FIRST CONFERENCE REPORT
The Committee of Conference on the matters of difference between the two Houses concerning
Senate Bill No. 118, entitled
A bill to make appropriations for the department of community health for the fiscal year ending September 30, 2016; and to provide for the expenditure of the appropriations.
Recommends:
First: That the House recede from the Substitute of the House as passed by the House.
Second: That the Senate and House agree to the Substitute of the Senate as passed by the Senate, amended to read as follows:
(attached)
Third: That the Senate and House agree to the title of the bill to read as follows:
A bill to make and supplement appropriations for the department of community health for the fiscal years ending September 30, 2015 and September 30, 2016; and to provide for the expenditure of the appropriations.
_______________________ ________________________
Jim Marleau Rob VerHeulen
_______________________ ________________________
Mike Shirkey John Bizon, M.D.
_______________________ ________________________
Curtis Hertel, Jr. Brandon Dillon
Conferees for the Senate Conferees for the House
SUBSTITUTE FOR
SENATE BILL NO. 118
A bill to make and supplement appropriations for the
department of community health for the fiscal years ending
September 30, 2015 and September 30, 2016; and to provide for the
expenditure of the appropriations.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
PART 1
LINE-ITEM APPROPRIATIONS
Sec. 101. There is appropriated for the department of
community health for the fiscal year ending September 30, 2016,
from the following funds:
DEPARTMENT OF COMMUNITY HEALTH
APPROPRIATION SUMMARY
Full-time equated unclassified positions.......... 6.0
Full-time equated classified positions........ 3,687.1
Average population.............................. 893.0
GROSS APPROPRIATION.................................... $ 19,562,369,000
Interdepartmental grant revenues:
Total interdepartmental grants and intradepartmental
transfers............................................ 9,678,100
ADJUSTED GROSS APPROPRIATION........................... $ 19,552,690,900
Federal revenues:
Social security act, temporary assistance for needy
families............................................. 17,814,100
Total other federal revenues........................... 14,018,103,800
Special revenue funds:
Total local revenues................................... 85,951,800
Total private revenues................................. 129,698,700
Merit award trust fund................................. 68,334,700
Total other state restricted revenues.................. 2,032,191,100
State general fund/general purpose..................... $ 3,200,596,700
Sec. 102. DEPARTMENTWIDE ADMINISTRATION
Full-time equated unclassified positions.......... 6.0
Full-time equated classified positions.......... 190.7
Director and other unclassified--6.0 FTE positions..... $ 735,500
Departmental administration and management--180.7 FTE
positions............................................ 28,049,500
Worker's compensation program.......................... 5,205,700
Rent and building occupancy............................ 10,602,500
Developmental disabilities council and projects--10.0
FTE positions........................................ 3,038,900
Human trafficking intervention services................ 200,000
GROSS APPROPRIATION.................................... $ 47,832,100
Appropriated from:
Federal revenues:
Total other federal revenues........................... 16,096,300
Special revenue funds:
Total private revenues................................. 35,200
Total other state restricted revenues.................. 834,500
State general fund/general purpose..................... $ 30,866,100
Sec. 103. BEHAVIORAL HEALTH PROGRAM ADMINISTRATION
AND SPECIAL PROJECTS
Full-time equated classified positions.......... 106.0
Behavioral health program administration--105.0 FTE
positions............................................ $ 61,874,500
Gambling addiction--1.0 FTE position................... 3,003,700
Protection and advocacy services support............... 194,400
Community residential and support services............. 592,100
Federal and other special projects..................... 2,535,600
Family support subsidy................................. 17,633,600
Housing and support services........................... 13,238,800
GROSS APPROPRIATION.................................... $ 99,072,700
Appropriated from:
Federal revenues:
Social security act, temporary assistance for needy
families............................................. 17,814,100
Total other federal revenues........................... 47,889,000
Special revenue funds:
Total private revenues................................. 1,000,000
Total other state restricted revenues.................. 3,003,700
State general fund/general purpose..................... $ 29,365,900
Sec. 104. BEHAVIORAL HEALTH SERVICES
Full-time equated classified positions............ 9.5
Medicaid mental health services........................ $ 2,383,364,300
Community mental health non-Medicaid services.......... 117,050,400
Mental health services for special populations......... 8,842,800
Medicaid substance use disorder services............... 47,495,700
Civil service charges.................................. 1,499,300
Federal mental health block grant--2.5 FTE positions... 15,444,600
State disability assistance program substance use
disorder services.................................... 2,018,800
Community substance use disorder prevention,
education, and treatment............................. 73,811,800
Children's waiver home care program.................... 20,000,000
Nursing home PAS/ARR-OBRA--7.0 FTE positions........... 12,258,800
Children with serious emotional disturbance waiver..... 12,647,900
Health homes........................................... 3,369,000
Healthy Michigan plan - behavioral health.............. 355,432,600
Autism services........................................ 36,418,500
University autism programs............................. 2,500,000
GROSS APPROPRIATION.................................... $ 3,092,154,500
Appropriated from:
Interdepartmental grant revenues:
Interdepartmental grant from the department of human
services............................................. 6,340,500
Federal revenues:
Total other federal revenues........................... 2,084,174,300
Special revenue funds:
Total local revenues................................... 25,475,800
Total other state restricted revenues.................. 22,512,700
State general fund/general purpose..................... $ 953,651,200
Sec. 105. STATE PSYCHIATRIC HOSPITALS AND FORENSIC
MENTAL HEALTH SERVICES
Total average population........................ 893.0
Full-time equated classified positions........ 2,130.9
Caro Regional Mental Health Center - psychiatric
hospital - adult--461.3 FTE positions................ $ 56,313,400
Average population.............................. 185.0
Kalamazoo Psychiatric Hospital - adult--466.1 FTE
positions............................................ 64,459,400
Average population.............................. 189.0
Walter P. Reuther Psychiatric Hospital - adult--420.8
FTE positions........................................ 55,835,000
Average population.............................. 234.0
Hawthorn Center - psychiatric hospital - children and
adolescents--226.4 FTE positions..................... 28,735,600
Average population............................... 75.0
Center for forensic psychiatry--556.3 FTE positions.... 72,538,000
Average population.............................. 210.0
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
Gifts and bequests for patient living and treatment
environment.......................................... 1,000,000
GROSS APPROPRIATION.................................... $ 280,529,500
Appropriated from:
Federal revenues:
Total other federal revenues........................... 34,711,200
Special revenue funds:
Total local revenues................................... 19,480,700
Total private revenues................................. 1,000,000
Total other state restricted revenues.................. 18,868,500
State general fund/general purpose..................... $ 206,469,100
Sec. 106. PUBLIC HEALTH ADMINISTRATION
Full-time equated classified positions.......... 100.4
Public health administration--7.3 FTE positions........ $ 1,567,800
Health and wellness initiatives--11.7 FTE positions.... 8,946,400
Vital records and health statistics--81.4 FTE
positions............................................ 11,763,400
GROSS APPROPRIATION.................................... $ 22,277,600
Appropriated from:
Interdepartmental grant revenues:
Interdepartmental grant from the department of human
services............................................. 1,206,100
Federal revenues:
Total other federal revenues........................... 3,650,800
Special revenue funds:
Total other state restricted revenues.................. 12,337,600
State general fund/general purpose..................... $ 5,083,100
Sec. 107. HEALTH POLICY
Full-time equated classified positions........... 64.8
Bone marrow transplant registry........................ $ 250,000
Certificate of need program administration--12.3 FTE
positions............................................ 2,781,400
Emergency medical services program--23.0 FTE positions. 6,415,200
Health innovation grants............................... 1,500,000
Health policy administration--24.1 FTE positions....... 28,106,300
Michigan essential health provider..................... 3,591,300
Minority health grants and contracts................... 612,700
Nurse education and research program--3.0 FTE
positions............................................ 1,041,500
Primary care services--1.4 FTE positions............... 4,067,500
Rural health services--1.0 FTE position................ 1,555,500
GROSS APPROPRIATION.................................... $ 49,921,400
Appropriated from:
Interdepartmental grant revenues:
Interdepartmental grant from the department of
licensing and regulatory affairs..................... 1,041,500
Interdepartmental grant from the department of
treasury, Michigan state hospital finance authority.. 116,000
Federal revenues:
Total other federal revenues........................... 32,987,200
Special revenue funds:
Total private revenues................................. 865,000
Total other state restricted revenues.................. 6,561,700
State general fund/general purpose..................... $ 8,350,000
Sec. 108. LABORATORY SERVICES
Full-time equated classified positions.......... 100.0
Laboratory services--100.0 FTE positions............... $ 20,295,500
GROSS APPROPRIATION.................................... $ 20,295,500
Appropriated from:
Interdepartmental grant revenues:
Interdepartmental grant from the department of
environmental quality................................ 974,000
Federal revenues:
Total other federal revenues........................... 2,294,400
Special revenue funds:
Total other state restricted revenues.................. 10,261,900
State general fund/general purpose..................... $ 6,765,200
Sec. 109. EPIDEMIOLOGY AND INFECTIOUS DISEASE
Full-time equated classified positions.......... 144.9
AIDS surveillance and prevention program............... $ 1,854,100
Bioterrorism preparedness--52.0 FTE positions.......... 30,077,600
Epidemiology administration--41.6 FTE positions........ 12,455,700
Healthy homes program--8.0 FTE positions............... 4,384,300
Immunization program--12.8 FTE positions............... 18,817,900
Newborn screening follow-up and treatment services--
10.5 FTE positions................................... 7,223,000
Sexually transmitted disease control program--20.0 FTE
positions............................................ 6,246,900
Tuberculosis control and prevention.................... 867,000
GROSS APPROPRIATION.................................... $ 81,926,500
Appropriated from:
Federal revenues:
Total other federal revenues........................... 60,864,000
Special revenue funds:
Total private revenues................................. 2,339,000
Total other state restricted revenues.................. 11,577,900
State general fund/general purpose..................... $ 7,145,600
Sec. 110. LOCAL HEALTH ADMINISTRATION AND GRANTS
Full-time equated classified positions............ 2.0
Essential local public health services................. $ 40,886,100
Implementation of 1993 PA 133, MCL 333.17015........... 20,000
Local health services--2.0 FTE positions............... 536,100
Medicaid outreach cost reimbursement to local health
departments.......................................... 9,000,000
GROSS APPROPRIATION.................................... $ 50,442,200
Appropriated from:
Federal revenues:
Total other federal revenues........................... 9,536,100
Special revenue funds:
Total local revenues................................... 5,150,000
State general fund/general purpose..................... $ 35,756,100
Sec. 111. CHRONIC DISEASE AND INJURY PREVENTION AND
HEALTH PROMOTION
Full-time equated classified positions.......... 113.0
AIDS prevention, testing, and care programs--47.7 FTE
positions............................................ $ 70,423,000
Alzheimer's disease in-home care pilot................. 150,000
Cancer prevention and control program--13.0 FTE
positions............................................ 15,005,800
Chronic disease control and health promotion
administration--29.4 FTE positions................... 6,356,200
Diabetes and kidney program--8.0 FTE positions......... 3,038,100
Smoking prevention program--12.0 FTE positions......... 2,107,600
Violence prevention--2.9 FTE positions................. 1,823,700
GROSS APPROPRIATION.................................... $ 98,904,400
Appropriated from:
Federal revenues:
Total other federal revenues........................... 52,671,100
Special revenue funds:
Total private revenues................................. 38,778,400
Total other state restricted revenues.................. 5,534,000
State general fund/general purpose..................... $ 1,920,900
Sec. 112. FAMILY, MATERNAL, AND CHILDREN'S HEALTH
SERVICES
Full-time equated classified positions........... 69.6
Childhood lead program--2.5 FTE positions.............. $ 1,563,300
Dental programs--3.0 FTE positions..................... 1,818,200
Family, maternal, and children's health services
administration--50.1 FTE positions................... 8,437,000
Family planning local agreements....................... 8,310,700
Local MCH services..................................... 7,018,100
Pregnancy prevention program........................... 602,100
Prenatal care outreach and service delivery support--
14.0 FTE positions................................... 18,383,000
Special projects....................................... 6,289,100
