FIRST CONFERENCE REPORT
The Committee of Conference on the matters of difference between the two Houses concerning
House Bill No. 4238, entitled
A bill to make appropriations for the department of health and human services for the fiscal year ending September 30, 2018; and to provide for the expenditure of the appropriations.
Recommends:
First: That the Senate recede from the Substitute of the Senate as passed by the Senate.
Second: That the House and Senate agree to the Substitute of the House as passed by the House, amended to read as follows:
(attached)
Third: That the House and Senate agree to the title of the bill to read as follows:
A bill to make appropriations for the department of health and human services for the fiscal year ending September 30, 2018; and to provide for the expenditure of the appropriations.
_______________________ ________________________
Edward J. Canfield, D.O. Jim Marleau
_______________________ ________________________
Sue Allor Peter MacGregor
_______________________ ________________________
Pam Faris Vincent Gregory
Conferees for the House Conferees for the Senate
SUBSTITUTE FOR
HOUSE BILL NO. 4238
A bill to make appropriations for the department of health and
human services for the fiscal year ending September 30, 2018; 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 health
and human services for the fiscal year ending September 30, 2018,
from the following funds:
DEPARTMENT OF HEALTH AND HUMAN SERVICES
APPROPRIATION SUMMARY
Full-time equated unclassified positions.......... 6.0
Full-time equated classified positions....... 15,421.5
Average population.............................. 770.0
GROSS APPROPRIATION.................................... $ 25,358,159,400
Interdepartmental grant revenues:
Total interdepartmental grants and intradepartmental
transfers............................................ 13,640,900
ADJUSTED GROSS APPROPRIATION........................... $ 25,344,518,500
Federal revenues:
Social security act, temporary assistance for needy
families............................................. 551,915,400
Capped federal revenues................................ 600,587,900
Total other federal revenues........................... 17,165,133,400
Special revenue funds:
Total local revenues................................... 116,545,300
Total private revenues................................. 149,875,700
Michigan merit award trust fund........................ 49,068,700
Total other state restricted revenues.................. 2,394,050,200
State general fund/general purpose..................... $ 4,317,341,900
Sec. 102. DEPARTMENTAL ADMINISTRATION AND SUPPORT
Full-time equated unclassified positions.......... 6.0
Full-time equated classified positions.......... 742.1
Unclassified salaries--6.0 FTE positions............... $ 1,153,000
Administrative hearings officers....................... 11,219,700
Demonstration projects--7.0 FTE positions.............. 7,355,100
Departmental administration and management--548.1 FTE
positions............................................ 86,434,400
Developmental disabilities council and projects--10.0
FTE positions........................................ 3,073,700
Merger savings......................................... (3,052,500)
Office of inspector general--177.0 FTE positions....... 21,892,200
Property management.................................... 64,339,500
Terminal leave payments................................ 5,686,100
Worker's compensation.................................. 7,502,800
GROSS APPROPRIATION.................................... $ 205,604,000
Appropriated from:
Interdepartmental grant revenues:
IDG from department of education....................... 1,919,500
Federal revenues:
Social security act, temporary assistance for needy
families............................................. 22,973,500
Capped federal revenues................................ 20,349,200
Total other federal revenues........................... 63,821,200
Special revenue funds:
Total local revenues................................... 16,400
Total private revenues................................. 3,843,200
Total other state restricted revenues.................. 841,400
State general fund/general purpose..................... $ 91,839,600
Sec. 103. CHILD SUPPORT ENFORCEMENT
Full-time equated classified positions.......... 185.7
Child support enforcement operations--179.7 FTE
positions............................................ $ 22,312,200
Child support incentive payments....................... 24,409,600
Legal support contracts................................ 113,607,100
State disbursement unit--6.0 FTE positions............. 8,112,800
GROSS APPROPRIATION.................................... $ 168,441,700
Appropriated from:
Federal revenues:
Capped federal revenues................................ 1,735,000
Total other federal revenues........................... 142,644,500
State general fund/general purpose..................... $ 24,062,200
Sec. 104. COMMUNITY SERVICES AND OUTREACH
Full-time equated classified positions........... 74.6
Bureau of community services and outreach--20.0 FTE
positions............................................ $ 2,529,300
Child advocacy centers--0.5 FTE position............... 1,500,000
Community services and outreach administration--11.0
FTE positions........................................ 1,465,000
Community services block grant......................... 25,840,000
Crime victim grants administration services--13.0 FTE
positions............................................ 2,177,100
Crime victim justice assistance grants................. 59,279,300
Crime victim rights services grants.................... 16,870,000
Domestic violence prevention and treatment--14.6 FTE
positions............................................ 15,817,200
Homeless programs...................................... 19,466,700
Housing and support services........................... 13,031,000
Michigan community service commission--15.0 FTE
positions............................................ 11,628,700
Rape prevention and services--0.5 FTE position......... 5,097,300
School success partnership program..................... 450,000
Weatherization assistance.............................. 16,340,000
GROSS APPROPRIATION.................................... $ 191,491,600
Appropriated from:
Federal revenues:
Social security act, temporary assistance for needy
families............................................. 13,188,400
Capped federal revenues................................ 66,676,300
Total other federal revenues........................... 75,829,400
Special revenue funds:
Private - collections.................................. 44,100
Compulsive gambling prevention fund.................... 1,040,500
Sexual assault victims' prevention and treatment fund.. 3,000,000
Child advocacy centers fund............................ 1,500,000
Crime victim's rights fund............................. 15,337,000
State general fund/general purpose..................... $ 14,875,900
Sec. 105. CHILDREN'S SERVICES AGENCY - CHILD
WELFARE
Full-time equated classified positions........ 3,844.2
Adoption subsidies..................................... $ 210,409,600
Adoption support services--10.0 FTE positions.......... 27,283,500
Attorney general contract.............................. 4,366,500
Child abuse and neglect - children's justice act--1.0
FTE position......................................... 622,600
Child care fund........................................ 192,526,200
Child protection....................................... 800,300
Child welfare administration travel.................... 375,000
Child welfare field staff - caseload compliance--
2,461.0 FTE positions................................ 229,613,400
Child welfare field staff - noncaseload compliance--
330.0 FTE positions.................................. 34,559,000
Child welfare first line supervisors--578.0 FTE
positions............................................ 72,890,500
Child welfare institute--45.0 FTE positions............ 8,203,600
Child welfare licensing--59.0 FTE positions............ 6,914,000
Child welfare medical/psychiatric evaluations.......... 10,435,500
Children's services administration--172.2 FTE
positions............................................ 20,075,100
Children's trust fund--12.0 FTE positions.............. 3,327,700
Contractual services, supplies, and materials.......... 9,300,000
Education planners--15.0 FTE positions................. 1,530,100
Family preservation and prevention services
administration--9.0 FTE positions.................... 1,299,300
Family preservation programs--13.0 FTE positions....... 38,877,000
Family support subsidy................................. 16,951,400
Foster care payments................................... 198,388,100
Guardianship assistance program........................ 11,505,400
Interstate compact..................................... 179,600
Peer coaches--45.5 FTE positions....................... 5,737,300
Performance based funding implementation--3.0 FTE
positions............................................ 1,444,800
Permanency resource managers--28.0 FTE positions....... 3,197,900
Prosecuting attorney contracts......................... 3,879,500
Psychotropic oversight................................. 618,200
Second line supervisors and technical staff--54.0 FTE
positions............................................ 8,912,000
Settlement monitor..................................... 1,885,800
Strong families/safe children.......................... 12,350,100
Title IV-E compliance and accountability office--4.0
FTE positions........................................ 424,700
Youth in transition--4.5 FTE positions................. 15,306,300
GROSS APPROPRIATION.................................... $ 1,154,190,000
Appropriated from:
Interdepartmental grant revenues:
IDG from department of education....................... 90,200
Federal revenues:
Social security act, temporary assistance for needy
families............................................. 348,865,400
Capped federal revenues................................ 112,020,100
Total other federal revenues........................... 246,344,900
Special revenue funds:
Private - collections.................................. 2,929,800
Local funds - county chargeback........................ 14,244,900
Children's trust fund.................................. 2,091,900
State general fund/general purpose..................... $ 427,602,800
Sec. 106. CHILDREN'S SERVICES AGENCY - JUVENILE
JUSTICE
Full-time equated classified positions.......... 120.5
Bay Pines Center--47.0 FTE positions................... $ 5,468,900
Committee on juvenile justice administration--2.5 FTE
positions............................................ 351,400
Committee on juvenile justice grants................... 3,000,000
Community support services--3.0 FTE positions.......... 2,116,600
County juvenile officers............................... 3,904,300
Juvenile justice, administration and maintenance--21.0
FTE positions........................................ 3,739,300
Shawono Center--47.0 FTE positions..................... 5,565,400
W.J. Maxey Training School............................. 250,000
GROSS APPROPRIATION.................................... $ 24,395,900
Appropriated from:
Federal revenues:
Capped federal revenues................................ 8,330,600
Special revenue funds:
Local funds - state share education funds.............. 1,339,000
Local funds - county chargeback........................ 5,037,000
State general fund/general purpose..................... $ 9,689,300
Sec. 107. PUBLIC ASSISTANCE
Full-time equated classified positions............ 8.0
Emergency services local office allocations............ $ 9,357,500
Family independence program............................ 82,350,800
Food assistance program benefits....................... 2,348,117,400
Food Bank Council of Michigan.......................... 2,045,000
Indigent burial........................................ 4,375,000
Low-income home energy assistance program.............. 181,718,400
Michigan corner store initiative....................... 100
Michigan energy assistance program--1.0 FTE position... 50,000,000
Multicultural integration funding...................... 15,303,800
Refugee assistance program--7.0 FTE positions.......... 27,993,400
State disability assistance payments................... 9,360,100
State supplementation.................................. 60,489,100
State supplementation administration................... 2,381,100
GROSS APPROPRIATION.................................... $ 2,793,491,700
Appropriated from:
Federal revenues:
Social security act, temporary assistance for needy
families............................................. 70,526,700
Capped federal revenues................................ 209,896,300
Total other federal revenues........................... 2,342,627,400
Special revenue funds:
Child support collections.............................. 10,979,000
Supplemental security income recoveries................ 4,142,700
Public assistance recoupment revenue................... 6,290,000
Low-income energy assistance fund...................... 50,000,000
State general fund/general purpose..................... $ 99,029,600
Sec. 108. FIELD OPERATIONS AND SUPPORT SERVICES
Full-time equated classified positions........ 6,287.5
Administrative support workers--221.0 FTE positions.... $ 12,872,400
Adult services field staff--460.0 FTE positions........ 49,365,200
Contractual services, supplies, and materials.......... 16,352,500
Donated funds positions--288.0 FTE positions........... 32,702,700
Elder Law of Michigan MiCAFE contract.................. 350,000
Electronic benefit transfer (EBT)...................... 8,509,000
Employment and training support services............... 4,219,100
Field policy and administration--66.0 FTE positions.... 11,103,600
Field staff travel..................................... 8,103,900
Independent living..................................... 12,031,600
Medical/psychiatric evaluations........................ 1,420,100
Michigan rehabilitation services--526.0 FTE positions.. 128,750,800
Nutrition education--2.0 FTE positions................. 33,045,300
Public assistance field staff--4,704.5 FTE positions... 478,474,200
SSI advocacy legal services............................ 250,000
Training and program support--20.0 FTE positions....... 2,448,000
Volunteer services and reimbursement................... 942,400
GROSS APPROPRIATION.................................... $ 800,940,800
Appropriated from:
Interdepartmental grant revenues:
IDG from department of corrections..................... 116,000
IDG from department of education....................... 7,769,500
Federal revenues:
Social security act, temporary assistance for needy
families............................................. 67,495,500
Capped federal revenues................................ 158,349,600
Federal supplemental security income................... 8,588,600
Total other federal revenues........................... 256,830,300
Special revenue funds:
Local funds - donated funds............................ 5,783,500
Local vocational rehabilitation match.................. 5,300,000
Private funds - donated funds.......................... 9,600,500
Private funds - gifts, bequests, and donations......... 531,500
Rehabilitation service fees............................ 40,000
Second injury fund..................................... 38,300
State general fund/general purpose..................... $ 280,497,500
Sec. 109. DISABILITY DETERMINATION SERVICES
Full-time equated classified positions.......... 587.4
Disability determination operations--583.3 FTE
positions............................................ $ 112,005,400
Retirement disability determination--4.1 FTE positions. 608,500
GROSS APPROPRIATION.................................... $ 112,613,900
Appropriated from:
Interdepartmental grant revenues:
IDG from DTMB - office of retirement services.......... 785,600
Federal revenues:
Total other federal revenues........................... 108,362,800
State general fund/general purpose..................... $ 3,465,500
Sec. 110. BEHAVIORAL HEALTH PROGRAM ADMINISTRATION
AND SPECIAL PROJECTS
Full-time equated classified positions........... 97.0
Behavioral health program administration--77.0 FTE
positions............................................ $ 55,828,200
Federal and other special projects..................... 2,535,600
Gambling addiction--1.0 FTE position................... 3,006,500
Office of recipient rights--19.0 FTE positions......... 2,721,900
Protection and advocacy services support............... 194,400
GROSS APPROPRIATION.................................... $ 64,286,600
Appropriated from:
Federal revenues:
Total other federal revenues........................... 33,225,600
Special revenue funds:
Total private revenues................................. 1,004,700
Total other state restricted revenues.................. 3,006,500
State general fund/general purpose..................... $ 27,049,800
Sec. 111. BEHAVIORAL HEALTH SERVICES
Full-time equated classified positions............ 9.5
Autism services........................................ $ 100,097,300
Children with serious emotional disturbance waiver..... 10,000,000
Children's waiver home care program.................... 20,241,100
Civil service charges.................................. 399,300
Community mental health non-Medicaid services.......... 120,050,400
Community substance use disorder prevention,
education, and treatment............................. 77,075,000
Federal mental health block grant--2.5 FTE positions... 15,457,300
Health homes........................................... 3,369,000
Healthy Michigan plan - behavioral health.............. 286,465,600
Medicaid mental health services........................ 2,300,593,100
Medicaid substance use disorder services............... 52,408,500
Nursing home PAS/ARR-OBRA--7.0 FTE positions........... 12,274,100
State disability assistance program substance use
disorder services.................................... 2,018,800
GROSS APPROPRIATION.................................... $ 3,000,449,500
Appropriated from:
Federal revenues:
Total other federal revenues........................... 1,981,549,300
Special revenue funds:
Total local revenues................................... 25,475,800
Total other state restricted revenues.................. 23,881,400
State general fund/general purpose..................... $ 969,543,000
Sec. 112. STATE PSYCHIATRIC HOSPITALS AND FORENSIC
MENTAL HEALTH SERVICES
Total average population........................ 770.0
Full-time equated classified positions........ 2,256.9
Caro Regional Mental Health Center - psychiatric
hospital - adult--467.8 FTE positions................ $ 58,565,600
Average population.............................. 145.0
Center for forensic psychiatry--607.3 FTE positions.... 82,823,400
Average population.............................. 240.0
Gifts and bequests for patient living and treatment
environment.......................................... 1,000,000
Hawthorn Center - psychiatric hospital - children and
adolescents--277.4 FTE positions..................... 30,638,600
Average population............................... 55.0
IDEA, federal special education........................ 120,000
Kalamazoo Psychiatric Hospital - adult--474.1 FTE
positions............................................ 67,273,500
Average population.............................. 170.0
Purchase of medical services for residents of
hospitals and centers................................ 445,600
Revenue recapture...................................... 750,000
Special maintenance.................................... 924,600
Walter P. Reuther Psychiatric Hospital - adult--430.3
FTE positions........................................ 58,601,500
Average population.............................. 160.0
GROSS APPROPRIATION.................................... $ 301,142,800
Appropriated from:
Federal revenues:
Total other federal revenues........................... 36,784,000
Special revenue funds:
Total local revenues................................... 20,000,500
Total private revenues................................. 1,000,000
Total other state restricted revenues.................. 19,376,600
State general fund/general purpose..................... $ 223,981,700
Sec. 113. HEALTH POLICY
Full-time equated classified positions........... 42.9
Bone marrow transplant registry........................ $ 250,000
Certificate of need program administration--12.3 FTE
positions............................................ 2,825,300
Health policy administration--25.2 FTE positions....... 13,065,200
Human trafficking intervention services................ 200,000
Michigan essential health provider..................... 3,591,300
Minority health grants and contracts................... 612,700
Nurse education and research program--3.0 FTE
positions............................................ 784,400
Primary care services--1.4 FTE positions............... 5,068,700
Rural health services--1.0 FTE position................ 1,555,500
GROSS APPROPRIATION.................................... $ 27,953,100
Appropriated from:
Interdepartmental grant revenues:
IDG from the department of licensing and regulatory
affairs.............................................. 784,400
IDG from the department of treasury, Michigan state
hospital finance authority........................... 117,700
Federal revenues:
Social security act, temporary assistance for needy
families............................................. 30,400
Capped federal revenues................................ 18,700
Total other federal revenues........................... 16,851,200
Special revenue funds:
Total private revenues................................. 865,000
Total other state restricted revenues.................. 2,709,400
State general fund/general purpose..................... $ 6,576,300
Sec. 114. LABORATORY SERVICES
Full-time equated classified positions.......... 100.0
Laboratory services--100.0 FTE positions............... $ 20,812,100
GROSS APPROPRIATION.................................... $ 20,812,100
Appropriated from:
Interdepartmental grant revenues:
IDG from the department of environmental quality....... 991,000
Federal revenues:
Total other federal revenues........................... 2,340,100
Special revenue funds:
Total other state restricted revenues.................. 10,633,400
State general fund/general purpose..................... $ 6,847,600
Sec. 115. DISEASE CONTROL, PREVENTION, AND
EPIDEMIOLOGY
Full-time equated classified positions.......... 101.9
Childhood lead program--4.5 FTE positions.............. $ 2,048,300
Epidemiology administration--62.1 FTE positions........ 19,273,600
Healthy homes program--12.0 FTE positions.............. 27,740,400
Immunization program--12.8 FTE positions............... 16,886,600
Newborn screening follow-up and treatment services--
10.5 FTE positions................................... 7,427,500
GROSS APPROPRIATION.................................... $ 73,376,400
Appropriated from:
Federal revenues:
Total other federal revenues........................... 53,683,100
Special revenue funds:
Total private revenues................................. 339,900
Total other state restricted revenues.................. 11,975,600
State general fund/general purpose..................... $ 7,377,800
Sec. 116. LOCAL HEALTH AND ADMINISTRATIVE SERVICES
Full-time equated classified positions.......... 226.2
AIDS prevention, testing, and care programs--37.7 FTE
positions............................................ $ 70,623,800
Cancer prevention and control program--13.0 FTE
positions............................................ 15,064,100
Chronic disease control and health promotion
administration--27.4 FTE positions................... 8,461,300
Dental programs--3.8 FTE positions..................... 3,753,500
Diabetes and kidney program--8.0 FTE positions......... 3,251,600
Essential local public health services................. 40,886,100
Health and wellness initiatives--11.7 FTE positions.... 9,008,400
Implementation of 1993 PA 133, MCL 333.17015........... 20,000
Injury control intervention project.................... 1,000,000
Local health services--1.3 FTE positions............... 1,955,100
Medicaid outreach cost reimbursement to local health
departments.......................................... 12,500,000
Public health administration--7.0 FTE positions........ 1,579,500
Sexually transmitted disease control program--20.0 FTE
positions............................................ 6,295,000
Smoking prevention program--12.0 FTE positions......... 2,148,300
Violence prevention--2.9 FTE positions................. 3,124,100
Vital records and health statistics--81.4 FTE
positions............................................ 10,049,700
GROSS APPROPRIATION.................................... $ 189,720,500
Appropriated from:
Federal revenues:
Capped federal revenues................................ 81,100
Total other federal revenues........................... 79,856,800
Special revenue funds:
Total local revenues................................... 5,150,000
Total private revenues................................. 39,279,600
Total other state restricted revenues.................. 18,306,800
State general fund/general purpose..................... $ 47,046,200
Sec. 117. FAMILY, MATERNAL, AND CHILD HEALTH
Full-time equated classified positions.......... 108.3
Family, maternal, and child health administration--
49.3 FTE positions................................... $ 8,507,700
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................................... 19,578,800
Special projects....................................... 6,289,100
Sudden and unexpected infant death and suffocation
prevention program................................... 321,300
Women, infants, and children program administration
and special projects--45.0 FTE positions............. 18,045,000
Women, infants, and children program local agreements
and food costs....................................... 256,285,000
GROSS APPROPRIATION.................................... $ 324,957,800
Appropriated from:
Federal revenues:
Social security act, temporary assistance for needy
families............................................. 650,000
Total other federal revenues........................... 252,926,000
Special revenue funds:
Total local revenues................................... 75,000
Total private revenues................................. 61,702,400
State general fund/general purpose..................... $ 9,604,400
Sec. 118. EMERGENCY MEDICAL SERVICES, TRAUMA, AND
PREPAREDNESS
Full-time equated classified positions........... 76.0
Bioterrorism preparedness--53.0 FTE positions.......... $ 30,398,600
Emergency medical services program--23.0 FTE positions. 6,773,600
GROSS APPROPRIATION.................................... $ 37,172,200
Appropriated from:
Federal revenues:
Total other federal revenues........................... 31,366,100
Special revenue funds:
Total other state restricted revenues.................. 4,020,500
State general fund/general purpose..................... $ 1,785,600
Sec. 119. CHILDREN'S SPECIAL HEALTH CARE SERVICES
Full-time equated classified positions........... 46.8
Bequests for care and services--2.8 FTE positions...... $ 1,535,300
Children's special health care services
administration--44.0 FTE positions................... 6,028,300
Medical care and treatment............................. 239,278,900
Nonemergency medical transportation.................... 905,900
Outreach and advocacy.................................. 5,510,000
GROSS APPROPRIATION.................................... $ 253,258,400
Appropriated from:
Federal revenues:
Total other federal revenues........................... 137,819,600
Special revenue funds:
Total private revenues................................. 1,013,700
Total other state restricted revenues.................. 3,382,900
State general fund/general purpose..................... $ 111,042,200
Sec. 120. AGING AND ADULT SERVICES AGENCY
Full-time equated classified positions........... 48.0
Aging and adult services administration--48.0 FTE
positions............................................ $ 9,394,700
Community services..................................... 43,567,300
Employment assistance.................................. 3,500,000
Nutrition services..................................... 42,254,200
Respite care program................................... 6,468,700
Senior volunteer service programs...................... 4,465,300
GROSS APPROPRIATION.................................... $ 109,650,200
Appropriated from:
Federal revenues:
Capped federal revenues................................ 371,500
Total other federal revenues........................... 59,627,100
Special revenue funds:
Total private revenues................................. 520,000
Michigan merit award trust fund........................ 4,068,700
Total other state restricted revenues.................. 2,000,000
State general fund/general purpose..................... $ 43,062,900
Sec. 121. MEDICAL SERVICES ADMINISTRATION
Full-time equated classified positions.......... 453.5
Electronic health record incentive program--24.0 FTE
positions............................................ $ 144,328,000
Healthy Michigan plan administration--30.0 FTE
positions............................................ 48,550,000
Medical services administration--384.5 FTE positions... 82,810,400
Technology supporting integrated service--15.0 FTE
positions............................................ 17,786,300
