STREET MEDICINE SERVICES; ALLOW S.B. 402:
SUMMARY OF INTRODUCED BILL
IN COMMITTEE
Senate Bill 402 (as introduced 6-11-25)
STREET MEDICINE SERVICES; ALLOW S.B. 402:
SUMMARY OF INTRODUCED BILL
IN COMMITTEE
Senate Bill 402 (as introduced 6-11-25)
CONTENT
The bill would amend Section 109 of the Social Welfare Act to allow a Medicaid eligible individual to receive street medicine services, including prescriptions for opioid use disorder by an eligible provider.
"Street medicine services" would mean health and social care provided directly to an unsheltered homeless individual in the individual's environment. "Eligible provider" would mean a nurse practitioner, physician assistant, or medical-assistance-enrolled physician that participates in a federally qualified health center, rural health clinic, or certified community behavioral health center.
MCL 400.109 Legislative Analyst: Alex Krabill
FISCAL IMPACT
The bill could have a fiscal impact on the Michigan Department of Health and Human Services and no fiscal impact on local units of government. The proposed changes to the Social Welfare Act under the bill would require Michigan’s Medicaid program to cover street medicine services, including prescriptions for opioid use disorder, by eligible providers.
Michigan’s Medicaid program already covers prescriptions for opioid use disorder, so the fiscal impact from the addition of providing prescriptions for opioid use disorder to unsheltered homeless individuals would be minimal.
The section of the bill that could have an uncertain fiscal impact would be the definition of "street medicine services". According to the bill, "street medicine services" would mean health and social care provided directly to an unsheltered homeless individual in their environment. The bill does not specify the exact nature of "health and social care", allowing for a broad interpretation that could mandate extensive provisions of such services. Depending on the scope and types of health and social care that would have to be provided, this definition would have the potential to result in a significant fiscal impact.
According to the 2024 United States Department of Housing and Urban Development Annual Homelessness Assessment Report, there were 9,739 homeless people in Michigan, of which 1,623 were unsheltered homeless and 8,116 were sheltered homeless.1 Depending on the
[1] In general, the United States Department of Housing and Urban Development classifies persons as sheltered or unsheltered. It considers individuals and families sleeping in a place not designed for or ordinarily used as a regular sleeping accommodation (e.g., abandoned buildings, train stations, or camping grounds) as unsheltered homeless. It would not consider any individual or family sleeping inside of a housing structure as unsheltered homeless, even if the room inside of that housing structure is not typically used for sleeping (e.g., a kitchen or bathroom).
interpretation of "health and social care", providing care to approximately 1,600 individuals in their own environment, instead of in a facility or mobile health clinic setting, could result in significant costs for the Medicaid program.
Fiscal Analyst: John P. Maxwell
SAS\S2526\s402sa This analysis was prepared by nonpartisan Senate staff for use by the Senate in its deliberations and does not constitute an official statement of legislative intent. |