Sudden infant death syndrome program................... 321,300
GROSS APPROPRIATION.................................... $ 52,742,800
Appropriated from:
Federal revenues:
Total other federal revenues........................... 42,214,500
Special revenue funds:
Total local revenues................................... 75,000
Total private revenues................................. 874,500
Total other state restricted revenues.................. 20,000
State general fund/general purpose..................... $ 9,558,800
Sec. 113. WOMEN, INFANTS, AND CHILDREN FOOD AND
NUTRITION PROGRAM
Full-time equated classified positions........... 45.0
Women, infants, and children program administration
and special projects--45.0 FTE positions............. $ 17,905,900
Women, infants, and children program local agreements
and food costs....................................... 256,285,000
GROSS APPROPRIATION.................................... $ 274,190,900
Appropriated from:
Federal revenues:
Total other federal revenues........................... 213,113,000
Special revenue funds:
Total private revenues................................. 61,077,900
State general fund/general purpose..................... $ 0
Sec. 114. CHILDREN'S SPECIAL HEALTH CARE SERVICES
Full-time equated classified positions........... 46.8
Children's special health care services
administration--44.0 FTE positions................... $ 5,897,900
Bequests for care and services--2.8 FTE positions...... 1,528,200
Outreach and advocacy.................................. 5,510,000
Nonemergency medical transportation.................... 905,900
Medical care and treatment............................. 188,291,400
GROSS APPROPRIATION.................................... $ 202,133,400
Appropriated from:
Federal revenues:
Total other federal revenues........................... 106,154,700
Special revenue funds:
Total private revenues................................. 1,008,900
Total other state restricted revenues.................. 3,858,400
State general fund/general purpose..................... $ 91,111,400
Sec. 115. CRIME VICTIM SERVICES COMMISSION
Full-time equated classified positions........... 13.0
Grants administration services--13.0 FTE positions..... $ 2,129,800
Justice assistance grants.............................. 15,000,000
Crime victim rights services grants.................... 16,870,000
GROSS APPROPRIATION.................................... $ 33,999,800
Appropriated from:
Federal revenues:
Total other federal revenues........................... 18,697,500
Special revenue funds:
Total other state restricted revenues.................. 15,302,300
State general fund/general purpose..................... $ 0
Sec. 116. AGING AND ADULT SERVICES AGENCY
Full-time equated classified positions........... 40.0
Aging and adult services administration--40.0 FTE
positions............................................ $ 7,784,500
Community services..................................... 39,013,900
Nutrition services..................................... 39,044,000
Employment assistance.................................. 3,500,000
Program of all-inclusive care for the elderly.......... 65,938,500
Respite care program................................... 5,868,700
Senior volunteer service programs...................... 4,465,300
GROSS APPROPRIATION.................................... $ 165,614,900
Appropriated from:
Federal revenues:
Total other federal revenues........................... 100,779,800
Special revenue funds:
Total private revenues................................. 520,000
Merit award trust fund................................. 4,068,700
Total other state restricted revenues.................. 1,400,000
State general fund/general purpose..................... $ 58,846,400
Sec. 117. MEDICAL SERVICES ADMINISTRATION
Full-time equated classified positions.......... 510.5
Medical services administration--450.5 FTE positions... $ 92,648,500
Healthy Michigan plan administration--36.0 FTE
positions............................................ 49,342,300
Facility inspection contract........................... 132,800
MIChild administration................................. 3,500,000
Electronic health record incentive program--24.0 FTE
positions............................................ 144,226,200
GROSS APPROPRIATION.................................... $ 289,849,800
Appropriated from:
Federal revenues:
Total other federal revenues........................... 242,788,100
Special revenue funds:
Total local revenues................................... 105,700
Total private revenues................................. 99,800
Total other state restricted revenues.................. 331,300
State general fund/general purpose..................... $ 46,524,900
Sec. 118. MEDICAL SERVICES
Hospital services and therapy.......................... $ 1,139,960,500
Hospital disproportionate share payments............... 45,000,000
Physician services..................................... 334,848,800
Medicare premium payments.............................. 410,077,800
Pharmaceutical services................................ 300,132,400
Home health services................................... 5,893,100
Hospice services....................................... 107,768,400
Transportation......................................... 21,636,100
Auxiliary medical services............................. 6,339,600
Dental services........................................ 233,674,300
Ambulance services..................................... 18,987,700
Long-term care services................................ 1,396,577,100
Integrated care organizations.......................... 454,700,000
Medicaid home- and community-based services waiver..... 329,692,700
Adult home help services............................... 303,047,800
Personal care services................................. 11,762,300
Health plan services................................... 5,011,623,000
MIChild program........................................ 22,211,200
Federal Medicare pharmaceutical program................ 203,481,400
Maternal and child health.............................. 20,279,500
Healthy Michigan plan.................................. 3,726,633,700
Subtotal basic medical services program................ 14,104,327,400
School-based services.................................. 112,102,700
Dental clinic program.................................. 1,000,000
Special Medicaid reimbursement......................... 388,891,700
Subtotal special medical services payments............. 501,994,400
GROSS APPROPRIATION.................................... $ 14,606,321,800
Appropriated from:
Federal revenues:
Total other federal revenues........................... 10,904,029,000
Special revenue funds:
Total local revenues................................... 35,664,600
Total private revenues................................. 2,100,000
Merit award trust fund................................. 64,266,000
Total other state restricted revenues.................. 1,917,800,800
State general fund/general purpose..................... $ 1,682,461,400
Sec. 119. INFORMATION TECHNOLOGY
Information technology services and projects........... $ 36,958,100
Michigan Medicaid information system................... 50,201,100
GROSS APPROPRIATION.................................... $ 87,159,200
Appropriated from:
Federal revenues:
Total other federal revenues........................... 45,452,800
Special revenue funds:
Total private revenues................................. 20,000,000
Total other state restricted revenues.................. 1,985,800
State general fund/general purpose..................... $ 19,720,600
Sec. 120. ONE-TIME BASIS ONLY APPROPRIATIONS
Pay for success contracts.............................. $ 1,500,000
Mental health commission recommendations............... 1,500,000
Drug policy initiatives................................ 1,500,000
Hospice services....................................... 2,500,000
GROSS APPROPRIATION.................................... $ 7,000,000
Appropriated from:
State general fund/general purpose..................... $ 7,000,000
PART 1B
SUPPLEMENTAL LINE-ITEM APPROPRIATIONS
Sec. 191. There is appropriated for the department of
community health for the fiscal year ending September 30, 2015,
from the following funds:
DEPARTMENT OF COMMUNITY HEALTH
APPROPRIATION SUMMARY
GROSS APPROPRIATION.................................... $ 1,019,662,600
Interdepartmental grant revenues:
Total interdepartmental grants and intradepartmental
transfers............................................ 0
ADJUSTED GROSS APPROPRIATION........................... $ 1,019,662,600
Federal revenues:
Total federal revenues................................. 993,680,600
Special revenue funds:
Total local revenues................................... 0
Total private revenues................................. 0
Total other state restricted revenues.................. 13,010,100
State general fund/general purpose..................... $ 12,971,900
Sec. 192. BEHAVIORAL HEALTH SERVICES
Medicaid mental health services........................ $ 9,232,100
Medicaid substance use disorder services............... (951,500)
Healthy Michigan plan - behavioral health.............. 35,131,500
GROSS APPROPRIATION.................................... $ 43,412,100
Appropriated from:
Federal revenues:
Total federal revenues................................. 40,558,600
State general fund/general purpose..................... $ 2,853,500
Sec. 193. CHILDREN'S SPECIAL HEALTH CARE SERVICES
Medical care and treatment............................. $ (2,931,700)
GROSS APPROPRIATION.................................... $ (2,931,700)
Appropriated from:
Federal revenues:
Total federal revenues................................. (1,621,200)
State general fund/general purpose..................... $ (1,310,500)
Sec. 194. MEDICAL SERVICES
Hospital services and therapy.......................... $ (43,310,000)
Physician services..................................... (20,246,400)
Medicare premium payments.............................. 2,002,500
Pharmaceutical services................................ 1,983,200
Home health services................................... (87,800)
Hospice services....................................... (8,257,400)
Transportation......................................... (2,667,500)
Auxiliary medical services............................. (1,369,300)
Dental services........................................ (12,920,700)
Ambulance services..................................... (1,123,000)
Long-term care services................................ 93,623,600
Integrated care organizations.......................... (30,478,000)
Medicaid home- and community-based services waiver..... (2,206,300)
Adult home help services............................... (116,800)
Personal care services................................. (548,700)
Program of all-inclusive care for the elderly.......... (17,974,300)
Autism services........................................ (171,800)
Health plan services................................... 89,683,800
MIChild program........................................ 16,096,200
Federal Medicare pharmaceutical program................ 3,802,500
Healthy Michigan plan.................................. 917,634,100
Subtotal basic medical services program................ 983,347,900
School-based services.................................. (4,165,700)
Subtotal special medical services payments............. (4,165,700)
GROSS APPROPRIATION.................................... $ 979,182,200
Appropriated from:
Federal revenues:
Total federal revenues................................. 954,743,200
Special revenue funds:
Total other state restricted revenues.................. 13,010,100
State general fund/general purpose..................... $ 11,428,900
PART 2
PROVISIONS CONCERNING APPROPRIATIONS
FOR FISCAL YEAR 2015-2016
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 2015-2016 is $5,301,122,500.00 and
state spending from state resources to be paid to local units of
government for fiscal year 2015-2016 is $1,127,817,700.00. The
itemized statement below identifies appropriations from which
spending to local units of government will occur:
DEPARTMENT OF COMMUNITY HEALTH
BEHAVIORAL HEALTH PROGRAM ADMINISTRATION AND SPECIAL PROJECTS
Community residential and support services............. $ 292,100
Housing and support services........................... 667,400
BEHAVIORAL HEALTH SERVICES
Medicaid mental health services........................ $ 791,137,400
Community mental health non-Medicaid services.......... 117,050,400
Mental health services for special populations......... 3,795,900
Medicaid substance use disorder services............... 16,338,900
State disability assistance program substance use
disorder services................................... 2,018,800
Community substance use disorder prevention,
education, and treatment............................ 14,553,400
Children's waiver home care program.................... 6,880,000
Nursing home PAS/ARR-OBRA.............................. 2,724,900
LABORATORY SERVICES
Laboratory services.................................... $ 5,000
EPIDEMIOLOGY AND INFECTIOUS DISEASE
Sexually transmitted disease control program........... $ 377,000
LOCAL HEALTH ADMINISTRATION AND GRANTS
Essential local public health services................. $ 34,199,500
Implementation of 1993 PA 133, MCL 333.17015........... 300
CHRONIC DISEASE AND INJURY PREVENTION AND HEALTH PROMOTION
AIDS prevention, testing, and care programs............ $ 606,100
Cancer prevention and control program.................. 116,700
FAMILY, MATERNAL, AND CHILDREN'S HEALTH SERVICES
Prenatal care outreach and service delivery support.... $ 2,044,900
CHILDREN'S SPECIAL HEALTH CARE SERVICES
Outreach and advocacy.................................. $ 2,204,000
Medical care and treatment............................. 949,800
CRIME VICTIM SERVICES COMMISSION
Crime victim rights services grants.................... $ 6,389,800
AGING AND ADULT SERVICES AGENCY
Community services..................................... $ 13,333,500
Nutrition services..................................... 9,287,000
Respite care program................................... 5,868,700
Senior volunteer service programs...................... 1,127,900
MEDICAL SERVICES
Hospital services and therapy.......................... $ 2,449,500
Physician services..................................... 10,665,900
Dental services........................................ 1,202,000
Long-term care services................................ 81,530,900
TOTAL OF PAYMENTS TO LOCAL UNITS
OF GOVERNMENT.......................................... $ 1,127,817,700
Sec. 202. The appropriations authorized under this part and
part 1 are subject to the management and budget act, 1984 PA 431,
MCL 18.1101 to 18.1594.