GROSS APPROPRIATION.................................... $ 293,474,700
Appropriated from:
Federal revenues:
Social security act, temporary assistance for needy
families............................................. 749,600
Capped federal revenues................................ 910,700
Total other federal revenues........................... 244,093,100
Special revenue funds:
Total local revenues................................... 107,300
Total private revenues................................. 101,300
Total other state restricted revenues.................. 336,300
State general fund/general purpose..................... $ 47,176,400
Sec. 122. MEDICAL SERVICES
Adult home help services............................... $ 316,947,200
Ambulance services..................................... 20,794,700
Auxiliary medical services............................. 6,061,200
Dental clinic program.................................. 1,000,000
Dental services........................................ 315,662,300
Federal Medicare pharmaceutical program................ 275,196,900
Health plan services................................... 5,036,661,800
Healthy Michigan plan.................................. 3,862,759,700
Home health services................................... 6,163,600
Hospice services....................................... 115,496,000
Hospital disproportionate share payments............... 45,000,000
Hospital services and therapy.......................... 770,000,000
Integrated care organizations.......................... 185,712,300
Long-term care services................................ 1,794,419,600
Maternal and child health.............................. 20,279,500
Medicaid home- and community-based services waiver..... 348,087,400
Medicare premium payments.............................. 541,623,900
Personal care services................................. 9,491,200
Pharmaceutical services................................ 423,004,600
Physician services..................................... 287,642,400
Program of all-inclusive care for the elderly.......... 106,289,100
School-based services.................................. 109,937,200
Special Medicaid reimbursement......................... 308,796,100
Transportation......................................... 22,717,800
GROSS APPROPRIATION.................................... $ 14,929,744,500
Appropriated from:
Federal revenues:
Total other federal revenues........................... 10,876,331,000
Special revenue funds:
Total local revenues................................... 34,015,900
Total private revenues................................. 2,100,000
Michigan merit award trust fund........................ 45,000,000
Total other state restricted revenues.................. 2,188,272,500
State general fund/general purpose..................... $ 1,784,025,100
Sec. 123. INFORMATION TECHNOLOGY
Child support automation............................... $ 41,877,600
Information technology services and projects........... 158,814,300
Michigan Medicaid information system................... 55,634,400
GROSS APPROPRIATION.................................... $ 256,326,300
Appropriated from:
Interdepartmental grant revenues:
IDG from department of education....................... 1,067,000
Federal revenues:
Social security act, temporary assistance for needy
families............................................. 23,935,900
Capped federal revenues................................ 21,848,800
Total other federal revenues........................... 109,673,300
Special revenue funds:
Total private revenues................................. 25,000,000
Total other state restricted revenues.................. 1,985,800
State general fund/general purpose..................... $ 72,815,500
Sec. 124. ONE-TIME BASIS ONLY APPROPRIATIONS
Full-time equated classified positions............ 4.5
Autism navigator....................................... $ 565,000
Child lead poisoning elimination board................. 500,000
Dental clinic program.................................. 1,000,000
Direct primary care pilot program...................... 5,724,000
Drinking water declaration of emergency--4.5 FTE
positions............................................ 14,041,700
Farmer's market wireless equipment purchases........... 500,000
Food Bank Council of Michigan.......................... 184,000
Food pantry grant...................................... 100,000
Prenatal diagnosis clearinghouse website............... 150,000
Primary care and dental health services................ 300,000
Primary care hospital grant............................ 850,000
Refugee assistance grant............................... 150,000
Special Olympics Michigan.............................. 100,000
University autism programs............................. 500,000
GROSS APPROPRIATION.................................... $ 24,664,700
Appropriated from:
Federal revenues:
Social security act, temporary assistance for needy
families............................................. 3,500,000
Total other federal revenues........................... 3,958,000
Special revenue funds:
Total other state restricted revenues.................. 8,861,700
State general fund/general purpose..................... $ 8,345,000
PART 2
PROVISIONS CONCERNING APPROPRIATIONS
FOR FISCAL YEAR 2017-2018
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 2017-2018 is $6,760,460,800.00 and
state spending from state resources to be paid to local units of
government for fiscal year 2017-2018 is $1,370,361,400.00. The
itemized statement below identifies appropriations from which
spending to local units of government will occur:
DEPARTMENT OF HEALTH AND HUMAN SERVICES
COMMUNITY SERVICES AND OUTREACH
Crime victim rights services grants.................... $ 7,216,000
Housing and support services........................... 637,300
CHILDREN'S SERVICES AGENCY - CHILD WELFARE
Child care fund........................................ $ 156,751,100
PUBLIC ASSISTANCE
Family independence program............................ $ 5,100
Multicultural integration funding...................... 5,478,200
State disability assistance payments................... 742,600
BEHAVIORAL HEALTH PROGRAM ADMINISTRATION AND SPECIAL PROJECTS
Behavioral health program administration............... $ 3,132,000
BEHAVIORAL HEALTH SERVICES
Autism services........................................ $ 33,648,700
Children with serious emotional disturbance waiver..... 3,522,000
Children's waiver home care program.................... 6,500,000
Community mental health non-Medicaid services.......... 120,050,400
Community substance use disorder prevention,
education, and treatment............................ 14,553,400
Health homes........................................... 70,700
Healthy Michigan plan - behavioral health.............. 16,472,000
Medicaid mental health services........................ 773,271,300
Medicaid substance use disorder services............... 18,117,100
Nursing home PAS/ARR-OBRA.............................. 2,728,200
State disability assistance program substance use
disorder services................................... 2,018,800
HEALTH POLICY
Primary care services.................................. $ 87,300
LABORATORY SERVICES
Laboratory services.................................... $ 5,300
DISEASE CONTROL, PREVENTION, AND EPIDEMIOLOGY
Childhood lead program................................. $ 314,800
Epidemiology administration............................ 154,800
Immunization program................................... 1,039,300
LOCAL HEALTH AND ADMINISTRATIVE SERVICES
AIDS prevention, testing, and care programs............ $ 1,809,300
Essential local public health services................. 35,736,100
Health and wellness initiatives........................ 2,189,900
Public health administration........................... 1,000
Sexually transmitted disease control program........... 701,300
FAMILY, MATERNAL, AND CHILD HEALTH
Family, maternal, and child health administration...... $ 8,800
Prenatal care outreach and service delivery support.... 2,997,600
CHILDREN'S SPECIAL HEALTH CARE SERVICES
Medical care and treatment............................. $ 1,236,200
Outreach and advocacy.................................. 2,755,000
AGING AND ADULT SERVICES AGENCY
Community services..................................... $ 21,286,900
Nutrition services..................................... 12,597,200
Respite care program................................... 6,468,700
Senior volunteer service programs...................... 940,800
MEDICAL SERVICES
Dental services........................................ $ 2,141,200
Hospital services and therapy.......................... 1,575,500
Long-term care services................................ 102,419,500
Physician services..................................... 8,926,800
Transportation......................................... 53,200
TOTAL OF PAYMENTS TO LOCAL UNITS OF GOVERNMENT......... $ 1,370,361,400
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) "CMS" means the Centers for Medicare and Medicaid
Services.
(d) "Current fiscal year" means the fiscal year ending
September 30, 2018.
(e) "Department" means the department of health and human
services.
(f) "Director" means the director of the department.
(g) "DSH" means disproportionate share hospital.
(h) "EPSDT" means early and periodic screening, diagnosis, and
treatment.
(i) "Federal poverty level" means the poverty guidelines
published annually in the Federal Register by the United States
Department of Health and Human Services under its authority to
revise the poverty line under 42 USC 9902.
(j) "FTE" means full-time equated.
(k) "GME" means graduate medical education.
(l) "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.
(m) "HEDIS" means healthcare effectiveness data and
information set.
(n) "HMO" means health maintenance organization.
(o) "IDEA" means the individuals with disabilities education
act, 20 USC 1400 to 1482.
(p) "IDG" means interdepartmental grant.
(q) "MCH" means maternal and child health.
(r) "Medicaid" means subchapter XIX of the social security
act, 42 USC 1396 to 1396w-5.
(s) "Medicare" means subchapter XVIII of the social security
act, 42 USC 1395 to 1395lll.
(t) "MiCAFE" means Michigan's coordinated access to food for
the elderly.
(u) "MIChild" means the program described in section 1670.
(v) "MiSACWIS" means Michigan statewide automated child
welfare information system.
(w) "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.
(x) "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.
(y) "Previous fiscal year" means the fiscal year ending
September 30, 2017.
(z) "Settlement" means the settlement agreement entered in the
case of Dwayne B. v Snyder, docket no. 2:06-cv-13548 in the United
States District Court for the Eastern District of Michigan.
(aa) "SSI" means supplemental security income.
(bb) "Temporary assistance for needy families" or "TANF" or
"title IV-A" means part A of subchapter IV of the social security
act, 42 USC 601 to 619.
(cc) "Title IV-B" means part B of title IV of the social
security act, 42 USC 620 to 629m.
(dd) "Title IV-D" means part D of title IV of the social
security act, 42 USC 651 to 669b.
(ee) "Title IV-E" means part E of title IV of the social
security act, 42 USC 670 to 679c.
(ff) "Title X" means subchapter VIII of the public health
service act, 42 USC 300 to 300a-8, which establishes grants to
states for family planning services.
Sec. 204. Unless otherwise specified, 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 shall include transmission of reports via electronic
mail to the recipients identified for each reporting requirement,
and it shall include placement of reports on the internet.
Sec. 205. 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. 206. The director shall take all reasonable steps to
ensure businesses in deprived and depressed communities compete for
and perform contracts to provide services or supplies, or both.
Each director shall strongly encourage firms with which the
department contracts to subcontract with certified businesses in
depressed and deprived communities for services, supplies, or both.
Sec. 207. The departments and agencies receiving
appropriations in part 1 shall prepare a report on out-of-state
travel expenses by 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. 208. 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. 209. By 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. 210. (1) In addition to the funds appropriated in part 1,
there is appropriated an amount not to exceed $400,000,000.00 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. These funds shall not be made available
to increase TANF authorization.
(2) In addition to the funds appropriated in part 1, there is
appropriated an amount not to exceed $45,000,000.00 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 $40,000,000.00 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 $60,000,000.00 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. 211. 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. 212. 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 on
the department budget, 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 previous fiscal year and the current fiscal
year.
Sec. 213. The department shall maintain, on a publicly
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. 214. Total authorized appropriations from all sources
under part 1 for legacy costs for the current fiscal year are
estimated at $335,657,300.00. From this amount, total agency
appropriations for pension-related legacy costs are estimated at
$172,731,300.00. Total agency appropriations for retiree health
care legacy costs are estimated at $162,926,000.00.
Sec. 215. If either of the following events occur, within 30
days the department shall notify the state budget director, the
chairs of the house and senate subcommittees on the department
budget, and the house and senate fiscal agencies and policy offices
of that fact:
(a) A legislative objective of this part or of a bill or
amendment to a bill to amend the social welfare act, 1939 PA 280,
MCL 400.1 to 400.119b, cannot be implemented because implementation
would conflict with or violate federal regulations.
(b) A federal grant, for which a notice of an award has been
received, cannot be used, or will not be used.
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 fund
sources 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. 217. (1) By February 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 director on the detailed name and
amounts of estimated 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. 218. The department shall include, but not be limited to,
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) Health and human services 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
Michigan Public Health 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 the department budget, 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 December 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 the department's budget
in the previous fiscal year and allocated to the Michigan Public
Health Institute.
Sec. 220. The department shall ensure that faith-based
organizations are able to apply and compete for services, programs,
or contracts that they are qualified and suitable to fulfill. The
department shall not disqualify faith-based organizations solely on
the basis of the religious nature of their organization or their
guiding principles or statements of faith.
Sec. 221. According to section 1b of the social welfare act,
1939 PA 280, MCL 400.1b, the department shall treat part 1 and this
part as a time-limited addendum to the social welfare act, 1939 PA
280, MCL 400.1 to 400.119b.
Sec. 222. (1) The department shall make the entire policy and
procedures manual available and accessible to the public via the
department website.
(2) The department shall report by April 1 of the current
fiscal year on each specific policy change made to implement a
public act affecting the department that took effect during the
prior calendar year to the house and senate appropriations
subcommittees on the budget for the department, the joint committee
on administrative rules, the senate and house fiscal agencies, and
policy offices. The department shall attach each policy bulletin
issued during the prior calendar year to this report.
Sec. 223. The department may establish and collect fees for
publications, videos and related materials, conferences, and
workshops. Collected fees are appropriated when received and 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.
When collected fees are appropriated under this section in an
amount that exceeds the current fiscal year appropriation, within
30 days the department shall notify the chairs of the house and
senate subcommittees on the department budget, the house and senate
fiscal agencies and policy offices, and the state budget director
of that fact.
Sec. 224. The department may retain all of the state's share
of food assistance overissuance collections as an offset to general
fund/general purpose costs. Retained collections shall be applied
against federal funds deductions in all appropriation units where
department costs related to the investigation and recoupment of
food assistance overissuances are incurred. Retained collections in
excess of such costs shall be applied against the federal funds
deducted in the departmental administration and support
appropriation unit.
Sec. 225. (1) Sanctions, suspensions, conditions for
provisional license status, and other penalties shall not be more
stringent for private service providers than for public entities
performing equivalent or similar services.
(2) Neither the department nor private service providers or
licensees shall be granted preferential treatment or considered
automatically to be in compliance with administrative rules based
on whether they have collective bargaining agreements with direct
care workers. Private service providers or licensees without
collective bargaining agreements shall not be subjected to
additional requirements or conditions of licensure based on their
lack of collective bargaining agreements.
Sec. 226. 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. 227. 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.
Sec. 229. (1) The department shall extend the interagency
agreement with the Michigan talent investment agency for the
duration of the current fiscal year, which concerns TANF funding to
provide job readiness and welfare-to-work programming. The
interagency agreement shall include specific outcome and
performance reporting requirements as described in this section.
TANF funding provided to the Michigan talent investment agency in
the current fiscal year is contingent on compliance with the data
and reporting requirements described in this section. The
interagency agreement must require the Michigan talent investment
agency to provide all of the following items by January 1 of the
current fiscal year for the previous fiscal year to the senate and
house appropriations subcommittees on the department budget and the
state budget office:
(a) An itemized spending report on TANF funding, including all
of the following:
(i) Direct services to recipients.
(ii) Administrative expenditures.
(b) The number of family independence program (FIP) recipients
served through the TANF funding, including all of the following:
(i) The number and percentage who obtained employment through
Michigan Works!
(ii) The number and percentage who fulfilled their TANF work
requirement through other job readiness programming.
(iii) Average TANF spending per recipient.
(iv) The number and percentage of recipients who were referred
to Michigan Works! but did not receive a job or job readiness
placement and the reasons why.
(2) By March 1 of the current fiscal year, the department
shall provide to the senate and house appropriations subcommittees
on the department budget, the senate and house fiscal agencies, the
senate and house policy offices, and the state budget office an
annual report on the following matters itemized by Michigan Works!
agency: the number of referrals to Michigan Works! job readiness
programs, the number of referrals to Michigan Works! job readiness
programs who became a participant in the Michigan Works! job
readiness programs, the number of participants who obtained
employment, and the cost per participant case.
Sec. 231. From the funds appropriated in part 1 for travel
reimbursements to employees, the department shall allocate up to
$100,000.00 toward reimbursing counties for the out-of-pocket
travel costs of the local county department board members and
county department directors to attend 1 meeting per year of the
Michigan County Social Services Association.
Sec. 232. (1) The department shall provide the approved
spending plan for each line item receiving an appropriation in the
current fiscal year to the senate and house appropriations
subcommittees on the department budget and the senate and house
fiscal agencies within 60 days of approval by the department but
not later than January 15 of the current fiscal year. The spending
plan shall include the following information regarding planned
expenditures for each category and contract: contract amount,
period of performance, each fund source, allocation in the previous
period, change in the allocation, and new allocation. The spending
plan shall include the following information regarding each revenue
source for the line item: name of the fund source, category of the
fund source indicated by general fund/general purpose, state
restricted, local, private or federal, grant number, original
authorization, adjusted authorization, expected revenue,
authorization less the expected revenue, planned expenditure, and
revenue less planned expenditure. Figures included in the approved
spending plan shall not be assumed to constitute the actual final
expenditures, as line items may be updated on an as-needed basis to
reflect changes in projected expenditures and projected revenue.
(2) Notwithstanding any other appropriation authority granted
in part 1, the department shall not appropriate any general
fund/general purpose funds or any related federal and state
restricted funds for special maintenance, remodeling, addition –
state facilities, or enterprisewide information technology
investments without providing a written 30-day notice to the senate
and house appropriations subcommittees on the department budget,
the senate and house fiscal agencies, and the senate and house
policy offices.
Sec. 233. By March 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, the senate and house policy offices, and state budget
office on the status of the merger, executed according to 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 report shall include, but not be limited to,
all of the following information:
(a) The impact on the lives and well-being of the people of
Michigan.
(b) Any direct and indirect fiscal costs or savings that
resulted from the merger.
(c) A step-by-step explanation as to how the integrated
service delivery will be implemented by the department and the
direct and indirect costs for each step of implementation.
(d) An explanation of actual or any planned consolidation of
duplicative programs as a result of the merger.
Sec. 239. The negative appropriation for merger savings in
part 1 shall be satisfied by savings identified by the director and
approved by the state budget director. Appropriation authorization
adjustments required due to negative appropriations for merger
savings shall be made only after the approval of transfers by the
legislature under section 393(2) of the management and budget act,
1984 PA 431, MCL 18.1393.
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. 263. (1) Except as otherwise provided in this subsection,
before submission of a waiver, a state plan amendment, or a similar
proposal to CMS or other federal agency, the department shall
provide written notification of the planned submission to the house
and senate appropriations subcommittees on the department budget,
the house and senate fiscal agencies and policy offices, and the
state budget office. This subsection does not apply to the
submission of a waiver, a state plan amendment, or similar proposal
that does not propose a material change or is outside of the
ordinary course of waiver, state plan amendment, or similar
proposed submissions.
(2) The department shall provide written biannual reports to
the senate and house appropriations subcommittees on the department
budget, the senate and house fiscal agencies, and the state budget
office summarizing the status of any new or ongoing discussions
with CMS or the United States Department of Health and Human
Services or other federal agency regarding potential or future
waiver applications as well as the status of submitted waivers that
have not yet received federal approval. If, at the time a biannual
report is due, there are no reportable items, then no report is
required to be provided.
Sec. 264. 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 the department budget, the
house and senate fiscal agencies, and the state budget office that
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. 274. (1) The department, in collaboration with the state
budget office, shall submit to the house and senate appropriations
subcommittees on the department budget, the house and senate fiscal
agencies, and the house and senate policy offices 1 week after the
day the governor submits to the legislature the budget for the
ensuing fiscal year a report on spending and revenue projections
for each of the capped federal funds listed below. The report shall
contain actual spending and revenue in the previous fiscal year,
spending and revenue projections for the current fiscal year as
enacted, and spending and revenue projections within the executive
budget proposal for the fiscal year beginning October 1, 2018 for
each individual line item for the department budget. The report
shall also include federal funds transferred to other departments.
The capped federal funds shall include, but not be limited to, all
of the following:
(a) TANF.
(b) Title XX social services block grant.
(c) Title IV-B part I child welfare services block grant.
(d) Title IV-B part II promoting safe and stable families
funds.
(e) Low-income home energy assistance program.
(2) It is the intent of the legislature that the department,
in collaboration with the state budget office, not utilize capped
federal funding for economics adjustments for FTEs or other
economics costs that are included as part of the budget submitted
to the legislature by the governor for the ensuing fiscal year,
unless there is a reasonable expectation for increased federal
funding to be available to the department from that capped revenue
source in the ensuing fiscal year.
(3) By February 15 of the current fiscal year, the department
shall prepare an annual report of its efforts to identify
additional TANF maintenance of effort sources and rationale for any
increases or decreases from all of the following, but not limited
to:
(a) Other departments.
(b) Local units of government.
(c) Private sources.
Sec. 279. (1) All master contracts relating to human services
as funded by the appropriations in sections 103, 104, 105, 106,
107, 108, and 109 of part 1 shall be performance-based contracts
that employ a client-centered results-oriented process that is
based on measurable performance indicators and desired outcomes and
includes the annual assessment of the quality of services provided.
(2) By February 1 of the current fiscal year, the department
shall provide the senate and house appropriations subcommittees on
the department budget, the senate and house fiscal agencies and
policy offices, and the state budget office a report detailing
measurable performance indicators, desired outcomes, and an
assessment of the quality of services provided by the department
during the previous fiscal year.
Sec. 280. On a quarterly basis, the department shall provide a
report to the house and senate appropriations committees, the house
and senate fiscal agencies, the house and senate policy offices,
and the state budget director that provides all of the following
for each line item in part 1 containing personnel-related costs,
including the specific individual amounts for salaries and wages,
payroll taxes, and fringe benefits:
(a) FTE authorization.
(b) Spending authorization for personnel-related costs, by
fund source, under the spending plan.
(c) Actual year-to-date expenditures for personnel-related
costs, by fund source, through the end of the prior month.
(d) The projected year-end balance or shortfall for personnel-
related costs, by fund source, based on actual monthly spending
levels through the end of the prior month.
(e) A specific plan for addressing any projected shortfall for
personnel-related costs at either the gross or fund source level.
Sec. 288. (1) Beginning October 1 of the current fiscal year,
no less than 95% 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 the department budget, 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. 289. By March 1 of the current fiscal year, the
department shall provide to the senate and house appropriations
subcommittees on the department budget, the senate and house fiscal
agencies, and the senate and house policy offices an annual report
on the supervisor-to-staff ratio by department divisions and
subdivisions.
Sec. 290. Any public advertisement for state assistance shall
also inform the public of the welfare fraud hotline operated by the
department.
