTH POLICY, REGULATION, AND PROFESSIONS
Nurse scholarship, education, and research programs............................................................................. $ 72,600
Primary care services..................................................................................................................................... 115,600
INFECTIOUS DISEASE CONTROL
AIDS prevention, testing, and care programs........................................................................................... $ 865,700
Immunization local agreements.................................................................................................................... 2,158,100
Immunization program management and field support........................................................................... 30,300
Sexually transmitted disease control local agreements............................................................................ 421,800
LABORATORY SERVICES
Laboratory services........................................................................................................................................ $ 3,300
EPIDEMIOLOGY
Epidemiology administration......................................................................................................................... $ 125,000
LOCAL HEALTH ADMINISTRATION AND GRANTS
Implementation of 1993 PA 133, MCL 333.17015...................................................................................... $ 5,300
Local public health operations....................................................................................................................... 34,932,800
CHRONIC DISEASE AND INJURY PREVENTION AND HEALTH PROMOTION
Cancer prevention and control program..................................................................................................... $ 397,300
Chronic disease prevention............................................................................................................................ 261,600
Diabetes and kidney program....................................................................................................................... 357,700
Smoking prevention program........................................................................................................................ 959,900
FAMILY, MATERNAL, AND CHILDREN’S HEALTH SERVICES
Childhood lead program................................................................................................................................. $ 107,600
Family, maternal, and children’s health administration........................................................................... 87,100
Family planning local agreements................................................................................................................ 111,300
Pregnancy prevention program.................................................................................................................... 1,145,100
Prenatal care outreach and service delivery support............................................................................... 1,028,900
School health education programs................................................................................................................ 297,000
Special projects................................................................................................................................................ 175,000
CHILDREN’S SPECIAL HEALTH CARE SERVICES
Medical care and treatment........................................................................................................................... $ 451,100
Outreach and advocacy................................................................................................................................... 3,077,500
MEDICAL SERVICES
Dental services................................................................................................................................................. $ 2,348,100
Long-term care services................................................................................................................................. 262,002,000
Transportation.................................................................................................................................................. 5,736,900
Medicaid adult benefits waiver..................................................................................................................... 9,443,300
Hospital services and therapy....................................................................................................................... 6,113,400
Physician services............................................................................................................................................ 3,717,400
OFFICE OF SERVICES TO THE AGING
Community services........................................................................................................................................ $ 12,326,700
Nutrition services............................................................................................................................................ 9,670,300
Foster grandparent volunteer program...................................................................................................... 679,800
Retired and senior volunteer program........................................................................................................ 187,300
Senior companion volunteer program.......................................................................................................... 206,500
Respite care program..................................................................................................................................... 5,384,800
CRIME VICTIM SERVICES COMMISSION
Crime victim rights services grants............................................................................................................. $ 6,800,000
TOTAL OF PAYMENTS TO LOCAL UNITS OF GOVERNMENT...................................................... $ 1,217,612,600
Sec. 202. (1) The appropriations authorized under this act are subject to the management and budget act, 1984 PA 431, MCL 18.1101 to 18.1594.
(2) Funds for which the state is acting as the custodian or agent are not subject to annual appropriation.
Sec. 203. As used in this act:
(a) “AIDS” means acquired immunodeficiency syndrome.
(b) “ARRA” means the American recovery and reinvestment act of 2009, Public Law 111-5.
(c) “CMHSP” means a community mental health services program as that term is defined in section 100a of the mental health code, 1974 PA 258, MCL 330.1100a.
(d) “Current fiscal year” means the fiscal year ending September 30, 2010.
(e) “Department” means the Michigan department of community health.
(f) “Director” means the director of the department.
(g) “DSH” means disproportionate share hospital.
(h) “EPSDT” means early and periodic screening, diagnosis, and treatment.
(i) “Federal poverty level” means the poverty guidelines published annually in the federal register by the United States department of health and human services under its authority to revise the poverty line under 42 USC 9902.
(j) “FMAP” means federal medical assistance percentages.
(k) “FTE” means full-time equated.
(l) “GME” means graduate medical education.
(m) “Health plan” means, at a minimum, an organization that meets the criteria for delivering the comprehensive package of services under the department’s comprehensive health plan.
(n) “HIV/AIDS” means human immunodeficiency virus/acquired immune deficiency syndrome.
(o) “HMO” means health maintenance organization.
(p) “IDEA” means the individuals with disabilities education act, 20 USC 1400 to 1482.
(q) “IDG” means interdepartmental grant.
(r) “MCH” means maternal and child health.
(s) “MIChild” means the program described in section 1670.
(t) “MIHP” means the maternal infant health program.
(u) “PASARR” means the preadmission screening and annual resident review required under the omnibus budget reconciliation act of 1987, section 1919(e)(7) of the social security act, 42 USC 1396r.
(v) “PIHP” means a specialty prepaid inpatient health plan for Medicaid mental health services, services to persons with developmental disabilities, and substance abuse services as described in section 232b of the mental health code, 1974 PA 258, MCL 330.1232b.
(w) “Title XVIII” means title XVIII of the social security act, 42 USC 1395 to 1395iii.
(x) “Title XIX” means title XIX of the social security act, 42 USC 1396 to 1396w-1.
(y) “Title XX” means title XX of the social security act, 42 USC 1397 to 1397f.
(z) “WIC” means women, infants, and children supplemental nutrition program.
Sec. 204. The civil service commission shall bill the department at the end of the first fiscal quarter for the 1% charge authorized by section 5 of article XI of the state constitution of 1963. The department shall pay the total amount of the billing by the end of the second fiscal quarter.
Sec. 205. (1) A hiring freeze is imposed on the state classified civil service. State departments and agencies are prohibited from hiring any new full-time state classified civil service employees and prohibited from filling any vacant state classified civil service positions. This hiring freeze does not apply to internal transfers of classified employees from 1 position to another within a department.
(2) The state budget director may grant exceptions to this hiring freeze when the state budget director believes that the hiring freeze will render a state department or agency unable to deliver basic services, will cause loss of revenue to the state, will result in the inability of the state to receive federal funds, or will necessitate additional expenditures that exceed any savings from maintaining a vacancy. The state budget director shall report annually to the chairpersons of the senate and house standing committees on appropriations the number of exceptions to the hiring freeze approved during the previous quarter and the reasons to justify the exception.
Sec. 206. (1) In addition to the funds appropriated in part 1, there is appropriated an amount not to exceed $100,000,000.00 for federal contingency funds. These funds are not available for expenditure until they have been transferred to another line item in this act under section 393(2) of the management and budget act, 1984 PA 431, MCL 18.1393.
(2) In addition to the funds appropriated in part 1, there is appropriated an amount not to exceed $20,000,000.00 for state restricted contingency funds. These funds are not available for expenditure until they have been transferred to another line item in this act under section 393(2) of the management and budget act, 1984 PA 431, MCL 18.1393.
(3) In addition to the funds appropriated in part 1, there is appropriated an amount not to exceed $20,000,000.00 for local contingency funds. These funds are not available for expenditure until they have been transferred to another line item in this act under section 393(2) of the management and budget act, 1984 PA 431, MCL 18.1393.
(4) In addition to the funds appropriated in part 1, there is appropriated an amount not to exceed $10,000,000.00 for private contingency funds. These funds are not available for expenditure until they have been transferred to another line item in this act under section 393(2) of the management and budget act, 1984 PA 431, MCL 18.1393.
Sec. 208. The department shall use the Internet to fulfill the reporting requirements of this act. This requirement may include transmission of reports via electronic mail to the recipients identified for each reporting requirement, or it may include placement of reports on the Internet or Intranet site.
Sec. 209. Funds appropriated in part 1 shall not be used for the purchase of foreign goods or services, or both, if competitively priced and of comparable quality American goods or services, or both, are available. Preference shall be given to goods or services, or both, manufactured or provided by Michigan businesses if they are competitively priced and of comparable quality. In addition, preference shall be given to goods or services, or both, that are manufactured or provided by Michigan businesses owned and operated by veterans if they are competitively priced and of comparable quality.
Sec. 210. The director shall take all reasonable steps to ensure businesses in deprived and depressed communities compete for and perform contracts to provide services or supplies, or both. The director shall strongly encourage firms with which the department contracts to subcontract with certified businesses in depressed and deprived communities for services, supplies, or both.
Sec. 211. (1) If the revenue collected by the department from fees and collections exceeds the amount appropriated in part 1, the revenue may be carried forward with the approval of the state budget director into the subsequent fiscal year. The revenue carried forward under this section shall be used as the first source of funds in the subsequent fiscal year.
(2) The department shall provide a report to the senate and house appropriations subcommittees on community health and the senate and house fiscal agencies on the balance of each of the restricted funds administered by the department as of September 30 of the current fiscal year.
Sec. 212. (1) From the amounts appropriated in part 1, no greater than the following amounts are supported with federal maternal and child health block grant, preventive health and health services block grant, substance abuse block grant, healthy Michigan fund, and Michigan health initiative funds:
(a) Maternal and child health block grant................................................................................................. $ 19,030,900
(b) Preventive health and health services block grant........................................................................... 3,589,800
(c) Substance abuse block grant................................................................................................................. 60,632,200
(d) Healthy Michigan fund........................................................................................................................... 37,428,200
(e) Michigan health initiative....................................................................................................................... 9,100,000
(2) On or before February 1 of the current fiscal year, the department shall report to the house and senate appropriations subcommittees on community health, the house and senate fiscal agencies, and the state budget director on the detailed name and amounts of federal, restricted, private, and local sources of revenue that support the appropriations in each of the line items in part 1 of this act.
(3) Upon the release of the next fiscal year executive budget recommendation, the department shall report to the same parties in subsection (2) on the amounts and detailed sources of federal, restricted, private, and local revenue proposed to support the total funds appropriated in each of the line items in part 1 of the next fiscal year executive budget proposal.
(4) The department shall provide to the same parties in subsection (2) all revenue source detail for consolidated revenue line item detail upon request to the department.
Sec. 213. The state departments, agencies, and commissions receiving tobacco tax funds and healthy Michigan funds from part 1 shall report by April 1 of the current fiscal year to the senate and house appropriations committees, the senate and house fiscal agencies, and the state budget director on the following:
(a) Detailed spending plan by appropriation line item including description of programs and a summary of organizations receiving these funds.
(b) Description of allocations or bid processes including need or demand indicators used to determine allocations.
(c) Eligibility criteria for program participation and maximum benefit levels where applicable.
(d) Outcome measures used to evaluate programs, including measures of the effectiveness of these programs in improving the health of Michigan residents.
(e) Any other information considered necessary by the house of representatives or senate appropriations committees or the state budget director.
Sec. 214. The use of state restricted tobacco tax revenue received for the purpose of tobacco prevention, education, and reduction efforts and deposited in the healthy Michigan fund shall not be used for lobbying as defined in section 5 of 1978 PA 472, MCL 4.415, and shall not be used in attempting to influence the decisions of the legislature, the governor, or any state agency.
Sec. 215. (1) The department shall report to the house and senate appropriations subcommittees on the budget for the department, the joint committee on administrative rules, and the senate and house fiscal agencies by no later than April 1, 2010 on each specific policy change made by the department to implement a public act affecting that department that took effect during the preceding calendar year.
(2) Funds appropriated in part 1 shall not be used by the department to adopt a rule that will apply to a small business and that will have a disproportionate economic impact on small businesses because of the size of those businesses if the department fails to reduce the disproportionate economic impact of the rule on small businesses as provided under section 40 of the administrative procedures act of 1969, 1969 PA 306, MCL 24.240.
(3) As used in this section:
(a) “Rule” means that term as defined under section 7 of the administrative procedures act of 1969, 1969 PA 306, MCL 24.207.
(b) “Small business” means that term as defined under section 7a of the administrative procedures act of 1969, 1969 PA 306, MCL 24.207a.
Sec. 216. (1) In addition to funds appropriated in part 1 for all programs and services, there is appropriated for write-offs of accounts receivable, deferrals, and for prior year obligations in excess of applicable prior year appropriations, an amount equal to total write-offs and prior year obligations, but not to exceed amounts available in prior year revenues.
(2) The department’s ability to satisfy appropriation deductions in part 1 shall not be limited to collections and accruals pertaining to services provided in the current fiscal year, but shall also include reimbursements, refunds, adjustments, and settlements from prior years.
(3) The department shall report by March 15 of the current fiscal year to the house of representatives and senate appropriations subcommittees on community health on all reimbursements, refunds, adjustments, and settlements from prior years.
Sec. 218. The department shall include the following in its annual list of proposed basic health services as required in part 23 of the public health code, 1978 PA 368, MCL 333.2301 to 333.2321:
(a) Immunizations.
(b) Communicable disease control.
(c) Sexually transmitted disease control.
(d) Tuberculosis control.
(e) Prevention of gonorrhea eye infection in newborns.
(f) Screening newborns for the conditions listed in section 5431 of the public health code, 1978 PA 368, MCL 333.5431, or recommended by the newborn screening quality assurance advisory committee created under section 5430 of the public health code, 1978 PA 368, MCL 333.5430.
(g) Community health annex of the Michigan emergency management plan.
(h) Prenatal care.
Sec. 219. (1) The department may contract with the Michigan public health institute for the design and implementation of projects and for other public health-related activities prescribed in section 2611 of the public health code, 1978 PA 368, MCL 333.2611. The department may develop a master agreement with the institute to carry out these purposes for up to a 3-year period. The department shall report to the house and senate appropriations subcommittees on community health, the house and senate fiscal agencies, and the state budget director on or before November 1 and May 1 of the current fiscal year all of the following:
(a) A detailed description of each funded project.
(b) The amount allocated for each project, the appropriation line item from which the allocation is funded, and the source of financing for each project.
(c) The expected project duration.
(d) A detailed spending plan for each project, including a list of all subgrantees and the amount allocated to each subgrantee.
(2) On or before September 30 of the current fiscal year, the department shall provide to the same parties listed in subsection (1) a copy of all reports, studies, and publications produced by the Michigan public health institute, its subcontractors, or the department with the funds appropriated in part 1 and allocated to the Michigan public health institute.
Sec. 220. All contracts with the Michigan public health institute funded with appropriations in part 1 shall include a requirement that the Michigan public health institute submit to financial and performance audits by the state auditor general of projects funded with state appropriations.
Sec. 223. The department may establish and collect fees for publications, videos and related materials, conferences, and workshops. Collected fees shall be used to offset expenditures to pay for printing and mailing costs of the publications, videos and related materials, and costs of the workshops and conferences. The department shall not collect fees under this section that exceed the cost of the expenditures.
Sec. 259. From the funds appropriated in part 1 for information technology, the department shall pay user fees to the department of information technology for technology-related services and projects. Such user fees shall be subject to provisions of an interagency agreement between the department and the department of information technology.
Sec. 260. Amounts appropriated in part 1 for information technology may be designated as work projects and carried forward to support technology projects under the direction of the department of information technology. Funds designated in this manner are not available for expenditure until approved as work projects under section 451a of the management and budget act, 1984 PA 431, MCL 18.1451a.