Sec. 203. As used in this part and part 1:
(a) "AIDS" means acquired immunodeficiency syndrome.
(b) "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.
(c) "Current fiscal year" means the fiscal year ending
September 30, 2016.
(d) "Department" means the department of community health.
(e) "Director" means the director of the department.
(f) "DSH" means disproportionate share hospital.
(g) "EPSDT" means early and periodic screening, diagnosis, and
treatment.
(h) "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.
(i) "FTE" means full-time equated.
(j) "GME" means graduate medical education.
(k) "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.
(l) "HEDIS" means healthcare effectiveness data and
information set.
(m) "HMO" means health maintenance organization.
(n) "IDEA" means the individuals with disabilities education
act, 20 USC 1400 to 1482.
(o) "MCH" means maternal and child health.
(p) "Medicare" means subchapter XVIII of the social security
act, 42 USC 1395 to 1395lll.
(q) "MIChild" means the program described in section 1670.
(r) "PAS/ARR-OBRA" 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.
(s) "PIHP" means an entity designated by the department as a
regional entity or a specialty prepaid inpatient health plan for
Medicaid mental health services, services to individuals with
developmental disabilities, and substance use disorder services.
Regional entities are described in section 204b of the mental
health code, 1974 PA 258, MCL 330.1204b. Specialty prepaid
inpatient health plans are described in section 232b of the mental
health code, 1974 PA 258, MCL 330.1232b.
(t) "Temporary assistance for needy families" means part A of
subchapter IV of the social security act, 42 USC 601 to 619.
(u) "Title X" means title X of the public health service act,
42 USC 300 to 300a-8, which establishes grants to states for family
planning services.
(v) "Title XIX" and "Medicaid" mean subchapter XIX of the
social security act, 42 USC 1396 to 1396w-5.
Sec. 204. In addition to the metrics required under section
447 of the management and budget act, 1984 PA 431, MCL 18.1447, for
each new program or program enhancement for which funds in excess
of $1,000,000.00 are appropriated in part 1, the department shall
provide not later than November 1, 2015 a list of program-specific
metrics intended to measure its performance based on a return on
taxpayer investment. The department shall deliver the program-
specific metrics to members of the senate and house subcommittees
that have subject matter jurisdiction for this budget, fiscal
agencies, and the state budget director. The department shall
provide an update on its progress in tracking program-specific
metrics and the status of program success at an appropriations
subcommittee meeting called for by the subcommittee chair.
Sec. 206. (1) In addition to the funds appropriated in part 1,
there is appropriated an amount not to exceed $200,000,000.00 for
federal contingency funds. These funds are not available for
expenditure until they have been transferred to another line item
in part 1 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 $40,000,000.00 for state
restricted contingency funds. These funds are not available for
expenditure until they have been transferred to another line item
in part 1 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 part 1
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 $40,000,000.00 for private
contingency funds. These funds are not available for expenditure
until they have been transferred to another line item in part 1
under section 393(2) of the management and budget act, 1984 PA 431,
MCL 18.1393.
Sec. 207. The department shall maintain, on a public
accessible website, a department scorecard that identifies, tracks,
and regularly updates key metrics that are used to monitor and
improve the department's performance.
Sec. 208. The departments and agencies receiving
appropriations in part 1 shall use the Internet to fulfill the
reporting requirements of this part and part 1. 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.
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 and the director of the aging and adult
services agency 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 and the director of the aging and adult services agency
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. If the revenue collected by the department from fees
and collections exceeds the amount appropriated in part 1, the
revenue may be carried forward with the approval of the state
budget director into the subsequent fiscal year. The revenue
carried forward under this section shall be used as the first
source of funds in the subsequent fiscal year.
Sec. 212. (1) 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.
(2) Upon the release of the next fiscal year executive budget
recommendation, the department shall report to the same parties in
subsection (1) 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.
Sec. 213. The state departments, agencies, and commissions
receiving tobacco tax funds and Healthy Michigan fund revenue 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. 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.
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 January 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. 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. 252. The appropriations in part 1 for Healthy Michigan
plan-behavioral health, Healthy Michigan plan administration, and
Healthy Michigan plan are contingent on the provisions of the
social welfare act, 1939 PA 280, MCL 400.1 to 400.119b, that were
contained in 2013 PA 107 not being amended, repealed, or otherwise
altered to eliminate the Healthy Michigan plan. If that occurs,
then, upon the effective date of the amendatory act that amends,
repeals, or otherwise alters those provisions, the remaining funds
in the Healthy Michigan plan-behavioral health, Healthy Michigan
plan administration, and Healthy Michigan plan line items shall
only be used to pay previously incurred costs and any remaining
appropriations shall not be allotted to support those line items.
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,
the house and senate fiscal agencies, and the state budget office
of the submission.
(2) The department shall provide written or verbal biannual
reports to the senate and house appropriations subcommittees on
community health, the senate and house fiscal agencies, and the
state budget office summarizing the status of any new or ongoing
discussions with the Centers for Medicare and Medicaid Services or
the United States Department of Health and Human Services regarding
potential or future Medicaid waiver applications.
(3) The department shall inform the senate and house
appropriations subcommittees on community health and the senate and
house fiscal agencies of any alterations or adjustments made to the
published plan for integrated care for individuals who are eligible
for both Medicare and Medicaid when the final version of the plan
has been submitted to the federal Centers for Medicare and Medicaid
Services or the United States Department of Health and Human
Services.
Sec. 266. The departments and agencies receiving
appropriations in part 1 shall prepare a report on out-of-state
travel expenses not later than January 1 of each year. The travel
report shall be a listing of 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 appropriations committees, the
house and senate fiscal agencies, and the state budget director.
The report shall include the following information:
(a) The dates of each travel occurrence.
(b) 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.
Sec. 267. The department shall not take disciplinary action
against an employee for communicating with a member of the
legislature or his or her staff.
Sec. 270. The department shall advise the legislature of the
receipt of a 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. By November 1 and May 1 of the current fiscal
year, 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. 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 outside services that
the attorney general authorizes.
Sec. 287. Not later than November 30, the state budget office
shall prepare and transmit a report that provides for estimates of
the total general fund/general purpose appropriation lapses at the
close of the prior 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 chairpersons of the senate and house
appropriations committees, and the senate and house fiscal
agencies.
Sec. 288. (1) Beginning October 1 of the current fiscal year,
no less than 90% of a new department contract supported solely from
state restricted funds or general fund/general purpose funds and
designated in this part or part 1 for a specific entity for the
purpose of providing services to individuals shall be expended for
such services after the first year of the contract.
(2) The department may allow a contract to exceed the
limitation on administrative and services costs if it can be
demonstrated that an exception should be made to the provision in
subsection (1).
(3) By September 30 of the current fiscal year, the department
shall report to the house and senate appropriations subcommittees
on community health, house and senate fiscal agencies, and state
budget office on the rationale for all exceptions made to the
provision in subsection (1) and the number of contracts terminated
due to violations of subsection (1).
Sec. 290. On a quarterly basis, the department shall report on
the status of the merger, executed under Executive Order No. 2015-
4, of the department of community health and the department of
human services to create the department of health and human
services. The department shall provide the report to the house and
senate appropriations subcommittees on community health, the house
and senate appropriations subcommittees on human services, and the
house and senate fiscal agencies. The report must include, but not
be limited to, the current status of FTE positions, facilities in
use, services including restructuring or consolidation,
efficiencies, and estimated savings or costs associated with the
merger. The report must indicate changes from the prior report.
Sec. 292. The department shall cooperate with the department
of technology, management, and budget to maintain a searchable
website accessible by the public at no cost that includes, but is
not limited to, all of the following for each department or agency:
(a) Fiscal year-to-date expenditures by category.
(b) Fiscal year-to-date expenditures by appropriation unit.
(c) Fiscal year-to-date payments to a selected vendor,
including the vendor name, payment date, payment amount, and
payment description.
