HOUSE BILL No. 5002 October 14, 1999, Introduced by Rep. Callahan and referred to the Committee on Regulatory Reform. A bill to amend 1939 PA 280, entitled "The social welfare act," by amending the title and sections 14, 18, 45, 50, 55, 58, and 68a (MCL 400.14, 400.18, 400.45, 400.50, 400.55, 400.58, and 400.68a), the title and section 14 as amended by 1987 PA 266, section 18 as amended by 1980 PA 486, section 45 as amended by 1995 PA 223, and section 55 as amended by 1998 PA 516. THE PEOPLE OF THE STATE OF MICHIGAN ENACT: 1 TITLE 2 An act to protect the welfare of the people of this state; 3 to provide general assistance, hospitalization,infirmaryand 4 medical care to poor or unfortunate persons; to provide for com- 5 pliance by this state with the social security act; to provide 6 protection, welfare, and services to aged persons, dependent 7 children, the blind, and the permanently and totally disabled; to 04079'99 b LTB 2 1 administer programs and services for the prevention and treatment 2 of delinquency, dependency, and neglect of children; to create a 3 statedepartment of social servicesFAMILY INDEPENDENCE AGENCY; 4 to prescribe the powers and duties of the department; to provide 5 for the interstate and intercounty transfer of dependents; to 6 create county and districtdepartments of social services7 FAMILY INDEPENDENCE AGENCIES; to create within certain county 8 departments, bureaus,of social aidand certain divisions and 9 offices;thereunder;to prescribe the powers and duties of the 10 departments, bureaus, and officers; to provide for appeals in 11 certain cases; to prescribe the powers and duties of the state 12 department with respect to county and district departments; to 13 prescribe certain duties of certain other state departments, 14 officers, and agencies; to make an appropriation; to prescribe 15 penalties for the violation of the provisions of this act; and to 16 repeal certainparts of this act on specific datesACTS AND 17 PARTS OF ACTS. 18 Sec. 14. (1) The state department has all of the following 19 additional powers and duties: 20 (a) To allocate and distribute to the county and district 21departments of social servicesFAMILY INDEPENDENCE AGENCIES, as 22 provided in section 18,and in accordance with the rules 23 promulgated by the director, money appropriated by the legisla- 24 ture or received from the federal government forthe relief of25 RELIEVING destitution or unemployment withintheTHIS state,26 or a political subdivision oftheTHIS state. 04079'99 b 3 1 (b) To distribute,as provided in this act, subject to 2 federal rules and regulations,and in accordance with the 3 rules promulgated by the director, money appropriated by the leg- 4 islature or received from the federal government forthegrant- 5 ingofaid to dependent children and supplemental security 6 income; for medical, dental, optometric, nursing, pharmaceutical, 7 and burial relief; for services furnished by professions under 8 the public health code,Act No. 368 of the Public Acts of 1978,9as amended, being sections 333.1101 to 333.25211 of the Michigan10Compiled Laws1978 PA 368, MCL 333.1101 TO 333.25211; and for 11 other relief orwelfareHUMAN services provided by law. 12 (c) To operate adayCHILD care program in rural and urban 13 areas and TO assist inthe development ofDEVELOPING sound pro- 14 grams and standards fordayCHILD care by public organizations 15 throughouttheTHIS state. If the director,OR commissioner 16,orthose officialsAN OFFICIAL responsible for enforcing a 17 state or local building codedetermineDETERMINES that a dwell- 18 ing unit fails to meet the standards of that code through fault 19 of the landlord, the department may refuse to pay public assist- 20 ance grants authorized under this act for payment of rent on the 21 dwelling unit. A written notice of the refusal, stating the 22 grounds for the refusal and listing the defects to be corrected, 23 shall be mailed immediately to the landlord by certified mail. 24 During the period of refusal, the landlord may bring an action 25 against the department in the nature of quo warranto, but may not 26 maintain an action for the rent or possession of the premises. 27 If the defects have been corrected or if the department's refusal 04079'99 b 4 1 to pay is determined by a court of competent jurisdiction to be 2 wrongful, the department shall pay the rent that is owed, but not 3 more than the amount of the grants withheld. 