Sec. 261. Funds appropriated in part 1 for the Medicaid management information system upgrade are contingent upon approval of an advanced planning document from the centers for Medicare and Medicaid services. If the necessary matching funds are identified and legislatively transferred to this line item, the corresponding federal Medicaid revenue shall be appropriated at a 90/10 federal/state match rate. This appropriation may be designated as a work project and carried forward to support completion of this project.
Sec. 264. (1) Upon submission of a Medicaid waiver, a Medicaid state plan amendment, or a similar proposal to the centers for Medicare and Medicaid services, the department shall notify the house and senate appropriations subcommittees on community health and the house and senate fiscal agencies of the submission.
(2) The department shall provide written or verbal quarterly reports to the senate and house appropriations subcommittees on community health and the senate and house fiscal agencies summarizing the status of any new or ongoing discussions with the centers for Medicare and Medicaid services or the federal department of health and human services regarding potential or future Medicaid waiver applications.
Sec. 265. The departments and agencies receiving appropriations in part 1 shall receive and retain copies of all reports funded from appropriations in part 1. Federal and state guidelines for short-term and long-term retention of records shall be followed.
Sec. 266. (1) Due to the current budgetary problems in this state, out-of-state travel shall be limited to situations in which 1 or more of the following conditions apply:
(a) The travel is required by legal mandate or court order or for law enforcement purposes.
(b) The travel is necessary to protect the health or safety of Michigan citizens or visitors or to assist other states in similar circumstances.
(c) The travel is necessary to produce budgetary savings or to increase state revenues, including protecting existing federal funds or securing additional federal funds.
(d) The travel is necessary to comply with federal requirements.
(e) The travel is necessary to secure specialized training for staff that is not available within this state.
(f) The travel is financed entirely by federal or nonstate funds.
(2) If out-of-state travel is necessary but does not meet 1 or more of the conditions in subsection (1), the state budget director may grant an exception to allow the travel. Any exceptions granted by the state budget director shall be reported on a monthly basis to the house of representatives and senate standing committees on appropriations.
(3) Not later than January 1 of each year, each department shall prepare a travel report listing all travel by classified and unclassified employees outside this state in the immediately preceding fiscal year that was funded in whole or in part with funds appropriated in the department’s budget. The report shall be submitted to the senate and house standing committees on appropriations, the senate and house fiscal agencies, and the state budget director. The report shall include the following information:
(a) The name of each person receiving reimbursement for travel outside this state or whose travel costs were paid by this state.
(b) The destination of each travel occurrence.
(c) The dates of each travel occurrence.
(d) A brief statement of the reason for each travel occurrence.
(e) The transportation and related costs of each travel occurrence, including the proportion funded with state general fund/general purpose revenues, the proportion funded with state restricted revenues, the proportion funded with federal revenues, and the proportion funded with other revenues.
(f) A total of all out-of-state travel funded for the immediately preceding fiscal year.
Sec. 267. A department or state agency shall not take disciplinary action against an employee for communicating with a member of the legislature or his or her staff.
Sec. 269. The amount appropriated in part 1 for medical services pharmaceutical services includes funds to cover reimbursement of mental health medications under the Medicaid program.
Sec. 270. Within 90 days after receipt of the notification from the attorney general’s office of a legal action in which expenses had been recovered pursuant to section 106(4) of the social welfare act, 1939 PA 280, MCL 400.106, or any other statute under which the department has the right to recover expenses, the department shall submit a written report to the house and senate appropriations subcommittees on community health, the house and senate fiscal agencies, and the state budget office which includes, at a minimum, all of the following:
(a) The total amount recovered from the legal action.
(b) The program or service for which the money was originally expended.
(c) Details on the disposition of the funds recovered such as the appropriation or revenue account in which the money was deposited.
(d) A description of the facts involved in the legal action.
Sec. 271. (1) The department, in cooperation with a PIHP, a Medicaid HMO, or a federally qualified health center shall establish and implement an early mental health services intervention pilot project. This project shall provide care coordination, disease management, and pharmacy management to eligible recipients suffering from chronic disease, including, but not limited to, diabetes, asthma, substance addiction, or stroke. Participating organizations may make use of data sharing, joint information technology efforts, and financial incentives to health providers and recipients in this project. The department shall encourage that each CMHSP and Medicaid health plan act in a coordinated manner in the establishment of their respective electronic medical record systems.
(2) The pilot project shall make use of preestablished objectives and outcome measures to determine the cost effectiveness of the project. Participating organizations shall collect data to study and monitor the correlation between early mental health treatment services to program participants and improvement in the management of their chronic disease.
(3) The department shall request any necessary Medicaid state plan amendments or waivers to ensure participation in this project by eligible Medicaid recipients.
(4) A progress report on the pilot project shall be provided to the house and senate appropriations subcommittees on community health, the house and senate fiscal agencies, and the state budget director no later than May 1 of the current fiscal year.
Sec. 272. (1) The department shall make efforts to implement the results of the study of current policies and allocation methodologies specified in section 272 of 2007 PA 123. These efforts to encourage administrative efficiencies shall apply to the following entities:
(a) Local public health departments.
(b) CMHSPs.
(c) Substance abuse coordinating agencies.
(d) Area agencies on aging.
(2) The department shall consult with at least the following applicable organizations in implementing the results of the study:
(a) The Michigan association of community mental health boards.
(b) The Michigan association for local public health.
(c) The Michigan association of substance abuse coordinating agencies.
(d) The area agencies on aging association of Michigan.
(3) The department shall submit a report on its efforts to implement the results of the study to the senate and house appropriations subcommittees on community health, the senate and house committees on health policy, the senate and house fiscal agencies, and the state budget director by April 1 of the current fiscal year.
Sec. 276. Funds appropriated in part 1 shall not be used by a principal executive department, state agency, or authority to hire a person to provide legal services that are the responsibility of the attorney general. This prohibition does not apply to legal services for bonding activities and for those activities that the attorney general authorizes.
Sec. 282. (1) The department, through its organizational units responsible for departmental administration, operation, and finance, shall establish uniform definitions, standards, and instructions for the classification, allocation, assignment, calculation, recording, and reporting of administrative costs by the following entities:
(a) Coordinating agencies on substance abuse, Salvation Army harbor light program, and their subcontractors that receive payment or reimbursement from funds appropriated under section 104.
(b) Area agencies on aging and local providers, and their subcontractors that receive payment or reimbursement from funds appropriated under section 117.
(2) By May 15 of the current fiscal year, the department shall provide a written draft of its proposed definitions, standards, and instructions to the house of representatives and senate appropriations subcommittees on community health, the house and senate fiscal agencies, and the state budget director.
Sec. 284. The department shall not approve the travel of more than 1 departmental employee to a specific professional development conference or training seminar that is located outside of this state unless the professional development conference or training seminar is funded by a federal or private funding source and requires more than 1 person from a department to attend, or the conference or training seminar includes multiple issues in which 1 employee from the department does not have expertise.
Sec. 285. (1) By April 1 of the current fiscal year, the department shall expand its current prescription drug website to provide all of the following information:
(a) The 150 most commonly prescribed brand-name drug products under the Medicaid program and, if available, their generic equivalents.
(b) The most commonly prescribed brand-name drug products used for the treatment of all major illnesses and diseases, if not already included under subdivision (a), and, if available, their generic equivalents.
(c) The usual and customary price of each brand-name and generic prescription drug listed.
(d) The dosage, including the number of doses and dosage strength, on which the price is based.
(e) Names and addresses for the pharmacies associated with the listed prescription drugs.
(f) A minimum of 5 links to other useful websites that can provide assistance to consumers.
(g) The department’s toll-free telephone number that residents of this state may call to determine which prescription drug programs they may be eligible for, including free and discounted prescription drug programs.
(h) An advisory statement alerting consumers of the need to tell their health professionals and pharmacists about all the medications they are taking so that they know how to avoid harmful interactions between medications.
(i) An advisory statement alerting consumers that the price posted for a listed drug product is only for the strength and quantity posted.
(j) A date stamp indicating the most recent date the usual and customary price of each brand-name and generic prescription drug listed was updated.
(k) A notation indicating a prescription drug price was corrected.
(2) The department shall provide a progress report on these efforts to the senate and house appropriations subcommittees on community health and the senate and house fiscal agencies by May 1 of the current fiscal year.
Sec. 286. From the funds appropriated in part 1, the department shall use an amount not to exceed $10,000.00 to develop, post, and maintain on a publicly accessible Internet site all expenditures made by the agency within a fiscal year. The department shall not be required to hire additional employees to comply with this section.
Sec. 287. Not later than December 1, 2010, the department shall prepare and transmit a report that provides for estimates of the total general fund/general purpose appropriation lapses at the close of the fiscal year. This report shall summarize the projected year-end general fund/general purpose appropriation lapses by major departmental program or program areas. The report shall be transmitted to the office of the state budget, the chairpersons of the senate and house appropriations committees, and the fiscal agencies.
Sec. 288. By April 1 of the current fiscal year, the department shall report to the house and senate appropriations subcommittees on community health, the house and senate fiscal agencies, and the state budget director on the feasibility and impact of including antipsychotic prescriptions, net of actual rebates, into the actuarially sound capitation rates for the PIHPs. If this initiative is feasible, the report shall include a proposed implementation plan.
Sec. 291. From the funds appropriated in part 1, up to $100.00 shall be allocated for a cooperative effort between the department, the department of human services, and the department of state police to coordinate the functions of the state police LEIN system and the department of human services Bridges case management system. The purpose of this effort will be to provide usable data that will allow authorized users of the Bridges case management system to identify those persons who may be ineligible to receive certain assistance services due to their law enforcement status.
DEPARTMENTWIDE ADMINISTRATION
Sec. 301. From funds appropriated for worker’s compensation, the department may make payments in lieu of worker’s compensation payments for wage and salary and related fringe benefits for employees who return to work under limited duty assignments.
Sec. 303. The department shall not require first-party payment from individuals or families with a taxable income of $10,000.00 or less for mental health services for determinations made under section 818 of the mental health code, 1974 PA 258, MCL 330.1818.
MENTAL HEALTH/SUBSTANCE ABUSE SERVICES ADMINISTRATION AND SPECIAL PROJECTS
Sec. 350. The department may enter into a contract with the protection and advocacy agency, authorized under section 931 of the mental health code, 1974 PA 258, MCL 330.1931, or a similar organization to provide legal services for purposes of gaining and maintaining occupancy in a community living arrangement that is under lease or contract with the department or a community mental health services program to provide services to persons with mental illness or developmental disability.
Sec. 351. The department shall provide $1,800,000.00 in Byrne justice assistance grant program funding to the judiciary by interdepartmental grant.
COMMUNITY MENTAL HEALTH/SUBSTANCE ABUSE SERVICES PROGRAMS
Sec. 401. Funds appropriated in part 1 are intended to support a system of comprehensive community mental health services under the full authority and responsibility of local CMHSPs or PIHPs. The department shall ensure that each CMHSP or PIHP provides all of the following:
(a) A system of single entry and single exit.
(b) A complete array of mental health services that includes, but is not limited to, all of the following services: residential and other individualized living arrangements, outpatient services, acute inpatient services, and long-term, 24-hour inpatient care in a structured, secure environment.
(c) The coordination of inpatient and outpatient hospital services through agreements with state-operated psychiatric hospitals, units, and centers in facilities owned or leased by the state, and privately-owned hospitals, units, and centers licensed by the state pursuant to sections 134 through 149b of the mental health code, 1974 PA 258, MCL 330.1134 to 330.1149b.
(d) Individualized plans of service that are sufficient to meet the needs of individuals, including those discharged from psychiatric hospitals or centers, and that ensure the full range of recipient needs is addressed through the CMHSP’s or PIHP’s program or through assistance with locating and obtaining services to meet these needs.
(e) A system of case management or care management to monitor and ensure the provision of services consistent with the individualized plan of services or supports.
(f) A system of continuous quality improvement.
(g) A system to monitor and evaluate the mental health services provided.
(h) A system that serves at-risk and delinquent youth as required under the provisions of the mental health code, 1974 PA 258, MCL 330.1001 to 330.2106.
Sec. 402. (1) From funds appropriated in part 1, final authorizations to CMHSPs or PIHPs shall be made upon the execution of contracts between the department and CMHSPs or PIHPs. The contracts shall contain an approved plan and budget as well as policies and procedures governing the obligations and responsibilities of both parties to the contracts. Each contract with a CMHSP or PIHP that the department is authorized to enter into under this subsection shall include a provision that the contract is not valid unless the total dollar obligation for all of the contracts between the department and the CMHSPs or PIHPs entered into under this subsection for the current fiscal year does not exceed the amount of money appropriated in part 1 for the contracts authorized under this subsection.
(2) The department shall immediately report to the senate and house appropriations subcommittees on community health, the senate and house fiscal agencies, and the state budget director if either of the following occurs:
(a) Any new contracts with CMHSPs or PIHPs that would affect rates or expenditures are enacted.
(b) Any amendments to contracts with CMHSPs or PIHPs that would affect rates or expenditures are enacted.
(3) The report required by subsection (2) shall include information about the changes and their effects on rates and expenditures.
Sec. 403. (1) From the funds appropriated in part 1 for multicultural services, the department shall ensure that CMHSPs or PIHPs meet with multicultural service providers to develop a workable framework for contracting, service delivery, and reimbursement.
(2) Funds appropriated in part 1 for multicultural services shall not be utilized for services provided to illegal immigrants, fugitive felons, and people who are not residents of this state. The department shall modify contracts with recipients of multicultural services grants to mandate that grantees establish that recipients of services are legally residing in the United States. An exception to the contractual provision will be allowed to address persons presenting with emergent mental health conditions.
(3) The department shall require an annual report from the independent organizations that receive multicultural services funding. The annual report shall include specific information on services and programs provided, the client base to which the services and programs were provided, and the expenditures for those services. The department shall provide the annual reports to the senate and house appropriations subcommittees on community health and the senate and house fiscal agencies.
Sec. 404. (1) Not later than May 31 of the current fiscal year, the department shall provide a report on the community mental health services programs to the members of the house and senate appropriations subcommittees on community health, the house and senate fiscal agencies, and the state budget director that includes the information required by this section.
(2) The report shall contain information for each CMHSP or PIHP and a statewide summary, each of which shall include at least the following information:
(a) A demographic description of service recipients which, minimally, shall include reimbursement eligibility, client population, age, ethnicity, housing arrangements, and diagnosis.
(b) Per capita expenditures by client population group.
(c) Financial information that, minimally, includes a description of funding authorized; expenditures by client group and fund source; and cost information by service category, including administration. Service category includes all department-approved services.
(d) Data describing service outcomes that includes, but is not limited to, an evaluation of consumer satisfaction, consumer choice, and quality of life concerns including, but not limited to, housing and employment.
(e) Information about access to community mental health services programs that includes, but is not limited to, the following:
(i) The number of people receiving requested services.
(ii) The number of people who requested services but did not receive services.
(f) The number of second opinions requested under the code and the determination of any appeals.
(g) An analysis of information provided by CMHSPs in response to the needs assessment requirements of the mental health code, 1974 PA 258, MCL 330.1001 to 330.2106, including information about the number of persons in the service delivery system who have requested and are clinically appropriate for different services.
(h) Lapses and carryforwards during the immediately preceding fiscal year for CMHSPs or PIHPs.