(d) The number of active department employees by job
classification.
(e) Job specifications and wage rates.
Sec. 296. Within 14 days after the release of the executive
budget recommendation, the department shall cooperate with the
state budget office to provide the senate and house appropriations
chairs, the senate and house appropriations subcommittees chairs,
and the senate and house fiscal agencies with an annual report on
estimated state restricted fund balances, state restricted fund
projected revenues, and state restricted fund expenditures for the
fiscal years ending September 30, 2015 and September 30, 2016.
Sec. 297. Total authorized appropriations from all sources
under part 1 for legacy costs for the fiscal year ending September
30, 2016 are $87,425,100.00. From this amount, total agency
appropriations for pension-related legacy costs are estimated at
$49,623,700.00. Total agency appropriations for retiree health care
legacy costs are estimated at $37,801,400.00.
Sec. 298. From the funds appropriated in part 1 for the
Michigan Medicaid information system line item, $20,000,000.00 in
private revenue will be allocated for the Michigan-Illinois
alliance Medicaid management information systems project.
Sec. 299. No state department or agency shall issue a request
for proposal (RFP) for a contract in excess of $5,000,000.00,
unless the department or agency has first considered issuing a
request for information (RFI) or a request for qualification (RFQ)
relative to that contract to better enable the department or agency
to learn more about the market for the products or services that
are the subject of the RFP. The department or agency shall notify
the department of technology, management, and budget of the
evaluation process used to determine if an RFI or RFQ was not
necessary prior to issuing the RFP.
BEHAVIORAL HEALTH SERVICES
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 in
accordance with the mental health code, 1974 PA 258, MCL 330.1001
to 330.2106, the Medicaid provider manual, federal Medicaid
waivers, and all other applicable federal and state laws.
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 the department budget, 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 mental
health services for special populations, the department may require
each contractor to provide data and information on performance-
related metrics. These metrics may include, but are not limited to,
all of the following:
(a) Each contractor or subcontractor shall have a mission that
is consistent with the purpose of multicultural integration
funding.
(b) Each contractor shall validate that any subcontractors
utilized within these appropriations share the same mission as the
lead agency receiving funding.
(c) Each contractor or subcontractor shall demonstrate cost-
effectiveness.
(d) Each contractor or subcontractor shall ensure its ability
to leverage private dollars to strengthen and maximize service
provision.
(e) Each contractor or subcontractor shall provide timely and
accurate reports regarding the number of clients served, units of
service provision, and ability to meet its stated goals.
(2) The department shall require an annual report from the
contractors that receive mental health services for special
populations funding. The annual report, due 60 days following the
end of the contract period, shall include specific information on
services and programs provided, the client base to which the
services and programs were provided, information on any wraparound
services provided, and the expenditures for those services. The
department shall provide the annual reports to the senate and house
appropriations subcommittees on the department budget, the senate
and house fiscal agencies, and the state budget office.
(3) The department shall convene a workgroup to discuss and
make recommendations on including accreditation in the contractor
specifications and potentially moving toward competitive bidding.
Each contractor required to provide data per this section shall be
invited to participate in the workgroup.
Sec. 404. (1) Not later than May 31 of the current fiscal
year, the department shall provide a report on the CMHSPs, PIHPs,
regional entities designated by the department as PIHPs, and
managing entities for substance use disorders to the members of the
house and senate appropriations subcommittees on the department
budget, 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, PIHP,
regional entity designated by the department as a PIHP, and
managing entity for substance use disorders 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 and
cultural and ethnic groups of the services area, including the deaf
and hard of hearing population.
(c) Financial information that, minimally, includes a
description of funding authorized; expenditures by client group and
fund source; and cost information by Medicaid and Healthy Michigan
plan service category, including administration and funds specified
for all outside contracts for services and products. Financial
information must include the amount of funding, from each fund
source, used to cover clinical services and supports. Service
category includes all department-approved services. General fund
expenditures should reflect those funds used to cover uninsured
individuals including Medicaid spenddowns.
(d) Data describing service outcomes that include, but are 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.
(h) Lapses and carryforwards during the immediately preceding
fiscal year for CMHSPs, PIHPs, regional entities designated by the
department as PIHPs, and managing entities for substance use
disorders.
(i) Information about contracts for both administrative and
mental health services entered into by CMHSPs, PIHPs, regional
entities designated by the department as PIHPs, and managing
entities for substance use disorders with providers and others,
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, including contract and consultant
costs, for services provided to CMHSPs, PIHPs, regional entities
designated by the department as PIHPs, and managing entities for
substance use disorders.
(j) Information on the community mental health Medicaid
managed care and Healthy Michigan plan programs, including, but not
limited to, the following:
(i) Expenditures by each CMHSP, PIHP, regional entity
designated by the department as a PIHP, and managing entity for
substance use disorders organized by Medicaid eligibility group,
including per eligible individual expenditure averages.
(ii) Expenditures on, and utilization of, each Medicaid and
Healthy Michigan plan service category by each CMHSP, PIHP,
regional entity designated by the department as a PIHP, and
managing entity for substance use disorders.
(iii) Performance indicator information required to be
submitted to the department in the contracts with CMHSPs, PIHPs,
regional entities designated by the department as PIHPs, and
managing entities for substance use disorders.
(k) Administrative expenditures of each CMHSP, PIHP, regional
entity designated by the department as a PIHP, and managing entity
for substance use disorders that includes a breakout of the salary,
benefits, and pension of each executive level staff and shall
include the director, chief executive, and chief operating officers
and other members identified as executive staff.
(3) The department shall include data reporting requirements
listed in subsection (2) in the annual contract with each
individual CMHSP, PIHP, regional entity designated by the
department as a PIHP, and managing entity for substance use
disorders.
(4) The department shall take all reasonable actions to ensure
that the data required are complete and consistent among all
CMHSPs, PIHPs, regional entities designated by the department as
PIHPs, and managing entities for substance use disorders.
Sec. 406. (1) The funds appropriated in part 1 for the state
disability assistance substance use disorder services program shall
be used to support per diem room and board payments in substance
use disorder residential facilities. Eligibility of clients for the
state disability assistance substance use disorder services program
shall include needy persons 18 years of age or older, or
emancipated minors, who reside in a substance use disorder
treatment center.
(2) The department shall reimburse all licensed substance use
disorder programs eligible to participate in the program at a rate
equivalent to that paid by the department 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
use disorder prevention, education, and treatment grants shall be
expended to coordinate care and services provided to individuals
with severe and persistent mental illness and substance use
disorder diagnoses.
(2) The department shall approve managing entity fee schedules
for providing substance use disorder services and charge
participants in accordance with their ability to pay.
(3) The managing entity shall continue current efforts to
collaborate on the delivery of services to those clients with
mental illness and substance use disorder diagnoses with the goal
of providing services in an administratively efficient manner.
Sec. 408. (1) By April 1 of the current fiscal year, the
department shall report the following data from the prior fiscal
year on substance use disorder prevention, education, and treatment
programs to the senate and house appropriations subcommittees on
the department budget, the senate and house fiscal agencies, and
the state budget office:
(a) Expenditures stratified by department-designated community
mental health entity, by central diagnosis and referral agency, by
fund source, by subcontractor, by population served, and by service
type. Additionally, data on administrative expenditures by
department-designated community mental health entity 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 department-
designated community mental health entity, by subcontractor, by
population served, and by service type.
(2) The department shall take all reasonable actions to ensure
that the required data reported are complete and consistent among
all department-designated community mental health entities.
Sec. 410. The department shall assure that substance use
disorder treatment is provided to applicants and recipients of
public assistance through the department who are required to obtain
substance use disorder 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 individuals 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 use disorder services.
Sec. 418. On or before the twenty-fifth of each month, the
department shall report to the senate and house appropriations
subcommittees on the department budget, 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 shall 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. 458. Medicaid services shall include treatment for autism
spectrum disorders as defined in the federally approved Medicaid
state plan. Such alternatives may be coordinated with the Medicaid
health plans and the Michigan Association of Health Plans.
Sec. 460. The department shall allocate funds appropriated in
part 1 for university autism programs through a grant process for
the purpose of increasing the number of applied behavioral analysis
therapists, autism diagnostic centers, autism treatment centers,
and employment programs, and to increase the autism clinical
expertise of health care providers.
Sec. 494. (1) Contingent upon federal approval, if a CMHSP,
PIHP, or subcontracting provider agency is reviewed and accredited
by a national accrediting entity for behavioral health care
services, the department, by April 1 of the current fiscal year,
shall consider that CMHSP, PIHP, or subcontracting provider agency
in compliance with state program review and audit requirements that
are addressed and reviewed by that national accrediting entity.
(2) By June 1 of the current fiscal year, the department shall
report to the house and senate appropriations subcommittees on the
department budget, the house and senate fiscal agencies, and the
state budget office all of the following:
(a) A list of each CMHSP, PIHP, and subcontracting provider
agency that is considered in compliance with state program review
and audit requirements under subsection (1).
(b) For each CMHSP, PIHP, or subcontracting provider agency
described in subdivision (a), all of the following:
(i) The state program review and audit requirements that the
CMHSP, PIHP, or subcontracting provider agency is considered in
compliance with.
(ii) The national accrediting entity that reviewed and
accredited the CMHSP, PIHP, or subcontracting provider agency.
(3) The department shall continue to comply with state and
federal law and shall not initiate an action that negatively
impacts beneficiary safety.
(4) As used in this section, "national accrediting entity"
means the Joint Commission, formerly known as the Joint Commission
on Accreditation of Healthcare Organizations, the Commission on
Accreditation of Rehabilitation Facilities, the Council on
Accreditation, the URAC, formerly known as the Utilization Review
Accreditation Commission, the National Committee for Quality
Assurance, or other appropriate entity, as approved by the
department.
Sec. 495. From the funds appropriated in part 1 for behavioral
health program administration, $4,350,000.00 is intended to address
the recommendations of the mental health diversion council.
Sec. 497. The population data used in determining the
distribution of substance use disorder block grant funds shall be
from the most recent federal census.
Sec. 498. For distribution of state general funds to CMHSPs,
if the department decides to use census data, the department shall
use the most recent federal decennial census data available.
Sec. 502. (1) The department shall continue developing an
outreach program on fetal alcohol syndrome services.
(2) The department shall explore federal grant funding to
address prevention services for fetal alcohol syndrome and reduce
alcohol consumption among pregnant women.
Sec. 503. The department shall notify the Michigan Association
of Community Mental Health Boards when developing policies and
procedures that will impact PIHPs or CMHSPs.
Sec. 504. (1) The department shall continue to work with the
workgroup created to make recommendations to achieve more
uniformity in capitation payments made to the PIHPs.