4 (g) To assist other departments, agencies, and institutions 5 of the federal and state governments,when soIF requested, in 6 performing services in conformity withthe purposes ofthis 7 act. The director shall act as certifying agent for federal 8 departments or agencies in determining eligibility of applicants 9 for aid or service rendered by those departments or agencies. 10 The rules of the state departments under this subsectionshall11beARE binding upon the countydepartments of social services12 FAMILY INDEPENDENCE AGENCIES. 13 (h) To collect and compile statistics, make special 14 fact-finding studies, and publish reports in reference to the 15 field of welfare, including a biennial report as provided in sec- 16 tion 17. 17 (i) To arbitrate and decide disputed or contested claims 18 between 2 or more counties relative to the COUNTY OF settlement 19 or domicile of a person or family given or in needof any form20 of public aid or relief, and to determine and declare the county 21 of settlement or domicilein any instance when soIF requested 22 or on the department's own volition. All decisions and determi- 23 nations made under this subdivisionshall beARE binding upon 24 the countydepartments of social servicesFAMILY INDEPENDENCE 25 AGENCIES. 26 (j) To administer or supervise relief or welfare functions 27 vested in the department by law, and to provide for the 04079'99 b 5 1 progressive codification of the laws governing relief and welfare 2 problems. 3 (k) To inspectcounty infirmaries andplaces of detention 4 for juvenilesfor the purpose of obtainingTO OBTAIN facts per- 5 taining to the usefulness and proper management of the 6infirmaries andplaces of detention, andof promotingTO 7 PROMOTE proper, efficient, and humane administration of those 8infirmaries andplaces of detention. A reasonable order of the 9 department fixing minimum standards of sanitation, fire protec- 10 tion, food, and comfortable lodging may be enforced, through man- 11 damus or injunction in the circuit court for the countywhere12 IN WHICH thecounty infirmary orplace of detention for the 13 juveniles is located, through proper proceedings instituted by 14 the attorney general on behalf of the department. The burden of 15 proofshall beIS on the department to establish the reason- 16 ableness of the order. 17 (l) To promulgate by rules a recommended schedule of payment 18 for care and maintenance, pursuant to the administrative proce- 19 dures act of 1969,Act No. 306 of the Public Acts of 1969, as20amended, being sections 24.201 to 24.328 of the Michigan Compiled21Laws1969 PA 306, MCL 24.201 TO 24.328, to be used, as provided 22 by law, in determining the amount of payment to be made by 23 patients, their guardians, or relatives who are liable for the 24 care and maintenance of persons entitled to treatment under the 25 mental health code,Act No. 258 of the Public Acts of 1974, as26amended, being sections 330.1001 to 330.2106 of the Michigan27Compiled Laws1974 PA 258, MCL 330.1001 TO 330.2106. The 04079'99 b 6 1 department in promulgating the schedule may give consideration to 2 the person's income, the number of other persons he or she is 3 obligated to support, his or her estate, medical and other neces- 4 sary expenses, and other relevant matters. 5 (n) To provide or contract for legal services for persons 6 receiving assistance under this act in guardianship and support 7 proceedings. 8 (p) To provide services to adults and aging persons,which9shall includeINCLUDING 1 OR MORE OF THE FOLLOWING: 10 (i) Services for the blind in accordance with the rehabili- 11 tation act of 1973,29 U.S.C. 701 to 796iPUBLIC LAW 93-112, 29 12 U.S.C. 701 TO 718, 720 TO 751, 760 TO 762, 763 TO 765, 772 TO 13 776, 780, 781 TO 785, 791 TO 794e, 795 TO 795n, 796 TO 796f-6, 14 AND 796j TO 796l. 15 (ii) Services authorized in title XX.of the social secur-16ity act, 42 U.S.C. 1397 to 1397e.17 (q) To license and regulate child care organizations and 18 programs as described inAct No. 116 of the Public Acts of 1973,19as amended, being sections 722.111 to 722.128 of the Michigan20Compiled Laws1973 PA 116, MCL 722.111 TO 722.128. 21 (2) Other sections of this act notwithstanding, all powers 22 and duties of the countysocial servicesFAMILY INDEPENDENCE 23 AGENCY boards to develop, implement, and administer a program of 24 general public relief, are transferred to the state department 25 effective beginning with the first county fiscal year following 26 December 1, 1975. However, in a county that operates a patient 27 care management system pursuant to section 66j, the county 04079'99 b 7 1social servicesFAMILY INDEPENDENCE AGENCY board may change the 2 eligibility standards and coverages for medical care for 3personsA PERSON eligible for services under a patient care 4 management system subject to the consent of the county board of 5 commissioners, or, in a charter county, subject to the consent of 6 the county board of commissioners and the county executive. 