(i) Information about contracts for mental health services entered into by CMHSPs or PIHPs with providers, including, but not limited to, all of the following:
(i) The amount of the contract, organized by type of service provided.
(ii) Payment rates, organized by the type of service provided.
(iii) Administrative costs for services provided to CMHSPs or PIHPs.
(j) Information on the community mental health Medicaid managed care program, including, but not limited to, both of the following:
(i) Expenditures by each CMHSP or PIHP organized by Medicaid eligibility group, including per eligible individual expenditure averages.
(ii) Performance indicator information required to be submitted to the department in the contracts with CMHSPs or PIHPs.
(k) An estimate of the number of direct care workers in local residential settings and paraprofessional and other nonprofessional direct care workers in settings where skill building, community living supports and training, and personal care services are provided by CMHSPs or PIHPs as of September 30 of the prior fiscal year employed directly or through contracts with provider organizations.
(3) The department shall include data reporting requirements listed in subsection (2) in the annual contract with each individual CMHSP or PIHP.
(4) The department shall take all reasonable actions to ensure that the data required are complete and consistent among all CMHSPs or PIHPs.
Sec. 405. (1) It is the intent of the legislature that the employee wage pass-through funded in previous years to the community mental health services programs for direct care workers in local residential settings and for paraprofessional and other nonprofessional direct care workers in settings where skill building, community living supports and training, and personal care services are provided shall continue to be paid to direct care workers.
(2) Each CMHSP awarded wage pass-through money from the funds established under subsection (1) shall report on the actual expenditures of the money in the format determined by the department.
Sec. 406. (1) The funds appropriated in part 1 for the state disability assistance substance abuse services program shall be used to support per diem room and board payments in substance abuse residential facilities. Eligibility of clients for the state disability assistance substance abuse services program shall include needy persons 18 years of age or older, or emancipated minors, who reside in a substance abuse treatment center.
(2) The department shall reimburse all licensed substance abuse programs eligible to participate in the program at a rate equivalent to that paid by the department of human services to adult foster care providers. Programs accredited by department-approved accrediting organizations shall be reimbursed at the personal care rate, while all other eligible programs shall be reimbursed at the domiciliary care rate.
Sec. 407. (1) The amount appropriated in part 1 for substance abuse prevention, education, and treatment grants shall be expended for contracting with coordinating agencies. Coordinating agencies shall work with CMHSPs or PIHPs to coordinate care and services provided to individuals with severe and persistent mental illness and substance abuse diagnoses.
(2) The department shall approve a fee schedule for providing substance abuse services and charge participants in accordance with their ability to pay.
(3) It is the intent of the legislature that the coordinating agencies continue current efforts to collaborate on the delivery of services to those clients with severe and persistent mental illness and substance abuse diagnoses.
(4) Coordinating agencies that are located completely within the boundary of a PIHP shall conduct a study of the administrative costs and efficiencies associated with consolidation with that PIHP. If that coordinating agency realizes an administrative cost savings of 5% or greater of their current costs, then that coordinating agency shall initiate discussions regarding a potential merger in accordance with section 6226 of the public health code, 1978 PA 368, MCL 333.6226.
(5) From the funds appropriated in part 1 for community substance abuse prevention, education, and treatment programs, $100.00 shall be used to fund medically necessary medications prescribed by a physician for the treatment of alcoholism and other substance abuse disorders.
(6) From the funds appropriated in part 1 for community substance abuse prevention, education, and treatment programs, $300,000.00 shall be used to establish a methadone/buprenorphine clinic in a county with a population less than 35,000. The department shall work with a local substance abuse coordinating agency to develop the clinic. The coordinating agency shall serve at least 25 counties.
(7) Effective April 1, 2010, only PIHPs shall be considered substance abuse coordinating agencies for purposes of reimbursement with funds appropriated in part 1.
Sec. 408. (1) By April 15 of the current fiscal year, the department shall report the following data from the prior fiscal year on substance abuse prevention, education, and treatment programs to the senate and house appropriations subcommittees on community health, the senate and house fiscal agencies, and the state budget office:
(a) Expenditures stratified by coordinating agency, by central diagnosis and referral agency, by fund source, by subcontractor, by population served, and by service type. Additionally, data on administrative expenditures by coordinating agency shall be reported.
(b) Expenditures per state client, with data on the distribution of expenditures reported using a histogram approach.
(c) Number of services provided by central diagnosis and referral agency, by subcontractor, and by service type. Additionally, data on length of stay, referral source, and participation in other state programs.
(d) Collections from other first- or third-party payers, private donations, or other state or local programs, by coordinating agency, by subcontractor, by population served, and by service type.
(2) The department shall take all reasonable actions to ensure that the required data reported are complete and consistent among all coordinating agencies.
Sec. 409. The funding in part 1 for substance abuse services shall be distributed in a manner that provides priority to service providers that furnish child care services to clients with children.
Sec. 410. The department shall assure that substance abuse treatment is provided to applicants and recipients of public assistance through the department of human services who are required to obtain substance abuse treatment as a condition of eligibility for public assistance.
Sec. 411. (1) The department shall ensure that each contract with a CMHSP or PIHP requires the CMHSP or PIHP to implement programs to encourage diversion of persons with serious mental illness, serious emotional disturbance, or developmental disability from possible jail incarceration when appropriate.
(2) Each CMHSP or PIHP shall have jail diversion services and shall work toward establishing working relationships with representative staff of local law enforcement agencies, including county prosecutors’ offices, county sheriffs’ offices, county jails, municipal police agencies, municipal detention facilities, and the courts. Written interagency agreements describing what services each participating agency is prepared to commit to the local jail diversion effort and the procedures to be used by local law enforcement agencies to access mental health jail diversion services are strongly encouraged.
Sec. 412. The department shall contract directly with the Salvation Army harbor light program to provide non‑Medicaid substance abuse services.
Sec. 414. Medicaid substance abuse treatment services shall be managed by selected PIHPs pursuant to the centers for Medicare and Medicaid services’ approval of Michigan’s 1915(b) waiver request to implement a managed care plan for specialized substance abuse services. The selected PIHPs shall receive a capitated payment on a per eligible per month basis to assure provision of medically necessary substance abuse services to all beneficiaries who require those services. The selected PIHPs shall be responsible for the reimbursement of claims for specialized substance abuse services. The PIHPs that are not coordinating agencies may continue to contract with a coordinating agency. Any alternative arrangement must be based on client service needs and have prior approval from the department.
Sec. 418. On or before the tenth of each month, the department shall report to the senate and house appropriations subcommittees on community health, the senate and house fiscal agencies, and the state budget director on the amount of funding paid to PIHPs to support the Medicaid managed mental health care program in the preceding month. The information shall include the total paid to each PIHP, per capita rate paid for each eligibility group for each PIHP, and number of cases in each eligibility group for each PIHP, and year-to-date summary of eligibles and expenditures for the Medicaid managed mental health care program.
Sec. 424. Each PIHP that contracts with the department to provide services to the Medicaid population shall adhere to the following timely claims processing and payment procedure for claims submitted by health professionals and facilities:
(a) A “clean claim” as described in section 111i of the social welfare act, 1939 PA 280, MCL 400.111i, shall be paid within 45 days after receipt of the claim by the PIHP. A clean claim that is not paid within this time frame shall bear simple interest at a rate of 12% per annum.
(b) A PIHP must state in writing to the health professional or facility any defect in the claim within 30 days after receipt of the claim.
(c) A health professional and a health facility have 30 days after receipt of a notice that a claim or a portion of a claim is defective within which to correct the defect. The PIHP shall pay the claim within 30 days after the defect is corrected.
Sec. 428. Each PIHP shall provide, from internal resources, local funds to be used as a bona fide part of the state match required under the Medicaid program in order to increase capitation rates for PIHPs. These funds shall not include either state funds received by a CMHSP for services provided to non-Medicaid recipients or the state matching portion of the Medicaid capitation payments made to a PIHP.
Sec. 435. A county required under the provisions of the mental health code, 1974 PA 258, MCL 330.1001 to 330.2106, to provide matching funds to a CMHSP for mental health services rendered to residents in its jurisdiction shall pay the matching funds in equal installments on not less than a quarterly basis throughout the fiscal year, with the first payment being made by October 1 of the current fiscal year.
Sec. 442. (1) It is the intent of the legislature that the $40,000,000.00 in funding transferred from the community mental health non-Medicaid services line to support the Medicaid adult benefits waiver program shall be used to provide state match for increases in federal funding for primary care and specialty services provided to Medicaid adult benefits waiver enrollees and for economic increases for the Medicaid specialty services and supports program.
(2) The department shall assure that persons enrolled in the Medicaid adult benefits waiver program shall receive mental health services as approved in the state plan amendment.
(3) Capitation payments to CMHSPs for persons who become enrolled in the Medicaid adult benefits waiver program shall be made using the same rate methodology as payments for the current Medicaid beneficiaries.
(4) If enrollment in the Medicaid adult benefits waiver program does not achieve expectations and the funding appropriated for the Medicaid adult benefits waiver program for specialty services is not expended, the general fund balance shall be transferred back to the community mental health non-Medicaid services line. The department shall report quarterly to the senate and house appropriations subcommittees on community health a summary of eligible expenditures for the Medicaid adult benefits waiver program by CMHSPs.
Sec. 452. Unless otherwise authorized by law, the department shall not implement retroactively any policy that would lead to a negative financial impact on CMHSPs or PIHPs.
Sec. 456. (1) CMHSPs and PIHPs shall honor consumer choice to the fullest extent possible when providing services and support programs for individuals with mental illness, developmental disabilities, or substance abuse issues. Consumer choices shall include skill-building assistance, rehabilitative and habilitative services, supported and integrated employment services program settings, and other work preparatory services provided in the community or by accredited community-based rehabilitation organizations. CMHSPs and PIHPs shall not arbitrarily eliminate or restrict any choices from the array of services and program settings available to consumers without reasonable justification that those services are not in the consumer’s best interest.
(2) CMHSPs and PIHPs shall take all necessary steps to ensure that individuals with mental illness, developmental disabilities, or substance abuse issues be placed in the least restrictive setting in the quickest amount of time possible if it is the individual’s choice.
Sec. 458. By April 15 of the current fiscal year, the department shall provide each of the following to the house and senate appropriations subcommittees on community health, the house and senate fiscal agencies, and the state budget director:
(a) An updated plan for implementing each of the recommendations of the Michigan mental health commission made in the commission’s report dated October 15, 2004.
(b) A report that evaluates the cost-benefit of establishing secure residential facilities of fewer than 17 beds for adults with serious mental illness, modeled after such programming in Oregon or other states. This report shall examine the potential impact that utilization of secure residential facilities would have upon the state’s need for adult mental health facilities.
(c) In conjunction with the state court administrator’s office, a report that evaluates the cost-benefit of establishing a specialized mental health court program that diverts adults with serious mental illness alleged to have committed an offense deemed nonserious into treatment prior to the filing of any charges.
Sec. 460. (1) The uniform definitions, standards, and instructions for the classification, allocation, assignment, calculation, recording, and reporting of administrative costs by PIHPs, CMHSPs, and contracted organized provider systems that receive payment or reimbursement from funds appropriated under section 104 that were implemented in fiscal year 2006-2007 by the department shall also be implemented for their subcontractors in fiscal year 2009-2010, and shall be consistent with Internal Revenue Service 990 and Office of Management and Budget A-87 guidelines.
(2) The department shall provide the house and senate appropriations subcommittees on community health, the house and senate fiscal agencies, and the state budget director with a progress report on the implementation required under subsection (1). The progress report is due on July 1 of the current fiscal year.
Sec. 462. By October 15 of the current fiscal year, the department shall report to the house and senate appropriations subcommittees on community health, the house and senate fiscal agencies, and the state budget director the funding formula and allocations for all CMHSPs that receive funds appropriated under the community mental health non‑Medicaid services line. The report shall include a comparison of the current fiscal year allocation to the prior fiscal year allocation and describe the factors used in the funding formula to achieve an equitable distribution of funds.
Sec. 463. The department shall use standard program evaluation measures to assess the overall effectiveness of programs provided through coordinating agencies and service providers in reducing and preventing the incidence of substance abuse. The measures established by the department shall be modeled after the program outcome measures and best practice guidelines for the treatment of substance abuse as proposed by the federal substance abuse and mental health services administration.
Sec. 468. To foster a more efficient administration of and to integrate care in publicly funded mental health and substance abuse services, the department shall maintain criteria for the incorporation of a city, county, or regional substance abuse coordinating agency into a local community mental health authority that will encourage those city, county, or regional coordinating agencies to incorporate as local community mental health authorities. If necessary, the department may make accommodations or adjustments in formula distribution to address administrative costs related to the maintenance of the criteria under this section and to the incorporation of the additional coordinating agencies into local community mental health authorities provided that all of the following are satisfied:
(a) The department provides funding for the administrative costs incurred by coordinating agencies incorporating into community mental health authorities. The department shall not provide more than $75,000.00 to any coordinating agency for administrative costs.
(b) The accommodations or adjustments do not favor coordinating agencies who voluntarily elect to integrate with local community mental health authorities.
(c) The accommodations or adjustments do not negatively affect other coordinating agencies.
Sec. 470. (1) For those substance abuse coordinating agencies that have voluntarily incorporated into community mental health authorities and accepted funding from the department for administrative costs incurred pursuant to section 468, the department shall establish written expectations for those CMHSPs, PIHPs, and substance abuse coordinating agencies and counties with respect to the integration of mental health and substance abuse services. At a minimum, the written expectations shall provide for the integration of those services as follows:
(a) Coordination and consolidation of administrative functions and redirection of efficiencies into service enhancements.
(b) Consolidation of points of 24-hour access for mental health and substance abuse services in every community.
(c) Alignment of coordinating agencies and PIHPs boundaries to maximize opportunities for collaboration and integration of administrative functions and clinical activities.
(2) By May 1 of the current fiscal year, the department shall report to the house and senate appropriations subcommittees on community health, the house and senate fiscal agencies, and the state budget office on the impact and effectiveness of this section and the status of the integration of mental health and substance abuse services.
Sec. 474. The department shall ensure that each contract with a CMHSP or PIHP requires the CMHSP or PIHP to provide each recipient and his or her family with information regarding the different types of guardianship and the alternatives to guardianship. A CMHSP or PIHP shall not, in any manner, attempt to reduce or restrict the ability of a recipient or his or her family from seeking to obtain any form of legal guardianship without just cause.
Sec. 480. The department shall provide to the senate and house appropriations subcommittees on community health and the senate and house fiscal agencies by March 30 of the current fiscal year a report on the number and reimbursement cost of atypical antipsychotic prescriptions by each PIHP for Medicaid beneficiaries.
Sec. 482. From the funds appropriated in part 1, the department shall continue funding for programs provided by Odyssey house.
Sec. 483. (1) A Medicaid recipient shall remain eligible and a qualifying applicant shall be determined eligible for medical assistance during a period of incarceration or detention. Medicaid coverage is limited during such a period to off-site inpatient hospitalization only.
(2) A Medicaid recipient is considered incarcerated or detained until released on bail, released as not guilty, released on parole, released on probation, released on pardon, released upon completing a sentence, or released under home detention or tether.