(2) The department shall provide the workgroup's progress
report to the senate and house appropriations subcommittees on the
department budget, the senate and house fiscal agencies, and the
state budget director by March 1 of the current fiscal year.
Sec. 505. For the purposes of special projects involving high-
need children or adults, including the not guilty by reason of
insanity population, the department may contract directly with
providers of services to these identified populations.
Sec. 506. No later than June 1 of the current fiscal year, the
department shall provide the house and senate appropriations
subcommittees on the department budget, the house and senate fiscal
agencies, and the state budget office with the most recent cost
data information submitted by the CMHSPs on how the funds
appropriated in part 1 for the community mental health services
non-Medicaid services line item were expended by each CMHSP. At a
minimum, the information must include CMHSPs general fund/general
purpose costs for each of the following categories: administration,
prevention, jail diversion and treatment services, MIChild program,
children's waiver home care program, children with serious
emotional disturbance waiver program, services provided to
individuals with mental illness and developmental disabilities who
are not eligible for Medicaid, and the Medicaid spenddown
population.
Sec. 507. (1) From the funds appropriated in part 1 for
behavioral health program administration, the department shall
establish a psychiatric residential treatment facility and
children's behavioral action team. These services will augment the
continuum of behavioral health services for high-need youth and
provide additional continuity of care and transition into
supportive community-based services.
(2) Outcomes and performance measures for this initiative
include, but are not limited to, the following:
(a) The rate of rehospitalization for youth served through the
program at 30 and 180 days.
(b) Measured change in the Child and Adolescent Functional
Assessment Scale for children served through the program.
Sec. 508. The PIHP shall do all of the following:
(a) Work to reduce administration costs by ensuring that PIHP
responsible functions are efficient to allow optimal transition of
dollars to direct services. This process must include limiting
duplicate layers of administration and minimizing PIHP-delegated
services that may result in higher costs or inconsistent service
delivery, or both.
(b) Take an active role in managing mental health care by
ensuring consistent and high-quality service delivery throughout
its network and promote a conflict-free care management
environment.
(c) Ensure that direct service rate variances are related to
the level of need or other quantifiable measures to ensure that the
most money possible reaches direct services.
(d) Whenever possible, promote fair and adequate direct care
reimbursement, including fair wages for direct service workers.
Sec. 509. (1) The department shall work with PIHP network
providers to analyze the workforce challenges of recruitment and
retention of staff who provide Medicaid-funded community living
supports, personal care services, respite services, skill building
services, and other similar supports and services. The department
workgroup must consider ways to attract and retain staff to provide
Medicaid-funded supports and services.
(2) The department workgroup must include PIHP providers,
CMHSPs, individuals with disabilities, and staff.
(3) The department shall provide a status report on the
workgroup's suggestions to the senate and house appropriations
subcommittees on the department budget, the senate and house fiscal
agencies, and the state budget director, making note in the report
when the participants outlined in subsection (2) reached consensus
on the workgroup's suggestions and when the participants outlined
in subsection (2) had points of difference on the workgroup's
suggestions.
Sec. 510. (1) If the federal government allows the
redistribution of lapsed federal Medicaid match funds in the
Medicaid mental health services line, the funds appropriated in part
1 for Medicaid mental health services funds, which have lapsed,
shall be distributed to individual PIHPs based on the PIHP
distribution formula in effect during the current fiscal year.
(2) It is the intent of the legislature that any funds that
lapse from the funds appropriated in part 1 for Medicaid mental
health services shall be redistributed to individual CMHSPs based
on the community mental health non-Medicaid services distribution
formula in effect during the current fiscal year. By April 1 of the
current fiscal year, the department shall report to the house and
senate subcommittees on the department budget, the house and senate
fiscal agencies, and the state budget office on the lapse by PIHP
from the previous fiscal year and the projected lapse by PIHP in
the current fiscal year.
STATE PSYCHIATRIC HOSPITALS AND FORENSIC MENTAL HEALTH SERVICES
Sec. 601. 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. A portion of
revenues collected through project efforts may be used for
departmental costs and contractual fees associated with these
retroactive collections and to improve ongoing departmental
reimbursement management functions.
Sec. 602. 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. 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
individuals currently in those facilities and a plan for service
provision for those individuals 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 individual currently in the facility. A
discharge and aftercare plan shall address the individual's housing
needs. A homeless shelter or similar temporary shelter arrangements
are inadequate to meet the individual'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 the department budget
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 individuals 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. Effective October 1 of the current fiscal year, the
department, in consultation with the department of technology,
management, and budget, may maintain a bid process to identify 1 or
more private contractors to provide food service and custodial
services for the administrative areas at any state hospital
identified by the department as capable of generating savings
through the outsourcing of such services.
PUBLIC HEALTH ADMINISTRATION
Sec. 651. The department shall work with the Michigan health
endowment fund corporation established under section 653 of the
nonprofit health care corporation reform act, 1980 PA 350, MCL
550.1653, to explore ways to fund and evaluate current and future
policies and programs.
Sec. 654. From the funds appropriated in part 1 for health and
wellness initiatives, $1,000,000.00 shall be allocated for a school
children's healthy exercise program to promote and advance physical
health for school children in kindergarten through grade 8. The
department shall recommend model programs for sites to implement
that incorporate evidence-based best practices. The department
shall grant no less than 1/2 of the funds appropriated in part 1
for before- and after-school programs. The department shall
establish guidelines for program sites, which may include schools,
community-based organizations, private facilities, recreation
centers, or other similar sites. The program format shall encourage
local determination of site activities and shall encourage local
inclusion of youth in the decision-making regarding site
activities. Program goals shall include children experiencing
improved physical health and access to physical activity
opportunities, the reduction of obesity, providing a safe place to
play and exercise, and nutrition education. To be eligible to
participate, program sites shall provide a 20% match to the state
funding, which may be provided in full, or in part, by a
corporation, foundation, or private partner. The department shall
seek financial support from corporate, foundation, or other private
partners for the program or for individual program sites.
Sec. 655. The department shall establish criteria for all
funds allocated under part 1 for health and wellness initiatives.
The criteria must include a requirement that all programs funded be
evidence-based and supported by research, include interventions
that have been shown to demonstrate outcomes that lower cost and
improve quality, and be designed for statewide impact. Preference
must be given to programs that utilize the funding as match for
additional resources including, but not limited to, federal
sources.
HEALTH POLICY
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" means nonprofit organizations
that use volunteer health professionals to provide care to
uninsured individuals.
Sec. 713. The department shall continue support of
multicultural agencies that provide primary care services from the
funds appropriated in part 1.
Sec. 715. The department shall continue to seek means to
increase retention of Michigan medical school students for
completion of their primary care residency requirements within this
state and ultimately, for some period of time, to remain in this
state and serve as primary care physicians. The department is
encouraged to work with Michigan institutions of higher education.
Sec. 717. The department may award health innovation grants to
address emerging issues and encourage cutting edge advances in
health care including strategic partners in both the public and
private sectors.
Sec. 718. (1) From the funds appropriated in part 1 for health
policy administration, the department shall allocate the federal
state innovation model grant funding that supports implementation
of the health delivery system innovations detailed in this state's
"Reinventing Michigan's Health Care System: Blueprint for Health
Innovation" document. Over the next 4 years this initiative will
test new payment methodologies, support improved population health
outcomes, and support improved infrastructure for technology and
data sharing and reporting. The funds will be used to provide
financial support directly to regions participating in the model
test and to support statewide stakeholder guidance and technical
support.
(2) Outcomes and performance measures for the initiative under
subsection (1) include, but are not limited to, the following:
(a) Increasing the number of physician practices fulfilling
patient-centered medical home functions.
(b) Reducing inappropriate health utilization, specifically
reducing preventable emergency department visits, reducing the
proportion of hospitalizations for ambulatory sensitive conditions,
and reducing this state's 30-day hospital readmission rate.
(3) By March 1 and September 1 of the current fiscal year, 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 on the status
of the program and progress made since the prior report.
(4) From the funds appropriated in part 1 for health policy
administration, any data aggregator created as part of the
allocation of the federal state innovation model grant funds must
meet the following standards:
(a) The primary purpose of the data aggregator must be to
increase the quality of health care delivered in this state, while
reducing costs.
(b) The data aggregator must be governed by a nonprofit
entity.
(c) All decisions regarding the establishment, administration,
and modification of the database must be made by an advisory board.
The membership of the advisory board must include the director of
the department or a designee of the director and representatives of
health carriers, consumers, and purchasers.
(d) The data aggregator must receive health care claims
information from, without limitation, commercial health carriers,
nonprofit health care corporations, health maintenance
organizations, and third party administrators that process claims
under a service contract.
(e) The data aggregator must use existing data sources and
technological infrastructure, to the extent possible.
Sec. 719. The department will take steps necessary to assure
that Indian Health Service, Tribal or Urban Indian Health Program
facilities that provide services under a contract with a Medicaid
managed care entity receive the maximum amount allowable under
federal law for Medicaid services.
Sec. 720. From the funds appropriated in part 1 for bone
marrow transplant registry, $250,000.00 shall be allocated to
Michigan Blood, the partner of the match registry of the national
marrow donor program. The funds shall be used to offset ongoing
tissue typing expenses associated with donor recruitment and
collection services and to expand those services to better serve
the citizens of this state.
EPIDEMIOLOGY AND INFECTIOUS DISEASE
Sec. 851. From the funds appropriated in part 1 for the
healthy homes program, no less than $1,750,000.00 shall be
allocated for lead abatement of homes.
Sec. 852. The department shall implement a plan designed to
improve Michigan's childhood and adolescent immunization rates. The
department shall engage organizations working to provide
immunizations and education about the value of vaccines, including,
but not limited to, statewide organizations representing health
care providers, local public health departments, child health
interest groups, and private foundations with a mission to increase
immunization rates.
Sec. 853. From the funds appropriated in part 1 for
immunization programs, for every $4.00 in private matching funds
received, this state shall allocate $1.00, up to $500,000.00 in
state contributions, to provide and promote education about the
value of vaccines for infants and toddlers.
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 be used to 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 essential
local public health services 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 essential local
public health services 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
department of agriculture and rural development. Public water
supply, private groundwater supply, and on-site sewage management
shall be provided in consultation with the 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).