7 Sec. 18. (1) The state department shall provide for the 8 distribution ofsuch moneys as shall beMONEY appropriated by 9 the legislature for public welfare grantsin respect toFOR 10 general relief, but not expendituresin respect toFOR a county 11 medical care facility, other infirmary care in a county infir-12mary not existing on January 1, 1981,or inpatient hospitaliza- 13 tion, to theseveralcounty and district departments ofsocial14servicesFAMILY INDEPENDENCE AGENCIES on the basis of monthly 15 reporting to the department by the county departments. 16 (2) Effective December 1, 1979 in counties having a fiscal 17 year beginning December 1 and ending November 30 and effective 18 January 1, 1980 in counties having a fiscal year beginning 19 January 1 and ending December 31, all expenditures for a program 20 ofgeneral public reliefFAMILY INDEPENDENCE ASSISTANCE shall 21 be appropriated from the general revenues oftheTHIS state. 22TheTHIS state shall assume the full cost of the general relief 23 program for public welfare costs including total administration, 24 but excluding costs incurred for county hospitalization and in 25 the administration of and care in a county medical care facility 26, or infirmarynot existing on January 1, 1981. 04079'99 b 8 1 (3) The period from December 1, 1974 through November 30, 2 1975shall beIS the base year upon which the reductions of 3 county expendituresshall beARE determined in those counties 4 having a fiscal year beginning December 1 and ending November 5 30. The period from January 1, 1975 through December 31, 1975 6shall beIS the base year upon which the reductions of county 7 expendituresshall beARE determined in those counties having a 8 fiscal year beginning January 1 and ending December 31. Net 9 county costsshall beARE the county portion of matchable gen- 10 eral relief expenditureswhichTHAT were matched by state funds 11 during the base year, not to exceed 1 mill of the county's 1974 12 state equalized valuation, as certified by the director. During 13 the first county fiscal year following the base year, county 14 costs shall be 80% of the net county costs. During the second 15 county fiscal year following the base year, county costs shall be 16 60% of the net county costs. During the third county fiscal year 17 following the base year, county costs shall be 40% of the net 18 county costs. During the fourth county fiscal year following the 19 base year, county costs shall be 20% of the net county costs. 20 (4) Beginning with the first county fiscal year following 21 the base year, county payments to recipients of general public 22 relief shall be reimbursed monthly bytheTHIS state for all 23 costs certified by the director, less the county costs. 24 (5) The difference between a county's unrestricted state 25 shared revenue distributed during the county's 1976 fiscal year 26 pursuant to theprovisions of Act No. 140 of the Public Acts of271971, as amended, being sections 141.901 to 141.921 of the04079'99 b 9 1Michigan Compiled LawsGLENN STEIL STATE REVENUE SHARING ACT OF 2 1971, 1971 PA 140, MCL 141.901 TO 141.921, and the county's costs 3 for general public relief in its 1976 fiscal year as certified by 4 the department of management and budget shall be at least 30 5 cents per capita more than the difference between the county's 6 unrestricted state shared revenue distributed during the county's 7 1975 fiscal year and the net county costs for general public 8 relief as defined in subsection (3). Any additional amount 9 required to fulfill the provisions of this subsection shall be 10 paid from the general fund and remitted to the county with the 11 June, 1977 payment provided under subsection (4). 12 (6) The state department shall provide for the allocation 13 and distribution ofsuch moneys as shall beMONEY appropriated 14 by the legislature or received from the federal government,15 for supplemental security income andaid to dependent children16 FAMILY INDEPENDENCE ASSISTANCE to be disbursed in accordance with 17 the laws of this state. 