Sec. 291. The department shall verify, using the e-verify
system, that all new department employees, and new hire employees
of contractors and subcontractors paid from funds appropriated in
part 1, are legally present in the United States. The department
may verify this information directly or may require contractors and
subcontractors to verify the information and submit a certification
to the department.
Sec. 295. (1) From the funds appropriated in part 1 to
agencies providing physical and behavioral health services to
multicultural populations, the department shall award grants in
accordance with the requirements of subsection (2). The state is
not liable for any spending above the contract amount. Funds shall
not be released until reporting requirements under section 295 of
article X of 2016 PA 268 are satisfied.
(2) The department shall require each contractor described in
subsection (1) that receives greater than $1,000,000.00 in state
grant funding to comply with performance-related metrics to
maintain their eligibility for funding. The organizational metrics
shall include, but not be limited to, all of the following:
(a) Each contractor or subcontractor shall have accreditations
that attest to their competency and effectiveness as behavioral
health and social service agencies.
(b) Each contractor or subcontractor shall have a mission that
is consistent with the purpose of the multicultural agency.
(c) Each contractor shall validate that any subcontractors
utilized within these appropriations share the same mission as the
lead agency receiving funding.
(d) Each contractor or subcontractor shall demonstrate cost-
effectiveness.
(e) Each contractor or subcontractor shall ensure their
ability to leverage private dollars to strengthen and maximize
service provision.
(f) Each contractor or subcontractor shall provide timely and
accurate reports regarding the number of clients served, units of
service provision, and ability to meet their stated goals.
(3) The department shall require an annual report from the
contractors described in subsection (2). 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 health and human
services, the senate and house fiscal agencies, and the state
budget office.
Sec. 297. By March 1 and August 1 of the current fiscal year,
the department shall report on the number of FTEs in pay status by
type of staff. The report shall include a comparison by line item
of the number of FTEs authorized from funds appropriated in part 1
to the actual number of FTEs employed by the department at the end
of the reporting period.
Sec. 298. (1) Before implementing the pilot projects and
demonstration models described in subsections (2), (3), and (4),
the department shall contract with an independent project
facilitator with at least 10 years of project management experience
to establish performance outcome metrics of the pilot projects and
demonstration models, finalize each pilot project's or
demonstration model's implementation milestones, determine and
manage the critical path to the pilot project's or demonstration
model's completion, provide independent guidance on resolving
conflicts between parties, and perform other necessary oversight
and implementation functions as determined by the department. These
performance metrics shall evaluate how the pilot projects and
demonstration models impact, at a minimum, each of the following
categories:
(a) Improvement of the coordination between behavioral health
and physical health.
(b) Improvement of services available to individuals with
mental illness, intellectual or developmental disabilities, or
substance use disorders.
(c) Benefits associated with full access to community-based
services and supports.
(d) Customer health status.
(e) Customer satisfaction.
(f) Provider network stability.
(g) Treatment and service efficacies.
(h) Financial efficiencies.
(i) Any other relevant categories.
(2) The department shall work with a willing CMHSP in Kent
County and all willing Medicaid health plans in the county to pilot
a full physical and behavioral health integrated service
demonstration model. The department shall ensure that the pilot
project described in this subsection is implemented in a manner
that ensures at least all of the following:
(a) That each willing Medicaid health plan is contractually
required to utilize the CMHSP in Kent County as the provider of
behavioral health specialty supports and services.
(b) That any changes made to a Medicaid waiver or Medicaid
state plan to implement the pilot project described in this
subsection must only be in effect for the duration of the pilot
project described in this subsection.
(c) That the project is consistent with the stated core values
as identified in the final report of the workgroup established in
section 298 of article X of 2016 PA 268.
(d) That updates are provided to the medical care advisory
council, behavioral health advisory council, and developmental
disabilities council.
(3) The department shall reduce the number of PIHPs providing
Medicaid behavioral health managed care services to 4.
(a) The department shall maintain single-county PIHPs in each
county that had a population greater than 800,000 according to the
most recent decennial census.
(b) The department shall create a single PIHP for those
counties not included in the PIHPs described in subdivision (a).
(c) The PIHPs described in this section shall operate in a
manner consistent with the core values stated by the workgroup
described in subsection (2).
(4) In addition to the pilot project described in subsection
(2), the department shall implement up to 3 pilot projects to
achieve fully financially integrated Medicaid behavioral health and
physical health benefit and financial integration demonstration
models. These demonstration models shall use single contracts
between the state and each licensed Medicaid health plan that is
currently contracted to provide Medicaid services in the geographic
area of the pilot project. The department shall ensure that the
pilot projects described in this subsection are implemented in a
manner that ensures at least all of the following:
(a) That allows the CMHSP in the geographic area of the pilot
project to be a provider of behavioral health supports and
services.
(b) That any changes made to a Medicaid waiver or Medicaid
state plan to implement the pilot projects described in this
subsection must only be in effect for the duration of the pilot
projects described in this subsection.
(c) That the project is consistent with the stated core values
as identified in the final report of the workgroup described in
subsection (2).
(d) That updates are provided to the medical care advisory
council, behavioral health advisory council, and developmental
disabilities council.
(5) The department shall begin to implement the pilot projects
and demonstration models described in subsections (2), (3), and (4)
by no later than October 1, 2017 and shall implement the pilot
projects and demonstration models described in subsections (2),
(3), and (4) by no later than March 1, 2018. Each pilot project
shall be designed to last at least 2 years.
(6) For the duration of any pilot projects and demonstration
models, any and all realized benefits and cost savings of
integrating the physical health and behavioral health systems shall
be reinvested in services and supports for individuals having or at
risk of having a mental illness, an intellectual or developmental
disability, or a substance use disorder.
(7) It is the intent of the legislature that the primary
purpose of the pilot projects and demonstration models is to test
how the state may better integrate behavioral and physical health
delivery systems in order to improve behavioral and physical health
outcomes, maximize efficiencies, minimize unnecessary costs, and
achieve material increases in behavioral health services without
increases in overall Medicaid spending.
(8) The department shall contract with 1 of the state's
research universities at least 6 months before the completion of
each pilot project or demonstration model to evaluate the pilot
project or demonstration model. The evaluation shall include
information on the pilot project's or demonstration model's success
in meeting the performance metrics developed in subsection (1) and
information on whether the pilot project could be replicated into
other geographic areas with similar performance metric outcomes.
The evaluation shall also include a comparison of Michigan model
outcomes with similar model outcomes in other states. The
evaluation shall be completed within 6 months of the end of the
pilot project or demonstration model and shall be provided to the
department, the house and senate appropriations subcommittees on
the department budget, the house and senate fiscal agencies, the
house and senate policy offices, and the state budget office.
(9) By October 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, the
house and senate policy offices, and the state budget office on
progress, a time frame for implementation, and any identified
barriers to implementation and the remedies to address any
identified barriers of the items described in subsections (2), (3),
and (4). The report shall also include information on policy
changes and any other efforts made to improve the coordination of
supports and services for individuals having or at risk of having a
mental illness, an intellectual or developmental disability, a
substance use disorder, or a physical health need.
(10) Upon completion of any pilot projects or demonstration
models advanced under this section, the managing entity of the
pilot project or demonstration model shall submit a report to the
senate and house appropriations subcommittees on the department
budget, the senate and house fiscal agencies, the senate and house
policy offices, and the state budget office within 30 days of
completion of that pilot project or demonstration model detailing
their experience, lessons learned, efficiencies and savings
revealed, increases in investment on behavioral health services,
and recommendations for extending pilot projects to full
implementation or discontinuation.
Sec. 299. (1) 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.
(2) From funds appropriated in part 1, for all RFPs issued
during the current fiscal year where an existing service received
proposals by multiple vendors, the department shall notify all
vendors within 30 days of the RFP decision. The notification to
vendors shall include details on the RFP process, including the
respective RFP scores and the respective cost for each vendor. If
the highest scored RFP or lowest cost RFP does not receive the
contract for an existing service offered by the department, the
notification shall issue an explanation for the reasons that the
highest scored RFP or lowest cost RFP did not receive the contract
and detail the incremental cost target amount or service level
required that was required to migrate the service to a new vendor.
Additionally, the department shall include in the notification
details as to why a cost or service difference is justifiable if
the highest scored or lowest cost vendor does not receive the
contract.
(3) The department shall submit to the senate and house
appropriations subcommittees on the department budget, the senate
and house fiscal agencies, the senate and house policy offices, and
the state budget office by September 30 of the current fiscal year
a report that summarizes all RFPs during the current fiscal year
where an existing service received proposals by multiple vendors.
The report shall list all finalized RFPs where there was a
divergence from awarding the contract to the lowest cost or highest
scoring vendor. The report shall also include the cost or service
threshold required by department policy that must be satisfied in
order for an existing contract to be received by new vendor.
DEPARTMENTAL ADMINISTRATION AND SUPPORT
Sec. 307. (1) From the funds appropriated in part 1 for
demonstration projects, $950,000.00 shall be distributed as
provided in subsection (2). The amount distributed under this
subsection shall not exceed 50% of the total operating expenses of
the program described in subsection (2), with the remaining 50%
paid by local United Way organizations and other nonprofit
organizations and foundations.
(2) Funds distributed under subsection (1) shall be
distributed to Michigan 2-1-1, a nonprofit corporation organized
under the laws of this state that is exempt from federal income tax
under section 501(c)(3) of the internal revenue code of 1986, 26
USC 501, and whose mission is to coordinate and support a statewide
2-1-1 system. Michigan 2-1-1 shall use the funds only to fulfill
the Michigan 2-1-1 business plan adopted by Michigan 2-1-1 in
January 2005.
(3) Michigan 2-1-1 shall refer to the department any calls
received reporting fraud, waste, or abuse of state-administered
public assistance.
(4) Michigan 2-1-1 shall report annually to the department and
the house and senate standing committees with primary jurisdiction
over matters relating to human services and telecommunications on
2-1-1 system performance, the senate and house appropriations
subcommittees on the department budget, and the senate and house
fiscal agencies, including, but not limited to, call volume by
health and human service needs and unmet needs identified through
caller data and customer satisfaction metrics.
Sec. 310. It is the intent of the legislature that the
department shall work with youth-oriented nonprofit organizations
to provide mentoring programming for children of incarcerated
parents and other at-risk children.
Sec. 316. From the funds appropriated in part 1 for terminal
leave payments, the department shall not spend in excess of its
annual gross appropriation unless it identifies and requests a
legislative transfer from another budgetary line item supporting
administrative costs, as provided by section 393(2) of the
management and budget act, 1984 PA 431, MCL 18.1393.
CHILD SUPPORT ENFORCEMENT
Sec. 401. (1) The appropriations in part 1 assume a total
federal child support incentive payment of $26,500,000.00.
(2) From the federal money received for child support
incentive payments, $12,000,000.00 shall be retained by the state
and expended for child support program expenses.
(3) From the federal money received for child support
incentive payments, $14,500,000.00 shall be paid to the counties
based on each county's performance level for each of the federal
performance measures as established in 45 CFR 305.2.
(4) If the child support incentive payment to the state from
the federal government is greater than $26,500,000.00, then 100% of
the excess shall be retained by the state and is appropriated until
the total retained by the state reaches $15,397,400.00.
(5) If the child support incentive payment to the state from
the federal government is greater than the amount needed to satisfy
the provisions identified in subsections (1), (2), (3), and (4),
the additional funds shall be subject to appropriation by the
legislature.
(6) If the child support incentive payment to the state from
the federal government is less than $26,500,000.00, then the state
and county share shall each be reduced by 50% of the shortfall.
Sec. 409. (1) If statewide retained child support collections
exceed $38,300,000.00, 75% of the amount in excess of
$38,300,000.00 is appropriated to legal support contracts. This
excess appropriation may be distributed to eligible counties to
supplement and not supplant county title IV-D funding.
(2) Each county whose retained child support collections in
the current fiscal year exceed its fiscal year 2004-2005 retained
child support collections, excluding tax offset and financial
institution data match collections in both the current fiscal year
and fiscal year 2004-2005, shall receive its proportional share of
the 75% excess.
Sec. 410. (1) If title IV-D-related child support collections
are escheated, the state budget director is authorized to adjust
the sources of financing for the funds appropriated in part 1 for
legal support contracts to reduce federal authorization by 66% of
the escheated amount and increase general fund/general purpose
authorization by the same amount. This budget adjustment is
required to offset the loss of federal revenue due to the escheated
amount being counted as title IV-D program income in accordance
with federal regulations at 45 CFR 304.50.
(2) The department shall notify the chairs of the house and
senate appropriations subcommittees on the department budget and
the house and senate fiscal agencies within 15 days of the
authorization adjustment in subsection (1).
COMMUNITY SERVICES AND OUTREACH
Sec. 450. (1) From the funds appropriated in part 1 for school
success partnership program, the department shall allocate
$450,000.00 by December 1 of the current fiscal year to support the
Northeast Michigan Community Service Agency programming, which will
take place in each county in the Governor's Prosperity Region 3.
The department shall require the following performance objectives
be measured and reported for the duration of the state funding for
the school success partnership program:
(a) Increasing school attendance and decreasing chronic
absenteeism.
(b) Increasing academic performance based on grades with
emphasis on math and reading.
(c) Identifying barriers to attendance and success and
connecting families with resources to reduce these barriers.
(d) Increasing parent involvement with the parent's child's
school and community.
(2) The Northeast Michigan Community Service Agency shall
provide reports to the department on January 31 and June 30 of the
current fiscal year on the number of children and families served
and the services that were provided to families to meet the
performance objectives identified in this section. The department
shall distribute the reports within 1 week after receipt to the
senate and house appropriations subcommittees on the department
budget, the senate and house fiscal agencies, the senate and house
policy offices, and the state budget office.
Sec. 452. From the funds appropriated in part 1 for crime
victim 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.
Sec. 453. From the funds appropriated in part 1 for homeless
programs, the department shall increase emergency shelter program
per diem rates to $16.00 per bed night to support efforts of
shelter providers to move homeless individuals and households into
permanent housing as quickly as possible. The purpose of this
enhancement is to increase the number of shelter discharges to
stable housing destinations, decrease recidivism rates for shelter
clients, and reduce the average length of stay in emergency
shelters.
Sec. 454. The department shall allocate the full amount of
funds appropriated in part 1 for homeless programs to provide
services for homeless individuals and families, including, but not
limited to, third-party contracts for emergency shelter services.
Sec. 455. As a condition of receipt of federal TANF funds,
homeless shelters and human services agencies shall collaborate
with the department to obtain necessary TANF eligibility
information on families as soon as possible after admitting a
family to the homeless shelter. From the funds appropriated in part
1 for homeless programs, the department is authorized to make
allocations of TANF funds only to the homeless shelters and human
services agencies that report necessary data to the department for
the purpose of meeting TANF eligibility reporting requirements.
Homeless shelters or human services agencies that do not report
necessary data to the department for the purpose of meeting TANF
eligibility reporting requirements will not receive reimbursements
that exceed the per diem amount they received in fiscal year 2000.
The use of TANF funds under this section is not an ongoing
commitment of funding.
CHILDREN'S SERVICES AGENCY - CHILD WELFARE
Sec. 501. (1) A goal is established that not more than 25% of
all children in foster care at any given time during the current
fiscal year will have been in foster care for 24 months or more.
(2) By March 1 of the current fiscal year, the department
shall provide to the senate and house appropriations subcommittees
on the department budget, the senate and house fiscal agencies, the
senate and house policy offices, and the state budget office a
report describing the steps that will be taken to achieve the
specific goal established in this section and on the percentage of
children who currently are in foster care and who have been in
foster care a total of 24 or more months.
Sec. 502. From the funds appropriated in part 1 for foster
care, the department shall provide 50% reimbursement to Indian
tribal governments for foster care expenditures for children who
are under the jurisdiction of Indian tribal courts and who are not
otherwise eligible for federal foster care cost sharing.
Sec. 503. (1) In accordance with the final report of the
Michigan child welfare performance-based funding task force issued
in response to section 503 of article X of 2013 PA 59, the
department shall continue to develop actuarially sound case rates
for necessary out-of-home child welfare services that achieve
permanency by the department and private child placing agencies in
a prospective payment system under a performance-based funding
model.
(2) The department shall continue to develop a prospective
rate payment system for private agencies that includes funding for
adoption incentive payments. The full cost prospective rate payment
system will identify and cover contractual costs paid through the
case rate developed by an independent actuary.
(3) By March 1 of the current fiscal year, the department
shall provide to the senate and house appropriations committees on
the department budget, the senate and house fiscal agencies and
policy offices, and the state budget office a report on the full
cost analysis of the performance-based funding model. The report
shall include background information on the project and give
details about the contractual costs covered through the case rate.
(4) In accordance with the final report of the Michigan child
welfare performance-based funding task force issued in response to
section 503 of article X of 2013 PA 59, the department shall
continue an independent, third-party evaluation of the performance-
based funding model. The evaluator shall be selected through a
competitive process by a rating committee that includes, but is not
limited to, representatives from the department and private child
placing agencies.
(5) The department shall only implement the performance-based
funding model into additional counties where the department,
private child welfare agencies, the county, and the court operating
within that county have signed a memorandum of understanding that
incorporates the intentions of the concerned parties in order to
implement the performance-based funding model.
(6) The department, in conjunction with members from both the
house of representatives and senate, private child placing
agencies, the courts, and counties shall implement the
recommendations that are described in the workgroup report that was
provided in section 503 of article X of 2013 PA 59 to establish a
performance-based funding for public and private child welfare
services providers. The department shall provide a quarterly report
on the status of the performance-based contracting model to the
senate and house appropriations subcommittees on the department
budget, the senate and house standing committees on families and
human services, and the senate and house fiscal agencies and policy
offices.
(7) From the funds appropriated in part 1 for the performance-
based funding model pilot, the department shall continue to work
with the West Michigan Partnership for Children Consortium on the
implementation of the performance-based funding model pilot. The
consortium shall accept and comprehensively assess referred youth,
assign cases to members of its continuum or leverage services from
other entities, and make appropriate case management decisions
during the duration of a case. The consortium shall operate an
integrated continuum of care structure, with services provided by
both private and public agencies, based on individual case needs.
The consortium shall demonstrate significant organizational
capacity and competencies, including experience with managing risk-
based contracts, financial strength, experienced staff and
leadership, and appropriate governance structure.
Sec. 504. (1) The department may establish a master agreement
with the West Michigan Partnership for Children Consortium for a
performance-based child welfare contracting pilot program. The
consortium shall consist of a network of affiliated child welfare
service providers that will accept and comprehensively assess
referred youth, assign cases to members of its continuum or
leverage services from other entities, and make appropriate case
management decisions during the duration of a case.
(2) The consortium shall operate an integrated continuum of
care structure, with services provided by private or public
agencies, based on individual case needs.
(3) By March 1 of the current fiscal year, the consortium
shall provide to the department and the house and senate
appropriations subcommittees on the department budget a report on
the consortium, including, but not limited to, actual expenditures,
number of children placed by agencies in the consortium, fund
balance of the consortium, and the status of the consortium
evaluation.
Sec. 505. By March 1 of the current fiscal year, the
department shall provide to the senate and house appropriations
subcommittees on the department budget, the senate and house fiscal
agencies and policy offices, and the state budget office a report
for youth referred or committed to the department for care or
supervision in the previous fiscal year and in the first quarter of
the current fiscal year outlining the number of youth within the
juvenile justice system, the type of setting for each youth,
performance outcomes, and financial costs or savings.
Sec. 507. The department's ability to satisfy appropriation
deducts in part 1 for foster care private collections shall not be
limited to collections and accruals pertaining to services provided
only in the current fiscal year but may include revenues collected
during the current fiscal year for services provided in prior
fiscal years.
Sec. 508. (1) In addition to the amount appropriated in part 1
for children's trust fund grants, money granted or money received
as gifts or donations to the children's trust fund created by 1982
PA 249, MCL 21.171 to 21.172, is appropriated for expenditure.
(2) The department and the child abuse and neglect prevention
board shall collaborate to ensure that administrative delays are
avoided and the local grant recipients and direct service providers
receive money in an expeditious manner. The department and board
shall make available the children's trust fund contract funds to
grantees within 31 days of the start date of the funded project.
Sec. 511. The department shall provide semiannual reports to
the senate and house appropriations subcommittees on the department
budget, the senate and house standing committees on families and
human services, and the senate and house fiscal agencies and policy
offices on the number and percentage of children who received
timely health examinations after entry into foster care and the
number and percentage of children entering foster care who received
a required mental health examination after entry into foster care.
Sec. 512. (1) By March 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, the senate and house policy offices, and the state budget
office on the following information from the previous fiscal year:
(a) The total number of relative care placements.
(b) The number of relative care placements ordered by the
court in accordance with the department's recommendation.
(c) The number of relative care placements ordered by the
court contrary to the department's recommendation.
(d) The number of relative care placements placed by the
department.
(e) The total number of relatives with a placement who became
licensed.
(f) The number of waivers of foster care licensure granted to
relative care providers.
(g) The number of waivers of foster care denied to relative
care providers.
(h) A list of the reasons the department denied granting a
waiver of foster care licensure for a relative care provider.
(i) A list of the reasons that relatives were declined foster
care licensure as documented by the department.
(j) The number of children removed from relative care
placement after their relative care providers were unable to
qualify for the foster care licensure waiver.
(k) The projected cost if all relative care providers became
licensed.
(l) The projected cost if all relative care providers became
eligible to receive assistance from the child care fund regardless
of licensure.
(2) The caseworker shall request a waiver of foster care
licensure if both of the following apply:
(a) The caseworker has fully informed the relative of the
benefits of licensure and the option of a licensure waiver.
(b) The caseworker has assessed the relative and the
relative's home using the department's initial relative safety
screen and the department's relative home assessment and has
determined that the relative's home is safe and placement there is
in the child's best interest.
Sec. 513. (1) The department shall not expend funds
appropriated in part 1 to pay for the direct placement by the
department of a child in an out-of-state facility unless all of the
following conditions are met:
(a) There is no appropriate placement available in this state
as determined by the department interstate compact office.
(b) An out-of-state placement exists that is nearer to the
child's home than the closest appropriate in-state placement as
determined by the department interstate compact office.
(c) The out-of-state facility meets all of the licensing
standards of this state for a comparable facility.
(d) The out-of-state facility meets all of the applicable
licensing standards of the state in which it is located.
(e) The department has done an on-site visit to the out-of-
state facility, reviewed the facility records, reviewed licensing
records and reports on the facility, and believes that the facility
is an appropriate placement for the child.
(2) The department shall not expend money for a child placed
in an out-of-state facility without approval of the executive
director of the children's services agency.