CHRONIC DISEASE AND INJURY PREVENTION AND HEALTH PROMOTION
Sec. 1001. From the funds appropriated in part 1 for
Alzheimer's disease in-home care pilot, $150,000.00 is appropriated
for Alzheimer's disease services and shall be remitted to the
Alzheimer's association-Michigan chapters for the purpose of
carrying out a pilot project in Macomb, Monroe, and St. Joseph
Counties. The fiduciary for the funds is the Alzheimer's
association-greater Michigan chapter. The Alzheimer's association
shall provide enhanced services, including 24/7 helpline, continued
care consultation, and support groups, to individuals with
Alzheimer's disease or dementia and their families in the 3
counties, and partner with a Michigan public university to study
whether provision of such in-home support services significantly
delays the need for residential long-term care services for
individuals with Alzheimer's disease or dementia. The study must
also consider potential cost savings related to the delay of long-
term care services, if a delay is shown.
FAMILY, MATERNAL, AND CHILDREN'S HEALTH SERVICES
Sec. 1103. By January 3 of the current fiscal year the
department shall annually issue to the legislature, and to the
public on the Internet, a report providing estimated public funds
administered by the department for family planning, sexually
transmitted infection prevention and treatment, and pregnancies and
births, as well as demographics collected by the department as
voluntarily self-reported by individuals utilizing those services.
The department shall provide the actual expenditures by marital
status or, where actual expenditures are not available, shall
provide estimated expenditures by marital status. The department
may utilize the DCH-1426 application for health coverage and help
paying costs or any other official application for public
assistance for medical coverage to determine the actual or
estimated public expenditures based on marital status.
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 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. 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 population affairs within the United States
Department of Health and Human Services specifies in the program
guidelines for project grants for family planning services. An
agency not in compliance with the indicators shall not receive
supplemental or reallocated funds.
Sec. 1107. The department shall not contract with an
organization which provides elective abortions, abortion
counseling, or abortion referrals, for services that are to be
funded with state restricted or state general fund/general purpose
funds appropriated in part 1 for family planning local agreements.
An organization under contract with the department shall not
subcontract with an organization which provides elective abortions,
abortion counseling, or abortion referrals, for services that are
to be funded with state restricted or state general fund/general
purpose funds appropriated in part 1 for family planning local
agreements.
Sec. 1108. The department shall not use state restricted funds
or state general funds appropriated in part 1 in the pregnancy
prevention program or family planning local agreements
appropriation line items for 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. The department shall use revenue from mobile
dentistry facility permit fees received under section 21605 of the
public health code, 1978 PA 368, MCL 333.21605, to offset the cost
of the permit program.
Sec. 1136. From the funds appropriated in part 1 for prenatal
care outreach and service delivery support, $50,000.00 shall be
allocated for a pregnancy and parenting support services program,
which program must promote childbirth, alternatives to abortion,
and grief counseling. The department shall establish a program with
a qualified contractor that will contract with qualified service
providers to provide free counseling, support, and referral
services to eligible women during pregnancy through 12 months after
birth. As appropriate, the goals for client outcomes shall include
an increase in client support, an increase in childbirth choice, an
increase in adoption knowledge, an improvement in parenting skills,
and improved reproductive health through abstinence education. The
contractor of the program shall provide for program training,
client educational material, program marketing, and annual service
provider site monitoring. The department shall submit a report to
the house and senate appropriations subcommittees on community
health and the house and senate fiscal agencies by April 1 of the
current fiscal year on the number of clients served.
Sec. 1137. From the funds appropriated in part 1 for prenatal
care outreach and service delivery support, not less than
$500,000.00 of funding shall be allocated for evidence-based
programs to reduce infant mortality including nurse family
partnership programs. The funds shall be used for enhanced support
and education to nursing teams or other teams of qualified health
professionals, client recruitment in areas designated as
underserved for obstetrical and gynecological services and other
high-need communities, strategic planning to expand and sustain
programs, and marketing and communications of programs to raise
awareness, engage stakeholders, and recruit nurses.
Sec. 1138. The department shall allocate funds appropriated in
section 112 of part 1 for family, maternal, and children's health
services pursuant to section 1 of 2002 PA 360, MCL 333.1091.
Sec. 1139. The department shall continue to work jointly with
the department of human services, the Michigan state housing
development authority, and the joint task force established under
article IV of 2014 PA 252 to review housing rehabilitation, energy
and weatherization, and hazard abatement program policies and to
make recommendations for integrating and coordinating project
delivery with the goals of serving more families and achieving
better outcomes by maximizing state and federal resources. The
joint task force may provide recommendations to the departments.
Recommendations of the joint task force must give consideration to
best practices and cost effectiveness.
Sec. 1140. From the funds appropriated in part 1 for prenatal
care outreach and service delivery support, equal consideration
shall be given to all eligible evidence-based providers in all
regions in contracting for rural health visitation services.
Sec. 1141. The department shall spend any available work
project money to enhance services provided under the rural home
visitation program.
WOMEN, INFANTS, AND CHILDREN FOOD AND NUTRITION PROGRAM
Sec. 1151. The women, infants, and children special
supplemental food and nutrition program shall encourage
participants to choose the lowest price product available at the
time of purchase. All products must satisfy nutritional
requirements of the federal program. The biannual food
authorization guidelines will be updated to reflect these changes.
CHILDREN'S SPECIAL HEALTH CARE SERVICES
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 medical care and treatment to eligible patients
with hereditary coagulation defects, commonly known as hemophilia,
who are 21 years of age or older.
(d) Provide human growth hormone to eligible patients.
Sec. 1205. From the funds appropriated in part 1 for medical
care and treatment, the department is authorized to spend those
funds for the continued development and expansion of telemedicine
capacity to allow families with children in the children's special
health care services program to access specialty providers more
readily and in a more timely manner.
CRIME VICTIM SERVICES COMMISSION
Sec. 1302. From the funds appropriated in part 1 for justice
assistance grants, the department shall continue to support
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.
AGING AND ADULT SERVICES AGENCY
Sec. 1403. (1) By February 1 of the current fiscal year, the
aging and adult services agency shall require each region to report
to the aging and adult services agency 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. 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. 1421. From the funds appropriated in part 1 for community
services, $1,100,000.00 shall be allocated to area agencies on
aging for locally determined needs.
MEDICAL SERVICES ADMINISTRATION
Sec. 1501. The unexpended funds appropriated in part 1 for the
electronic health records incentive program are considered work
project appropriations, and any unencumbered or unallotted funds
are carried forward into the following fiscal year. The following
is in compliance with section 451a(1) of the management and budget
act, 1984 PA 431, MCL 18.1451a:
(a) The purpose of the project to be carried forward is to
implement the Medicaid electronic health record program that
provides financial incentive payments to Medicaid health care
providers to encourage the adoption and meaningful use of
electronic health records to improve quality, increase efficiency,
and promote safety.
(b) The projects will be accomplished according to the
approved federal advanced planning document.
(c) The estimated cost of this project phase is identified in
the appropriation line item.
(d) The tentative completion date for the work project is
September 30, 2020.
Sec. 1502. The department shall spend available work project
revenue and any associated federal match to create and develop a
transparency database website. This funding is contingent upon
enactment of enabling legislation.
Sec. 1503. From the funds appropriated in part 1 for Healthy
Michigan plan administration, the department shall maintain an
accounting structure within the Michigan administrative information
network that will allow expenditures associated with the
administration of the Healthy Michigan plan to be identified.
Sec. 1505. By March 1 and September 1 of the current fiscal
year, the department shall submit a report to the senate and house
appropriations subcommittees on the department budget, the senate
and house fiscal agencies, and the state budget office including
both of the following:
(a) The department's projected annual increase in
reimbursement savings and cost offsets that will result from the
additional funds appropriated in part 1 for the office of inspector
general and third party liability efforts.
(b) The actual increase in reimbursement savings and cost
offsets that have resulted from the additional funds appropriated
in part 1 for the office of inspector general and third party
liability efforts.
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. 1603. (1) The department may establish a program for
individuals 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. 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.
Sec. 1606. For the purpose of guardian and conservator
charges, the department 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. 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 not enrolled in the Healthy Michigan plan or
with an income less than 100% of the federal poverty level 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) The department shall require a prescription co-payment for
Medicaid recipients enrolled in the Healthy Michigan plan with an
income of at least 100% of the federal poverty level of $4.00 for a
generic drug and $8.00 for a brand-name drug, except as prohibited
by federal or state law or regulation.
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 this state.
Sec. 1631. (1) The department shall require co-payments on
dental, podiatric, and vision 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
regulation, the department shall require Medicaid recipients not
enrolled in the Healthy Michigan plan or with an income less than
100% of the federal poverty level to pay not less than 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.
(3) Except as otherwise prohibited by federal or state law or
regulation, the department shall require Medicaid recipients
enrolled in the Healthy Michigan plan with an income of at least
100% of the federal poverty level to pay the following co-payments:
(a) Four dollars for a physician office visit.
(b) Eight dollars for a hospital emergency room visit.
(c) One hundred dollars for the first day of an inpatient
hospital stay.
(d) Four dollars for an outpatient hospital visit or any other
medical provider visit to the extent allowed by federal or state
law or regulation.
Sec. 1641. An institutional provider that is required to
submit a cost report under the medical services program shall
submit cost reports completed in full within 5 months after the end
of its fiscal year.
Sec. 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 shall receive authorization
from the recipient's HMO prior to admitting the recipient.
(3) Subsections (1) and (2) do not require an alteration to an
existing agreement between an HMO and its contracting hospitals and
do not require an HMO to reimburse for services that are not
considered to be medically necessary.
Sec. 1659. The following sections of this part 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 use disorder, and
developmentally disabled services program: 404, 411, 418, 428, 494,
508, 1607, 1657, 1662, 1699, 1764, 1806, 1807, 1809, 1810, 1820,
1850, and 1888.
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 HEDIS
well child health measures in accordance with the National
Committee for Quality Assurance prescribed methodology.
(3) The department shall provide a copy of the analysis of the
Medicaid HMO annual audited HEDIS reports and the annual external
quality review report to the senate and house of representatives
appropriations subcommittees on the department budget, 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.
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 212% 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
part and part 1.
(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 212% of the federal poverty level. The department's
verification policy shall be used to determine eligibility.
(5) The department shall contract with Medicaid health plans
to provide physical health services to MIChild enrollees. The
department may continue to obtain physical health services for
MIChild enrollees from health maintenance organizations and
preferred provider organizations currently under contract for
whatever duration is needed as determined by the department. The
department shall contractually require that health plans pay out-
of-network providers at the department fee schedule. The department
shall contract with qualified dental plans to provide dental
coverage for MIChild enrollees.
(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.
(10) MIChild services shall include treatment for autism
spectrum disorders as defined in the federally approved Medicaid
state plan.
Sec. 1673. The department may establish premiums for MIChild
eligible individuals in families with income at or below 212% of
the federal poverty level. The monthly premiums shall be $10.00 per
month.