18 (7) The state department may make arrangements to disburse 19 amounts togeneral public relief recipientsA FAMILY INDEPEN- 20 DENCE ASSISTANCE RECIPIENT after determination of the 21recipients'RECIPIENT'S needs by county. The arrangements 22 shall permitgeneral public relief paymentsA FAMILY INDEPEN- 23 DENCE ASSISTANCE PAYMENT by the department and A voucher or 24 vendorpaymentsPAYMENT forpersonsA PERSON entitled to 25general public reliefFAMILY INDEPENDENCE ASSISTANCE not 26 involvinganyfederal funds,whereIF the well-being of the 27 recipient or the protection ofgeneral public reliefFAMILY 04079'99 b 10 1 INDEPENDENCE ASSISTANCE funds makessuch paymentsTHE PAYMENT 2 desirable. Nothing in this section or act shall be construed, 3 however, as limiting the right of the state department to make 4warrantsA WARRANT payable to and TO deliversameTHE WARRANT 5 toanyA creditor of a recipient ofgeneral public relief6 FAMILY INDEPENDENCE ASSISTANCE who has provided food, shelter, or 7 public utility service tosuch recipientsTHAT RECIPIENT at the 8 request of the state department. 9 Sec. 45. (1) A county family independence agency is created 10 in each county of this state, whichTHAT shall possess the 11 powers granted and perform the duties imposed in this act. The 12 county family independence agency shall consist of a county 13 family independence agency board and the director of the county 14 family independence agency, together with assistants and employ- 15 eesas may benecessary to operate the county family indepen- 16 dence agency. As used in this act, references to "county depart- 17 ment of social services" or "county department" mean the county 18 family independence agency and references to "county social serv- 19 ices board" and "county board" mean the county family indepen- 20 dence agency board. 21 (2) The powers and duties of the county family independence 22 agency board include all of the following: 23 (a) Supervision of and responsibility for the administration 24 of thecounty infirmary andcounty medical care facility and 25 child caring institution, except as provided in sections 55(c) 26 and 58. 04079'99 b 11 1 (b) Conduct, in conjunction with the family independence 2 agency, an annual review of social service programs operating 3 within the county. 4 (c)Development ofDEVELOP policy andsupervision of5 SUPERVISE the administration of social service programs autho- 6 rized by the county board of commissioners or financed solely 7 from county funds or county administered funds. 8 (d)Development and administration ofDEVELOP AND 9 ADMINISTER employment programs and work training projects comple- 10 mentary to and not in conflict with state programs. 11 (e) Review and submit recommendations on contracts involving 12 programs administered by the family independence agency proposed 13 to be entered into between the family independence agency and 14 public or private agencies within the county, including proposed 15 purchases of service contracts from applicant agencies within the 16 county eligible for funding under title XX.of the social secur-17ity act, chapter 531, 49 Stat. 620, 42 U.S.C. 1397 to 1397f. A18contract shall not be entered into between theTHE family inde- 19 pendence agencyandSHALL NOT ENTER INTO A CONTRACT WITH a 20 public or private agency within the county until the board has 21 been provided an opportunity for review of the contract. The 22board shall be advised by thefamily independence agency SHALL 23 ADVISE THE BOARD within 30 days after contracts have been signed 24 with an explanation of the differences between contracts recom- 25 mended by the board and those actually entered into. 26 (f) Act as the agent for the county board of commissioners 27 in the development of coordinated or consolidated approaches to 04079'99 b 12 1 the delivery of social services and cooperative service delivery 2 arrangements between the family independence agency and each 3 public and private social service agency within the county. 4 (g) Represent the county board of commissioners in all nego- 5 tiations between the county and the family independence agency. 6 (h) Make annual policy recommendations to the Michigan 7 county social services association on annual departmental appro- 8 priations, priorities for utilization of title XX funds, eligi- 9 bility standards for general public relief and burial, employment 10 programs, work training projects, and other related issues. 