Sec. 489. The department shall work with the Michigan association of community mental health boards and individual CMHSPs in an effort to mitigate necessary reductions to the community mental health non-Medicaid services line by seeking alternative funding sources.
STATE PSYCHIATRIC HOSPITALS, CENTERS FOR PERSONS WITH DEVELOPMENTAL DISABILITIES,
AND FORENSIC AND PRISON MENTAL HEALTH SERVICES
Sec. 601. (1) In funding of staff in the financial support division, reimbursement, and billing and collection sections, priority shall be given to obtaining third-party payments for services. Collection from individual recipients of services and their families shall be handled in a sensitive and nonharassing manner.
(2) The department shall continue a revenue recapture project to generate additional revenues from third parties related to cases that have been closed or are inactive. Revenues collected through project efforts are appropriated to the department for departmental costs and contractual fees associated with these retroactive collections and to improve ongoing departmental reimbursement management functions.
Sec. 602. Unexpended and unencumbered amounts and accompanying expenditure authorizations up to $1,000,000.00 remaining on September 30 of the current fiscal year from the amounts appropriated in part 1 for gifts and bequests for patient living and treatment environments shall be carried forward for 1 fiscal year. The purpose of gifts and bequests for patient living and treatment environments is to use additional private funds to provide specific enhancements for individuals residing at state-operated facilities. Use of the gifts and bequests shall be consistent with the stipulation of the donor. The expected completion date for the use of gifts and bequests donations is within 3 years unless otherwise stipulated by the donor.
Sec. 603. The funds appropriated in part 1 for forensic mental health services provided to the department of corrections are in accordance with the interdepartmental plan developed in cooperation with the department of corrections. The department is authorized to receive and expend funds from the department of corrections in addition to the appropriations in part 1 to fulfill the obligations outlined in the interdepartmental agreements.
Sec. 604. (1) The CMHSPs or PIHPs shall provide annual reports to the department on the following information:
(a) The number of days of care purchased from state hospitals and centers.
(b) The number of days of care purchased from private hospitals in lieu of purchasing days of care from state hospitals and centers.
(c) The number and type of alternative placements to state hospitals and centers other than private hospitals.
(d) Waiting lists for placements in state hospitals and centers.
(2) The department shall annually report the information in subsection (1) to the house and senate appropriations subcommittees on community health, the house and senate fiscal agencies, and the state budget director.
Sec. 605. (1) The department shall not implement any closures or consolidations of state hospitals, centers, or agencies until CMHSPs or PIHPs have programs and services in place for those persons currently in those facilities and a plan for service provision for those persons who would have been admitted to those facilities.
(2) All closures or consolidations are dependent upon adequate department-approved CMHSP and PIHP plans that include a discharge and aftercare plan for each person currently in the facility. A discharge and aftercare plan shall address the person’s housing needs. A homeless shelter or similar temporary shelter arrangements are inadequate to meet the person’s housing needs.
(3) Four months after the certification of closure required in section 19(6) of the state employees’ retirement act, 1943 PA 240, MCL 38.19, the department shall provide a closure plan to the house and senate appropriations subcommittees on community health and the state budget director.
(4) Upon the closure of state-run operations and after transitional costs have been paid, the remaining balances of funds appropriated for that operation shall be transferred to CMHSPs or PIHPs responsible for providing services for persons previously served by the operations.
Sec. 606. The department may collect revenue for patient reimbursement from first- and third-party payers, including Medicaid and local county CMHSP payers, to cover the cost of placement in state hospitals and centers. The department is authorized to adjust financing sources for patient reimbursement based on actual revenues earned. If the revenue collected exceeds current year expenditures, the revenue may be carried forward with approval of the state budget director. The revenue carried forward shall be used as a first source of funds in the subsequent year.
Sec. 608. By March 1, 2010, the department shall update the figures contained in the January 1, 2009 report and, in consultation with the department of management and budget, shall establish and implement a bid process to identify 1 or more private contractors to provide food service and custodial services or otherwise implement opportunities to reduce these costs at those state hospitals identified in the updated report as capable of generating savings through the outsourcing of such services.
Sec. 609. The department shall continue to ban the use of all tobacco products in and on the grounds of state psychiatric facilities. As used in this section, “tobacco product” means a product that contains tobacco and is intended for human consumption, including, but not limited to, cigarettes, noncigarette smoking tobacco, or smokeless tobacco, as those terms are defined in section 2 of the tobacco products tax act, 1993 PA 327, MCL 205.422, and cigars.
Sec. 610. (1) The department shall make every effort to minimize job losses due to any reductions in force or closing of facilities by placing those employees displaced by the reduction or closing within other positions within the department or, to the extent applicable, within other positions in another state department and by encouraging CMHSPs to hire those employees displaced by the reduction or closing.
(2) It is the intent of the legislature that employees displaced by any reductions in force or closing of facilities who are not placed within other positions in the department or hired by a CMHSP be given priority in state programs for job retraining or education, such as the no worker left behind program.
PUBLIC HEALTH ADMINISTRATION
Sec. 650. The department shall communicate the annual public health consumption advisory for sportfish. The department shall, at a minimum, post the advisory on the Internet and make the information in the advisory available to the clients of the women, infants, and children special supplemental nutrition program.
Sec. 651. By April 30 of the current fiscal year, the department shall submit a report to the house and senate fiscal agencies and the state budget director on the activities and efforts of the department to improve the health status of the citizens of this state with regard to the goals and objectives stated in the “Healthy Michigan 2010” report, and the measurable progress made toward those goals and objectives.
HEALTH POLICY, REGULATION, AND PROFESSIONS
Sec. 704. The department shall continue to contract with grantees supported through the appropriation in part 1 for the emergency medical services grants and contracts to ensure that a sufficient number of qualified emergency medical services personnel exist to serve rural areas of the state.
Sec. 706. When hiring any new nursing home inspectors funded through appropriations in part 1, the department shall make every effort to hire qualified individuals with past experience in the long-term care industry.
Sec. 707. The funds appropriated in part 1 for the nursing scholarship program, established in section 16315 of the public health code, 1978 PA 368, MCL 333.16315, shall be used to increase the number of nurses practicing in Michigan. The board of nursing is encouraged to structure scholarships funded under this act in a manner that rewards recipients who intend to practice nursing in Michigan. In addition, the department and the board of nursing shall work cooperatively with the Michigan higher education assistance authority to coordinate scholarship assistance with scholarships provided pursuant to the Michigan nursing scholarship act, 2002 PA 591, MCL 390.1181 to 390.1189.
Sec. 708. Nursing facilities shall report in the quarterly staff report to the department, the total patient care hours provided each month, by state licensure and certification classification, and the percentage of pool staff, by state licensure and certification classification, used each month during the preceding quarter. The department shall make available to the public, the quarterly staff report compiled for all facilities including the total patient care hours and the percentage of pool staff used, by classification.
Sec. 709. The funds appropriated in part 1 for the Michigan essential health care provider program may also provide loan repayment for dentists that fit the criteria established by part 27 of the public health code, 1978 PA 368, MCL 333.2701 to 333.2727.
Sec. 710. From the funds appropriated in part 1 for primary care services, an amount not to exceed $2,172,700.00 is appropriated to enhance the service capacity of the federally qualified health centers and other health centers that are similar to federally qualified health centers.
Sec. 711. The department may make available to interested entities customized listings of nonconfidential information in its possession, such as names and addresses of licensees. The department may establish and collect a reasonable charge to provide this service. The revenue received from this service shall be used to offset expenses to provide the service. Any balance of this revenue collected and unexpended at the end of the fiscal year shall revert to the appropriate restricted fund.
Sec. 712. From the funds appropriated in part 1 for primary care services, $250,000.00 shall be allocated to free health clinics operating in the state. The department shall distribute the funds equally to each free health clinic. For the purpose of this appropriation, free health clinics are nonprofit organizations that use volunteer health professionals to provide care to uninsured individuals.
Sec. 713. The department is directed to continue support of multicultural agencies that provide primary care services from the funds appropriated in part 1.
Sec. 714. The department shall report by April 1 of the current fiscal year to the legislature on the timeliness of nursing facility complaint investigations and the number of allegations that are substantiated on an annual basis. The report shall consist of the number of allegations filed by consumers and the number of facility-reported incidents. The department shall make every effort to contact every complainant and the subject of a complaint during an investigation.
Sec. 716. The department shall give priority in investigations of alleged wrongdoing by licensed health care professionals to instances that are alleged to have occurred within 2 years of the initial complaint.
Sec. 718. The department shall gather information on its most frequently cited complaint deficiencies for the prior 3 fiscal years. The department shall determine whether there is an increase in the number of citations from 1 year to the next and assess the cause of the increase, if any, and whether education and training of nursing facility staff or department staff is needed. The department will implement any training indicated by the study. The department shall provide the results of the study to the senate and house appropriations subcommittees on community health and the senate and house fiscal agencies by May 1 of the current fiscal year.
Sec. 720. From the funds appropriated in part 1 for primary care services, $75,000.00 shall be allocated to the Helen M. Nickless volunteer clinic in Bay City.
Sec. 722. A medical professional who is newly accepted into the Michigan essential health provider program in fiscal year 2008-2009 is eligible for 4 years of loan repayments.
Sec. 724. From the funds appropriated in part 1 for emergency medical services program state staff, up to $100.00 may be allocated for the development of a coordinated statewide trauma care system.
Sec. 725. From the funds appropriated in part 1 for rural health services, up to $100.00 may be allocated to support rural health improvement as identified in “Michigan Strategic Opportunities for Rural Health Improvement, A State Rural Health Plan 2008-2012”. The department shall make these funds available to rural and micropolitan communities under a competitive bid process. The department shall not allocate more than $5,000.00 to each rural or micropolitan community under this section. The department shall not allocate funds appropriated under this section unless a 50/50 state and local match rate has occurred. The department shall submit a report to the house and senate appropriations subcommittees on community health, house and senate fiscal agencies, and state budget director by April 1 of the current fiscal year on the projects supported by this allocation.
Sec. 726. (1) The department shall submit a report to the house and senate appropriations subcommittees on community health, the house and senate fiscal agencies, and the state budget director, on an annual basis, that includes all data on the amount collected from medical marihuana program application and renewal fees along with the cost of administering the medical marihuana program under the Michigan medical marihuana act, 2008 IL 1, MCL 333.26421 to 333.26430.
(2) If the required fees are shown to be insufficient to offset all expenses of implementing and administering the medical marihuana program, the department shall review and revise the application and renewal fees accordingly to ensure that all expenses of implementing and administering the medical marihuana program are offset as is permitted under section 5 of the Michigan medical marihuana act, 2008 IL 1, MCL 333.26425.
Sec. 727. By March 1 of the current fiscal year, the department shall report to the house and senate appropriations subcommittees on community health, the house and senate fiscal agencies, and the state budget director on the feasibility and cost of outsourcing the medical marihuana program. The report shall include the current projected annual cost of the program and the current projected annual fee revenue. If the report identifies privatization savings of 10% or greater and privatization is allowable under the Michigan medical marihuana act, 2008 IL 1, MCL 333.26421 to 333.26430, the department, in consultation with the department of management and budget, shall establish and implement a bid process to identify a private or public contractor to provide management of the medical marihuana program.
INFECTIOUS DISEASE CONTROL
Sec. 801. In the expenditure of funds appropriated in part 1 for AIDS programs, the department and its subcontractors shall ensure that high-risk individuals ages 9 through 18 receive priority for prevention, education, and outreach services.
Sec. 803. The department shall continue the AIDS drug assistance program maintaining the prior year eligibility criteria and drug formulary. This section does not prohibit the department from providing assistance for improved AIDS treatment medications. If the appropriation in part 1 or actual revenue is not sufficient to maintain the prior year eligibility criteria and drug formulary, the department may revise the eligibility criteria and drug formulary in a manner that is consistent with federal program guidelines.
Sec. 804. The department, in conjunction with efforts to implement the Michigan prisoner reentry initiative, shall cooperate with the department of corrections to share data and information as they relate to prisoners being released who are HIV positive or positive for the hepatitis C antibody.
EPIDEMIOLOGY
Sec. 851. The department shall provide a report annually to the house and senate appropriations subcommittees on community health, the senate and house fiscal agencies, and the state budget director on the expenditures and activities undertaken by the lead abatement program. The report shall include, but is not limited to, a funding allocation schedule, expenditures by category of expenditure and by subcontractor, revenues received, description of program elements, and description of program accomplishments and progress.
LOCAL HEALTH ADMINISTRATION AND GRANTS
Sec. 901. The amount appropriated in part 1 for implementation of the 1993 additions of or amendments to sections 9161, 16221, 16226, 17014, 17015, and 17515 of the public health code, 1978 PA 368, MCL 333.9161, 333.16221, 333.16226, 333.17014, 333.17015, and 333.17515, shall reimburse local health departments for costs incurred related to implementation of section 17015(18) of the public health code, 1978 PA 368, MCL 333.17015.
Sec. 902. If a county that has participated in a district health department or an associated arrangement with other local health departments takes action to cease to participate in such an arrangement after October 1 of the current fiscal year, the department shall have the authority to assess a penalty from the local health department’s operational accounts in an amount equal to no more than 6.25% of the local health department’s local public health operations funding. This penalty shall only be assessed to the local county that requests the dissolution of the health department.
Sec. 904. (1) Funds appropriated in part 1 for local public health operations shall be prospectively allocated to local health departments to support immunizations, infectious disease control, sexually transmitted disease control and prevention, hearing screening, vision services, food protection, public water supply, private groundwater supply, and on-site sewage management. Food protection shall be provided in consultation with the Michigan department of agriculture. Public water supply, private groundwater supply, and on-site sewage management shall be provided in consultation with the Michigan department of environmental quality.
(2) Local public health departments shall be held to contractual standards for the services in subsection (1).
(3) Distributions in subsection (1) shall be made only to counties that maintain local spending in the current fiscal year of at least the amount expended in fiscal year 1992-1993 for the services described in subsection (1).
(4) By April 1 of the current fiscal year, the department shall make available a report to the senate and house appropriations subcommittees on community health, the senate and house fiscal agencies, and the state budget director on the planned allocation of the funds appropriated for local public health operations.
CHRONIC DISEASE AND INJURY PREVENTION AND HEALTH PROMOTION
Sec. 1003. Funds appropriated in part 1 for the Alzheimer’s information network shall be used to provide information and referral services through regional networks for persons with Alzheimer’s disease or related disorders, their families, and health care providers.
Sec. 1006. (1) In spending the funds appropriated in part 1 for the smoking prevention program, priority shall be given to prevention and smoking cessation programs for pregnant women, women with young children, and adolescents.
(2) For purposes of complying with 2004 PA 164, $365,000.00 of the funds appropriated in part 1 for the smoking prevention program shall be used for the quit kit program that includes the nicotine patch or nicotine gum.
Sec. 1007. (1) The funds appropriated in part 1 for violence prevention shall be used for, but not be limited to, the following:
(a) Programs aimed at the prevention of spouse, partner, or child abuse and rape.
(b) Programs aimed at the prevention of workplace violence.
(2) In awarding grants from the amounts appropriated in part 1 for violence prevention, the department shall give equal consideration to public and private nonprofit applicants.
(3) From the funds appropriated in part 1 for violence prevention, the department may include local school districts as recipients of the funds for family violence prevention programs.