Sec. 1677. The MIChild program shall provide, at a minimum,
all benefits available under the Michigan benchmark 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 use
disorder 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
use disorder 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 use disorder treatment services that may include
inpatient, outpatient, and residential substance use disorder
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. 1682. (1) 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.
(2) Any unexpended penalty money, at the end of the year,
shall carry forward to the following year.
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. From the funds appropriated in part 1 for special
Medicaid reimbursement, $386,700.00 of general fund/general purpose
revenue and any associated federal match shall be distributed for
poison control services to an academic health care system that
includes a children's hospital that has a high indigent care
volume.
Sec. 1699. (1) The department may make separate payments in
the amount of $45,000,000.00 directly to qualifying hospitals
serving a disproportionate share of indigent patients and to
hospitals providing GME training programs. If direct payment for
GME and DSH is made to qualifying hospitals for services to
Medicaid clients, hospitals shall not include GME costs or DSH
payments in their contracts with HMOs.
(2) The department shall allocate $45,000,000.00 in DSH
funding using the distribution methodology used in fiscal year
2003-2004.
(3) By September 30 of the current fiscal year, the department
shall report to the senate and house appropriations subcommittees
on the department budget, the senate and house fiscal agencies, and
the state budget office on the distribution of funding to each
eligible hospital from the GME and DSH pools.
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. 1730. (1) The department shall work with the department
of education to evaluate the feasibility of including an assessment
tool to promote literacy development of pregnant women and new
mothers in the maternal infant health program.
(2) By March 1 of the current fiscal year, the department
shall provide a report to the house and senate appropriations
subcommittees on the department budget, the house and senate fiscal
agencies, and the state budget office on the findings of the
feasibility study on including an assessment tool to promote
literacy development of pregnant women and new mothers in the
maternal infant health program.
Sec. 1757. The department shall 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.
Sec. 1764. The department shall annually certify whether rates
paid to Medicaid health plans and specialty prepaid inpatient
health plans are actuarially sound in accordance with federal
requirements and shall provide a copy of the rate certification and
approval of rates paid to Medicaid health plans and specialty
prepaid inpatient health plans within 5 business days after
certification or approval to the house and senate appropriations
subcommittees on the department budget and the house and senate
fiscal agencies. When calculating the annual actuarial soundness
adjustment, the department shall take into account all Medicaid
policy bulletins affecting Medicaid health plans or specialty
prepaid inpatient health plans issued after the most recent
actuarial soundness process concluded.
Sec. 1770. The department shall report to the senate and house
appropriations subcommittees on the department budget, the senate
and house fiscal agencies, and the state budget office information
on savings from the reduction in managed care laboratory services
fees enacted under Executive Order No. 2015-5 and continued in the
current fiscal year. This report shall include the actual gross
reduction in expenditures by Medicaid health plans that result from
the reduction in the laboratory services fees.
Sec. 1775. (1) By March 1 and September 1 of the current
fiscal year, the department shall report to the senate and house
appropriations subcommittees on the department budget, the senate
and house fiscal agencies, and the state budget office on progress
in implementing the waiver to implement managed care for
individuals who are eligible for both Medicare and Medicaid, known
as MI Health Link, including, but not limited to, a description of
how the department intends to ensure that service delivery is
integrated, how key components of the proposal are implemented
effectively, and any problems and potential solutions as identified
by the ombudsman described in subsection (2).
(2) The department shall ensure the existence of an ombudsman
program that is not associated with any project service manager or
provider to assist MI Health Link beneficiaries with navigating
complaint and dispute resolution mechanisms and to identify
problems in the demonstrations and in the complaint and dispute
resolution mechanisms.
Sec. 1800. For the distribution of each of the pools within
the $85,000,000.00 outpatient disproportionate share hospital
payment, the department shall develop a formula for the
distribution of each pool based on the quality of care, cost,
traditional disproportionate share hospital factors such as
Medicaid utilization and uncompensated care, and any other factor
that the department determines should be considered. By May 1 of
the current fiscal year, the department shall report to the senate
and house appropriations subcommittees on the department budget,
the senate and house fiscal agencies, and the state budget office
on the distribution of each pool.
Sec. 1801. From the funds appropriated in part 1 for physician
services and health plan services, the department shall use
$33,318,800.00 in general fund/general purpose plus associated
federal match to continue the increase to Medicaid rates for
primary care services provided only by primary care providers. For
the purpose of this section, a primary care provider is a
physician, or a practitioner working under the personal supervision
of a physician, who is board-eligible or certified with a specialty
designation of family medicine, general internal medicine, or
pediatric medicine, or a provider who provides the department with
documentation of equivalency. The department shall examine
including the subspecialty of neonatal medicine in its definition
of primary care provider. Providers performing a service and whose
primary practice is as a non-primary-care subspecialty is not
eligible for the increase. The department shall establish policies
that most effectively limit the increase to primary care providers
for primary care services only.
Sec. 1802. From the funds appropriated in part 1, a lump-sum
payment shall be made to hospitals that qualified for rural
hospital access payments in fiscal year 2013-2014 and that provide
obstetrical care in the current fiscal year. The payment shall be
calculated as $830.00 for each obstetrical care case payment and
each newborn care case payment for all such cases billed by the
qualified hospitals for fiscal year 2012-2013 and shall be paid
through the Medicaid health plan hospital rate adjustment process
by January 1 of the current fiscal year.
Sec. 1804. The department, in cooperation with the department
of military and veterans affairs, shall work with the federal
public assistance reporting information system to identify Medicaid
recipients who are veterans and who may be eligible for federal
veterans health care benefits or other benefits.
Sec. 1805. Hospitals receiving medical services payments for
graduate medical education shall submit fully completed quality
data to the same national nonprofit organization with extensive
experience in collecting and reporting hospital quality data on a
public website. The reporting must utilize consensus-based
nationally endorsed standards that meet National Quality Forum-
endorsed safe practices. The organization collecting the data must
be one that uses severity-adjusted risk models and measures that
will help patients and payers identify hospital campuses likely to
have superior outcomes. The department shall withhold a hospital's
fourth quarter graduate medical education payment until the
hospital submits the data to the qualifying nonprofit organization
described in this section.
Sec. 1806. (1) The contracts for Medicaid health plans that
will be effective January 1, 2016 must include a provision that
requires the cooperation and participation in a workgroup that
develops and implements a common formulary that will be used by all
contracting Medicaid health plans. The department shall convene the
workgroup, make final decisions, and consult with health plans and
other organizations as this requirement is implemented.
(2) The department may establish performance standards to
measure progress in the implementation of the common formulary.
(3) The ongoing implementation of the common formulary must
include consideration of the department's preferred drug list.
(4) To achieve the objective of low net cost, the contracted
health plans may use evidence-based utilization management
techniques in the development and implementation of the common
formulary.
(5) The contracted health plans and the department shall
continue to facilitate and emphasize the value of increased
participation in the use of e-prescribing and electronic medical
records.
Sec. 1807. The process and results from the request for
proposals for the comprehensive health plan contract for this
state's Medicaid health plans must assure a fair, transparent and
deliberative process that emphasizes the value of choice and access
for beneficiaries.
Sec. 1809. The department shall establish separate contract
performance standards for Medicaid health plans that adhere to the
requirements of section 105d of the social welfare act, 1939 PA
280, MCL 400.105d, associated with the 0.75% and 0.25% capitation
withhold. The determination of the performance of the 0.75%
capitation withhold is at the discretion of the department but must
include recognized concepts such as 1-year continuous enrollment
and the HEDIS audited data. The determination of the performance of
the 0.25% capitation withhold is at the discretion of the
department but must include recognized concepts such as encouraging
the utilization of high-value services and discouraging the
utilization of low-value services.
Sec. 1810. The department shall enhance encounter data
reporting processes and develop rules that would make each health
plan's encounter data as complete as possible, provide a fair
measure of acuity for each health plan's enrolled population for
risk adjustment purposes, capitation rate setting, diagnosis-
related group rate setting, and research and analysis of program
efficiencies while minimizing health plan administrative expense.
Sec. 1812. (1) By June 1 of the current fiscal year, the
department shall require each hospital that receives funds
appropriated in part 1 for graduate medical education to submit a
report disclosing all direct and indirect costs associated with the
residency training program to the department, the house and senate
appropriations subcommittees on the department budget, and the
house and senate fiscal agencies.
(2) By August 1 of the current fiscal year, the department
shall require each hospital that receives funds appropriated in
part 1 for graduate medical education to submit a report
identifying and explaining the following:
(a) The marginal cost to add 1 additional residency training
program slot.
(b) The number of additional slots that would result in the
need to add additional administrative costs to oversee the
residents in the training program.
(c) The postresidency retention rate for the residency
training program.
(3) The department shall hold graduate medical education
recipients' fourth quarter payments until the submission of the
information required in subsections (1) and (2).
(4) The department shall convene a workgroup to use the
reports submitted under subsections (1) and (2) to assist in the
development of metrics for distribution of graduate medical
education funds and shall report to the senate and house
appropriations subcommittees on the department budget and the
senate and house fiscal agencies on the results of the workgroup by
September 30 of the current fiscal year. It is the intent of the
legislature that, beginning with the budget for the fiscal year
ending September 30, 2017, the metrics developed by this workgroup
be used to determine the distribution of funds for graduate medical
education.
(5) If needed, the department shall seek a federal waiver to
fulfill the requirements of this section.
Sec. 1820. (1) In order to avoid duplication of efforts, the
department shall utilize applicable national accreditation review
criteria to determine compliance with corresponding state
requirements for Medicaid health plans that have been reviewed and
accredited by a national accrediting entity for health care
services.
(2) The department shall continue to comply with state and
federal law and shall not initiate an action that negatively
impacts beneficiary safety.
(3) As used in this section, "national accrediting entity"
means the National Committee for Quality Assurance, the URAC,
formerly known as the Utilization Review Accreditation Commission,
or other appropriate entity, as approved by the department.
(4) By July 1 of the current fiscal year, the department shall
provide a progress report to the house and senate appropriations
subcommittees on the department budget, the house and senate fiscal
agencies, and the state budget office on implementation of this
section.
Sec. 1837. The department shall continue, and expand where
appropriate, utilization of telemedicine and telepsychiatry as
strategies to increase access to services for Medicaid recipients
in medically underserved areas.
Sec. 1846. From the funds appropriated in part 1 for graduate
medical education, the department shall distribute the funds with
an emphasis on the following health care workforce goals:
(a) The encouragement of the training of physicians in
specialties, including primary care, that are necessary to meet the
future needs of residents of this state.
(b) The training of physicians in settings that include
ambulatory sites and rural locations.