11 (3) The family independence agency shall provide suitable 12 office accommodations for programs funded in whole or in part 13 with state funds. The county family independence agency board 14 shall review and recommend to the director proposed office sites 15 within the county. The director shall notify the board before 16 final site selection with an explanation of the selection of a 17 site other than that proposed by the board. 18 (4) The COUNTY BOARD OF COMMISSIONERS SHALL FIX THE salary 19 and expenses of each member of the county boardshall be fixed20by the county board of commissionersaccording to the amount of 21 time the member devotes to the performance of official duties. A 22 member of the county board may not serve as the director or an 23 employee of the county family independence agency. The members 24 of the countyboardsBOARD shall be appointed at the annual 25 October session of commissioners., andTHE members shall qual- 26 ify by taking and filing the oath of office with the county clerk 04079'99 b 13 1,and shall assume their duties as prescribed by this act not 2 later than November 1 of the year appointed. 3 (5) The FAMILY INDEPENDENCE AGENCY SHALL APPOINT THE direc- 4 tor, employees, and assistants of the county family independence 5 agencyshall be appointed by the family independence agency6 from among persons certified as qualified by the state civil 7 service commission. The county family independence agency board 8 shall review the qualifications of and interview each applicant 9 for the position of county family independence agency director. 10 The county director shall be appointed from among persons certi- 11 fied as eligible and recommended by the family independence 12 agency and by the county board. These appointment provisions do 13 not apply under conditions of reduction in state work force, in 14 which case the administrative employment preference rules for 15 bumping promulgated by the Michigan civil service commission 16 apply. The county board shall advise and make recommendations to 17 the state director regarding the performance of the county direc- 18 tor within 6 months after the appointment of the county director 19 and annually after that time. A copy of each evaluation shall be 20 provided to the county director. 21 (6) Except as prescribed in sections 35 and 64, a writing 22 prepared, owned, used, in the possession of, or retained by the 23 county family independence agency in the performance of an offi- 24 cial function shall be made available to the public in compliance 25 with the freedom of information act,Act No. 442 of the Public26Acts of 1976, being sections 15.231 to 15.246 of the Michigan27Compiled Laws1976 PA 442, MCL 15.231 TO 15.246. 04079'99 b 14 1 Sec. 50.AnyA county employee or officer who transports, 2 brings, or causes to be transported or brought, any otherA 3 person receivinggeneral relief,PUBLIC ASSISTANCE OR 4 hospitalization,or infirmary care,or in need ofgeneral5relief,PUBLIC ASSISTANCE OR hospitalization,or infirmary6carefromanyA county or fromanyA city operating a sepa- 7 ratedepartment of social welfareFAMILY INDEPENDENCE AGENCY 8 under this act into any other county or city operating a separate 9 department without legal authority andthere leave theLEAVES 10 THAT personreceiving general relief or in need of general11reliefTHERE; or who inducessuchTHAT person by threat or 12 other means toremoveMOVE to another county or city operating 13 a separate department, with the intent to make the county or city 14 to which theremovalMOVE is made chargeable with the support 15 of the person receiving or in need of public assistance, is 16 guilty of a misdemeanor. 17 Sec. 55. The county department shall administer a public 18 welfare program, as followsTO DO ALL OF THE FOLLOWING: 19 (a)To grantGRANT general assistance, including medical 20 care as defined in this section and care in the county medical 21 care facility, but not including hospitalizationand infirmary22careexcept for care in the county medical care facilityor a23county infirmaryexisting on January 1, 1981, toanyA person 24 domiciled in the county who has a legal settlement in this 25 state. General assistance may also be granted to a person who 26 has a legal settlement in this state but no domicile in the 27 county and a recoupment may be made when appropriatein the04079'99 b 15 1mannerAS provided in cases of emergency hospitalization under 2 this act. In a temporary emergency, general assistance may be 3 given to indigents without a settlement in this state as the 4 county department considers necessary, including, if other