(3) The department shall submit an annual report to the state
court administrative office, the house and senate appropriations
subcommittees on the department budget, the house and senate fiscal
agencies, the house and senate policy offices, and the state budget
office on the number of Michigan children residing in out-of-state
facilities at the time of the report, the total cost and average
per diem cost of these out-of-state placements to this state, and a
list of each such placement arranged by the Michigan county of
residence for each child.
(4) It is the intent of the legislature that the department
shall work in conjunction with the courts and the state court
administrative office to identify data needed to calculate
statewide recidivism rates for adjudicated youth placed in either
residential secure or nonsecure facilities, defined at 6 months
after a youth is released from placement.
(5) By March 1 of the current fiscal year, the department
shall notify the legislature on the status of efforts to accomplish
the intent of subsection (4).
Sec. 514. The department shall make a comprehensive report
concerning children's protective services (CPS) to the legislature,
including the senate and house policy offices and the state budget
director, by March 1 of the current fiscal year, that shall include
all of the following:
(a) Statistical information including, but not limited to, all
of the following:
(i) The total number of reports of child abuse or child
neglect investigated under the child protection law, 1975 PA 238,
MCL 722.621 to 722.638, and the number of cases classified under
category I or category II and the number of cases classified under
category III, category IV, or category V.
(ii) Characteristics of perpetrators of child abuse or child
neglect and the child victims, such as age, relationship, race, and
ethnicity and whether the perpetrator exposed the child victim to
drug activity, including the manufacture of illicit drugs, that
exposed the child victim to substance abuse, a drug house, or
methamphetamine.
(iii) The mandatory reporter category in which the individual
who made the report fits, or other categorization if the individual
is not within a group required to report under the child protection
law, 1975 PA 238, MCL 722.621 to 722.638.
(iv) The number of cases that resulted in the separation of
the child from the parent or guardian and the period of time of
that separation, up to and including termination of parental
rights.
(v) For the reported complaints of child abuse or child
neglect by teachers, school administrators, and school counselors,
the number of cases classified under category I or category II and
the number of cases classified under category III, category IV, or
category V.
(vi) For the reported complaints of child abuse or child
neglect by teachers, school administrators, and school counselors,
the number of cases that resulted in separation of the child from
the parent or guardian and the period of time of that separation,
up to and including termination of parental rights.
(b) New policies related to children's protective services
including, but not limited to, major policy changes and court
decisions affecting the children's protective services system
during the immediately preceding 12-month period.
(c) Statistical information regarding families that were
classified in category III, including, but not limited to, all of
the following:
(i) The total number of cases classified in category III.
(ii) The number of cases in category III referred to voluntary
community services and closed with no additional monitoring.
(iii) The number of cases in category III referred to
voluntary community services and monitored for up to 90 days.
(iv) The number of cases in category III for which the
department entered more than 1 determination that there was
evidence of child abuse or child neglect.
(v) The number of cases in category III that the department
reclassified from category III to category II.
(vi) The number of cases in category III that the department
reclassified from category III to category I.
(vii) The number of cases in category III that the department
reclassified from category III to category I that resulted in a
removal.
(d) The department policy, or changes to the department
policy, regarding children who have been exposed to the production
or manufacture of methamphetamines.
Sec. 519. The department shall permit any private agency that
has an existing contract with this state to provide foster care
services to be also eligible to provide treatment foster care
services.
Sec. 522. (1) From the funds appropriated in part 1 for youth
in transition, the department shall allocate $750,000.00 for
college scholarships through the fostering futures scholarship
program in the Michigan education trust to youths who were in
foster care because of child abuse or child neglect and are
attending a college located in this state. Of the funds
appropriated, 100% shall be used to fund scholarships for the
youths described in this section.
(2) By March 1 of the current fiscal year, the department
shall provide a report to the senate and house appropriations
subcommittees on the department budget, the senate and house fiscal
agencies, the senate and house policy offices, and the state budget
office that includes the number of youths who received scholarships
and the amount of each scholarship, and the total amount of funds
spent or encumbered in the current fiscal year.
Sec. 523. (1) By February 15 of the current fiscal year, the
department shall report on the families first, family
reunification, and families together building solutions family
preservation programs to the senate and house appropriations
subcommittees on the department budget, the senate and house fiscal
agencies, the senate and house policy offices, and the state budget
office. The report shall provide an estimate of total costs savings
as a result of avoiding placement of children in foster care for
families who received family preservation services and shall
include information for each program on any innovations that may
increase savings or reductions in administrative costs.
(2) From the funds appropriated in part 1 for youth in
transition and domestic violence prevention and treatment, the
department is authorized to make allocations of TANF funds only to
agencies that report necessary data to the department for the
purpose of meeting TANF eligibility reporting requirements.
Sec. 524. As a condition of receiving funds appropriated in
part 1 for strong families/safe children, counties must submit the
service spending plan to the department by October 1 of the current
fiscal year for approval. The department shall approve the service
spending plan within 30 calendar days after receipt of a properly
completed service spending plan.
Sec. 525. The department shall implement the same on-site
evaluation processes for privately operated child welfare and
juvenile justice residential facilities as is used to evaluate
state-operated facilities. Penalties for noncompliance shall be the
same for privately operated child welfare and juvenile justice
residential facilities and state-operated facilities.
Sec. 526. From the funds appropriated in part 1 for foster
care payments and related administrative costs, the department may
implement the federally approved title IV-E child welfare waiver
demonstration project. As required under the waiver, any savings
resulting from the demonstration project must be quantified and
reinvested into child welfare programming.
Sec. 531. The department shall notify the house and senate
appropriations subcommittees on the department budget, the house
and senate fiscal agencies, and the house and senate policy offices
of any changes to a child welfare master contract template,
including the adoption master contract template, the independent
living plus master contract template, the child placing agency
foster care master contract template, and the residential foster
care juvenile justice master contract template, not less than 30
days before the change takes effect.
Sec. 532. The department, in collaboration with
representatives of private child and family agencies, shall revise
and improve the annual licensing review process and the annual
contract compliance review process for child placing agencies and
child caring institutions. The improvement goals shall be safety
and care for children. Improvements to the review process shall be
directed toward alleviating administrative burdens so that agency
resources may be focused on children. The revision shall include
identification of duplicative staff activities and information
sought from child placing agencies and child caring institutions in
the annual review process. The department shall report to the
senate and house appropriations subcommittees on the department
budget, the senate and house fiscal agencies and policy offices,
and the state budget director on or before January 15 of the
current fiscal year on the findings of the annual licensing review
and include summaries of actions undertaken to revise, improve, and
identify weaknesses in the current annual licensing process and
annual contract compliance.
Sec. 533. (1) The department shall make payments to child
placing facilities for in-home and out-of-home care services and
adoption services within 30 days of receiving all necessary
documentation from those agencies. It is the intent of the
legislature that the burden of ensuring that these payments are
made in a timely manner and no payments are in arrears is upon the
department.
(2) By March 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, the senate and house policy offices, and the state budget
office that details each private child placing agency and the
percentage of payments that were in excess of 30 days during the
entire prior fiscal year and the first quarter of the current
fiscal year.
Sec. 537. (1) The department, in collaboration with child
placing agencies, shall develop a strategy to implement section
115o of the social welfare act, 1939 PA 280, MCL 400.115o. The
strategy shall include a requirement that a department caseworker
responsible for preparing a recommendation to a court concerning a
juvenile placement shall provide, as part of the recommendation,
information regarding the requirements of section 115o of the
social welfare act, 1939 PA 280, MCL 400.115o.
(2) By March 1 of the current fiscal year, the department
shall provide to the senate and house appropriations subcommittees
on the department budget, the senate and house fiscal agencies, the
senate and house policy offices, and the state budget office a
report on the strategy described in subsection (1).
Sec. 540. If a physician or psychiatrist who is providing
services to state or court wards placed in a residential facility
submits a formal request to the department to change the
psychotropic medication of a ward, the department shall, if the
ward is a state ward, make a determination on the proposed change
within 7 business days after the request or, if the ward is a
temporary court ward, seek parental consent within 7 business days
after the request. If parental consent is not provided within 7
business days, the department shall petition the court on the
eighth business day.
Sec. 546. (1) From the funds appropriated in part 1 for foster
care payments and from child care fund, the department shall pay
providers of general foster care, independent living, and trial
reunification services not less than a $37.00 administrative rate.
(2) From the funds appropriated in part 1, the department
shall pay providers of independent living plus services statewide
per diem rates for staff-supported housing and host-home housing
based on proposals submitted in response to a solicitation for
pricing. The independent living plus program provides staff-
supported housing and services for foster youth ages 16 through 19
who, because of their individual needs and assessments, are not
initially appropriate for general independent living foster care.
(3) From the funds appropriated in part 1, the department
shall pay providers of foster care services an additional $9.20
administrative rate, if section 117a of the social welfare act,
1939 PA 280, MCL 400.117a, is amended to eliminate the county match
rate for the additional administrative rate provided in this
subsection. Payments under this subsection shall be made, not less
than, on a monthly basis.
(4) If required by the federal government to meet title IV-E
requirements, providers of foster care services shall submit
quarterly expenditure reports to the department to identify actual
costs of providing foster care services.
(5) From the funds appropriated in part 1, the department
shall provide an increase to each private provider of residential
services, if section 117a of the social welfare act, 1939 PA 280,
MCL 400.117a, is amended to eliminate the county match rate for the
additional rate provided in this section.
Sec. 547. From the funds appropriated in part 1 for the
guardianship assistance program, the department shall pay a minimum
rate that is not less than the approved age-appropriate payment
rates for youth placed in family foster care.
Sec. 550. (1) The department shall not offset against
reimbursement payments to counties or seek reimbursement from
counties for charges that were received by the department more than
12 months before the department seeks to offset against
reimbursement. A county shall not request reimbursement for and
reimbursement payments shall not be paid for a charge that is more
than 12 months after the date of service or original status
determination when initially submitted by the county.
(2) Subsequent to any original funding source determination
made by the department for the status of a youth, the department
shall not seek reimbursement from a county if the funding source
status of a youth has changed.
Sec. 551. The department shall respond to counties within 30
days regarding any request for a clarification requested through
the department's child care fund management unit electronic mail
address.
Sec. 552. Sixty days after a county's child care fund on-site
review is completed, the department shall provide the results of
the review to the county.
Sec. 558. (1) The department shall permit private nationally
accredited foster care and adoption agencies to conduct their own
staff training, based on current department policies and
procedures, if the agency trainer and training materials are
certified by the department through a train the trainer model and
that the agency documents to the department that the training was
provided. The department shall provide access to all training
materials the private agencies will need to facilitate this
training.
(2) The department shall post on the department's website a
list of all relevant departmental training materials available to
private nationally accredited foster care and adoption agencies
that are allowed to conduct their own training in accordance with
this section. The department shall also provide to private child
placing agencies that are allowed to conduct their own training any
updated training materials as those materials become available.
Sec. 559. (1) From the funds appropriated in part 1 for
adoption support services, the department shall allocate
$250,000.00 to the Adoptive Family Support Network by December 1 of
the current fiscal year to operate and expand its adoptive parent
mentor program to provide a listening ear, knowledgeable guidance,
and community connections to adoptive parents and children who were
adopted in this state or another state.
(2) The Adoptive Family Support Network shall submit to the
senate and house appropriations subcommittees on the department
budget, the senate and house fiscal agencies, the senate and house
policy offices, and the state budget office by March 1 of the
current fiscal year a report on the program described in subsection
(1), including, but not limited to, the number of cases served and
the number of cases in which the program prevented an out-of-home
placement.
Sec. 562. The department shall provide time and travel
reimbursements for foster parents who transport a foster child to
parent-child visitations. As part of the foster care parent
contract, the department shall provide written confirmation to
foster parents that states that the foster parents have the right
to request these reimbursements for all parent-child visitations.
The department shall provide these reimbursements within 60 days of
receiving a request for eligible reimbursements from a foster
parent.
Sec. 564. (1) The department shall develop a clear policy for
parent-child visitations. The local county offices, caseworkers,
and supervisors shall meet an 85% success rate, after accounting
for factors outside of the caseworkers' control.
(2) Per the court-ordered number of required meetings between
caseworkers and a parent, the caseworkers shall achieve a success
rate of 85%, after accounting for factors outside of the
caseworkers' control.
(3) By March 1 of the current fiscal year, the department
shall provide to the senate and house appropriations subcommittees
on the department budget, the senate and house fiscal agencies, the
senate and house policy offices, and the state budget office a
report on the following:
(a) The percentage of success rate for parent-child
visitations and court-ordered required meetings between caseworkers
referenced in subsections (1) and (2) for the previous year.
(b) The barriers to achieve the success rates in subsections
(1) and (2) and how this information is tracked.
Sec. 567. The department shall submit to the senate and house
appropriations subcommittees on the department budget, the senate
and house fiscal agencies, the senate and house policy offices, and
the state budget office by March 1 of the current fiscal year a
report on completion of medical passports for children in foster
care, including the following:
(a) The percentage of medical passports that were properly
filled out.
(b) From the total medical passports transferred, the
percentage that transferred within 2 weeks from the date of
placement or return to the home.
(c) From the total school records, the percentage that
transferred within 2 weeks from the date of placement or return to
the home.
(d) The implementation steps that have been taken to improve
the outcomes for the measures in subdivisions (a) and (b).
Sec. 569. The department shall reimburse private child placing
agencies that complete adoptions at the rate according to the date
on which the petition for adoption and required support
documentation was accepted by the court and not according to the
date the court's order placing for adoption was entered.
Sec. 573. The department may pay providers of foster care
services a per diem daily administrative rate for every case on a
caseworker's caseload for the duration of a case from referral
acceptance to the discharge of wardship.
Sec. 574. (1) From the funds appropriated in part 1 for foster
care payments, $3,500,000.00 is allocated to support performance-
based contracts with child placing agencies to facilitate the
licensure of relative caregivers as foster parents. Agencies shall
receive $4,500.00 for each facilitated licensure if completed
within 180 days after case acceptance, or, if a waiver was
previously approved, 180 days from the referral date. If the
facilitated licensure, or approved waiver, is completed after 180
days, the agency shall receive up to $3,500.00. The agency
facilitating the licensure would retain the placement and continue
to provide case management services for the newly licensed cases
for which the placement was appropriate to the agency.
(2) From the funds appropriated for foster care payments,
$375,000.00 is allocated to support family incentive grants to
private and community-based foster care service providers to assist
with home improvements or payment for physical exams for applicants
needed by foster families to accommodate foster children.
Sec. 583. By February 1 of the current fiscal year, the
department shall provide to the senate and house appropriations
subcommittees on the department budget, the senate and house
standing committees on families and human services, the senate and
house fiscal agencies and policy offices, and the state budget
office a report that includes:
(a) The number and percentage of foster parents that dropped
out of the program in the previous fiscal year and the reasons the
foster parents left the program and how those figures compare to
prior fiscal years.
(b) The number and percentage of foster parents successfully
retained in the previous fiscal year and how those figures compare
to prior fiscal years.
Sec. 585. The department shall make available at least 1 pre-
service training class each month in which new caseworkers for
private foster care and adoption agencies can enroll.
Sec. 588. (1) Concurrently with public release, the department
shall transmit all reports from the court-appointed settlement
monitor, including, but not limited to, the needs assessment and
period outcome reporting, to the state budget office, the senate
and house appropriations subcommittees on the department budget,
and the senate and house fiscal agencies and policy offices,
without revision.
(2) The department shall report quarterly to the state budget
office, the senate and house appropriations subcommittees on the
department budget, the senate and house fiscal agencies, and the
senate and house policy offices on the number of children enrolled
in the guardianship assistance and foster care - children with
serious emotional disturbance waiver programs.
Sec. 589. (1) From the funds appropriated in part 1 for child
care fund, the department shall pay 100% of the administrative rate
for all new cases referred to providers of foster care services.
(2) On a monthly basis, the department shall report on the
number of all foster care cases administered by the department and
all foster care cases administered by private providers.
Sec. 590. From funds appropriated in part 1 for youth in
transition, $280,000.00 shall be awarded to a charter high school
for students ages 16 to 22 who have previously dropped out or are
at risk of not graduating on time operating in a county with a
population of greater than 172,000 but less than 175,000 according
to the most recent federal decennial census. It is the intent of
the legislature that this is the second year out of 3 years that
funding is to be provided by the legislature for the charter high
school described in this section.
Sec. 593. The department may allow residential service
providers for child abuse and child neglect cases to implement a
staff ratio during working hours of 1 staff to 5 children.
Sec. 594. From the funds appropriated in part 1 for foster
care payments, the department shall support regional resource teams
to provide for the recruitment, retention, and training of foster
and adoptive parents and shall expand the Michigan youth
opportunities initiative to all Michigan counties. The purpose of
this investment is to increase the number of annual inquiries from
prospective foster parents, increase the number of nonrelative
foster homes that achieve licensure each year, increase the annual
retention rate of nonrelative foster homes, reduce the number of
older foster youth placed outside of family settings, and provide
older youth with enhanced support in transitioning to adulthood.
PUBLIC ASSISTANCE
Sec. 601. Whenever a client agrees to the release of his or
her name and address to the local housing authority, the department
shall request from the local housing authority information
regarding whether the housing unit for which vendoring has been
requested meets applicable local housing codes. Vendoring shall be
terminated for those units that the local authority indicates in
writing do not meet local housing codes until such time as the
local authority indicates in writing that local housing codes have
been met.
Sec. 602. The department shall establish a policy to conduct a
full evaluation of an individual's assistance needs if the
individual has applied for disability more than 1 time within a 1-
year period.
Sec. 603. By March 1 of the current fiscal year, the
department shall provide to the senate and house appropriations
subcommittees on the department budget, the senate and house fiscal
agencies, the senate and house policy offices, and the state budget
office a report on continued work effort on the action plan
developed by the Medicaid claim workgroup established in section
603 of article X of 2014 PA 252, including the steps taken to
implement the action plan developed by the workgroup, and the
department's ongoing efforts to maximize Medicaid claims for foster
children and adjudicated youths and any developments to the
Medicaid program that could affect foster children and adjudicated
youths.
Sec. 604. (1) The department shall operate a state disability
assistance program. Except as provided in subsection (3), persons
eligible for this program shall include needy citizens of the
United States or aliens exempted from the supplemental security
income citizenship requirement who are at least 18 years of age or
emancipated minors meeting 1 or more of the following requirements:
(a) A recipient of supplemental security income, social
security, or medical assistance due to disability or 65 years of
age or older.
(b) A person with a physical or mental impairment that meets
federal supplemental security income disability standards, except
that the minimum duration of the disability shall be 90 days.
Substance use disorder alone is not defined as a basis for
eligibility.
(c) A resident of an adult foster care facility, a home for
the aged, a county infirmary, or a substance use disorder treatment
center.
(d) A person receiving 30-day postresidential substance use
disorder treatment.
(e) A person diagnosed as having acquired immunodeficiency
syndrome.
(f) A person receiving special education services through the
local intermediate school district.
(g) A caretaker of a disabled person who meets the
requirements specified in subdivision (a), (b), (e), or (f).
(2) Applicants for and recipients of the state disability
assistance program shall be considered needy if they:
(a) Meet the same asset test as is applied for the family
independence program.
(b) Have a monthly budgetable income that is less than the
payment standards.
(3) Except for a person described in subsection (1)(c) or (d),
a person is not disabled for purposes of this section if his or her
drug addiction or alcoholism is a contributing factor material to
the determination of disability. "Material to the determination of
disability" means that, if the person stopped using drugs or
alcohol, his or her remaining physical or mental limitations would
not be disabling. If his or her remaining physical or mental
limitations would be disabling, then the drug addiction or
alcoholism is not material to the determination of disability and
the person may receive state disability assistance. Such a person
must actively participate in a substance abuse treatment program,
and the assistance must be paid to a third party or through vendor
payments. For purposes of this section, substance abuse treatment
includes receipt of inpatient or outpatient services or
participation in alcoholics anonymous or a similar program.
Sec. 605. The level of reimbursement provided to state
disability assistance recipients in licensed adult foster care
facilities shall be the same as the prevailing supplemental
security income rate under the personal care category.
Sec. 606. County department offices shall require each
recipient of family independence program and state disability
assistance who has applied with the social security administration
for supplemental security income to sign a contract to repay any
assistance rendered through the family independence program or
state disability assistance program upon receipt of retroactive
supplemental security income benefits.
Sec. 607. (1) The department's ability to satisfy
appropriation deductions in part 1 for state disability
assistance/supplemental security income recoveries and public
assistance recoupment revenues shall not be limited to recoveries
and accruals pertaining to state disability assistance, or family
independence assistance grant payments provided only in the current
fiscal year, but may include revenues collected during the current
year that are prior year related and not a part of the department's
accrued entries.
(2) The department may use supplemental security income
recoveries to satisfy the deduct in any line in which the revenues
are appropriated, regardless of the source from which the revenue
is recovered.
Sec. 608. Adult foster care facilities providing domiciliary
care or personal care to residents receiving supplemental security
income or homes for the aged serving residents receiving
supplemental security income shall not require those residents to
reimburse the home or facility for care at rates in excess of those
legislatively authorized. To the extent permitted by federal law,
adult foster care facilities and homes for the aged serving
residents receiving supplemental security income shall not be
prohibited from accepting third-party payments in addition to
supplemental security income if the payments are not for food,
clothing, shelter, or result in a reduction in the recipient's
supplemental security income payment.
Sec. 609. The state supplementation level under the
supplemental security income program for the personal care/adult
foster care and home for the aged categories shall not be reduced
during the current fiscal year. The legislature shall be notified
not less than 30 days before any proposed reduction in the state
supplementation level.
Sec. 610. (1) In developing good cause criteria for the state
emergency relief program, the department shall grant exemptions if
the emergency resulted from unexpected expenses related to
maintaining or securing employment.
(2) For purposes of determining housing affordability
eligibility for state emergency relief, a group is considered to
have sufficient income to meet ongoing housing expenses if their
total housing obligation does not exceed 75% of their total net
income.
(3) State emergency relief payments shall not be made to
individuals who have been found guilty of fraud in regard to
obtaining public assistance.
(4) State emergency relief payments shall not be made
available to persons who are out-of-state residents or illegal
immigrants.
(5) State emergency relief payments for rent assistance shall
be distributed directly to landlords and shall not be added to
Michigan bridge cards.
Sec. 611. The state supplementation level under the
supplemental security income program for the living independently
or living in the household of another categories shall not exceed
the minimum state supplementation level as required under federal
law or regulations.