Sec. 1850. The department may allow Medicaid health plans to
assist with the redetermination process through outreach activities
to ensure continuation of Medicaid eligibility and enrollment in
managed care. This may include mailings, telephone contact, or
face-to-face contact with beneficiaries enrolled in the individual
Medicaid health plan. Health plans may offer assistance in
completing paperwork for beneficiaries enrolled in their plan.
Sec. 1861. The department shall encourage cooperation between
the Medicaid managed care health plans, other health providers, and
nonprofit entities to help facilitate a pilot nonemergency
transportation system.
Sec. 1862. From the funds appropriated in part 1, the
department shall maintain payment rates for Medicaid obstetrical
services at 95% of Medicare levels effective October 1, 2014.
Sec. 1866. (1) From the funds appropriated in part 1 for
hospital services and therapy and health plan services,
$12,000,000.00 in general fund/general purpose revenue and any
associated federal match shall be awarded to hospitals that meet
criteria established by the department for services to low-income
rural residents. One of the reimbursement components of the
distribution formula shall be assistance with labor and delivery
services.
(2) No hospital or hospital system shall receive more than
10.0% of the total funding referenced in subsection (1).
(3) To allow hospitals to understand their rural payment
amounts under this section, the department shall provide hospitals
with the methodology for distribution under this section and
provide each hospital with its applicable data that are used to
determine the payment amounts by August 1 of the current fiscal
year. The department shall publish the distribution of payments for
the current fiscal year and the immediately preceding fiscal year.
(4) The department shall report to the senate and house
appropriations subcommittees on the department budget and the
senate and house fiscal agencies on the distribution of funds
referenced in subsection (1) by April 1 of the current fiscal year.
Sec. 1870. The department shall work in collaboration with
Michigan-based medical schools that choose to participate in the
creation of a graduate medical education consortium known as
MIDocs. The purpose of MIDocs is to develop freestanding residency
training programs in primary care and other ambulatory care-based
specialties. MIDocs shall design residency training programs to
address physician shortage needs in this state, including placing
physicians post-residency in underserved communities across this
state. MIDocs shall give special consideration to small and rural
hospitals with a GME program director. MIDocs' voting members will
include any Michigan-based university with a medical school or an
affiliated faculty practice physician group that is making a
substantial contribution to MIDocs programs. The department shall
be a permanent nonvoting member of MIDocs. The department, in
collaboration with MIDocs voting members, may also appoint
nonvoting members to MIDocs to represent various stakeholders. As
the sponsoring institution and fiduciary, MIDocs shall assure
initial and continued accreditation from the accreditation council
for graduate medical education or ACGME, financial accountability,
clinical quality, and compliance. The department shall require an
annual report from MIDocs detailing per resident costs for medical
training and clinical quality measures. The department shall create
MIDocs no later than January 10, 2015. MIDocs shall provide the
department with a report proposing the creation of new residency
programs and an actionable plan for retaining consortium related
students post-residency, especially in underserved communities. The
work project allocation from the fiscal year ending September 30,
2015 is allocated to prepare the report, legally create the
consortium, prepare to obtain ACGME accreditation, and develop new
residency programs.
Sec. 1883. For the purposes of more effectively managing
inpatient care for Medicaid health plans and Medicaid fee-for-
service, the department shall consider developing an appropriate
policy and rate for observation stays.
Sec. 1888. The department shall establish contract performance
standards associated with the capitation withhold provisions for
Medicaid health plans at least 3 months in advance of the
implementation of those standards. The determination of whether
performance standards have been met shall be based primarily on
recognized concepts such as 1-year continuous enrollment and the
healthcare effectiveness data and information set, HEDIS, audited
data.
Sec. 1890. From the funds appropriated in part 1 for
pharmaceutical services, the department shall ensure Medicaid
recipients access to breast pumps to support and encourage
breastfeeding. The department shall adjust Medicaid policy to, at a
minimum, provide an individual double electric style pump to a
breastfeeding mother when a physician prescribes such a device
based on diagnosis of mother or infant. If the distribution method
for pumps or other equipment is a department contract with durable
medical equipment providers, the department shall guarantee
providers stock and rent to Medicaid recipients without delay or
undue restriction.
Sec. 1894. (1) From the funds appropriated in part 1 for
dental services, the department shall expand the healthy kids
dental program to children who have not yet reached the age of 13
in Kent, Oakland, and Wayne Counties. This program expansion will
improve access to necessary dental services for Medicaid-enrolled
children.
(2) Outcomes and performance measures for the initiative under
subsection (1) include, but are not limited to, the following:
(a) The number of Medicaid-enrolled children under the age of
13 in Kent, Oakland, and Wayne Counties who visited the dentist in
the prior year.
(b) The number of dentists in Kent, Oakland, and Wayne
Counties who will accept Medicaid payment for services to children.
(c) The change in dental utilization in Kent, Oakland, and
Wayne Counties, before and after implementation.
(3) It is the intent of the legislature that the healthy kids
dental program be expanded in the fiscal year ending September 30,
2017 to cover additional children in Kent, Oakland, and Wayne
Counties.
Sec. 1899. From the funds appropriated in part 1 for personal
care services, the department shall maintain the personal care
services rate at the level in effect October 1, 2014.
ONE-TIME BASIS ONLY APPROPRIATIONS
Sec. 1906. (1) The department may initiate pay for success
pilot projects to identify and deliver services to improve outcomes
and lower costs for government services in this state. From the
funds appropriated in part 1 for pay for success contracts, the
department may initiate contracts with private and not-for-profit
vendors, selected through a competitive bid process, to implement
these pilot projects. Payments shall not be issued to funding
intermediaries or vendors until contractual performance measures
have been achieved and project savings have been confirmed by a
third-party evaluator, certified by the department, and approved by
the state budget director.
(2) Within 30 days, a copy of contracts executed pursuant to
this section shall be provided to the chairs of the senate and
house appropriations subcommittees on community health, the senate
and house fiscal agencies, and the state budget office.
(3) Unexpended funds appropriated in part 1 for pay for
success contracts are designated as work project appropriations,
and any unencumbered or unalloted funds shall not lapse at the end
of the fiscal year and shall be available for expenditures for the
pay for success contracts under this section until the projects
have been completed. All of the following are in compliance with
section 451a of the management and budget act, 1984 PA 431, MCL
18.1451a:
(a) The purpose of the projects is to coordinate cost-saving
projects to the state with public-private partnerships.
(b) The projects will be carried out through contracts with
private and not-for-profit vendors.
(c) The estimated cost of this work project is $1,500,000.00.
(d) The estimated work project completion date is September
30, 2020.
Sec. 1907. (1) From the funds appropriated in part 1 for drug
policy initiatives, the department shall develop and begin
implementation of a comprehensive plan that addresses the problem
of drug abuse.
(2) Outcomes and performance measures for the new initiative
under subsection (1) include, but are not limited to, the
following:
(a) A decrease in the number of residents of this state aged
12 and older who have experienced substance dependence or abuse in
the past year.
(b) A decrease in the number of residents of this state who
have engaged in the nonmedical use of pain relievers or engaged in
binge alcohol use.
(3) The department shall not spend the funds appropriated in
part 1 for drug policy initiatives until a statewide plan on these
initiatives is issued by the governor and the statewide plan is
submitted to the senate and house appropriations subcommittees on
the department budget.
Sec. 1908. The funds appropriated in part 1 for hospice
services shall be expended to provide room and board for Medicaid
recipients who meet hospice eligibility requirements and receive
services at Medicaid enrolled hospice residences in this state. The
qualifying hospice residences must be enrolled with Medicaid by
October 1, 2014.
PART 2A
PROVISIONS CONCERNING ANTICIPATED APPROPRIATIONS
FOR FISCAL YEAR 2016-2017
GENERAL SECTIONS
Sec. 2001. It is the intent of the legislature to provide
appropriations for the fiscal year ending on September 30, 2017 for
the line items listed in part 1. The fiscal year 2016-2017
appropriations are anticipated to be the same as those for fiscal
year 2015-2016, except that the line items will be adjusted for
changes in caseload and related costs, federal fund match rates,
economic factors, and available revenue. These adjustments will be
determined after the January 2016 consensus revenue estimating
conference.
PART 2B
PROVISIONS CONCERNING APPROPRIATIONS
FOR FISCAL YEAR 2014-2015
GENERAL SECTIONS
Sec. 3001. Pursuant to section 30 of article IX of the state
constitution of 1963, total state spending from state resources
under part 1B for fiscal year 2014-2015 is $25,982,000.00 and state
spending from state resources to be paid to local units of
government for fiscal year 2014-2015 is $2,853,500.00. The itemized
statement below identifies appropriations from which spending to
local units will occur:
DEPARTMENT OF COMMUNITY HEALTH
Medicaid mental health services....................... $ 3,181,400
Medical substance abuse services....................... (327,900)
TOTAL PAYMENTS TO LOCAL UNITS OF GOVERNMENT........... $ 2,853,500
Sec. 3002. The appropriations authorized under this part and
part 1B are subject to the management and budget act, 1984 PA 431,
MCL 18.1101 to 18.1594.
Sec. 3003. The unexpended funds appropriated in part 1B for
long-term health care services are considered work project
appropriations, and any unencumbered or unallotted funds are
carried forward into the following fiscal year. The following is in
compliance with section 451a(1) of the management and budget act,
1984 PA 431, MCL 18.1451a:
(a) The purpose of the project is to support a new psychiatry
residency program to address the shortage of psychiatrists in this
state.
(b) The project will be accomplished through grants.
(c) The estimated cost of this project is $1,500,000.00.
(d) The tentative completion date for the work project is
September 30, 2016.
Sec. 3004. The unexpended funds appropriated in article IV of
2014 PA 252 for medical services administration are considered work
project appropriations, and any unencumbered or unallotted funds
are carried forward into the following fiscal year. The following
is in compliance with section 451a(1) of the management and budget
act, 1984 PA 431, MCL 18.1451a:
(a) The purpose of the project is stated in section 1870 of
article IV of 2014 PA 252.
(b) The project will be accomplished through state employees
and contracts.
(c) The estimated cost of this project is $500,000.00.
(d) The tentative completion date for the work project is
September 30, 2016.
Sec. 3005. The unexpended funds appropriated in article IV of
2014 PA 252 for prenatal care outreach and service delivery support
are considered work project appropriations, and any unencumbered or
unallotted funds are carried forward into the following fiscal
year. The following is in compliance with section 451a(1) of the
management and budget act, 1984 PA 431, MCL 18.1451a:
(a) The purpose of the project is to provide evidence-based
prenatal and early childhood home visiting programs in rural areas.
(b) The project will be accomplished through grants.
(c) The estimated cost of this project is $550,000.00.
(d) The tentative completion date for the work project is
September 30, 2016.