Sec. 1008. From the funds appropriated in part 1 for the diabetes and kidney program, the department may allocate up to $25,000.00 for a diabetes management pilot project in Muskegon County.
Sec. 1009. From the funds appropriated in part 1 for the diabetes and kidney program, a portion of the funds may be allocated to the National Kidney Foundation of Michigan for kidney disease prevention programming including early identification and education programs and kidney disease prevention demonstration projects.
Sec. 1019. From the funds appropriated in part 1 for chronic disease prevention, $50,000.00 may be allocated for stroke prevention, education, and outreach. The objectives of the program shall include education to assist persons in identifying risk factors, and education to assist persons in the early identification of the occurrence of a stroke in order to minimize stroke damage.
Sec. 1028. Contingent on the availability of state restricted healthy Michigan fund money or federal preventive health and health services block grant fund money, funds may be appropriated for the African-American male health initiative.
Sec. 1031. (1) From the funds appropriated in part 1 for the injury control intervention project, $200,000.00 shall be used to continue 2 incentive-based pilot programs for level I and level II trauma hospitals to ensure greater state utilization of an interactive, evidence-based treatment guideline model for traumatic brain injury.
(2) One pilot program shall be placed in a county with a population of less than 225,000. The other pilot program shall be placed in a county with a population over 1,000,000.
FAMILY, MATERNAL, AND CHILDREN’S HEALTH SERVICES
Sec. 1101. The department shall review the basis for the distribution of funds to local health departments and other public and private agencies for the women, infants, and children food supplement program; family planning; and prenatal care outreach and service delivery support program and indicate the basis upon which any projected underexpenditures by local public and private agencies shall be reallocated to other local agencies that demonstrate need.
Sec. 1104. (1) Before April 1 of the current fiscal year, the department shall submit a report to the house and senate fiscal agencies and the state budget director on planned allocations from the amounts appropriated in part 1 for local MCH services, prenatal care outreach and service delivery support, family planning local agreements, and pregnancy prevention programs. Using applicable federal definitions, the report shall include information on all of the following:
(a) Funding allocations.
(b) Actual number of women, children, and/or adolescents served and amounts expended for each group for the immediately preceding fiscal year.
(c) A breakdown of the expenditure of these funds between urban and rural communities.
(2) The department shall ensure that the distribution of funds through the programs described in subsection (1) takes into account the needs of rural communities.
(3) For the purposes of this section, “rural” means a county, city, village, or township with a population of 30,000 or less, including those entities if located within a metropolitan statistical area.
Sec. 1105. For all family, maternal, and children’s health services programs for which an appropriation is made in part 1, the department shall contract with those local agencies best able to serve clients. Factors to be used by the department in evaluating agencies under this section include the ability to serve high-risk population groups; ability to provide access to individuals in need of services in rural communities; ability to serve low-income clients, where applicable; availability of, and access to, service sites; management efficiency; and ability to meet federal standards, when applicable.
Sec. 1106. Each family planning program receiving federal title X family planning funds under 42 USC 300 to 300a‑8 shall be in compliance with all performance and quality assurance indicators that the office of family planning within the United States department of health and human services specifies in the family planning annual report. An agency not in compliance with the indicators shall not receive supplemental or reallocated funds.
Sec. 1107. (1) Of the amount appropriated in part 1 for prenatal care outreach and service delivery support, not more than 9% shall be expended for local administration, data processing, and evaluation.
(2) The department shall provide to the senate and house appropriations subcommittees on community health, senate and house fiscal agencies, and state budget director a report by March 30 of the current fiscal year that contains all of the following:
(a) The total allocation of state resources made to each recipient agency by individual program and administration.
(b) Detail expenditure by each recipient agency by individual program and administration including both state-funded resources and locally funded resources.
Sec. 1108. The funds appropriated in part 1 for pregnancy prevention programs shall not be used to provide abortion counseling, referrals, or services.
Sec. 1109. (1) From the amounts appropriated in part 1 for dental programs, funds shall be allocated to the Michigan dental association for the administration of a volunteer dental program that provides dental services to the uninsured.
(2) Not later than December 1 of the current fiscal year, the department shall report to the senate and house appropriations subcommittees on community health and the senate and house standing committees on health policy the number of individual patients treated, number of procedures performed, and approximate total market value of those procedures from the immediately preceding fiscal year.
Sec. 1110. Agencies that currently receive pregnancy prevention funds and either receive or are eligible for other family planning funds shall have the option of receiving all of their family planning funds directly from the department and be designated as delegate agencies.
Sec. 1111. The department shall allocate no less than 88% of the funds appropriated in part 1 for family planning local agreements and the pregnancy prevention program for the direct provision of family planning/pregnancy prevention services.
Sec. 1112. From the funds appropriated in part 1 for prenatal care outreach and service delivery support, the department shall allocate at least $1,000,000.00 to communities with high infant mortality rates.
Sec. 1129. The department shall provide a report annually to the house and senate appropriations subcommittees on community health, the house and senate fiscal agencies, and the state budget director on the number of children with elevated blood lead levels from information available to the department. The report shall provide the information by county, shall include the level of blood lead reported, and shall indicate the sources of the information.
Sec. 1133. The department shall release infant mortality rate data to all local public health departments 72 hours or more before releasing infant mortality rate data to the public.
Sec. 1135. (1) Provision of the school health education curriculum, such as the Michigan model or another comprehensive school health education curriculum, shall be in accordance with the health education goals established by the Michigan model for comprehensive school health education state steering committee. The state steering committee shall be comprised of a representative from each of the following offices and departments:
(a) The department of education.
(b) The department of community health.
(c) The health administration in the department of community health.
(d) The bureau of mental health and substance abuse services in the department of community health.
(e) The department of human services.
(f) The department of state police.
(2) Upon written or oral request, a pupil not less than 18 years of age or a parent or legal guardian of a pupil less than 18 years of age, within a reasonable period of time after the request is made, shall be informed of the content of a course in the health education curriculum and may examine textbooks and other classroom materials that are provided to the pupil or materials that are presented to the pupil in the classroom. This subsection does not require a school board to permit pupil or parental examination of test questions and answers, scoring keys, or other examination instruments or data used to administer an academic examination.
Sec. 1137. From the funds appropriated in part 1 for special projects, up to $100.00 may be allocated to support an Alzheimer’s disease patient care training program involving a community college and a retirement community.
Sec. 1138. From the funds appropriated in part 1 for special projects, up to $100.00 shall be allocated to the Ele’s Place organization in Lansing.
Sec. 1139. From the funds appropriated in part 1 for prenatal care outreach and service delivery support, the department shall fund the Kalamazoo nurse family partnership at the same level of funding as was provided in fiscal year 2007-2008.
WOMEN, INFANTS, AND CHILDREN FOOD AND NUTRITION PROGRAM
Sec. 1151. The department may work with local participating agencies to define local annual contributions for the farmer’s market nutrition program, project FRESH, to enable the department to request federal matching funds based on local commitment of funds.
Sec. 1153. The department shall ensure that individuals residing in rural communities have sufficient access to the services offered through the WIC program.
CHILDREN’S SPECIAL HEALTH CARE SERVICES
Sec. 1201. Funds appropriated in part 1 for medical care and treatment of children with special health care needs shall be paid according to reimbursement policies determined and published by the Michigan medical services program.
Sec. 1202. The department may do 1 or more of the following:
(a) Provide special formula for eligible clients with specified metabolic and allergic disorders.
(b) Provide medical care and treatment to eligible patients with cystic fibrosis who are 21 years of age or older.
(c) Provide genetic diagnostic and counseling services for eligible families.
(d) Provide medical care and treatment to eligible patients with hereditary coagulation defects, commonly known as hemophilia, who are 21 years of age or older.
Sec. 1203. All children who are determined medically eligible for the children’s special health care services program shall be referred to the appropriate locally-based services program in their community.
Sec. 1204. Effective July 1, 2010, children who are determined medically eligible for and enroll in the children’s special health care services program and who also have Medicaid will have the option to enroll in a Medicaid health plan and have their care co-managed by the children’s special health care services program.
CRIME VICTIM SERVICES COMMISSION
Sec. 1302. From the funds appropriated in part 1 for justice assistance grants, up to $200,000.00 shall be allocated for expansion of forensic nurse examiner programs to facilitate training for improved evidence collection for the prosecution of sexual assault. The funds shall be used for program coordination and training.
Sec. 1304. The department shall work with the department of state police, the Michigan health and hospital association, the Michigan state medical society, and the Michigan nurses association to ensure that the recommendations included in the “Standard Recommended Procedures for the Emergency Treatment of Sexual Assault Victims” are followed in the collection of evidence.
OFFICE OF SERVICES TO THE AGING
Sec. 1401. The appropriation in part 1 to the office of services to the aging for community services and nutrition services shall be restricted to eligible individuals at least 60 years of age who fail to qualify for home care services under title XVIII, XIX, or XX.
Sec. 1403. (1) The office of services to the aging shall require each region to report to the office of services to the aging and to the legislature home-delivered meals waiting lists based upon standard criteria. Determining criteria shall include all of the following:
(a) The recipient’s degree of frailty.
(b) The recipient’s inability to prepare his or her own meals safely.
(c) Whether the recipient has another care provider available.
(d) Any other qualifications normally necessary for the recipient to receive home-delivered meals.
(2) Data required in subsection (1) shall be recorded only for individuals who have applied for participation in the home-delivered meals program and who are initially determined as likely to be eligible for home-delivered meals.
Sec. 1404. The area agencies and local providers may receive and expend fees for the provision of day care, care management, respite care, and certain eligible home- and community-based services. The fees shall be based on a sliding scale, taking client income into consideration. The fees shall be used to expand services.
Sec. 1406. The appropriation of $4,468,700.00 of merit award trust funds to the office of services to the aging for the respite care program shall be allocated in accordance with a long-term care plan developed by the long-term care working group established in section 1657 of 1998 PA 336 upon implementation of the plan. The use of the funds shall be for direct respite care or adult respite care center services. Not more than 9% of the amount allocated under this section shall be expended for administration and administrative purposes.
Sec. 1413. Local counties may request to change membership in the area agencies on aging if the change is to an area agency on aging that is contiguous to that county pursuant to office of services to the aging policies and procedures for area agency on aging designation. The office of services to the aging shall adjust allocations to area agencies on aging to account for any changes in county membership. The office of services to the aging shall ensure annually that county boards of commissioners are aware that county membership in area agencies on aging can be changed subject to office of services to the aging policies and procedures for area agency on aging designation.
Sec. 1417. The department shall provide to the senate and house appropriations subcommittees on community health, senate and house fiscal agencies, and state budget director a report by March 30 of the current fiscal year that contains all of the following:
(a) The total allocation of state resources made to each area agency on aging by individual program and administration.
(b) Detail expenditure by each area agency on aging by individual program and administration including both state-funded resources and locally funded resources.
Sec. 1418. From the funds appropriated in part 1 for nutrition services, the department shall maximize funding for home-delivered meals to the extent allowable under federal law and regulation.
Sec. 1419. From the funds appropriated in part 1 for nutrition services, $120,100.00 shall be allocated to provide an interdepartmental grant to the department of agriculture to support the Michigan agricultural surplus system.
MEDICAL SERVICES
Sec. 1601. The cost of remedial services incurred by residents of licensed adult foster care homes and licensed homes for the aged shall be used in determining financial eligibility for the medically needy. Remedial services include basic self-care and rehabilitation training for a resident.
Sec. 1602. Medical services shall be provided to elderly and disabled persons with incomes less than or equal to 100% of the official poverty level, pursuant to the state’s option to elect such coverage set out at section 1902(a)(10)(A)(ii) and (m) of title XIX, 42 USC 1396a.
Sec. 1603. (1) The department may establish a program for persons to purchase medical coverage at a rate determined by the department.
(2) The department may receive and expend premiums for the buy-in of medical coverage in addition to the amounts appropriated in part 1.
(3) The premiums described in this section shall be classified as private funds.
Sec. 1605. (1) The protected income level for Medicaid coverage determined pursuant to section 106(1)(b)(iii) of the social welfare act, 1939 PA 280, MCL 400.106, shall be 100% of the related public assistance standard.
(2) The department shall notify the senate and house appropriations subcommittees on community health and the state budget director of any proposed revisions to the protected income level for Medicaid coverage related to the public assistance standard 90 days prior to implementation.
Sec. 1606. For the purpose of guardian and conservator charges, the department of community health may deduct up to $60.00 per month as an allowable expense against a recipient’s income when determining medical services eligibility and patient pay amounts.
Sec. 1607. (1) An applicant for Medicaid, whose qualifying condition is pregnancy, shall immediately be presumed to be eligible for Medicaid coverage unless the preponderance of evidence in her application indicates otherwise. The applicant who is qualified as described in this subsection shall be allowed to select or remain with the Medicaid participating obstetrician of her choice.
(2) An applicant qualified as described in subsection (1) shall be given a letter of authorization to receive Medicaid covered services related to her pregnancy. All qualifying applicants shall be entitled to receive all medically necessary obstetrical and prenatal care without preauthorization from a health plan. All claims submitted for payment for obstetrical and prenatal care shall be paid at the Medicaid fee-for-service rate in the event a contract does not exist between the Medicaid participating obstetrical or prenatal care provider and the managed care plan. The applicant shall receive a listing of Medicaid physicians and managed care plans in the immediate vicinity of the applicant’s residence.
(3) In the event that an applicant, presumed to be eligible pursuant to subsection (1), is subsequently found to be ineligible, a Medicaid physician or managed care plan that has been providing pregnancy services to an applicant under this section is entitled to reimbursement for those services until such time as they are notified by the department that the applicant was found to be ineligible for Medicaid.
(4) If the preponderance of evidence in an application indicates that the applicant is not eligible for Medicaid, the department shall refer that applicant to the nearest public health clinic or similar entity as a potential source for receiving pregnancy-related services.
(5) The department shall develop an enrollment process for pregnant women covered under this section that facilitates the selection of a managed care plan at the time of application.
(6) The department shall mandate enrollment of women, whose qualifying condition is pregnancy, into Medicaid managed care plans.
(7) The department shall encourage physicians to provide women, whose qualifying condition for Medicaid is pregnancy, with a referral to a Medicaid participating dentist at the first pregnancy-related appointment.
Sec. 1610. The department shall provide an administrative procedure for the review of cost report grievances by medical services providers with regard to reimbursement under the medical services program. Settlements of properly submitted cost reports shall be paid not later than 9 months from receipt of the final report.
Sec. 1611. (1) For care provided to medical services recipients with other third-party sources of payment, medical services reimbursement shall not exceed, in combination with such other resources, including Medicare, those amounts established for medical services-only patients. The medical services payment rate shall be accepted as payment in full. Other than an approved medical services co-payment, no portion of a provider’s charge shall be billed to the recipient or any person acting on behalf of the recipient. Nothing in this section shall be considered to affect the level of payment from a third-party source other than the medical services program. The department shall require a nonenrolled provider to accept medical services payments as payment in full.
(2) Notwithstanding subsection (1), medical services reimbursement for hospital services provided to dual Medicare/medical services recipients with Medicare part B coverage only shall equal, when combined with payments for Medicare and other third-party resources, if any, those amounts established for medical services-only patients, including capital payments.