Sec. 613. (1) The department shall provide reimbursements for
the final disposition of indigent persons. The reimbursements shall
include the following:
(a) The maximum allowable reimbursement for the final
disposition is $800.00.
(b) The adult burial with services allowance is $725.00.
(c) The adult burial without services allowance is $490.00.
(d) The infant burial allowance is $170.00.
(2) Reimbursement for a cremation permit fee of up to $75.00
and for mileage at the standard rate will be made available for an
eligible cremation. The reimbursements under this section shall
take into consideration religious preferences that prohibit
cremation.
Sec. 614. The department shall report to the senate and house
of representatives appropriations subcommittees on the department
budget, the senate and house fiscal agencies, and the senate and
house policy offices by January 15 of the current fiscal year on
the number and percentage of state disability assistance recipients
who were determined to be eligible for federal supplemental
security income benefits in the previous fiscal year.
Sec. 615. Except as required by federal law or regulations,
funds appropriated in part 1 shall not be used to provide public
assistance to a person who is an illegal alien. This section shall
not prohibit the department from entering into contracts with food
banks, emergency shelter providers, or other human services
agencies who may, as a normal part of doing business, provide food
or emergency shelter.
Sec. 616. The department shall require retailers that
participate in the electronic benefits transfer program to charge
no more than $2.50 in fees for cash back as a condition of
participation.
Sec. 618. By March 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, the senate and house policy offices, and the state budget
office the status of the implementation of section 84 of the
corrections code of 1953, 1953 PA 232, MCL 791.284.
Sec. 619. (1) Subject to subsection (2), the department shall
exempt from the denial of title IV-A assistance and food assistance
benefits under 21 USC 862a any individual who has been convicted of
a felony that included the possession, use, or distribution of a
controlled substance, after August 22, 1996, if the individual is
not in violation of his or her probation or parole requirements.
Benefits shall be provided to such individuals as follows:
(a) A third-party payee or vendor shall be required for any
cash benefits provided.
(b) An authorized representative shall be required for food
assistance receipt.
(2) Subject to federal approval, an individual is not entitled
to the exemption in this section if the individual was convicted in
2 or more separate cases of a felony that included the possession,
use, or distribution of a controlled substance after August 22,
1996.
Sec. 620. (1) The department shall make a determination of
Medicaid eligibility not later than 90 days if disability is an
eligibility factor. For all other Medicaid applicants, including
patients of a nursing home, the department shall make a
determination of Medicaid eligibility within 45 days of
application.
(2) The department shall report on a quarterly basis to the
senate and house appropriations subcommittees on the department
budget, the senate and house standing committees on families and
human services, the senate and house fiscal agencies, the senate
and house policy offices, and the state budget office on the
average Medicaid eligibility standard of promptness for each of the
required standards of promptness under subsection (1) and for
medical review team reviews achieved statewide and at each local
office.
Sec. 625. From the funds appropriated in part 1 for SSI
advocacy legal services, the department shall allocate $250,000.00
to contract with the Legal Services Association of Michigan to
provide assistance to individuals who have applied for or wish to
apply for SSI or other federal disability benefits. The Legal
Services Association of Michigan shall provide a list of new
recipients accepted to the department to verify that services have
been provided to department recipients. The Legal Services
Association of Michigan and the department shall work together to
develop release forms to share information in appropriate cases.
The Legal Services Association of Michigan shall provide quarterly
reports indicating cases opened, cases closed, level of services
provided on closed cases, and case outcomes on closed cases.
Sec. 645. An individual or family is considered homeless, for
purposes of eligibility for state emergency relief, if living
temporarily with others in order to escape domestic violence. For
purposes of this section, domestic violence is defined and verified
in the same manner as in the department's policies on good cause
for not cooperating with child support and paternity requirements.
Sec. 650. The department shall apply the food assistance
eligibility requirements as prescribed in 7 CFR 273.24(a) to (d) on
a statewide basis for the fiscal year beginning October 1, 2017.
Sec. 651. (1) From the funds appropriated in part 1, the
department shall allocate up to $1,500,000.00 to Michigan State
University (MSU) Extension for the Michigan corner store
initiative. Funds provided for the Michigan corner store initiative
shall be used to provide grants to small food retailers to increase
the availability and sales of fresh and nutritious food in low- and
moderate-income areas of the state. In determining qualified
projects to fund, the MSU Extension shall consider the level of
need in the area to be served. The MSU Extension shall report
annually to the department on the projects funded, the geographic
distribution of the projects, the costs of the program, and the
outcomes, including the number and type of jobs created and health
impacts associated with the program. The department shall provide
the annual report described in this section to the house and senate
appropriations subcommittees on the department budget, the house
and senate fiscal agencies, and the house and senate policy
offices. To qualify, grant applicants must do all of the following:
(a) Be a small food retailer.
(b) Be located in a low- or moderate-income area.
(c) Accept or agree to accept, as a condition of receiving
assistance, food assistance program benefits.
(d) Agree to apply to accept special supplemental nutrition
program for women, infants, and children (WIC) benefits and accept
WIC benefits, if eligible.
(e) Agree to abide by the conditions for receiving assistance.
(f) Collect and provide data and other information required by
the department and MSU Extension for monitoring, accountability,
and evaluation purposes.
(2) Grant money disbursed under the Michigan corner store
initiative may be used for the following purposes:
(a) Salary and associated costs of employees or contractors
providing education, advice, or other assistance on food safety and
handling, nutrition education, business operations, and promotion
to small food retailers.
(b) Refrigeration, display shelving, or other equipment for
small food retailers necessary for stocking healthy foods and fresh
produce, at a cost of less than $5,000.00 per retailer.
(c) Materials and supplies for nutrition education and healthy
food promotion.
(d) Mini-grants to retailers of no more than $100.00 per
retailer to meet initial expenses incurred with participation in
the program.
Sec. 653. From the funds appropriated in part 1 for food
assistance, an individual who is the victim of domestic violence
and does not qualify for any other exemption may be exempt from the
3-month in 36-month limit on receiving food assistance under 7 USC
2015. This exemption can be extended an additional 3 months upon
demonstration of continuing need.
Sec. 654. The department shall notify recipients of food
assistance program benefits that their benefits can be spent with
their bridge cards at many farmers' markets in the state. The
department shall also notify recipients about the Double Up Food
Bucks program that is administered by the Fair Food Network.
Recipients shall receive information about the Double Up Food Bucks
program, including information that when the recipient spends
$20.00 at participating farmers' markets through the program, the
recipient can receive an additional $20.00 to buy Michigan produce.
Sec. 655. Within 14 days after the spending plan for low-
income home energy assistance program is approved by the state
budget office, the department shall provide the spending plan,
including itemized projected expenditures, to the chairpersons of
the senate and house appropriations subcommittees on the department
budget, the senate and house fiscal agencies, the senate and house
policy offices, and the state budget office.
Sec. 660. From the funds appropriated in part 1 for Food Bank
Council of Michigan, the department is authorized to make
allocations of TANF funds only to the agencies that report
necessary data to the department for the purpose of meeting TANF
eligibility reporting requirements. The agencies that do not report
necessary data to the department for the purpose of meeting TANF
eligibility reporting requirements will not receive allocations in
excess of those received in fiscal year 2000. The use of TANF funds
under this section is not an ongoing commitment of funding.
Sec. 669. The department shall allocate $6,270,000.00 for the
annual clothing allowance. The allowance shall be granted to all
eligible children in a family independence program group.
Sec. 672. (1) The department's office of inspector general
shall report to the senate and house of representatives
appropriations subcommittees on the department budget, the senate
and house fiscal agencies, and the senate and house policy offices
by February 15 of the current fiscal year on department efforts to
reduce inappropriate use of Michigan bridge cards. The department
shall provide information on the number of recipients of services
who used their electronic benefit transfer card inappropriately and
the current status of each case, the number of recipients whose
benefits were revoked, whether permanently or temporarily, as a
result of inappropriate use, and the number of retailers that were
fined or removed from the electronic benefit transfer program for
permitting inappropriate use of the cards. The report shall
distinguish between savings and cost avoidance. Savings include
receivables established from instances of fraud committed. Cost
avoidance includes expenditures avoided due to front-end
eligibility investigations and other preemptive actions undertaken
in the prevention of fraud.
(2) It shall be the policy of the department that the
department shall require an explanation from a recipient if a
bridge card is replaced more than 2 times over any 3-month period.
(3) As used in this section, "inappropriate use" means not
used to meet a family's ongoing basic needs, including food,
clothing, shelter, utilities, household goods, personal care items,
and general incidentals.
Sec. 677. (1) The department shall establish a state goal for
the percentage of family independence program cases involved in
employment activities. The percentage established shall not be less
than 50%. The goal for long-term employment shall be 15% of cases
for 6 months or more.
(2) On a quarterly basis, the department shall report to the
senate and house appropriations subcommittees on the department
budget, the senate and house fiscal agencies and policy offices,
and the state budget director on the number of cases referred to
Partnership. Accountability. Training. Hope. (PATH), the current
percentage of family independence program cases involved in PATH
employment activities, an estimate of the current percentage of
family independence program cases that meet federal work
participation requirements on the whole, and an estimate of the
current percentage of the family independence program cases that
meet federal work participation requirements for those cases
referred to PATH.
(3) The department shall submit to the senate and house
appropriations subcommittees on the department budget, the senate
and house fiscal agencies, the senate and house policy offices, and
the state budget office a quarterly report that includes all of the
following:
(a) The number and percentage of nonexempt family independence
program recipients who are employed.
(b) The average and range of wages of employed family
independence program recipients.
(c) The number and percentage of employed family independence
program recipients who remain employed for 6 months or more.
Sec. 686. (1) The department shall ensure that program policy
requires caseworkers to confirm that individuals presenting
personal identification issued by another state seeking assistance
through the family independence program, food assistance program,
state disability assistance program, or medical assistance program
are not receiving benefits from any other state.
(2) The department shall require caseworkers to confirm the
address provided by any individual seeking family independence
program benefits or state disability assistance benefits.
(3) The department shall prohibit individuals with property
assets assessed at a value higher than $200,000.00 from accessing
assistance through department-administered programs, unless such a
prohibition would violate federal rules and guidelines.
(4) The department shall require caseworkers to obtain an up-
to-date telephone number during the eligibility determination or
redetermination process for individuals seeking medical assistance
benefits.
Sec. 687. (1) The department shall, on a quarterly basis by
February 1, May 1, August 1, and November 1, compile and make
available on its website all of the following information about the
family independence program, state disability assistance, the food
assistance program, Medicaid, and state emergency relief:
(a) The number of applications received.
(b) The number of applications approved.
(c) The number of applications denied.
(d) The number of applications pending and neither approved
nor denied.
(e) The number of cases opened.
(f) The number of cases closed.
(g) The number of cases at the beginning of the quarter and
the number of cases at the end of the quarter.
(2) The information provided under subsection (1) shall be
compiled and made available for the state as a whole and for each
county and reported separately for each program listed in
subsection (1).
(3) The department shall, on a quarterly basis by February 1,
May 1, August 1, and November 1, compile and make available on its
website the family independence program information listed as
follows:
(a) The number of new applicants who successfully met the
requirements of the 21-day assessment period for PATH.
(b) The number of new applicants who did not meet the
requirements of the 21-day assessment period for PATH.
(c) The number of cases sanctioned because of the school
truancy policy.
(d) The number of cases closed because of the 48-month and 60-
month lifetime limits.
(e) The number of first-, second-, and third-time sanctions.
(f) The number of children ages 0-5 living in FIP-sanctioned
households.
(4) The department shall notify the state budget office, the
senate and house appropriations subcommittees on the department
budget, the senate and house fiscal agencies, and the senate and
house policy offices when the reports required in this section are
made available on the department's website.
Sec. 688. From the funds appropriated in part 1 for the low-
income home energy assistance program, up to $6,766,800.00 of
federal funding shall be allocated to provide an additional $20.01
payment to food assistance program cases that are not currently
eligible for the standard utility allowance to enable these cases
to receive expanded food assistance benefits through the program
commonly known as the heat and eat program.
CHILDREN'S SERVICES AGENCY - JUVENILE JUSTICE
Sec. 701. Unless required from changes to federal or state law
or at the request of a provider, the department shall not alter the
terms of any signed contract with a private residential facility
serving children under state or court supervision without written
consent from a representative of the private residential facility.
Sec. 706. Counties shall be subject to 50% chargeback for the
use of alternative regional detention services, if those detention
services do not fall under the basic provision of section 117e of
the social welfare act, 1939 PA 280, MCL 400.117e, or if a county
operates those detention services programs primarily with
professional rather than volunteer staff.
Sec. 707. In order to be reimbursed for child care fund
expenditures, counties are required to submit department-developed
reports to enable the department to document potential federally
claimable expenditures. This requirement is in accordance with the
reporting requirements specified in section 117a(7) of the social
welfare act, 1939 PA 280, MCL 400.117a.
Sec. 708. (1) As a condition of receiving funds appropriated
in part 1 for the child care fund line item, by December 15 of the
current fiscal year, counties shall have an approved service
spending plan for the current fiscal year. Counties must submit the
service spending plan to the department by October 1 of the current
fiscal year for approval. Upon submission of the county service
spending plan, the department shall approve within 30 calendar days
after receipt of a properly completed service plan that complies
with the requirements of the social welfare act, 1939 PA 280, MCL
400.1 to 400.119b. The department shall notify and submit county
service spending plan revisions to any county whose county service
spending plan is not accepted upon initial submission. The
department shall not request any additional revisions to a county
service spending plan outside of the requested revision
notification submitted to the county by the department. The
department shall notify a county within 30 days after approval that
its service plan was approved.
(2) The department shall submit a report to the house and
senate appropriations subcommittees on the department budget, the
house and senate fiscal agencies, the house and senate policy
offices, and the state budget office by February 15 of the current
fiscal year on the number of counties that fail to submit a service
spending plan by October 1 and the number of service spending plans
not approved by December 15. The report shall include the number of
county service spending plans that were not approved as first
submitted by the counties, as well as the number of plans that were
not approved by the department after being resubmitted by the
county with the first revisions that were requested by the
department.
Sec. 709. The department's master contract for juvenile
justice residential foster care services shall be amended to
prohibit contractors from denying a referral for placement of a
youth, or terminating a youth's placement, if the youth's assessed
treatment needs are in alignment with the facility's residential
program type, as identified by the court or the department. In
addition, the master contract shall require that youth placed in
juvenile justice residential foster care facilities must have
regularly scheduled treatment sessions with a licensed psychologist
or psychiatrist, or both, and access to the licensed psychologist
or psychiatrist as needed.
Sec. 710. The department shall submit a report to the house
and senate appropriations subcommittees on the department budget,
the house and senate fiscal agencies, the house and senate policy
offices, and the state budget office by February 15 of the current
fiscal year on the number of days of care and expenditures by
funding source for the previous year for out-of-home placements by
specific placement programs, including, but not limited to, paid
relative placement, department direct family foster care, private
agency supervised foster care, private child caring institutions,
county-supervised facilities, court-supervised facilities, and
independent living. The report shall identify out-of-home placement
days of care as to whether the placement is child abuse or child
neglect or delinquent in nature. The report shall also identify
days of care for department-operated residential juvenile justice
facilities by security classification.
Sec. 721. If the demand for placements at state-operated
juvenile justice residential facilities exceeds capacity, the
department shall not increase the available occupancy or services
at the facilities, and shall post a request for proposals for a
contract with not less than 1 private provider of residential
services for juvenile justice youth to be a residential facility of
last resort.
FIELD OPERATIONS AND SUPPORT SERVICES
Sec. 801. (1) Funds appropriated in part 1 for independent
living shall be used to support the general operations of centers
for independent living in delivering mandated independent living
services in compliance with federal rules and regulations for the
centers, by existing centers for independent living to serve
underserved areas, and for projects to build the capacity of
centers for independent living to deliver independent living
services. Applications for the funds shall be reviewed in
accordance with criteria and procedures established by the
department. The funds appropriated in part 1 may be used to
leverage federal vocational rehabilitation innovation and expansion
funds consistent with 34 CFR 361.35 up to $5,543,000.00, if
available. If the possibility of matching federal funds exists, the
centers for independent living network will negotiate a mutually
beneficial contractual arrangement with Michigan rehabilitation
services. Funds shall be used in a manner consistent with the state
plan for independent living. Services provided should assist people
with disabilities to move toward self-sufficiency, including
support for accessing transportation and health care, obtaining
employment, community living, nursing home transition, information
and referral services, education, youth transition services,
veterans, and stigma reduction activities and community education.
This includes the independent living guide project that
specifically focuses on economic self-sufficiency.
(2) The Michigan centers for independent living shall provide
a report by March 1 of the current fiscal year to the house and
senate appropriations subcommittees on the department budget, the
house and senate fiscal agencies, the house and senate policy
offices, and the state budget office on direct customer and system
outcomes and performance measures.
Sec. 802. The Michigan rehabilitation services shall work
collaboratively with the bureau of services for blind persons,
service organizations, and government entities to identify
qualified match dollars to maximize use of available federal
vocational rehabilitation funds.
Sec. 803. The department shall provide an annual report by
February 1 to the house and senate appropriations subcommittees on
the department budget, the house and senate fiscal agencies, the
house and senate policy offices, and the state budget office on
efforts taken to improve the Michigan rehabilitation services. The
report shall include all of the following items:
(a) Reductions and changes in administration costs and
staffing.
(b) Service delivery plans and implementation steps achieved.
(c) Reorganization plans and implementation steps achieved.
(d) Plans to integrate Michigan rehabilitative services
programs into other services provided by the department.
(e) Quarterly expenditures by major spending category.
(f) Employment and job retention rates from both Michigan
rehabilitation services and its nonprofit partners.
(g) Success rate of each district in achieving the program
goals.
Sec. 804. (1) From the funds appropriated in part 1 for
Michigan rehabilitation services, the department shall allocate
$50,000.00 along with available federal match to support the
provision of vocational rehabilitation services to eligible
agricultural workers with disabilities. Authorized services shall
assist agricultural workers with disabilities in acquiring or
maintaining quality employment and independence.
(2) By March 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, the
senate and house policy offices, and the state budget office on the
total number of clients served and the total amount of federal
matching funds obtained throughout the duration of the program.
Sec. 805. It is the intent of the legislature that Michigan
rehabilitation services shall not implement an order of selection
for vocational and rehabilitative services. If the department is at
risk of entering into an order of selection for services, the
department shall notify the chairs of the senate and house
subcommittees on the department budget and the senate and house
fiscal agencies and policy offices within 2 weeks of receiving
notification.
Sec. 806. (1) From the funds appropriated in part 1 for
Michigan rehabilitation services, the department shall allocate
$6,100,300.00, including federal matching funds, to service
authorizations with community-based rehabilitation organizations
for an array of needed services throughout the rehabilitation
process.
(2) The department shall support the objectives stated in
Executive Order No. 2015-15, by providing the service provider
community with technical assistance in the process of provider
transformation among community rehabilitation organizations and
restructuring the reimbursement rates for employment supports and
services among those who provide job preparation, job placement,
and job retention supports and services. Additionally, the
department shall ensure technical assistance to promote seamless
transition outcomes from education to employment for individuals
with disabilities and providing education and outreach to clients
and their families, including information on benefits coordination
and planning for the promotion of successful employment outcomes.
Sec. 807. From the funds appropriated in part 1 for Elder Law
of Michigan MiCAFE contract, the department shall allocate not less
than $350,000.00 to the Elder Law of Michigan MiCAFE to assist this
state's elderly population in participating in the food assistance
program. Of the $350,000.00 allocated under this section, the
department shall use $175,000.00, which are general fund/general
purpose funds, as state matching funds for not less than
$175,000.00 in United States Department of Agriculture funding to
provide outreach program activities, such as eligibility screening
and information services, as part of a statewide food assistance
hotline.
Sec. 808. By March 1 of the current fiscal year, the
department shall provide a report to the senate and house
appropriations subcommittees on the department budget, the senate
and house fiscal agencies, the senate and house policy offices, and
the state budget office on the nutrition education program. The
report shall include planned allocation and actual expenditures for
the supplemental nutrition assistance program education funding,
planned and actual grant amounts for the supplemental nutrition
assistance program education funding, the total amount of expected
carryforward balance at the end of the current fiscal year for the
supplemental nutrition assistance program education funding, a list
of all supplemental nutrition assistance program education funding
programs by implementing agency, and the stated purpose of each
program.
Sec. 809. (1) The purpose of the pathways to potential program
is to reduce chronic absenteeism by 20%, decrease the number of
students who repeat grades by 15%, decrease the rate of dropouts by
10%, and increase graduation by 20% for schools that are current
participants in the pathways to potential program and to reduce
chronic absenteeism by 25%, decrease the number of students who
repeat grades by 20%, decrease the rate of dropouts by 15%, and
increase graduation by 25% for schools that are new participants in
the pathways to potential program. The funding priority for the
pathways to potential program shall be based on schools achieving
successful outcomes on the above measurements.
(2) From the funds appropriated in part 1 for public
assistance field staff intended for the pathways to potential
program, the department shall allocate $75,000.00 by December 1 of
the current fiscal year to support the Northeast Michigan Community
Service Agency programming, which will take place in each county in
the governor's prosperity region 3.
(3) From the funds appropriated in part 1 for public
assistance field staff intended for the pathways to potential
program, the department shall allocate $60,000.00 to the Early
Neighborhood Learning Collaborative to improve the attendance and
retention of students enrolled in an early neighborhood learning
collaborative great start readiness program approved classroom. It
is the intent of the legislature that these funds shall be
allocated on a one-time basis only.
Sec. 825. From the funds appropriated in part 1, the
department shall provide individuals not more than $500.00 for
vehicle repairs, including any repairs done in the previous 12
months. However, the department may in its discretion pay for
repairs up to $900.00. Payments under this section shall include
the combined total of payments made by the department and work
participation program.
Sec. 850. (1) The department shall maintain out-stationed
eligibility specialists in community-based organizations, community
mental health agencies, nursing homes, adult placement and
independent living settings, federally qualified health centers,
and hospitals unless a community-based organization, community
mental health agency, nursing home, adult placement and independent
living setting, federally qualified health centers, or hospital
requests that the program be discontinued at its facility.
(2) From the funds appropriated in part 1 for donated funds
positions, the department shall enter into contracts with agencies
that are able and eligible under federal law to provide the
required matching funds for federal funding, as determined by
federal statute and regulations.
(3) A contract for an assistance payments donated funds
position must include, but not be limited to, the following
performance metrics:
(a) Meeting a standard of promptness for processing
applications for Medicaid and other public assistance programs
under state law.
(b) Meeting required standards for error rates in determining
programmatic eligibility as determined by the department.