Sec. 1620. (1) For fee-for-service recipients who do not reside in nursing homes, the pharmaceutical dispensing fee shall be $2.75 or the pharmacy’s usual or customary cash charge, whichever is less. For nursing home residents, the pharmaceutical dispensing fee shall be $3.00 or the pharmacy’s usual or customary cash charge, whichever is less.
(2) The department shall require a prescription co-payment for Medicaid recipients of $1.00 for a generic drug and $3.00 for a brand-name drug, except as prohibited by federal or state law or regulation.
(3) It is the intent of the legislature that if the department realizes savings as a result of the implementation of average manufacturer’s price for reimbursement of multiple source generic medication dispensing as imposed pursuant to the federal deficit reduction act of 2005, Public Law 109-171, the savings shall be returned to pharmacies in the form of an increased dispensing fee for medications not to exceed $2.00. The savings shall be calculated as the difference in state expenditure between the current methodology of payment, which is maximum allowable cost, and the proposed new reimbursement method of average manufacturer’s price.
Sec. 1621. The department may implement prospective drug utilization review and disease management systems. The prospective drug utilization review, a pharmacist-approved medication therapy program, and disease management systems authorized by this section shall have physician oversight, shall focus on patient, physician, and pharmacist education, and shall be developed in consultation with the national pharmaceutical council, Michigan state medical society, Michigan osteopathic association, Michigan pharmacists association, Michigan health and hospital association, and Michigan nurses association.
Sec. 1623. (1) The department shall continue the Medicaid policy that allows for the dispensing of a 100-day supply for maintenance drugs.
(2) The department shall notify all HMOs, physicians, pharmacies, and other medical providers that are enrolled in the Medicaid program that Medicaid policy allows for the dispensing of a 100-day supply for maintenance drugs.
(3) The notice in subsection (2) shall also clarify that a pharmacy shall fill a prescription written for maintenance drugs in the quantity specified by the physician, but not more than the maximum allowed under Medicaid, unless subsequent consultation with the prescribing physician indicates otherwise.
Sec. 1627. (1) The department shall use procedures and rebates amounts specified under section 1927 of title XIX, 42 USC 1396r-8, to secure quarterly rebates from pharmaceutical manufacturers for outpatient drugs dispensed to participants in the MIChild program, maternal outpatient medical services program, children’s special health care services, and adult benefit waiver program.
(2) For products distributed by pharmaceutical manufacturers not providing quarterly rebates as listed in subsection (1), the department may require preauthorization.
Sec. 1629. The department shall utilize maximum allowable cost pricing for generic drugs that is based on wholesaler pricing to providers that is available from at least 2 wholesalers who deliver in the state of Michigan.
Sec. 1630. (1) Medicaid coverage for podiatric services, adult dental services, and chiropractic services shall continue at not less than the level in effect on October 1, 2002, except that reasonable utilization limitations may be adopted in order to prevent excess utilization. The department shall not impose utilization restrictions on chiropractic services unless a recipient has exceeded 18 office visits within 1 year.
(2) The department may implement the bulk purchase of hearing aids, impose limitations on binaural hearing aid benefits, and limit the replacement of hearing aids to once every 3 years.
Sec. 1631. (1) The department shall require co-payments on dental, podiatric, chiropractic, vision, and hearing aid services provided to Medicaid recipients, except as prohibited by federal or state law or regulation.
(2) Except as otherwise prohibited by federal or state law or regulations, the department shall require Medicaid recipients to pay the following co-payments:
(a) Two dollars for a physician office visit.
(b) Three dollars for a hospital emergency room visit.
(c) Fifty dollars for the first day of an inpatient hospital stay.
(d) One dollar for an outpatient hospital visit.
Sec. 1633. By March 1 of the current fiscal year, the department shall report to the house and senate appropriations subcommittees on community health, the house and senate fiscal agencies, and the state budget director on the feasibility of providing healthy kids dental coverage in cities rather than entire counties.
Sec. 1635. From the funds appropriated in part 1 for physician services and health plan services, the department shall continue the increase in Medicaid reimbursement rates for obstetrical services implemented in fiscal year 2005‑2006.
Sec. 1636. From the funds appropriated in part 1 for physician services and health plan services, the department shall continue the increase in Medicaid reimbursement rates for physician well child procedure codes and primary care procedure codes implemented in fiscal year 2006-2007 and fiscal year 2008-2009. The increased reimbursement rates in this section shall not exceed the comparable Medicare payment rate for the same services.
Sec. 1637. (1) All adult Medicaid recipients shall be offered the opportunity to sign a Medicaid personal responsibility agreement.
(2) The personal responsibility agreement shall include at minimum the following provisions:
(a) That the recipient shall not smoke.
(b) That the recipient shall attend all scheduled medical appointments.
(c) That the recipient shall exercise regularly.
(d) That if the recipient has children, those children shall be up to date on their immunizations.
(e) That the recipient shall abstain from abusing controlled substances and narcotics.
Sec. 1641. An institutional provider that is required to submit a cost report under the medical services program shall submit cost reports completed in full within 5 months after the end of its fiscal year.
Sec. 1642. The department shall continue to allow ambulatory surgery centers in this state to fully participate in the Medicaid program when hospitals are reimbursed for Medicaid services through the new Michigan Medicaid information system. Ambulatory surgery centers that provide services to Medicaid eligible patients shall be reimbursed in the same manner as hospitals. The reimbursement schedule for ambulatory surgery centers that was developed and implemented in consultation with the industry in fiscal year 2007-2008 shall continue to be used in fiscal year 2009-2010.
Sec. 1643. Of the funds appropriated in part 1 for graduate medical education in the hospital services and therapy line-item appropriation, not less than $10,947,400.00 shall be allocated for the psychiatric residency training program that establishes and maintains collaborative relations with the schools of medicine at Michigan State University and Wayne State University if the necessary allowable Medicaid matching funds are provided by the universities.
Sec. 1647. From the funds appropriated in part 1 for medical services, the department shall allocate for graduate medical education not less than the level of rates and payments in effect on April 1, 2005.
Sec. 1648. The department shall maintain and make available an online resource to enable medical providers to obtain enrollment and benefit information of Medicaid recipients. There shall be no charge to providers for the use of the online resource.
Sec. 1649. From the funds appropriated in part 1 for medical services, the department shall continue breast and cervical cancer treatment coverage for women up to 250% of the federal poverty level, who are under age 65, and who are not otherwise covered by insurance. This coverage shall be provided to women who have been screened through the centers for disease control breast and cervical cancer early detection program, and are found to have breast or cervical cancer, pursuant to the breast and cervical cancer prevention and treatment act of 2000, Public Law 106-354.
Sec. 1650. (1) The department may require medical services recipients residing in counties offering managed care options to choose the particular managed care plan in which they wish to be enrolled. Persons not expressing a preference may be assigned to a managed care provider.
(2) Persons to be assigned a managed care provider shall be informed in writing of the criteria for exceptions to capitated managed care enrollment, their right to change HMOs for any reason within the initial 90 days of enrollment, the toll-free telephone number for problems and complaints, and information regarding grievance and appeals rights.
(3) The criteria for medical exceptions to HMO enrollment shall be based on submitted documentation that indicates a recipient has a serious medical condition, and is undergoing active treatment for that condition with a physician who does not participate in 1 of the HMOs. If the person meets the criteria established by this subsection, the department shall grant an exception to mandatory enrollment at least through the current prescribed course of treatment, subject to periodic review of continued eligibility.
Sec. 1651. (1) Medical services patients who are enrolled in HMOs have the choice to elect hospice services or other services for the terminally ill that are offered by the HMOs. If the patient elects hospice services, those services shall be provided in accordance with part 214 of the public health code, 1978 PA 368, MCL 333.21401 to 333.21420.
(2) The department shall not amend the medical services hospice manual in a manner that would allow hospice services to be provided without making available all comprehensive hospice services described in 42 CFR part 418.
Sec. 1652. Any new contracts with Medicaid health plans negotiated or signed, or both, during the current fiscal year shall include the following provisions regarding expansion of services by the Medicaid HMOs to counties not previously served by that Medicaid HMO:
(a) The Medicaid HMO shall not sell, transfer, or otherwise convey to any person all or any portion of the HMO’s assets or business, whether in the form of equity, debt or otherwise, for a period of 3 years from the date the Medicaid HMO commences operations in a new service area.
(b) That any Medicaid HMOs that expand into a county with a population of at least 1,500,000 shall also expand its coverage to a county with a population of less than 100,000 which has 1 or fewer HMOs participating in the Medicaid program.
Sec. 1653. Implementation and contracting for managed care by the department through HMOs shall be subject to the following conditions:
(a) Continuity of care is assured by allowing enrollees to continue receiving required medically necessary services from their current providers for a period not to exceed 1 year if enrollees meet the managed care medical exception criteria.
(b) The department shall require contracted HMOs to submit data determined necessary for evaluation on a timely basis.
(c) Mandatory enrollment of Medicaid beneficiaries living in counties defined as rural by the federal government, which is any nonurban standard metropolitan statistical area, is allowed if there is only 1 HMO serving the Medicaid population, as long as each Medicaid beneficiary is assured of having a choice of at least 2 physicians by the HMO.
(d) Enrollment of recipients of children’s special health care services in HMOs shall continue to be voluntary for those enrolled in the children’s special health care services program before October 1, 2009. Children’s special health care services recipients shall be informed of the opportunity to enroll in HMOs.
(e) The department shall develop a case adjustment to its rate methodology that considers the costs of persons with HIV/AIDS, end stage renal disease, organ transplants, and other high-cost diseases or conditions and shall implement the case adjustment when it is proven to be actuarially and fiscally sound. Implementation of the case adjustment must be budget neutral.
(f) Prior to contracting with an HMO for managed care services that did not have a contract with the department before October 1, 2002, the department shall receive assurances from the office of financial and insurance regulation that the HMO meets the net worth and financial solvency requirements contained in chapter 35 of the insurance code of 1956, 1956 PA 218, MCL 500.3501 to 500.3580.
Sec. 1654. Medicaid HMOs shall provide for reimbursement of HMO covered services delivered other than through the HMO’s providers if medically necessary and approved by the HMO, immediately required, and that could not be reasonably obtained through the HMO’s providers on a timely basis. Such services shall be considered approved if the HMO does not respond to a request for authorization within 24 hours of the request. Reimbursement shall not exceed the Medicaid fee-for-service payment for those services.
Sec. 1655. (1) The department may require a 12-month lock-in to the HMO selected by the recipient during the initial and subsequent open enrollment periods, but allow for good cause exceptions during the lock-in period.
(2) Medicaid recipients shall be allowed to change HMOs for any reason within the initial 90 days of enrollment.
Sec. 1656. (1) The department shall provide an expedited complaint review procedure for Medicaid eligible persons enrolled in HMOs for situations in which failure to receive any health care service would result in significant harm to the enrollee.
(2) The department shall provide for a toll-free telephone number for Medicaid recipients enrolled in managed care to assist with resolving problems and complaints. If warranted, the department shall immediately disenroll persons from managed care and approve fee-for-service coverage.
Sec. 1657. (1) Reimbursement for medical services to screen and stabilize a Medicaid recipient, including stabilization of a psychiatric crisis, in a hospital emergency room shall not be made contingent on obtaining prior authorization from the recipient’s HMO. If the recipient is discharged from the emergency room, the hospital shall notify the recipient’s HMO within 24 hours of the diagnosis and treatment received.
(2) If the treating hospital determines that the recipient will require further medical service or hospitalization beyond the point of stabilization, that hospital must receive authorization from the recipient’s HMO prior to admitting the recipient.
(3) Subsections (1) and (2) shall not be construed as a requirement to alter an existing agreement between an HMO and their contracting hospitals nor as a requirement that an HMO must reimburse for services that are not considered to be medically necessary.
Sec. 1658. (1) HMOs shall have contracts with hospitals within a reasonable distance from their enrollees. If a hospital does not contract with the HMO in its service area, that hospital shall enter into a hospital access agreement as specified in the Medical Services Administration Bulletin Hospital 01-19.
(2) A hospital access agreement specified in subsection (1) shall be considered an affiliated provider contract pursuant to the requirements contained in chapter 35 of the insurance code of 1956, 1956 PA 218, MCL 500.3501 to 500.3580.
Sec. 1659. The following sections of this act are the only ones that shall apply to the following Medicaid managed care programs, including the comprehensive plan, MIChoice long-term care plan, and the mental health, substance abuse, and developmentally disabled services program: 271, 288, 401, 402, 404, 411, 414, 418, 424, 428, 456, 462, 1607, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1660, 1661, 1662, 1699, 1711, 1752, 1783, 1787, 1791, 1815, 1820, 1821, and 1828.
Sec. 1660. (1) The department shall assure that all Medicaid children have timely access to EPSDT services as required by federal law. Medicaid HMOs shall provide EPSDT services to their child members in accordance with Medicaid EPSDT policy.
(2) The primary responsibility of assuring a child’s hearing and vision screening is with the child’s primary care provider. The primary care provider shall provide age-appropriate screening or arrange for these tests through referrals to local health departments. Local health departments shall provide preschool hearing and vision screening services and accept referrals for these tests from physicians or from Head Start programs in order to assure all preschool children have appropriate access to hearing and vision screening. Local health departments shall be reimbursed for the cost of providing these tests for Medicaid eligible children by the Medicaid program.
(3) The department shall prohibit HMOs from requiring prior authorization of their contracted providers for any EPSDT screening and diagnosis services.
(4) The department shall require HMOs to be responsible for well child visits as described in Medicaid policy. These responsibilities shall be specified in the information distributed by the HMOs to their members.
(5) The department shall provide, on an annual basis, budget-neutral incentives to Medicaid HMOs and local health departments to improve performance on measures related to the care of children.
Sec. 1661. (1) The department shall assure that all Medicaid eligible children and pregnant women have timely access to MIHP services. Medicaid HMOs shall assure that MIHP screening is available to their pregnant members and that those women found to meet the MIHP high-risk criteria are offered maternal support services. Local health departments shall assure that MIHP screening is available for Medicaid pregnant women and that those women found to meet the MIHP high-risk criteria are offered MIHP services or are referred to a certified MIHP provider.
(2) The department shall require HMOs to be responsible for the coordination of MIHP services as described in Medicaid policy. These responsibilities shall be specified in the information distributed by the HMOs to their members.
(3) The department shall assure the coordination of MIHP services with the WIC program, state-supported substance abuse, smoking prevention, and violence prevention programs, the department of human services, and any other state or local program with a focus on preventing adverse birth outcomes and child abuse and neglect.
(4) The department shall provide, on an annual basis, budget-neutral incentives to Medicaid HMOs and local health departments to improve performance on measures related to the care of pregnant women.
Sec. 1662. (1) The department shall assure that an external quality review of each contracting HMO is performed that results in an analysis and evaluation of aggregated information on quality, timeliness, and access to health care services that the HMO or its contractors furnish to Medicaid beneficiaries.
(2) The department shall require Medicaid HMOs to provide EPSDT utilization data through the encounter data system, and health employer data and information set well child health measures in accordance with the National Committee on Quality Assurance prescribed methodology.
(3) The department shall provide a copy of the analysis of the Medicaid HMO annual audited health employer data and information set reports and the annual external quality review report to the senate and house of representatives appropriations subcommittees on community health, the senate and house fiscal agencies, and the state budget director, within 30 days of the department’s receipt of the final reports from the contractors.
(4) The department shall work with the Michigan association of health plans and the Michigan association for local public health to improve service delivery and coordination in the MIHP and EPSDT programs.
(5) The department shall assure that training and technical assistance are available for EPSDT and MIHP for Medicaid health plans, local health departments, and MIHP contractors.
Sec. 1670. (1) The appropriation in part 1 for the MIChild program is to be used to provide comprehensive health care to all children under age 19 who reside in families with income at or below 200% of the federal poverty level, who are uninsured and have not had coverage by other comprehensive health insurance within 6 months of making application for MIChild benefits, and who are residents of this state. The department shall develop detailed eligibility criteria through the medical services administration public concurrence process, consistent with the provisions of this act. Health coverage for children in families between 150% and 200% of the federal poverty level shall be provided through a state-based private health care program.
(2) The department may provide up to 1 year of continuous eligibility to children eligible for the MIChild program unless the family fails to pay the monthly premium, a child reaches age 19, or the status of the children’s family changes and its members no longer meet the eligibility criteria as specified in the federally approved MIChild state plan.
(3) Children whose category of eligibility changes between the Medicaid and MIChild programs shall be assured of keeping their current health care providers through the current prescribed course of treatment for up to 1 year, subject to periodic reviews by the department if the beneficiary has a serious medical condition and is undergoing active treatment for that condition.
(4) To be eligible for the MIChild program, a child must be residing in a family with an adjusted gross income of less than or equal to 200% of the federal poverty level. The department’s verification policy shall be used to determine eligibility.
(5) The department shall enter into a contract to obtain MIChild services from any HMO, dental care corporation, or any other entity that offers to provide the managed health care benefits for MIChild services at the MIChild capitated rate. As used in this subsection:
(a) “Dental care corporation”, “health care corporation”, “insurer”, and “prudent purchaser agreement” mean those terms as defined in section 2 of the prudent purchaser act, 1984 PA 233, MCL 550.52.
(b) “Entity” means a health care corporation or insurer operating in accordance with a prudent purchaser agreement.
(6) The department may enter into contracts to obtain certain MIChild services from community mental health service programs.
(7) The department may make payments on behalf of children enrolled in the MIChild program from the line-item appropriation associated with the program as described in the MIChild state plan approved by the United States department of health and human services, or from other medical services.
(8) The department shall assure that an external quality review of each MIChild contractor, as described in subsection (5), is performed, which analyzes and evaluates the aggregated information on quality, timeliness, and access to health care services that the contractor furnished to MIChild beneficiaries.
(9) The department shall develop an automatic enrollment algorithm that is based on quality and performance factors.
Sec. 1671. From the funds appropriated in part 1, the department shall continue a comprehensive approach to the marketing and outreach of the MIChild program. The marketing and outreach required under this section shall be coordinated with current outreach, information dissemination, and marketing efforts and activities conducted by the department.
Sec. 1673. The department may establish premiums for MIChild eligible persons in families with income above 150% of the federal poverty level. The monthly premiums shall not be less than $10.00 or exceed $15.00 for a family.
Sec. 1677. The MIChild program shall provide all benefits available under the state employee insurance plan that are delivered through contracted providers and consistent with federal law, including, but not limited to, the following medically necessary services:
(a) Inpatient mental health services, other than substance abuse treatment services, including services furnished in a state-operated mental hospital and residential or other 24-hour therapeutically planned structured services.
(b) Outpatient mental health services, other than substance abuse services, including services furnished in a state‑operated mental hospital and community-based services.
(c) Durable medical equipment and prosthetic and orthotic devices.
(d) Dental services as outlined in the approved MIChild state plan.
(e) Substance abuse treatment services that may include inpatient, outpatient, and residential substance abuse treatment services.
(f) Care management services for mental health diagnoses.
(g) Physical therapy, occupational therapy, and services for individuals with speech, hearing, and language disorders.
(h) Emergency ambulance services.
Sec. 1680. Payment increases for enhanced wages and new or enhanced employee benefits provided in previous years through the Medicaid nursing home wage pass-through program shall be continued.
Sec. 1681. From the funds appropriated in part 1 for home- and community-based services, the department and local waiver agents shall encourage the use of family members, friends, and neighbors of home- and community-based services participants, where appropriate, to provide homemaker services, meal preparation, transportation, chore services, and other nonmedical covered services to participants in the Medicaid home- and community-based services program. This section shall not be construed as allowing for the payment of family members, friends, or neighbors for these services unless explicitly provided for in federal or state law.
Sec. 1682. (1) The department shall implement enforcement actions as specified in the nursing facility enforcement provisions of section 1919 of title XIX, 42 USC 1396r.
(2) In addition to the appropriations in part 1, the department is authorized to receive and spend penalty money received as the result of noncompliance with medical services certification regulations. Penalty money, characterized as private funds, received by the department shall increase authorizations and allotments in the long-term care accounts.
(3) The department is authorized to provide civil monetary penalty funds to the disability network of Michigan to be distributed to the 15 centers for independent living for the purpose of assisting individuals with disabilities who reside in nursing homes to return to their own homes.
(4) The department is authorized to use civil monetary penalty funds to conduct a survey evaluating consumer satisfaction and the quality of care at nursing homes. Factors can include, but are not limited to, the level of satisfaction of nursing home residents, their families, and employees. The department may use an independent contractor to conduct the survey.
(5) Any unexpended penalty money, at the end of the year, shall carry forward to the following year.
Sec. 1683. The department shall promote activities that preserve the dignity and rights of terminally ill and chronically ill individuals. Priority shall be given to programs, such as hospice, that focus on individual dignity and quality of care provided persons with terminal illness and programs serving persons with chronic illnesses that reduce the rate of suicide through the advancement of the knowledge and use of improved, appropriate pain management for these persons; and initiatives that train health care practitioners and faculty in managing pain, providing palliative care, and suicide prevention.
Sec. 1684. The department shall submit a report by September 30, 2010 to the house and senate appropriations subcommittees on community health, the house and senate fiscal agencies, and the state budget director that will identify by waiver agent, Medicaid home- and community-based services waiver costs by administration, case management, and direct services.
Sec. 1685. All nursing home rates, class I and class III, must have their respective fiscal year rate set 30 days prior to the beginning of their rate year. Rates may take into account the most recent cost report prepared and certified by the preparer, provider corporate owner or representative as being true and accurate, and filed timely, within 5 months of the fiscal year end in accordance with Medicaid policy. If the audited version of the last report is available, it shall be used. Any rate factors based on the filed cost report may be retroactively adjusted upon completion of the audit of that cost report.
Sec. 1687. The department shall study the feasibility, impact, and cost of supporting a Medicaid rate enhancement to be used exclusively to fund affordable, accessible, and adequate health insurance for direct care workers in nursing homes, adult foster care homes, homes for the aged, and home- and community-based services programs. The department shall report its findings and recommendations to the senate and house appropriations subcommittees on community health and the senate and house fiscal agencies by April 1, 2010.
Sec. 1688. The department shall not impose a limit on per unit reimbursements to service providers that provide personal care or other services under the Medicaid home- and community-based services waiver program for the elderly and disabled. The department’s per day per client reimbursement cap calculated in the aggregate for all services provided under the Medicaid home- and community-based services waiver is not a violation of this section.
Sec. 1689. (1) Priority in enrolling additional persons in the Medicaid home- and community-based services waiver program shall be given to those who are currently residing in nursing homes or who are eligible to be admitted to a nursing home if they are not provided home- and community-based services. The department shall use screening and assessment procedures to assure that no additional Medicaid eligible persons are admitted to nursing homes who would be more appropriately served by the Medicaid home- and community-based services waiver program.
(2) Within 60 days of the end of each fiscal quarter, the department shall provide a report to the senate and house appropriations subcommittees on community health and the senate and house fiscal agencies that details existing and future allocations for the home- and community-based services waiver program by regions as well as the associated expenditures. The report shall include information regarding the net cost savings from moving individuals from a nursing home to the home- and community-based services waiver program, the number of individuals transitioned from nursing homes to the home- and community-based services waiver program, the number of individuals on waiting lists by region for the program, and the amount of funds transferred during the fiscal quarter. The report shall also include the number of Medicaid individuals served and the number of days of care for the home- and community-based services waiver program and in nursing homes.
(3) The department shall develop a system to collect and analyze information regarding individuals on the home- and community-based services waiver program waiting list to identify the community supports they receive, including, but not limited to, adult home help, food assistance, and housing assistance services and to determine the extent to which these community supports help individuals remain in their home and avoid entry into a nursing home. The department shall provide a progress report on implementation to the senate and house appropriations subcommittees on community health and the senate and house fiscal agencies by June 1 of the current fiscal year.
(4) It is the intent of the legislature that the department shall revise any policies, guidelines, procedures, standards, and regulations in order to limit the self-determination option with respect to the home- and community-based services waiver program to those services furnished by approved home-based service providers meeting provider qualifications established in the waiver and approved by the centers for Medicare and Medicaid services.
Sec. 1690. (1) The department shall submit a report to the house and senate appropriations subcommittees on community health, the house and senate fiscal agencies, and the state budget director by April 1 of the current fiscal year, to include all data collected on the quality assurance indicators in the preceding fiscal year for the home- and community-based services waiver program, as well as quality improvement plans and data collected on critical incidents in the waiver program and their resolutions.
(2) The department shall submit a report to the house and senate appropriations subcommittees on community health, the house and senate fiscal agencies, and the state budget director by April 1 of the current fiscal year, to include all data collected on the quality assurance indicators in the preceding fiscal year for the adult home help program, as well as quality improvement plans and data collected on critical incidents in the adult home help program and their resolutions.
Sec. 1691. (1) Payment increases provided in previous years to adult home help workers shall be continued. From the funds appropriated in part 1 for adult home help services, $16,584,000.00 is appropriated to increase the wages of adult home help workers by 50 cents per hour in all counties effective October 1, 2009.
(2) The department, in conjunction with the department of human services, shall revise any policies, rules, procedures, or regulations that may be an administrative barrier to the implementation of the wage adjustments described in this section.
Sec. 1692. (1) The department is authorized to pursue reimbursement for eligible services provided in Michigan schools from the federal Medicaid program. The department and the state budget director are authorized to negotiate and enter into agreements, together with the department of education, with local and intermediate school districts regarding the sharing of federal Medicaid services funds received for these services. The department is authorized to receive and disburse funds to participating school districts pursuant to such agreements and state and federal law.
(2) From the funds appropriated in part 1 for medical services school-based services payments, the department is authorized to do all of the following:
(a) Finance activities within the medical services administration related to this project.
(b) Reimburse participating school districts pursuant to the fund-sharing ratios negotiated in the state-local agreements authorized in subsection (1).
(c) Offset general fund costs associated with the medical services program.
Sec. 1693. The special Medicaid reimbursement appropriation in part 1 may be increased if the department submits a medical services state plan amendment pertaining to this line item at a level higher than the appropriation. The department is authorized to appropriately adjust financing sources in accordance with the increased appropriation.
Sec. 1694. The department shall distribute $1,122,300.00 to an academic health care system that includes a children’s hospital that has a high indigent care volume.
Sec. 1695. (1) The department shall evaluate the impact of implementing a case mix reimbursement system for nursing facilities. The department shall consult with representatives from the department, the health care association of Michigan, the Michigan county medical care facilities council, and the Michigan association of homes and services for the aging.
(2) The department shall provide a progress report to the senate and house appropriations subcommittees on community health and to the senate and house fiscal agencies by August 1 of the current fiscal year.
Sec. 1697. (1) As may be allowed by federal law or regulation, the department may use funds provided by a local or intermediate school district, which have been obtained from a qualifying health system, as the state match required for receiving federal Medicaid or children health insurance program funds. Any such funds received shall be used only to support new school-based or school-linked health services.
(2) A qualifying health system is defined as any health care entity licensed to provide health care services in the state of Michigan, that has entered into a contractual relationship with a local or intermediate school district to provide or manage school-based or school-linked health services.
Sec. 1699. The department may make separate payments directly to qualifying hospitals serving a disproportionate share of indigent patients in the amount of $50,000,000.00, and to hospitals providing graduate medical education training programs. If direct payment for GME and DSH is made to qualifying hospitals for services to Medicaid clients, hospitals will not include GME costs or DSH payments in their contracts with HMOs.
Sec. 1711. (1) The department shall maintain the 2-tier reimbursement methodology for Medicaid emergency physicians professional services that was in effect on September 30, 2002, subject to the following conditions:
(a) Payments by case and in the aggregate shall not exceed 70% of Medicare payment rates.
(b) Total expenditures for these services shall not exceed the level of total payments made during fiscal year 2001‑2002, after adjusting for Medicare co-payments and deductibles and for changes in utilization.
(2) To ensure that total expenditures stay within the spending constraints of subsection (1)(b), the department shall develop a utilization adjustor for the basic 2-tier payment methodology. The adjustor shall be based on a good faith estimate by the department as to what the expected utilization of emergency room services will be during the current fiscal year given changes in the number and category of Medicaid recipients. If expenditure and utilization data indicate that the amount and/or type of emergency physician professional services are exceeding the department’s estimate, the utilization adjustor shall be applied to the 2-tier reimbursement methodology in such a manner as to reduce aggregate expenditures to the fiscal year 2001-2002 adjusted expenditure target.
Sec. 1712. (1) Subject to the availability of funds, the department shall implement a rural health initiative. Available funds shall first be allocated as an outpatient adjustor payment to be paid directly to hospitals in rural counties in proportion to each hospital’s Medicaid and indigent patient population. Additional funds, if available, shall be allocated for defibrillator grants, EMT training and support, or other similar programs.
(2) Except as otherwise specified in this section, “rural” means a county, city, village, or township with a population of not more than 30,000, including those entities if located within a metropolitan statistical area.
Sec. 1716. The department shall seek to maintain a constant enrollment level within the Medicaid adult benefits waiver program throughout fiscal year 2009-2010.
Sec. 1717. (1) The department shall create 2 pools for distribution of disproportionate share hospital funding. The first pool, totaling $45,000,000.00, shall be distributed using the distribution methodology used in fiscal year 2003-2004. The second pool, totaling $5,000,000.00, shall be distributed to unaffiliated hospitals and hospital systems that received less than $900,000.00 in disproportionate share hospital payments in fiscal year 2007-2008 based on a formula that is weighted proportional to the product of each eligible system’s Medicaid revenue and each eligible system’s Medicaid utilization, except that no payment of less than $1,000.00 shall be made.
(2) By September 30 of the current fiscal year, the department shall report to the senate and house appropriations subcommittees on community health and the senate and house fiscal agencies on the new distribution of funding to each eligible hospital from the 2 pools.
Sec. 1718. The department shall provide each Medicaid adult home help beneficiary or applicant with the right to a fair hearing when the department or its agent reduces, suspends, terminates, or denies adult home help services. If the department takes action to reduce, suspend, terminate, or deny adult home help services, it shall provide the beneficiary or applicant with a written notice that states what action the department proposes to take, the reasons for the intended action, the specific regulations that support the action, and an explanation of the beneficiary’s or applicant’s right to an evidentiary hearing and the circumstances under which those services will be continued if a hearing is requested.