(4) The department shall only fill additional donated funds
positions after a new contract has been signed. That position shall
also be abolished when the contract expires or is terminated.
(5) The department shall classify as limited-term FTEs any new
employees who are hired to fulfill the donated funds position
contracts or are hired to fill any vacancies from employees who
transferred to a donated funds position.
(6) By March 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 policy offices, and the state budget office detailing
information on the donated funds positions, including the total
number of occupied positions, the total private contribution of the
positions, and the total cost to the state for any nonsalary
expenditure for the donated funds position employees.
Sec. 851. From the funds appropriated in part 1 for adult
services field staff, the department shall improve staffing ratios
in adult protective services programs with the goal of reducing the
number of older adults who are victims of crime and fraud. The
purpose of the staffing enhancement is to increase standard of
promptness by 90% or above in every county, as measured by
commencing an investigation within 24 hours, establishing face-to-
face contact with the client within 72 hours, and completing the
investigation within 30 days.
Sec. 852. The 29 additional FTE authorizations in part 1 added
to the public assistance field staff line item in the current
fiscal year shall be allocated to support the pathways to potential
program to provide additional staff in schools.
BEHAVIORAL HEALTH SERVICES
Sec. 901. Except for the pilot projects and demonstration
models described in section 298, the 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. 902. (1) Except for the pilot projects and demonstration
models described in section 298, from the 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 the department has entered into with
CMHSPs or PIHPs that would affect rates or expenditures.
(b) Any amendments to contracts the department has entered
into with CMHSPs or PIHPs that would affect rates or expenditures.
(3) The report required by subsection (2) shall include
information about the changes and their effects on rates and
expenditures.
Sec. 904. (1) By 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 that,
minimally, shall include reimbursement eligibility, client
population, age, ethnicity, housing arrangements, and diagnosis.
(b) Per capita expenditures in total and 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 diagnosis group,
service category, and reimbursement eligibility; and cost
information by Medicaid, Healthy Michigan plan, state appropriated
non-Medicaid mental health services, local funding, and other fund
sources, 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.
(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 CMHSPs 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 mental
health code, 1974 PA 258, MCL 330.1001 to 330.2106, and the
determination of any appeals.
(g) 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.
(h) 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.
(i) 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. 905. (1) From the funds appropriated in part 1 for
behavioral health program administration, the department shall
maintain a psychiatric transitional unit 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. 906. (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. 907. (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. 908. (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. 909. From the funds appropriated in part 1 for community
substance use disorder prevention, education, and treatment, the
department shall use available revenue from the marihuana
regulatory fund established in section 604 of the medical marihuana
facilities licensing act, 2016 PA 281, MCL 333.27604, to improve
physical health; expand access to substance use disorder prevention
and treatment services; and strengthen the existing prevention,
treatment, and recovery systems.
Sec. 910. The department shall ensure 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. 911. (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. 912. The department shall contract directly with the
Salvation Army Harbor Light program to provide non-Medicaid
substance use disorder services if the local coordinating agency or
the department confirms the Salvation Army Harbor Light program
meets the standard of care. The standard of care shall include, but
is not limited to, utilization of the medication assisted treatment
option.
Sec. 915. (1) From the funds appropriated in part 1 for
behavioral health program administration and intended to support
the mental health and wellness commission, the department shall
maintain the funding level for Special Olympics Michigan at the
level in effect during the fiscal year ending September 30, 2017.
(2) By March 1 of the current fiscal year, the department
shall report the following information on the mental health and
wellness commission to the house and senate appropriations
subcommittees on the department budget, the house and senate fiscal
agencies, the house and senate policy offices, and the state budget
office:
(a) Previous fiscal year expenditures by actionable
recommendation of the mental health and wellness commission.
(b) Programs utilized during the previous fiscal year to
address each actionable recommendation of the mental health and
wellness commission.
(c) Outcomes and performance measures achieved during the
previous fiscal year by actionable recommendation of the mental
health and wellness commission.
(d) Current fiscal year funding by actionable recommendation
of the mental health and wellness commission.
(e) Current fiscal year funding by program utilized to address
each actionable recommendation of the mental health and wellness
commission.
(f) Funding within the executive budget proposal for the
fiscal year ending September 30, 2019, by actionable recommendation
of the mental health and wellness commission.
Sec. 918. 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. 920. (1) As part of the Medicaid rate-setting process for
behavioral health services, the department shall work with PIHP
network providers and actuaries to include any state and federal
wage and compensation increases that directly impact staff who
provide Medicaid-funded community living supports, personal care
services, respite services, skill-building services, and other
similar supports and services as part of the Medicaid rate.
(2) It is the intent of the legislature that any increased
Medicaid rate related to state minimum wage increases shall also be
distributed to direct care employees.
Sec. 928. (1) Each PIHP shall provide, from internal
resources, local funds to be used as a 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.
(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 as a
reimbursement of local funds on a proportional basis to those
CMHSPs whose local funds were used as state Medicaid match. By
April 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, the senate and house
policy offices, 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.
Sec. 935. 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. 940. (1) According to section 236 of the mental health
code, 1974 PA 258, MCL 330.1236, the department shall do both of
the following:
(a) Review expenditures for each CMHSP to identify CMHSPs with
projected allocation surpluses and to identify CMHSPs with
projected allocation shortfalls. The department shall encourage the
board of a CMHSP with a projected allocation surplus to concur with
the department's recommendation to reallocate those funds to CMHSPs
with projected allocation shortfalls.
(b) Withdraw unspent funds that have been allocated to a CMHSP
if other reallocated funds were expended in a manner not provided
for in the approved contract, including expending funds on services
and programs provided to individuals residing outside of the
CMHSP's geographic region.
(2) A CMHSP that has its funding allocation transferred out or
withdrawn during the current fiscal year as described in subsection
(1) is not eligible for any additional funding reallocations during
the remainder of the current fiscal year, unless that CMHSP is
responding to a public health emergency as determined by the
department.
(3) CMHSPs shall report to the department on any proposed
reallocations described in this section at least 30 days before any
reallocations take effect.
(4) The department shall notify the chairs of the
appropriation subcommittees on the department budget when a request
is made and when the department grants approval for reallocation or
withdraw as described in subsection (1). By September 30 of the
current fiscal year, the department shall provide a report on the
amount of funding reallocated or withdrawn to the senate and house
appropriation subcommittees on the department budget, the senate
and house fiscal agencies, the senate and house policy offices, and
the state budget office.
Sec. 942. A CMHSP shall provide at least 30 days' notice
before reducing, terminating, or suspending services provided by a
CMHSP to CMHSP clients, with the exception of services authorized
by a physician that no longer meet established criteria for medical
necessity.
Sec. 943. The department shall study the viability of using
telemedicine to perform competency examinations by a forensic
psychiatrist. By January 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 findings of the
viability study, the total transportation costs by county for the
previous fiscal year, and any savings, by county, from the use of
telemedicine.
Sec. 950. The department, in collaboration with the Michigan
Association of Community Mental Health Boards, shall determine the
best payment method and financial cost of providing $95.00 per
month to court-appointed guardians and conservators that are
providing services to individuals receiving community mental health
services. 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, the house and senate policy offices, and the state budget
office on the proposed payment method and financial cost of
providing $95.00 per month to court-appointed guardians and
conservators that are providing services to individuals receiving
community mental health services.
Sec. 958. Medicaid services shall include treatment for autism
spectrum disorders as defined in the federally approved Medicaid
state plan. These services may be coordinated with the Medicaid
health plans and the Michigan Association of Health Plans.
Sec. 994. (1) By January 1 of the current fiscal year, the
department shall seek federal approval through either a waiver
request or state plan amendment to allow a CMHSP, PIHP, or
subcontracting provider agency that is reviewed and accredited by a
national accrediting entity for behavioral health care services to
be considered in compliance with state program review and audit
requirements that are addressed and reviewed by that national
accrediting entity.
(2) By April 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) The status of the federal approval process required in
subsection (1).
(b) A list of each CMHSP, PIHP, and subcontracting provider
agency that is considered to be in compliance with state program
review and audit requirements under subsection (1).
(c) For each CMHSP, PIHP, or subcontracting provider agency
described in subdivision (b), both of the following:
(i) The state program review and audit requirements that the
CMHSP, PIHP, or subcontracting provider agency is considered to be
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. Any cost savings attributed to this
action shall be reinvested back into services.
(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 another appropriate entity, as approved by the
department.
Sec. 995. 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. 997. The population data used in determining the
distribution of substance use disorder block grant funds shall be
from the most recent federal census.
Sec. 998. For distribution of state general funds to CMHSPs,
if the department decides to use census data, the department shall
use the most recent federal census data available.
Sec. 1003. The department shall notify the Michigan
Association of Community Mental Health Boards when developing
policies and procedures that will impact PIHPs or CMHSPs.
Sec. 1004. The department shall provide the senate and house
appropriations subcommittee on the department budget, the senate
and house fiscal agencies, and the state budget office any rebased
formula changes to either Medicaid behavioral health services or
non-Medicaid mental health services 90 days before implementation.
The notification shall include a table showing the changes in
funding allocation by PIHP for Medicaid behavioral health services
or by CMHSP for non-Medicaid mental health services.
Sec. 1005. 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. 1008. The PIHP shall do all of the following:
(a) Work to reduce administration costs by ensuring that PIHP
responsible functions are efficient in allowing optimal transition
of dollars to those direct services considered most effective in
assisting individuals served. Any consolidation of administrative
functions must be demonstrated by independent analysis, a reduction
in dollars spent on administration resulting in greater dollars
spent on direct services. Savings resulting from increased
efficiencies shall not be applied to PIHP net assets, internal
service fund increases, building costs, increases in the number of
PIHP personnel, or other areas not directly related to the delivery
of improved services.
(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. 1009. (1) From the funds appropriated in part 1 for
Medicaid mental health services and Healthy Michigan plan -
behavioral health, the department shall allocate up to
$22,500,000.00 to increase hourly wages by $0.25 for direct care
workers providing Medicaid behavioral health supports and services.
The department shall contractually mandate these funds be fully
passed through to agencies directly responsible for paying the
direct care workers' wages and shall contractually mandate that the
agencies provide the department with ending wages at the end of the
previous fiscal year and the new increased wages provided in the
current fiscal year. The purpose of this allocation is to increase
access to direct care services as reported in CMHSP sub-element
cost reports, to reduce the turnover rate among direct care
workers, and to improve the quality of direct care workers
providing Medicaid behavioral health supports and services.
(2) Effective June 1, 2018, and utilizing the wage information
provided in subsection (1), the department shall establish a pool
of funds available to PIHPs to provide for an additional hourly
wage increase of up to $0.25 for direct care workers whose wages
after the hourly rate increase in subsection (1) are less than
$10.90. These funds shall not be utilized to provide an hourly rate
of greater than $10.90. To receive these funds, each PIHP shall do
the following:
(a) Each PIHP shall apply to the department to receive funds
for the direct care worker wage pass-through fund, not to exceed
their proportionate share of the funds allocated for this purpose.
The application shall specify the amount of funds requested and the
agencies or programs to receive the wage pass-through funds
requested.
(b) Each PIHP awarded wage pass-through funds shall report to
the department the actual expenditures of such funds in the format
to be determined by the department.
(c) Each PIHP awarded wage pass-through funds shall report to
the department the range of wages paid to workers impacted by the
wage pass-through, including information on the number of workers
at each wage level.
(3) Any of the funds provided in this section not utilized by
a PIHP for increasing direct care worker wages or for the
employer's share of federal insurance contributions act costs shall
be deducted from the base allocation to that PIHP in the subsequent
fiscal year.
Sec. 1010. From the funds appropriated in part 1 for
behavioral health program administration, up to $2,000,000.00 shall
be allocated to address the implementation of court-ordered
assisted outpatient treatment as provided under chapter 4 of the
mental health code, 1974 PA 258, MCL 330.1400 to 330.1490.
Sec. 1011. From the funds available in part 1 through the
state targeted response to the opioid crisis grant, the department
shall provide $850,000.00 for the development of a genomic based
demonstration program to predict opioid response and abuse and
analyze cost savings to the state Medicaid population. The
demonstration program shall be operated by a CMHSP located in a
county with a population between 245,000 and 255,000 according to
the most recent decennial census and shall identify relevant
biomarkers that predict risk of opioid abuse and overdose by
analyzing test results from the Medicaid population served by the
CMHSP. The demonstration program shall utilize a custom screening
panel developed by a Michigan based genomics lab that is certified
under the clinical laboratory improvement amendments of 1988,
Public Law 100-578. The CMHSP shall analyze data and compile
results relating to relevant biomarkers and their impact on cost to
the Medicaid population in the demonstration program and present a
final report to the department, the senate and house appropriations
subcommittees on the department budget, and the senate and house
fiscal agencies by June 1 of the current fiscal year.
Sec. 1012. By March 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, the senate and house policy offices, and
the state budget office addressing the challenge of meeting monthly
deductible requirements in the Medicaid program and establish
policy recommendations. The report shall include, but not be
limited to, all of the following items:
(a) The average number of individuals who do not meet their
monthly Medicaid deductibles in this state each year.
(b) How the reduction in general fund investment to CMHSPs for
non-Medicaid services has played a role in the inability of many
individuals to meet their spenddown.
(c) What currently counts as the protected income level and
countable asset limit and how that compares to other states.
(d) An action plan for implementation of any proposed changes.
(e) An estimate of the costs that may be incurred from
adoption of recommendations included in the report.
STATE PSYCHIATRIC HOSPITALS AND FORENSIC MENTAL HEALTH SERVICES
Sec. 1051. 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. 1052. 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. 1055. (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. 1056. 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. 1057. The department shall work with the department of
technology, management, and budget to evaluate the condition of the
Hawthorn Center, the cost-effectiveness of improvements and
investments and make recommendations to improve the quality of the
facility needed by the patients.
Sec. 1058. 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.
Sec. 1059. The department shall identify specific outcomes and
performance measures for the center for forensic psychiatry,
including, but not limited to, the following:
(a) The average wait time for persons determined incompetent
to stand trial before admission to the center for forensic
psychiatry.
(b) The average wait time for persons determined incompetent
to stand trial before admission to other state-operated psychiatric
facilities.
(c) The number of persons waiting to receive services at the
center for forensic psychiatry.
(d) The number of persons waiting to receive services at other
state-operated hospitals and centers.
Sec. 1060. (1) The department shall convene a workgroup in
collaboration with the chairs of the house and senate
appropriations subcommittees on the department budget or their
designees, labor union representation, civil service, and any other
appropriate parties to recommend solutions to address mandatory
overtime, staff turnover, and staff retention at the state
psychiatric hospitals and centers, including, but not limited to,
permitting retired workers to return and permitting hiring of part-
time workers.
(2) By March 1 of the current fiscal year, the department
shall provide the workgroup's recommendations to the senate and
house appropriations subcommittees on the department budget, the
senate and house fiscal agencies, and the state budget office.
Sec. 1061. The funds appropriated in part 1 for Caro Regional
Mental Health Center shall only be utilized to support a
psychiatric hospital located at its current location. It is the
intent of the legislature that the Caro Regional Mental Health
Center shall remain open and operational at its current location on
an ongoing basis, and that any capital outlay funding shall be
utilized for planning and construction at the current location
instead of at a new location.
HEALTH POLICY
Sec. 1140. 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. 1142. 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. 1144. (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. 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 the department budget, 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 Michigan Data Collaborative shall be the data
aggregator to 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. 1145. The department will take steps necessary to work
with Indian Health Service, tribal health program facilities, or
Urban Indian Health Program facilities that provide services under
a contract with a Medicaid managed care entity to ensure that those
facilities receive the maximum amount allowable under federal law
for Medicaid services.
Sec. 1146. 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.
Sec. 1147. (1) From the funds appropriated in part 1 for
primary care services, $1,000,000.00 shall be appropriated for the
first year of a 6-year early primary care pilot program to
facilitate the placement of physicians in medically underserved
areas of this state. The early primary care pilot program format
includes all of the following:
(a) Recruitment of interested physicians before completion of
first year of residency.
(b) To participate in the pilot program, a physician must do
all of the following:
(i) Complete 1 year of post-graduate education.
(ii) Complete and pass all 3 parts of a national licensing
board examination.
(iii) Obtain an unrestricted license to engage in the practice
of osteopathic medicine and surgery or an unrestricted license to
engage in the practice of medicine in this state.
(c) A participating physician shall enter into a contract to
work with an employer for no less than 2 years in a federally
underserved rural or urban area in this state, beginning the year
following completion of 1 year of post-graduate education.
(d) The employer shall employ the physician at a competitive
salary. A contractual employer may include, but is not limited to,
a private practice physician or physician group, a hospital or
hospital system, a community clinic, or a federally qualified
health center.
(e) Assistance with repayment of medical education loans of
the participating physician shall be provided through local, state,
federal, or other sources during the employment period, with a
target assistance amount of $50,000.00 over 2 years.
(f) Upon completion of the 2-year employment period,
participating physicians may reenter and complete a post-graduate
residency program.
(2) The department shall seek philanthropic support for the
early primary care pilot program to achieve increased participation
and may use state funds to match philanthropic contributions.
(3) The department shall contract with the Michigan Health
Council for the purpose of administering the early primary care
pilot program. Funds shall be disbursed by the department to the
Michigan Health Council by December 1 of the current fiscal year
for this purpose.
(4) Use of funds for administration of the early primary care
pilot program is limited to no more than 10% of the total of all
sources of funding.
(5) The department shall prepare a report on the status of the
early primary care pilot program that shall include, but is not
limited to, the number of physicians placed, location of placement,
type of employer, average student loan burden of the participating
physicians, and average loan relief provided under the program. By
April 1 of the current fiscal year, the department shall provide
the report described in this subsection to the house and senate
appropriations subcommittees on the department budget, the house
and senate fiscal agencies and policy offices, and the state budget
office.
(6) Unexpended and unencumbered funds up to a maximum of
$1,000,000.00 general fund/general purpose revenue in part 1 for
primary care services 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 early primary care pilot program under this
section until the project has 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 work project is to fund the cost of an
early primary care program as provided by this section.
(b) The work project will be accomplished by administering the
partnering of participating physicians with qualifying employers
and coordinating the negotiation of medical school loan repayment
assistance for the participating physician.
(c) The total estimated cost of the work project is
$1,000,000.00 of general fund/general purpose revenue.
(d) The tentative completion date of the work project is
September 30, 2022.
Sec. 1150. From the funds appropriated in part 1 for health
policy administration, the department shall dedicate 1.0 FTE
position to coordinate with the department of licensing and
regulatory affairs, the department of the attorney general, all
appropriate law enforcement agencies, and the Medicaid health plans
to reduce fraud related to opioid prescribing within Medicaid, and
to address other appropriate recommendations of the prescription
drug and opioid abuse task force outlined in its report of October
2015. By October 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, the senate and house policy offices, and the state budget
office on steps the department has taken to coordinate with the
entities listed in this section and other stakeholders to reduce
fraud related to opioid prescribing, and to address other
appropriate recommendations of the task force.
Sec. 1151. From the funds appropriated in part 1 for health
policy administration, the department shall dedicate 1.0 FTE
position to coordinate with the department of licensing and
regulatory affairs, the department of the attorney general, all
appropriate law enforcement agencies, and the Medicaid health plans
to work with local substance use disorder agencies and addiction
treatment providers to help inform Medicaid beneficiaries of all
medically appropriate treatment options for opioid addiction when
their treating physician stops prescribing prescription opioid
medication for pain, and to address other appropriate
recommendations of the prescription drug and opioid abuse task
force outlined in its report of October 2015. By October 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, the senate and house
policy offices, and the state budget office on how the department
is working with local substance use disorder agencies and addiction
treatment providers to ensure that Medicaid beneficiaries are
informed of all available and medically appropriate treatment
options for opioid addiction when their treating physician stops
prescribing prescription opioid medication for pain, and to address
other appropriate recommendations of the task force. The report
shall include any potential barriers to medication-assisted
treatment, as recommended by the Michigan medication-assisted
treatment guidelines, for Medicaid beneficiaries in both office-
based opioid treatment and opioid treatment program facility
settings.
DISEASE CONTROL, PREVENTION, AND EPIDEMIOLOGY
Sec. 1180. From the funds appropriated in part 1 for
epidemiology administration and for childhood lead program, the
department shall reestablish a public health drinking water unit
and enhance current efforts to monitor child blood lead levels. The
public health drinking water unit shall ensure that appropriate
investigations of potential health hazards occur for all community
and noncommunity drinking water supplies where chemical exceedances
of action levels, health advisory levels, or maximum contaminant
limits are identified. With the fiscal year 2017-2018 increase in
funding, the childhood lead program shall improve the timeliness
and quality of care provided to children with lead exposure, to
achieve a long-term reduction in the percentage of children in this
state with elevated blood lead levels.
Sec. 1181. From the funds appropriated in part 1 for
epidemiology administration, the department shall establish and
maintain a vapor intrusion response unit. The vapor intrusion
response unit shall assess risks to public health at vapor
intrusion sites and respond to vapor intrusion risks where
appropriate. The goals of the vapor intrusion response unit shall
include reducing the number of residents of this state exposed to
toxic substances through vapor intrusion and improving health
outcomes for individuals that are identified as having been exposed
to vapor intrusion.
Sec. 1182. (1) From the funds appropriated in part 1 for the
healthy homes program, no less than $1,750,000.00 of general
fund/general purpose funds and $23,480,000.00 of federal funds
shall be allocated for lead abatement of homes.
(2) By January 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 expenditures and
activities undertaken by the lead abatement program in the previous
fiscal year from the funds appropriated in part 1 for the healthy
homes program. The report shall include, but is not limited to, a
funding allocation schedule, expenditures by category of
expenditure and by subcontractor, revenues received, description of
program elements, and description of program accomplishments and
progress.
LOCAL HEALTH AND ADMINISTRATIVE SERVICES
Sec. 1220. 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. 1221. 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. 1222. (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).
(4) By December 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 director on the planned allocation
of the funds appropriated for essential local public health
services.
Sec. 1223. (1) From the funds appropriated in part 1 for
dental programs, $150,000.00 shall be allocated to the Michigan
Dental Association for the administration of a volunteer dental
program that provides dental services to the uninsured.
(2) By December 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 standing committees
on health policy, the senate and house fiscal agencies, and the
state budget office the number of individual patients treated,
number of procedures performed, and approximate total market value
of those procedures from the previous fiscal year.