Sec. 1721. The department shall conduct a review of Medicaid eligibility pertaining to funds prepaid to a nursing home or other health care facility that are subsequently returned to an individual who becomes Medicaid eligible and shall report its findings to the members of the house and senate appropriations subcommittees on community health and the house and senate fiscal agencies not later than May 15 of the current fiscal year. Included in its report shall be recommendations for policy and procedure changes regarding whether any funds prepaid to a nursing home or other health care facility that are subsequently returned to an individual, after the date of Medicaid eligibility and patient pay amount determination, shall be considered as a countable asset and recommendations for a mechanism for departmental monitoring of those funds.
Sec. 1724. The department shall allow licensed pharmacies to purchase injectable drugs for the treatment of respiratory syncytial virus for shipment to physicians’ offices to be administered to specific patients. If the affected patients are Medicaid eligible, the department shall reimburse pharmacies for the dispensing of the injectable drugs and reimburse physicians for the administration of the injectable drugs.
Sec. 1725. The department shall continue to work with the department of human services to reduce Medicaid eligibility errors related to basic eligibility requirements, residency issues, and income requirements.
Sec. 1728. The department shall make available to qualifying Medicaid recipients, not based on Medicare guidelines, freestanding electrical lifting and transferring devices.
Sec. 1731. The department shall continue an asset test to determine Medicaid eligibility for individuals who are parents, caretaker relatives, or individuals between the ages of 18 and 21 and who are not required to be covered under federal Medicaid requirements.
Sec. 1732. The department shall assure that, if proposed modifications to the quality assurance assessment program for nursing homes are not implemented, the projected general fund/general purpose savings shall not be achieved through reductions in nursing home reimbursement rates.
Sec. 1733. (1) The department shall seek additional federal funds to permit the state to provide financial support for electronic prescribing and other health information technology initiatives.
(2) The department shall develop a 3-year strategic plan for the implementation of electronic prescribing for the Medicaid program.
Sec. 1734. The department shall seek federal money for demonstration programs that will permit this state to provide financial incentives for positive health behavior practiced by Medicaid recipients, including, but not limited to, consumer-driven strategies that enable Medicaid recipients to choose coverage that meets their individual needs and that authorize monetary or other rewards for demonstrating positive health behavior changes.
Sec. 1739. The department shall continue the contractor performance bonus program for Medicaid health plans. The contractor performance bonus program may include indicators based on the prevalent and chronic conditions affecting the Medicaid population and indicators of preventive health status for adults and children.
Sec. 1740. From the funds appropriated in part 1 for health plan services, the department shall assure that all GME funds continue to be promptly distributed to qualifying hospitals using the methodology developed in consultation with the graduate medical education advisory group during fiscal year 2006-2007.
Sec. 1741. The department shall continue to provide nursing homes the opportunity to receive interim payments upon their request. The department shall make efforts to ensure that the interim payments are as similar to expected cost-settled payments as possible.
Sec. 1742. The department shall allow the retention of up to $100.00 in special Medicaid reimbursement funding by any public hospital that meets each of the following criteria:
(a) The hospital participates in the intergovernmental transfers.
(b) The hospital is not affiliated with a university.
(c) The hospital provides surgical services.
(d) The hospital has at least 10,000 Medicaid bed days.
Sec. 1752. The department shall provide a Medicaid health plan with any information that may assist the Medicaid health plan in determining whether another party may be responsible, in whole or in part, for the payment of health benefits.
Sec. 1756. The department shall establish and implement a specialized case and care management program to serve the most costly Medicaid beneficiaries who are noncompliant with medical management, including persons with chronic diseases and mental health diagnoses, high prescription drug utilizers, members demonstrating noncompliance with previous medical management, and neonates. The case and care management program shall, at a minimum, provide a performance payment incentive for physicians who manage the recipient’s care and health costs in the most effective way. The department may also develop additional contractual arrangements with 1 or more Medicaid HMOs for the provision of specialized case management services. Contracts with Medicaid HMOs may include provisions requiring collection of data related to Medicaid recipient compliance. Measures of patient compliance may include the proportion of clients who fill their prescriptions, the rate of clients who do not show for scheduled medical appointments, and the proportion of clients who use their medication.
Sec. 1757. (1) The department shall direct the department of human services to obtain proof from all Medicaid recipients that they are legal United States citizens or otherwise legally residing in this country and that they are residents of this state before approving Medicaid eligibility.
(2) It is the intent of the legislature that the department seek clarification from the federal government on whether states can deny Medicaid eligibility to fugitive felons through a state plan amendment or waiver.
Sec. 1759. The department shall implement the following policy changes included in the federal deficit reduction act of 2005, Public Law 109-171:
(a) Lengthening the look-back policy for asset transfers from 3 to 5 years.
(b) Changing the penalty period to begin the day an individual applies for Medicaid.
(c) Individuals with more than $500,000.00 in home equity do not qualify for Medicaid.
(d) Utilize the Medicaid false claim act, 1977 PA 72, MCL 400.601 to 400.613, to collect an enhanced state share of damages collected from entities that have been successfully prosecuted for filing a fraudulent Medicaid claim.
Sec. 1764. The department shall annually certify rates paid to Medicaid health plans as being actuarially sound in accordance with federal requirements and shall provide a copy of the rate certification and approval immediately to the house and senate appropriations subcommittees on community health and the house and senate fiscal agencies.
Sec. 1767. The department shall study and evaluate the impact of the change in the way in which the Medicaid program pays pharmacists for prescriptions from average wholesale price to average manufacturer price as required by the federal deficit reduction act of 2005, Public Law 109-171. Upon release of the data by the centers for Medicare and Medicaid services, the department shall submit a report of its study to the senate and house appropriations subcommittees on community health and the senate and house fiscal agencies. If the department finds that there is a negative impact on the pharmacists, the department shall reexamine the current pharmaceutical dispensing fee structure established under section 1620 and include in the report recommendations and proposals to counter the negative impact of that federal legislation.
Sec. 1770. In conjunction with the consultation requirements of the social welfare act, 1939 PA 280, MCL 400.1 to 400.119b, and except as otherwise provided in this section, the department shall attempt to make the effective date for a proposed Medicaid policy bulletin or adjustment to the Medicaid provider manual on October 1, January 1, April 1, or July 1 after the end of the consultation period. The department may provide an effective date for a proposed Medicaid policy bulletin or adjustment to the Medicaid provider manual other than provided for in this section if necessary to be in compliance with federal or state law, regulations, or rules or with an executive order of the governor.
Sec. 1772. From the funds appropriated in part 1, the department shall continue a program, the primary goal of which is to enroll all children in foster care in Michigan in a Medicaid health maintenance organization.
Sec. 1773. (1) The department shall establish and implement a bid process to identify a single private contractor to provide Medicaid covered nonemergency transportation services in each county with a population over 750,000 individuals.
(2) The department shall reimburse mileage for nonemergency transportation that encourages contractors to participate.
Sec. 1775. The department shall provide a progress report on ongoing efforts to implement long-term managed care pilot programs to the senate and house appropriations subcommittees on community health and the senate and house fiscal agencies by June 1 of the current fiscal year.
Sec. 1777. From the funds appropriated in part 1 for long-term care services, the department shall permit, in accordance with applicable federal and state law, nursing homes to use dining assistants to feed eligible residents if legislation to permit the use of dining assistants is enacted into law. The department shall not be responsible for costs associated with training dining assistants.
Sec. 1783. (1) The department shall develop rates by April 1, 2010 for the enrollment of individuals dually eligible for Medicare and Medicaid into Medicaid health plans if those health plans also maintain a Medicare advantage special needs plan certified by the centers for Medicare and Medicaid services.
(2) The department shall report quarterly to the house and senate appropriations subcommittees on community health and to the house and senate fiscal agencies the status of the rate development described in subsection (1) and the number of dual eligibles enrolled by month in Medicaid health plans with Medicare advantage special needs plan certification for fiscal year 2009-2010.
Sec. 1786. (1) For services where the actual length of stay is less than the published low-day threshold, reimbursement for inpatient admissions shall be the actual charge multiplied by the individual hospital’s cost-to-charge ratio net of indirect medical education, not to exceed the full diagnosis related group payment rate.
(2) The reimbursement changes specified in subsection (1) shall not be implemented unless the changes are budget-neutral.
(3) The department shall define a low-day threshold of 1 as an inpatient stay of less than 24 hours.
(4) Any adjustment of low-day outliers implemented by the department shall also include an appropriate adjustment to diagnosis-related group weights and prices.
(5) The department shall identify any cost savings associated with the implementation of low-day outliers for 1-day admissions to hospitals that are less than 24 hours and diagnosis related group weights and recalculations excluding the payments made outside of rates. This information shall be submitted by March 1, 2010 to the legislature and the fiscal agencies as part of an effort to identify additional cost savings in the Medicaid program.
Sec. 1787. The department shall work with the department of human services to obtain the telephone number of Medicaid beneficiaries and shall provide each Medicaid health plan with the telephone number of that health plan’s enrollees on a monthly basis.
Sec. 1789. The department shall study whether the current nursing home occupancy ceiling is adequate and shall recommend whether to retain the ceiling at 85% or to lower it. The department shall report its findings and recommendations to the state budget director, senate and house appropriations subcommittees on community health, and senate and house fiscal agencies by April 1 of the current fiscal year.
Sec. 1791. (1) From the money appropriated in part 1 for physician services and health plan services, $5,285,700.00, of which $2,100,000.00 is general fund/general purpose money, shall be allocated to increase Medicaid reimbursement rates for primary care and well child visit procedure codes. The increased reimbursement rates in this section shall be implemented October 1, 2008 and shall not exceed the comparable Medicare payment rate for the same services.
(2) The money allocated under subsection (1) shall be distributed as a fee-for-service rate increase for primary care procedure codes and as an adjustment paid exclusively to Medicaid managed care organizations for well child visit procedure codes.
(3) By October 1, 2008, the department shall provide a report to the house and senate appropriations subcommittees on community health and the house and senate fiscal agencies that identifies the specific procedure codes affected by this section and the amount and percentage increase provided for each procedure code.
Sec. 1794. From the funds appropriated in part 1 for hospital services and therapy, up to $100.00 may be allocated for a program to provide a per-person per-day reimbursement for a hospital located in a city with a population over 500,000.
Sec. 1796. The department shall direct the health information technology commission to examine strategies that promote the ability to share medical records. The department shall report the commission’s findings by July 1, 2010.
Sec. 1802. The department may spend up to $100,000.00 on a pilot program targeting Medicaid recipients with certain high-cost or complex health conditions. This pilot shall provide financial incentives to primary care physicians to handle disease management responsibilities for these Medicaid recipients.
Sec. 1804. The department, in cooperation with the department of human services, shall work with the federal government’s public assistance reporting information system to identify Medicaid recipients who are veterans who may be eligible for federal veterans health care benefits or other benefits.
Sec. 1812. From the funds appropriated in part 1 for medical services administration, up to $100.00 may be allocated to support a pilot project to develop a regional health care resource sharing network. By encouraging collaboration and partnerships between local hospitals, this network is expected to enable each hospital to maintain independence and community control while sharing best practices and resources. The pilot shall be designed to improve access, improve patient outcomes, and lower costs in a medical home model. The region for the pilot shall encompass 22 counties and have 10 hospitals.
Sec. 1813. The department shall inform county boards of commissioners in counties not presently covered by the program of all-inclusive care for the elderly of the possibility of expansion of the program to their county.
Sec. 1815. From the funds appropriated in part 1 for health plan services, the department may not implement a capitation withhold as part of the overall capitation rate schedule that exceeds the 0.19% withhold administered during fiscal year 2008-2009.
Sec. 1816. The department shall work with the Michigan association of health plans to develop and implement strategies for the use of information technology services for claims payment, claims status, and related functions.
Sec. 1817. The department shall convene a workgroup including members of the Michigan association of health plans and the Michigan health and hospital association to discuss implementation of a policy that will prohibit billing for care made necessary by preventable medical errors or adverse health events. The workgroup shall take into account similar policies implemented by the Medicare program and by Medicaid programs in other states. The workgroup shall report its findings and recommendations to the legislature no later than April 1, 2010.
Sec. 1819. It is the intent of the legislature that, beginning in fiscal year 2010-2011, the department shall use Medicaid health plan encounter data in the development and revision of hospital diagnosis related group pricing policy.
Sec. 1820. The department shall recognize accrediting organizations for Medicaid health plans and shall consider accreditation results when reviewing the performance of Medicaid health plans.
Sec. 1821. The department shall establish appropriate performance standards for Medicaid health plans a year in advance of the application of those standards. The determination of performance shall be based on and include such recognized concepts as 1-year continuous enrollment and HEDIS audited data.
Sec. 1822. The department, the department’s contracted Medicaid pharmacy benefit manager, and all Medicaid health plans shall implement coverage for a mental health prescription drug within 30 days of that drug’s approval by the department’s pharmacy and therapeutics committee.
Sec. 1824. Individuals who live in homes for the aged or adult foster care facilities shall be eligible to apply for enrollment for services from the home- and community-based waiver program.
Sec. 1825. The department may work in conjunction with relevant stakeholders to determine the feasibility of implementing quality assurance assessment programs targeted to certain providers of medical services, as permitted by federal law.
Sec. 1826. The department shall develop a plan to expand and improve the beneficiary monitoring program. This plan shall include cost-effective methods to monitor and reduce unnecessary health care services, including prescription drugs, improve coordination of services between the primary care physician and mental health/substance abuse service providers, and improve compliance with prescribed medical management to reduce more costly use of emergency services. The department shall submit this plan to the house and senate appropriations subcommittees on community health, the house and senate fiscal agencies, and the state budget director by April 1 of the current fiscal year.
Sec. 1828. (1) Effective October 1, 2009, Medicaid payment rates for providers described in subsection (2) shall be reduced to 8% less than the rates in effect on May 1, 2009.
(2) Providers subject to the payment rate reduction shall be limited to those providers subject to percentage rate reductions in Executive Order No. 2009-22.
(3) The department shall reduce rates paid to Medicaid health plans to correspond to the savings realized by the health plans from the reduction in other Medicaid provider rates.
(4) If new revenue is generated to match federal Medicaid funds, the revenue shall be used to reduce or eliminate the rate reductions described in subsections (1), (2), and (3) and to restore other reductions made to the fiscal year 2009‑2010 department budget.
Sec. 1829. Notwithstanding the removal of coverage for certain optional Medicaid services, the department shall continue its policy of providing coverage for emergency services. For this purpose, the department shall continue to adhere to the guidelines outlined in MSA policy bulletin MSA 09-28.
For Fiscal Year
Ending Sept. 30,
2010
For Fiscal Year
Ending Sept. 30,
2010
For Fiscal Year
Ending Sept. 30,
2010
For Fiscal Year
Ending Sept. 30,
2010
For Fiscal Year
Ending Sept. 30,
2010
For Fiscal Year
Ending Sept. 30,
2010
For Fiscal Year
Ending Sept. 30,
2010
This act is ordered to take immediate effect.
Clerk of the House of Representatives
Secretary of the Senate
Approved
Governor