Sec. 1224. 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. 1225. 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. It is the intent of the legislature that, by
March 1 of the current fiscal year, the senate and house
appropriations subcommittees on the department budget shall hold a
joint hearing for the purpose of a presentation by the Michigan
health endowment fund corporation and the department, detailing the
steps taken to work together, and to report on initiatives
supported by the Michigan health endowment fund.
Sec. 1226. 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. 1227. 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.
Sec. 1228. From the funds appropriated in part 1 for injury
control intervention project, $1,000,000.00 shall be allocated for
implementation of evidence-based, real-time, quality assurance
decision support software in the treatment of pediatric traumatic
brain injury and for protocols that are to be available to all
hospitals providing those trauma services. The funds shall be used
to purchase statewide licenses for pediatric traumatic brain injury
treatment software and related software services and to offset
hospital software integration costs. The department shall seek
federal matching funds that may be available for implementation of
this section.
Sec. 1229. (1) From the funds appropriated in part 1 for
dental programs, $1,550,000.00 shall be distributed to local health
departments who partner with a qualified nonprofit provider of
dental services for the purpose of providing high-quality dental
homes for seniors, children, and adults enrolled in Medicaid, and
low-income uninsured.
(2) In order to be considered a qualified nonprofit provider
of dental services, the provider must demonstrate an effective
health insurance enrollment process for uninsured patients and
demonstrate to the department an effective process of charging
patients on a sliding scale based on the patient's ability to pay.
(3) Outcomes and performance measures for the program under
this section include, but are not limited to, the following:
(a) The number of uninsured patients who visited a
participating dentist over the prior year, broken down between
adults and children.
(b) The number of patients assisted with health insurance
enrollment, broken down between adults and children.
(c) A 5-year trend of the number of uninsured patients being
served, broken down between adults and children.
Sec. 1230. The department shall consider the development and
implementation of a school-based pilot program for children up to
grade 7 that may include, but is not limited to, oral health
assessments, primary dental services, and referrals. The department
shall consult with the department of education in considering the
development of the school-based pilot program, and seek
partnerships with local entities, and dental and philanthropic
organizations to carry out the program. The school-based pilot
program shall track the number of children offered and receiving
services at the school sites. Program goals shall include improving
oral and physical health outcomes for children, improving rates of
children receiving dental sealants, and reduction of rates of
childhood tooth decay.
FAMILY, MATERNAL, AND CHILD HEALTH
Sec. 1301. (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. 1302. 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. 1303. The department shall not contract with an
organization that 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 that 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. 1304. 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. 1307. From the funds appropriated in part 1 for prenatal
care outreach and service delivery support, $650,000.00 of TANF
revenue 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 the department budget and the house
and senate fiscal agencies by April 1 of the current fiscal year on
the number of clients served.
Sec. 1308. 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. 1309. The department shall allocate funds appropriated in
section 117 of part 1 for family, maternal, and child health
according to section 1 of 2002 PA 360, MCL 333.1091.
Sec. 1310. The department shall continue to work jointly with
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 department. Recommendations of the joint task force must
give consideration to best practices and cost effectiveness.
Sec. 1311. 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 home visitation services.
Sec. 1313. (1) The department shall continue developing an
outreach program on fetal alcohol syndrome services, targeting
health promotion, prevention, and intervention as described in the
Michigan fetal alcohol spectrum disorders 5-year plan 2015-2020.
(2) The department shall explore federal grant funding to
address prevention services for fetal alcohol syndrome and reduce
alcohol consumption among pregnant women.
Sec. 1314. The department shall enhance education and outreach
efforts that encourage women of childbearing age to seek
confirmation at the earliest indication of possible pregnancy and
initiate continuous and routine prenatal care upon confirmation of
pregnancy. The department shall ensure that department programs,
policies, and practices promote prenatal and obstetrical care by
doing the following:
(a) Supporting access to care.
(b) Reducing and eliminating barriers to care.
(c) Supporting recommendations for best practices.
(d) Encouraging optimal prenatal habits such as prenatal
medical visits, use of prenatal vitamins, and cessation of use of
tobacco, alcohol, or drugs.
(e) Tracking of birth outcomes to study improvements in
prevalence of fetal drug addiction, fetal alcohol syndrome, and
other preventable neonatal disease.
(f) Tracking of maternal increase in healthy behaviors
following childbirth.
Sec. 1340. The department shall include national brand peanut
butter on the list of approved women, infants, and children special
supplemental nutrition program basket items.
EMERGENCY MEDICAL SERVICES, TRAUMA, AND PREPAREDNESS
Sec. 1350. From the funds appropriated in part 1 for emergency
medical services, the department shall allocate $182,000.00 for
emergency medical services in the Upper Peninsula for the provision
of emergency medical services in rural counties.
CHILDREN'S SPECIAL HEALTH CARE SERVICES
Sec. 1360. 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. 1361. 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.
AGING AND ADULT SERVICES AGENCY
Sec. 1402. The department may encourage the Food Bank Council
of Michigan to collaborate directly with each area agency on aging
and any other organizations that provide senior nutrition services
to secure the food access of vulnerable seniors.
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 the department budget, 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.
Sec. 1422. (1) From the funds appropriated in part 1 for aging
and adult services administration, not less than $300,000.00 shall
be allocated for the department to contract with the Prosecuting
Attorneys Association of Michigan to provide the support and
services necessary to increase the capability of the state's
prosecutors, adult protective service system, and criminal justice
system to effectively identify, investigate, and prosecute elder
abuse and financial exploitation.
(2) By March 1 of the current fiscal year, the Prosecuting
Attorneys Association of Michigan shall provide a report on the
efficacy of the contract to the state budget office, the house and
senate appropriations subcommittees on the department budget, the
house and senate fiscal agencies, and the house and senate policy
offices.
Sec. 1425. The department shall coordinate with the department
of licensing and regulatory affairs to ensure that, upon receipt of
the order of suspension of a licensed adult foster care home, home
for the aged, or nursing home, the department of licensing and
regulatory affairs shall provide notice to the department, to the
house and senate appropriations subcommittees on the department
budget, and to the members of the house and senate that represent
the legislative districts of the county in which the facility lies.
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, 2021.
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 statewide integrated governmental
management applications 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
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 funds appropriated in part 1
for the office of inspector general and third party liability
efforts.
Sec. 1506. The department shall submit to the senate and house
appropriations subcommittees on the department budget, the senate
and house fiscal agencies, the senate and house policy offices, and
the state budget office a quarterly report on the implementation
status of the public assistance call center that includes all of
the following information:
(a) Call volume during the prior quarter.
(b) Percentage of calls resolved through the public assistance
call center.
(c) Percentage of calls transferred to a local department
office or other office for resolution.
(d) Number of Medicaid applications completed by the public
assistance call center staff and submitted on behalf of clients.
Sec. 1507. (1) From the funds appropriated in part 1 for
technology supporting integrated service delivery, the department
shall establish new information technology tools and enhance
existing systems to improve the eligibility and enrollment process
for citizens accessing department administered programs. This
information technology system will consolidate beneficiary
information, support department caseworker efforts in building a
success plan for beneficiaries, and better support department staff
in supporting enrollees in assistance programs.
(2) Outcomes and performance measures for the initiative under
subsection (1) include, but are not limited to, the following:
(a) Successful consolidation of data warehouses maintained by
the department.
(b) The amount of time a department caseworker devotes to data
entry when initiating an enrollee application.
(c) A reduction in wait times for persons enrolled in
assistance programs to speak with department staff and get
necessary changes made.
(d) A reduction in department caseworker workload.
Sec. 1508. From the funds appropriated in part 1 for medical
services administration, $500,000.00 is appropriated for the
operation and maintenance of the Michigan dental registry in
support of the enhanced dental benefit for the Healthy Kids Dental
program. Additionally, the department shall explore the expansion
of the scope of the Michigan dental registry to enhance the
Medicaid adult dental benefit for pregnant women.
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 $95.00 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) According to the federal covered outpatient
drug final rule with comment (CMS-2345-FC), the department shall
establish a professional pharmaceutical dispensing fee for pharmacy
benefits that are reimbursed on a fee-for-service basis. In
establishing this fee, the department shall comply with federal law
while taking into consideration the state's long-term financial
exposure and Medicaid beneficiaries' access to care. The
established fee shall not be lower than the amount in effect on
October 1, 2015.
(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. 1621. 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 on
strategies the department is using to minimize the state cost of
specialty drugs. Also, the department may take additional measures
in order to further reduce state costs, while also ensuring that
appropriate clinical care is being utilized. The report shall also
include information on savings generated as a result of these
additional measures that may include additional cost sharing, step
therapy, and prior authorization.
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. 1645. The department shall consider using the most recent
3 years of actual days of care provided, as reported in the annual
cost reports, for the purpose of establishing the nursing facility
quality assurance assessment fee. For any year in which the
estimated days of care compared to the actual days of care provided
by each nursing home and hospital long-term care unit creates an
aggregate overpayment of $1,000,000.00 or more as a result of the
nursing facility quality assurance assessment fee, the department
shall report the excess assessed amount to the senate and house
appropriation subcommittees on the department budget, the senate
and house fiscal agencies, and the state budget office. By April 1
of the current fiscal year, the department shall report on
feasibility of creating a more accurate formula for next year's
assessment and a recommendation if a refund can or cannot be made
to the senate and house appropriation subcommittees on the
department budget, the senate and house fiscal agencies, and the
state budget office.
Sec. 1646. (1) From the funds appropriated in part 1 for long-
term care services, the department shall implement a nursing
facility quality measure initiative program. The initiative shall
be financed through an increase of the quality assurance assessment
for nursing homes and hospital long-term care units, and the funds
shall be distributed according to the following criteria:
(a) The department shall award more dollars to nursing
facilities that have a higher CMS 5-star quality measure domain
rating.
(b) If the reward payment is expended on a Medicaid allowable
cost basis, that cost must be included in accordance with the
current Medicaid reimbursement methodology.
(c) A nursing facility with a CMS 5-star quality measure
domain star rating of 1 or 2 must file an action plan with the
department describing how it intends to use funds appropriated
under this section to increase quality outcomes before funding
shall be released.
(d) Licensed beds must be factored into the formula to address
overall capacity.
(e) The percentage of total incentive dollars must reflect the
following Medicaid utilization scale:
(i) For nursing facilities with a Medicaid participation rate
of above 63%, the facility shall receive 100% of the incentive
payment.
(ii) For nursing facilities with a Medicaid participation rate
between 50% and 63%, the facility shall receive 75% of the
incentive payment.
(iii) For nursing facilities with a Medicaid participation
rate of less than 50%, the facility shall receive 50% of the
incentive payment.
(iv) For nursing facilities not enrolled in Medicaid, the
facility shall not receive an incentive payment.
(f) The incentive payment shall be paid as a monthly gross
adjustment.
(2) It is the intent of the legislature that, beginning in the
fiscal year ending September 30, 2019, the department and nursing
facility representatives shall evaluate the program's effectiveness
on quality, measured by the change in the CMS 5-star quality
measure domain rating since the implementation of this section.
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: 904, 911, 918, 920, 928,
942, 994, 1008, 1009, 1607, 1657, 1662, 1699, 1700, 1702, 1764,
1809, 1810, 1820, 1850, 1875, 1882, and 1888.
Sec. 1662. (1) The department shall ensure 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 state
plan.
(3) The department may make payments on behalf of children
enrolled in the MIChild program as described in the MIChild state
plan approved by the United States Department of Health and Human
Services, or from other medical services.
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 recipients, 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.
Sec. 1700. (1) By December 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
funding provided, and the net benefit if the special hospital
payment is not financed with general fund/general purpose revenue,
to each eligible hospital during the previous fiscal year from the
following special hospital payments:
(a) DSH, separated out by unique DSH pool.
(b) GME.
(c) Special rural hospital payments provided under section
1866.
(d) Lump-sum payments to rural hospitals for obstetrical care
provided under section 1802.
(2) 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 projected distribution of funding, and
the projected net benefit if the special hospital payment is not
financed with general fund/general purpose revenue, to each
eligible hospital from the following special hospital payments:
(a) DSH, separated out by unique DSH pool.
(b) GME.
(c) Special rural hospital payments provided under section
1866.
(d) Lump-sum payments to rural hospitals for obstetrical care
provided under section 1802.
Sec. 1702. From the funds appropriated in part 1, the
department shall maintain the 15% rate increase provided during the
fiscal year ending September 30, 2017 for private duty nursing
services for Medicaid beneficiaries under the age of 21. These
additional funds must be used to attract and retain highly
qualified registered nurses and licensed practical nurses to
provide private duty nursing services so that medically frail
children can be cared for in the most homelike setting possible.
Sec. 1704. (1) From the funds appropriated in part 1 for
dental services, the department shall allocate $2,697,300.00 to
support the enhancement of the Medicaid adult dental benefit for
pregnant women enrolled in a Medicaid program.
(2) 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 by October 1
of the current fiscal year on the steps taken by the department to
implement subsection (1).
(3) Outcomes and performance measures for the program change
under this section include, but are not limited to, the following:
(a) The number of pregnant women enrolled in Medicaid who
visited a dentist over the prior year.
(b) The number of dentists statewide who participate in
providing dental services to pregnant women enrolled in Medicaid.
Sec 1705. By January 1 of the current fiscal year, the
department shall provide to the senate and house appropriations
subcommittees on the department budget, the senate and house fiscal
agencies, and the state budget office a report on the top 10
procedures by volume in the Medicaid fee for service program that
were performed in hospital outpatient departments.
Sec. 1706. From the funds appropriated in part 1 for adult
home help services, the department may issue a request for proposal
for the purpose of implementing a pilot program to conduct criminal
history background checks on home help aides employed by individual
providers, and to require agency providers to conduct criminal
history background checks on their employees or subcontractors.
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. The department shall continue to maintain enhanced
assessment tools established in collaboration with the department
of education that promote literacy development of pregnant women
and new mothers in the maternal infant health program. When
possible, the department shall include new fathers of the infants
in the literacy promotion efforts that are included in the
assessment tools and in the subsequent services provided. The
assessment tools shall expand the assessment of maternal and
parental literacy and provide support and referrals to resources to
enable program participants to achieve an increase in literacy that
may contribute to improvements in family health, economic, and life
outcomes.
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 PIHPs 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 PIHPs within 5 business days
after certification or approval to the senate and house
appropriations subcommittees on the department budget, the senate
and house fiscal agencies, and the state budget office. Following
the rate certification, the department shall ensure that no new or
revised state Medicaid policy bulletin that is promulgated
negatively impacts the capitation rates that have been certified.
Sec. 1775. (1) By March 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. 1782. Subject to federal approval, from the funds
appropriated in part 1 for health plan services, the department
shall allocate $500,000.00 general fund/general purpose plus any
available work project funds and federal match to the Medicaid
health plans through a capitation rate increase for children. This
rate increase shall be used to support a statewide media campaign
for improving this state's immunization rates.
Sec. 1790. It is the intent of the legislature that any
restricted funds provided for ambulance provider reimbursements
must come from an ambulance provider quality assurance assessment
with a base narrowly tailored to ambulance services that does not
include other municipal services.
Sec. 1791. From the funds appropriated in part 1 for health
plan services and physician services, the department shall increase
Medicaid reimbursement rates for neonatal services to no more than
75% of the Medicare rate received for those services in effect on
the date the services are provided to eligible Medicaid recipients.
The current procedural terminology (CPT) codes that are eligible
for this reimbursement rate increase are 99468, 99469, 99471,
99472, 99475, 99476, 99477, 99478, 99479, and 99480.
Sec. 1800. For the distribution of each of the pools within
the $85,000,000.00 outpatient disproportionate share hospital
payment, the department shall maintain 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.
Sec. 1801. (1) From the funds appropriated in part 1 for
physician services and health plan services, the department shall
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
either licensed under part 170 or part 175 of the public health
code, 1978 PA 368, MCL 333.17001 to 333.17084 and 333.17501 to
333.17556, and working as a primary care provider in general
practice or 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. 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.
(2) The department shall report by March 1 of the current
fiscal year to the senate and house subcommittees on the department
budget, the senate and house fiscal agencies, the senate and house
policy offices, and the state budget office the following:
(a) A list of medical specialties and licensed providers that
were paid enhanced primary care rates in the fiscal year ending
September 30, 2016.
(b) Information on the geographic distribution of specialists
who received enhanced rates in the fiscal year ending September 30,
2016.
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 a 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 an organization that
uses severity-adjusted risk models and measures that will help
patients and payers identify hospital campuses likely to have
superior outcomes. The public website shall provide information to
allow consumers to compare safe practices by hospital campus,
including, but not limited to, perinatal care, hospital-acquired
infection, and serious reportable events. Hospitals receiving
medical services payments for graduate medical education shall also
make their fully completed quality data available on the hospital's
website. The department shall withhold 25% of a hospital's graduate
medical education payment if the hospital does not submit the data
to a qualifying nonprofit organization described in this section by
January 1 of the current fiscal year.
Sec. 1806. (1) The department shall monitor the progress of
implementing the Medicaid health plan common formulary. As part of
the monitoring process, 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
following:
(a) The progress of implementing the Medicaid health plan
common formulary.
(b) The participation by the Medicaid health plans in the
Medicaid health plan common formulary.
(c) The timeliness of prior authorization approvals or
disapprovals.
(d) Any areas of inconsistency across the Medicaid health
plans' implementation of the Medicaid health plan common formulary.
(2) The department shall develop policies and procedures to
govern the operations of the Michigan Medicaid health plan common
formulary workgroup to ensure fair and full public participation.
The policies and procedures must include, but not be limited to,
open workgroup meetings, solicitation of public comments during
workgroup meetings, and a 45-day public comment period before any
common formulary changes can be made.
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 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.
Before final rate certification, the department shall notify each
contracting Medicaid health plan of any encounter data that have
not been accepted for the purposes of rate setting.
Sec. 1812. By June 1 of the current fiscal year, and using the
most recent available cost reports, the department shall complete a
report of all direct and indirect costs associated with residency
training programs for each hospital that receives funds
appropriated in part 1 for graduate medical education. The report
shall be submitted to the house and senate appropriations
subcommittees on the department budget, the house and senate fiscal
agencies, and the state budget office.
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. 1851. From the funds appropriated in part 1 for adult
home help services, the department shall allocate $150,000.00 state
general fund/general purpose revenue plus any associated federal
match to develop and deploy a mobile electronic visit verification
solution that shall include biometric identity verification to
create administrative efficiencies, reduce error, and minimize
fraud. The development of the solution shall be predicated on input
from the results of the 2017 stakeholder survey.
Sec. 1853. As the department achieves compliance with CMS
home- and community-based services (HCBS) final rule, the
department shall do all of the following:
(a) By January 1 of the current fiscal year, provide the
senate and house appropriations subcommittees on the department
budget, the senate and house fiscal agencies, and the state budget
office the department's compliance guidelines and plan to ensure
fidelity with the rule's intent that HCBS beneficiaries have the
opportunity to receive services in a manner that protects
individual choice and promotes community integration.
(b) Before final implementation of the rule, the department
shall submit to the senate and house appropriations subcommittees
on the department budget, the senate and house fiscal agencies, and
the state budget office a report detailing the potential fiscal
impact related to HCBS compliance.
(c) Before final implementation of the rule, the department
shall solicit public comment on the impact of HCBS compliance,
including, but not limited to, a public forum, and submit the
public comments to the senate and house appropriations
subcommittees on the department budget, the senate and house fiscal
agencies, and the state budget office.
Sec. 1855. From the funds appropriated in part 1 for program
of all-inclusive care for the elderly (PACE), to the extent that
funding is available in the PACE line item and unused program slots
are available, the department may do the following:
(a) Increase the number of slots for an already-established
local PACE program if the local PACE program has provided
appropriate documentation to the department indicating its ability
to expand capacity to provide services to additional PACE clients.
(b) Suspend the 10 member per month individual PACE program
enrollment increase cap in order to allow unused and unobligated
slots to be allocated to address unmet demand for PACE services.
Sec. 1856. (1) 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 have been enrolled with Medicaid
by October 1, 2014.
(2) By September 15 of the current fiscal year, qualifying
hospice residences receiving funds under this section shall submit
to the department, the senate and house appropriations
subcommittees on the department budget, the senate and house fiscal
agencies, and the state budget office a report that includes, but
is not limited to, all of the following:
(a) The number of patients served.
(b) The number of days served.
(c) The total cost of services provided.
(d) The per patient cost of services provided.
(e) The number of patients who did not receive care.
(3) At the end of the current fiscal year, any unexpended
funds shall lapse back to the general fund.
Sec. 1857. By July 1 of the current fiscal year, the
department shall explore the implementation of a managed care long-
term support service.
Sec. 1858. By April 1 of the current fiscal year, the
department shall report to the senate and house subcommittees on
the department budget and the senate and house fiscal agencies on
all of the following elements related to the current Medicaid
pharmacy carve-out of pharmaceutical products as provided for in
section 109h of the social welfare act, 1939 PA 280, MCL 400.109h:
(a) The number of prescriptions paid by the department during
the previous fiscal year and for the fiscal year ending September
30, 2016.
(b) The total amount of expenditures for prescriptions paid by
the department during the previous fiscal year and for the fiscal
year ending September 30, 2016.
(c) The total amount of rebates provided by the pharmaceutical
manufacturer for prescriptions paid by the department during the
previous fiscal year and for the fiscal year ending September 30,
2016.
(d) The number of and total expenditures for prescriptions
paid for by the department for generic equivalents during the
previous fiscal year and for the fiscal year ending September 30,
2016.
Sec. 1859. The department shall partner with the Michigan
Association of Health Plans (MAHP) and Medicaid health plans to
develop and implement strategies for the use of information
technology services for Medicaid research activities. The
department shall make available state medical assistance program
data, including Medicaid behavioral data, without charge, to MAHP
and Medicaid health plans or any vendor considered qualified by the
department for the purpose of research activities consistent with
this state's goals of improving health; increasing the quality,
reliability, availability, and continuity of care; and reducing the
cost of care for the eligible population of Medicaid recipients.
Sec. 1860. By March 1 of the current fiscal year, the
department shall provide a report to the senate and house
appropriations subcommittees, the senate and house fiscal agencies,
and the state budget office on uncollected co-pays and deductibles
in the Healthy Michigan plan. The report shall include information
on the number of participants who have not paid their co-pays and
deductibles, the total amount of uncollected co-pays and
deductibles, and steps taken by the department and health plans to
ensure greater collection of co-pays and deductibles.
Sec. 1861. From the funds appropriated in part 1 for
transportation, the department shall increase the number of
counties in which a local public transportation entity is the
primary administrator of the Medicaid nonemergency transportation
benefit. The purpose of this expansion is to improve Medicaid
beneficiary access to care, reduce the number of missed physician
appointments by Medicaid beneficiaries, and reduce time spent by
caseworkers facilitating nonemergency transportation for Medicaid
beneficiaries. Performance goals include an increase in utilization
of local public transportation, a reduction in the rate of trips
reported as missed to no more than 0.5%, and the successful
collection of data on program utilization, access, and beneficiary
satisfaction.
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.
Sec. 1867. (1) The department shall convene a workgroup that
includes psychiatrists, other relevant prescribers, and pharmacists
to identify best practices and to develop a protocol for
psychotropic medications. Any changes proposed by the workgroup
shall protect a Medicaid beneficiary's current psychotropic
pharmaceutical treatment regimen by not requiring a physician
currently prescribing any treatment to alter or adjust that
treatment.
(2) By March 1 of the current fiscal year, the department
shall provide the workgroup's recommendations to the senate and
house appropriations subcommittees on the department budget, the
senate and house fiscal agencies, and the state budget office.
Sec. 1870. The department shall continue to work with the
MiDocs consortium to explore alternative graduate medical education
financing sources and mechanisms that expand residency
opportunities for primary care training, per approval from CMS. By
December 1 of the current fiscal year, the MiDocs consortium shall
submit a report presenting a comprehensive funding plan to the
senate and house appropriations subcommittees on the department
budget and the senate and house fiscal agencies.
Sec. 1873. From the funds appropriated in part 1 for long-term
care services, the department may allocate up to $3,700,000.00 for
the purpose of outreach and education to nursing home residents and
the coordination of housing in order to move out of the facility.
In addition, any funds appropriated shall be used for other quality
improvement activities of the program. The department shall
consider working with the Area Agencies on Aging Association of
Michigan, the non-Area Agencies on Aging waivers, and the
Disability Network/Michigan to develop a plan for the ongoing
sustainability of the nursing facility transition initiative.
Sec. 1874. The department shall ensure, in counties where
program of all-inclusive care for the elderly or PACE services are
available, that the program of all-inclusive care for the elderly
(PACE) is included as an option in all options counseling and
enrollment brokering for aging services and managed care programs,
including, but not limited to, Area Agencies on Aging, centers for
independent living, and the MiChoice home and community-based
waiver. Such options counseling must include approved marketing and
discussion materials.
Sec. 1875. (1) The department and its contractual agents may
not subject Medicaid prescriptions to prior authorization
procedures during the current fiscal year if that drug is carved
out or is not subject to prior authorization procedures as of May
9, 2016, and is generally recognized in a standard medical
reference or the American Psychiatric Association's Diagnostic and
Statistical Manual for the Treatment of a Psychiatric Disorder.
(2) The department and its contractual agents may not subject
Medicaid prescriptions to prior authorization procedures during the
current fiscal year if that drug is carved out or is not subject to
prior authorization procedures as of May 9, 2016 and is a
prescription drug that is generally recognized in a standard
medical reference for the treatment of epilepsy or seizure disorder
or organ replacement therapy.
(3) As used in this section, "prior authorization" means a
process implemented by the department or its contractual agents
that conditions, delays, or denies delivery or particular pharmacy
services to Medicaid beneficiaries upon application of
predetermined criteria by the department or its contractual agents
to those pharmacy services. The process of prior authorization
often requires that a prescriber do 1 or both of the following:
(a) Obtain preapproval from the department or its contractual
agents before prescribing a given drug.
(b) Verify to the department or its contractual agents that
the use of a drug prescribed for an individual meets predetermined
criteria from the department or its contractual agents for a
prescription drug that is otherwise available under the Medicaid
program in this state.
Sec. 1876. (1) From the funds appropriated in part 1 for
Healthy Michigan plan, the department shall allocate up to
$830,000.00 to facilitate the development and implementation of a
demonstration project in cooperation with 1 or more contracting
Medicaid health plans. These provisions shall be part of the
protocol for implementation of incentives under the Healthy
Michigan plan and must do all of the following:
(a) Target Healthy Michigan plan health plan enrollees who are
above 100% of the federal poverty level, in at least 2 prosperity
regions.
(b) Implement a web-based technology that links providers,
beneficiaries, and health plans, in real-time, for the purpose of
addressing deficiency in medical literacy and demonstrating that
personal responsibility is enhanced by technology.
(c) Identify specific behavioral changes that will result as
indicated by changes in measurable health outcomes and health care
utilization.
(2) The demonstration project shall be implemented by April 1
of the current fiscal year. Prior to implementation, the department
shall present a summary description to the senate and house
appropriations subcommittees on the department budget and the
senate and house committees on health policy that must include the
estimated cost of the demonstration project, identify a shared
savings proposal for Medicaid health plans who participate in the
demonstration project, and identify intended measurable results.
(3) It is the intent of the legislature that the demonstration
project shall test the cost containment capabilities of a program
that uses financial incentives to improve health and health care by
promoting health literacy and doctor-patient mutual accountability.
Outcomes and performance measures for this initiative shall
include, but are not limited to, the following:
(a) The total annual per capita or per-member-per-year health
care expenditures. This metric shall be derived by dividing the
total annual health care expenditures of a population by the
average annual number of people in that population. Claims data
shall be used to compute health care expenditures.
(b) The per-member-per-year health care expenditures of a
reasonably matched population not covered by the demonstration
project. To account for minor differences in the 2 populations,
each group's annual trend during the pilot shall be measured
against their respective baseline trends in the year before
implementing the program.
(c) In order to attribute the finding to the program, other
process metrics that have been found to correlate with health
literacy must be analyzed. These metrics may include
hospitalization rates, frequency of emergency room use, and the
percentage of health education sessions prescribed by medical
providers and successfully completed by patients relative to the
total number of possible session opportunities offered through the
program.
(4) It is the intent of the legislature that, beginning with
the budget for the fiscal year ending September 30, 2018, the
department shall submit quarterly reports to the senate and house
appropriations committees on the department budget, the senate and
house fiscal agencies, the senate and house policy offices, and the
state budget office detailing the information required in
subsection (3).
Sec. 1877. By March 1 of the current fiscal year, the
department shall evaluate and provide a report to the house and
senate appropriations subcommittees on the department budget on how
the Healthy Michigan plan has contributed to assisting individuals
in utilizing high-value services, minimized the use of low-value
services, and how individuals' lives may be improving as a result
of their access to services provided through the Healthy Michigan
plan.
Sec. 1878. By March 1 of the current fiscal year, the
department shall provide a report to the senate and house
appropriations subcommittees on the department budget, the senate
and house fiscal agencies, the senate and house policy offices, and
the state budget office on hepatitis C tracking data. At a minimum,
the report shall include information on the following for
individuals treated with Harvoni or any other treatment used to
cure hepatitis C during the current fiscal year or a previous
fiscal year:
(a) The total number of people treated broken down by those
treated through traditional Medicaid and those treated through the
Healthy Michigan plan.
(b) The total cost of treatment.
(c) The total cost of treatment broken down by those treated
through traditional Medicaid and those treated through the Healthy
Michigan plan.
(d) The cure rate broken down by Metavir Score, genotype,
Medicaid match rate, and drug used during treatment.
(e) The reinfection rate broken down by Metavir Score,
genotype, Medicaid match rate, and drug used during treatment.
Sec. 1882. By December 31 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, documentation of the
expenses incurred during the immediate preceding fiscal year by
Medicaid health plans and PIHPs for the purpose of meeting the
contractual requirements to join the Michigan Health Information
Network Shared Services and incentivizing providers to become
members of the Health Information Exchange Qualified Organization.
The report should also include an estimation of the expenses to be
incurred in the current fiscal year by Medicaid health plans and
PIHPs for the same purpose of meeting their contractual
obligations.
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. 1893. For the purposes of the request for proposal for
the Healthy Kids Dental program, a vendor, upon being awarded the
contract, must pass a readiness review not less than 60 days before
the effective date of the contract. Additionally, the request for
proposal shall not require respondents to submit contracts, letters
of intent, or letters of application during the request for
proposal process.
Sec. 1894. (1) By July 1 of the current fiscal year, the
department shall provide a report to the senate and house
appropriations subcommittees on the department budget, the senate
and house fiscal agencies, and the state budget office on outcomes
and performance measures of the Healthy Kids Dental program.
(2) Outcomes and performance measures for the Healthy Kids
Dental program include, but are not limited to, the following:
(a) The number of children enrolled in the Healthy Kids Dental
program who visited the dentist during the previous fiscal year.
(b) The number of dentists who will accept payment from the
Healthy Kids Dental program.
(c) The annual change in dental utilization of children
enrolled in the Healthy Kids Dental program.
INFORMATION TECHNOLOGY
Sec. 1901. (1) By December 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, the senate and house policy offices, and the state budget
office all of the following information:
(a) The process used to define requests for proposals for each
expansion of information technology projects, including timelines,
project milestones, and intended outcomes.
(b) If the department decides not to contract the services out
to design and implement each element of the information technology
expansion, the department shall submit its own project plan that
includes, at a minimum, the requirements in subdivision (a).
(c) A recommended project management plan with milestones and
time frames.
(d) The proposed benefits from implementing the information
technology expansion, including customer service improvement, form
reductions, potential time savings, caseload reduction, and return
on investment.
(2) Once an award for an expansion of information technology
is made, the department shall report to the senate and house
appropriations subcommittees on the department budget, the senate
and house fiscal agencies, the senate and house policy offices, and
the state budget office a projected cost of the expansion broken
down by use and type of expense.
Sec. 1902. From the funds appropriated in part 1 for the
Michigan Medicaid information system (MMIS) line item, private
revenue may be received from and allocated for other states
interested in participating as part of the broader MMIS initiative.
By March 1 of the current fiscal year, the department shall provide
a report on the use of MMIS by other states for the previous fiscal
year, including a list of states, type of use, and revenue and
expenditures related to the agreements with the other states to use
the MMIS. The report shall be provided to the house and senate
appropriations subcommittees on the department budget, the house
and senate fiscal agencies, and the state budget office.
Sec. 1903. (1) The department shall report to the senate and
house appropriations subcommittees on the department budget, the
senate and house fiscal agencies, the senate and house policy
offices, and the state budget office by November 1 of the current
fiscal year an implementation plan regarding the appropriation in
part 1 to implement the MiSACWIS. The plan shall include, but not
be limited to, efforts to bring the system in compliance with the
settlement and other federal guidelines set forth by the United
States Department of Health and Human Services Administration for
Children and Families.
(2) The department shall report to the senate and house
appropriations subcommittees on the department budget, the senate
and house fiscal agencies, the senate and house policy offices, and
the state budget office by November 1 of the current fiscal year a
status report on the planning, implementation, and operation,
regardless of the current operational status, regarding the
appropriation in part 1 to implement the MiSACWIS. The report shall
provide details on the planning, implementation, and operation of
the system, including, but not limited to, all of the following:
(a) Areas where implementation went as planned.
(b) The number of known issues.
(c) The average number of help tickets submitted per day.
(d) Any additional overtime or other staffing costs to address
known issues and volume of help tickets.
(e) Any contract revisions to address known issues and volume
of help tickets.
(f) Other strategies undertaken to improve implementation.
(g) Progress developing cross-system trusted data exchange
with MiSACWIS.
(h) Progress in moving away from a statewide/tribal automated
child welfare information system (SACWIS/TACWIS) to a comprehensive
child welfare information system (CCWIS).
(i) Progress developing and implementing a program to monitor
data quality.
(j) Progress developing and implementing custom integrated
systems for private agencies and tribal governments.
Sec. 1904. From the funds appropriated in part 1 for
information technology services and projects, by December 1 of the
current fiscal year, the department shall make the appropriate
information technology modifications to MiSACWIS so that partial
child care fund reimbursements to counties for undisputed charges
shall be made within 15 business days of the receipt of the
required forms and documentation. The department shall notify a
county within 15 business days of a disputed reimbursement request.
The department shall reimburse for corrected charges within 15
business days of a properly corrected submission by the county.
ONE-TIME BASIS ONLY APPROPRIATIONS
Sec. 1905. From the funds appropriated in part 1 for the
drinking water declaration of emergency, the department shall
allocate funds to address needs in a city in which a declaration of
emergency was issued because of drinking water contamination. These
funds may support, but are not limited to, the following
activities:
(a) Nutrition assistance, nutritional and community education,
food bank resources, and food inspections.
(b) Epidemiological analysis and case management of
individuals at risk of elevated blood lead levels.
(c) Support for child and adolescent health centers,
children's healthcare access program, and pathways to potential
programming.
(d) Nursing services, breastfeeding education, evidence-based
home visiting programs, intensive services, and outreach for
children exposed to lead coordinated through local community mental
health organizations.
(e) Department field operations costs.
(f) Lead poisoning surveillance, treatment, and abatement.
(g) Nutritional incentives provided to local residents through
the Double Up Food Bucks Expansion Program.
(h) Genesee County health department food inspectors to
perform water testing at local food service establishments.
Sec. 1906. (1) From the funds appropriated in part 1 for
university autism programs, the department shall continue a grant
process for autism programs. These grants are intended to increase
the number of applied behavioral analysts, increase the number of
autism diagnostic services provided, or increase employment of
individuals who are diagnosed with autism spectrum disorder.
(2) As a condition of accepting the grants described in
subsection (1), each university shall track and report back to the
department where the individuals who have completed the applied
behavioral analysis training are initially employed and the
location of the initial employment.
(3) Outcomes and performance measures related to this
initiative include, but are not limited to, the following:
(a) An increase in applied behavioral analysts certified from
university autism programs.
(b) The number of autism diagnostic services provided.
(c) The employment rate of employment program participants.
(d) The employment rate of applied behavioral analysts trained
through the university autism programs.
Sec. 1907. From the funds appropriated in part 1 for child
lead poisoning elimination board, the department shall implement
recommendations of the board offered in the board's report of
November 2016. The recommendations implemented by the department
under this section shall be based in science and best practices,
and the department shall give priority to the implementation of the
recommendations that are most in agreement with recommendations of
nationally recognized organizations and authorities.
Sec. 1908. From the funds appropriated in part 1 for prenatal
diagnosis clearinghouse website, the department shall allocate
$150,000.00 to develop or contract to develop a website providing
information regarding prenatally diagnosed conditions consistent
with the requirements in section 21418 of the public health code,
1978 PA 368, MCL 333.21418.
Sec. 1910. From the funds appropriated in part 1 for food
pantry grant, the department shall allocate $100,000.00 to a
nonprofit corporation organized under the laws of this state that
is exempt from federal income tax under section 501(c)(3) of the
internal revenue code of 1986, 26 USC 501, and that operates a food
pantry located in a township with a population between 71,700 and
71,800 according to the most recent decennial census.
Sec. 1911. From the funds appropriated in part 1 for Special
Olympics Michigan, the department shall allocate $100,000.00 to
Special Olympics Michigan to operate its Healthy Athletes
initiative. This initiative must create community networks to
support physical activity and healthy food choices for athletes and
their families across the state.
Sec. 1913. (1) The department shall apply to CMS for a waiver
to allow the department to bill CMS for direct primary care
services for Medicaid enrollees. After the department receives a
response from CMS regarding the waiver, the department shall do 1
of the following:
(a) If CMS approves the waiver, from the funds appropriated in
part 1 for direct primary care pilot program, the department shall
expend $710,000.00 general fund/general purpose plus associated
federal match for this program as part of a work project.
(b) If CMS does not approve the waiver, from the funds
appropriated in part 1 for direct primary care pilot program, the
department shall expend $864,000.00 general fund/general purpose to
fund a direct primary care pilot program as part of a work project.
(2) If the waiver in subsection (1) is approved, the
department shall implement a direct primary care pilot program for
Medicaid enrollees in Wayne, Oakland, Kent, Genesee, and Livingston
Counties that shall run from October 1, 2017 to September 30, 2018.
The pilot program shall include 400 enrollees from each of the
following Medicaid eligibility categories:
(a) Childless adults.
(b) Children ages 0 to 6 years.
(c) Children ages 7 to 18 years.
(d) Parents.
(e) Elderly individuals.
(f) Disabled individuals.
(3) If the waiver in subsection (1) is not approved, the
department shall implement a direct primary care pilot program for
Medicaid enrollees in Wayne, Oakland, Kent, Genesee, and Livingston
Counties that shall run from October 1, 2017 to September 30, 2018.
The pilot program shall include 400 enrollees from each of the
following Medicaid eligibility categories:
(a) Childless adults.
(b) Children ages 0 to 18 years.
(c) Parents.
(4) For the purposes of the pilot program, each enrollee shall
be enrolled in a single, eligible direct primary care service
provider plan. The department shall maintain and publicly share a
list of eligible direct primary care service providers with
potential pilot program enrollees.
(5) An eligible direct primary care service provider must meet
the following requirements:
(a) The direct primary care service provider must be a
licensed physician in a primary care specialty.
(b) If the waiver in subsection (1) is approved, the monthly
direct primary care enrollment fee shall not exceed a weighted
average of $70.00 per month across all eligibility categories. The
average shall be weighted by the population makeup of the pilot
program. If the waiver in subsection (1) is not approved, the
monthly direct primary care enrollment fee shall not exceed a
weighted average of $60.00 per month across all eligibility
categories. The average shall be weighted by the population makeup
of the pilot program.
(c) The direct primary care service provider will be
contracted with the department and must not accept any other third-
party payments for providing health care services to enrollees
under this pilot program.
(d) The direct primary care service provider must only provide
primary care services.
(e) The direct primary care service provider's services must
include, but are not limited to, access to telemedicine and same or
next business day appointments.
(6) Managed care organizations contracted by this state to
provide Medicaid services within the county where a direct primary
care pilot program enrollee lives shall authorize direct primary
care service providers participating in the pilot program to serve
as "gateway" service providers who are able to refer pilot
enrollees to non-primary care services within the managed care
organization's provider network. The managed care provider is not
liable for increased costs resulting from the implementation of the
pilot program. The direct primary care service providers must do
all of the following:
(a) Only refer pilot program enrollees to non-primary care
service providers within the managed care organization's provider
network.
(b) For pharmacy services not covered in the direct primary
care services agreement, only authorize the use of pharmaceuticals
covered under the managed care organization's formulary management
system.
(c) Follow all prior authorization requirements mandated by
the managed care organization.
(7) The department shall have access to the patient records of
each enrollee in the pilot program for the sole purpose of
aggregate data collection.
(8) On a quarterly basis, the department shall report to the
senate and house appropriations subcommittees on the department
budget, the senate and house fiscal agencies, the senate and house
policy offices, and the state budget office on the implementation
of the direct primary care pilot program. The report shall include,
but is not limited to, the following performance metrics:
(a) The number of enrollees in the pilot program by
eligibility category.
(b) The per-member-per-month rate paid in the previous fiscal
year per eligibility category.
(c) The number of claims paid in the previous fiscal year per
eligibility category.
(d) The number of claims per category weighted to reflect 400
enrollees.
(e) The dollar value of all claims per eligibility category.
(f) The per-member-per-month actual cost. As used in this
subdivision, "per-member-per-month actual cost" means the direct
primary care plan costs and any managed care costs not covered
through the direct primary care plan, including managed care
provider overhead costs.
(g) The average direct primary care cost per enrollee per
eligibility category.
(h) The average number of actual claims per eligibility
category.
(i) The average actual dollar value of claims per eligibility
category.
(j) The number of enrollees in the pilot program during the
previous quarter who are no longer eligible for Medicaid in the
current quarter, broken down by eligibility category.
(k) The category savings subtotal. As used in this
subdivision, "category savings subtotal" means the per-member-per-
month rate paid in fiscal year 2016-2017 minus the per-member-per-
month actual cost, times the number of enrollees in the eligibility
category.
(l) The total savings. As used in this subdivision, "total
savings" means the per-member-per-month rate paid in the previous
fiscal year minus the per-member-per-month actual cost, times the
total number of enrollees in the program.
(9) Unexpended and unencumbered funds up to a maximum of
$2,016,000.00 general fund/general purpose revenue plus any
associated federal match remaining in accounts appropriated in part
1 for direct primary care pilot program 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 direct primary care pilot
program for Medicaid enrollees in Wayne, Oakland, and Livingston
Counties under this section until the work project has been
completed. All of the following are in compliance with section
451a(1) of the management and budget act, 1984 PA 431, MCL
18.1451a:
(a) The purpose of the work project is to fund the cost of a
direct primary care pilot program as provided by this section.
(b) The work project will be accomplished by contracting with
a managed care organization under contract with the department to
provide Medicaid services.
(c) The total estimated completion cost of the work project is
$6,048,000.00.
(d) The tentative completion date is September 30, 2020.
(10) The department may take out a stop loss policy to
mitigate the potential cost impact if pilot program per member per
month costs exceed per member per month costs for the program the
enrollee would have been in had they not participated in the pilot
program. The cost of the stop loss plan shall not be used in the
assessment of the success of the pilot program.
Sec. 1914. From the funds appropriated in part 1 for primary
care and dental health services, $300,000.00 shall be allocated for
primary care clinic and dental health clinic services for indigent
individuals to be provided in clinic locations in the city of
Detroit and Wayne County by a public nonprofit organization that is
pursuing certification as a federally qualified health center and
is expected to be certified within 2 years.
Sec. 1915. From the funds appropriated in part 1 for primary
care hospital grant, the department shall make a one-time grant of
$850,000.00 to support primary care services provided by a hospital
that qualifies for rural hospital access payments and is located in
a county with a population between 130,000 and 140,000 according to
the most recent decennial census.
Sec. 1916. From the funds appropriated in part 1 for refugee
assistance grant, the department shall allocate $150,000.00 to a
nonprofit corporation organized under the laws of this state that
is exempt from federal income tax under section 501(c)(3) of the
internal revenue code of 1986, 26 USC 501, to operate an initiative
to transition low-income refugee families to self-sufficiency. To
be eligible to receive funding, the organization must have a stated
core purpose of providing programs that guide, support, and empower
individuals to achieve self-sufficiency with dignity and hope. This
initiative must utilize a measurable, evidence-based approach that
integrates treatment for poverty across health care, human
services, educational, faith-based, and governmental programs. The
organization receiving funds under this section must report to the
department by September 30 of the current fiscal year on metrics
used to measure the success and viability of the initiative.
PART 2A
PROVISIONS CONCERNING ANTICIPATED APPROPRIATIONS
FOR FISCAL YEAR 2018-2019
GENERAL SECTIONS
Sec. 2001. It is the intent of the legislature to provide
appropriations for the fiscal year ending on September 30, 2019 for
the line items listed in part 1. The fiscal year 2018-2019
appropriations are anticipated to be the same as those for fiscal
year 2017-2018, 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 2018 consensus revenue estimating
conference.