funds 5 are not available for the purpose, all necessary expenses in 6 transporting an indigent to his or her domicile in this state, or 7 in another state or nation,whenIF information reasonably 8 tends to show that the person has a home available in his or her 9 place of domicile in this state or a legal residence in another 10 state or nation. A legal settlement in this state is acquired by 11 an emancipated person who has lived continuously in this state 12 for 1 year with the intent to make it his or her home and who, 13 during the 1-year period has not received public assistance, 14 other than assistance received during and as a direct result of a 15 civil defense emergency, or support from relatives. Time spent 16 in a public institutionshall not beIS NOT counted in deter- 17 mining settlement. A legal settlementshall beIS lost by 18 remaining away from this state for an uninterrupted period of 1 19 year except that absence from this state for labor or other spe- 20 cial or temporary purposeshallDOES notoccasionCAUSE loss 21 of settlement. 22 (b)To administerADMINISTER categorical assistance 23 including medical care. 24 (c)To superviseSUPERVISE and be responsible for the 25 operation of thecounty infirmary andcounty medical care 26 facility. In a county having a population of 1,000,000 or more 27whichTHAT maintains acounty infirmary orcounty hospital 04079'99 b 16 1or a joint infirmary and hospitalproviding formental2 MENTALLY ILL patients, the institution and theadmissions3 ADMISSION to the institutionshall beARE subject to the con- 4 trol ofa board to be known asthe board of county 5 institutions. The board OF COUNTY INSTITUTIONS shall consist of 6 5 members appointed by the county board of commissioners, except 7 that in a county having a board of county auditors, 3 members of 8 the board of county institutions shall be appointed by the county 9 board of commissioners and 2 members shall be appointed by the 10 board of county auditors. Each member of the board OF COUNTY 11 INSTITUTIONS shall hold office for a term and receive compensa- 12 tion as the county board of commissioners provides by ordinance. 13 In relation to the administration of the institutions the board 14shall have and succeed toOF COUNTY INSTITUTIONS HAS all powers 15 and duties formerly vested by law, general, local or special, in 16 the superintendents of the poor in the county and the board of 17 county institutions as constituted on April 13, 1943. The board 18 of county institutions of the county may also maintain outpatient 19 facilities for the treatment of needy persons suffering from 20 mentaldisordersILLNESS. The board shall also have the same 21 powers as are given to the county board in section 78. 22 (d)To furnishFURNISH in all cases,insofaras practi- 23 cable, care and treatmentwhichTHAT will tend to restore needy 24 persons to a condition of financial and social independence. 25 (e)To requireREQUIRE that each applicantshallfurnish 26 proof satisfactory to the county board that the applicant is 27 entitled to the aid, assistance, or benefit sought. 04079'99 b 17 1 (f)To investigateINVESTIGATE, in respect to each 2 application foranyA form of public aid or assistance, the 3 circumstances of the applicant, both at the time of application 4 and periodically during the receipt of aid or assistance. 5 (g)To maintainMAINTAIN adequate social and financial 6 records pertaining to each recipient of aid or assistance andso7farasispracticable engage in the prevention of social 8 disabilities. 9 (h) Except as otherwise provided in this subdivision,to10 investigate, when requested by the probate court or the family 11 division of circuit court, matters pertaining to dependent, 12 neglected, and delinquent children and wayward minors under the 13 court's jurisdiction, to provide supervision and foster care as 14 provided by court order, andtofurnish the court, on request, 15 investigational service in respect to the hospitalization of 16 children under the program of services for crippled children 17 established under part 58 of the public health code, 1978 PA 368, 18 MCL 333.5801 to 333.5879, which servicesshallinclude the 19 follow-up investigation and continuing observations. If the 20 county is a county juvenile agency as defined in section 2 of the 21 county juvenile agency act, 1998 PA 518, MCL 45.622, the county 22 department's obligations under this subdivision are limited to 23 public wards within the county's jurisdiction under the youth 24 rehabilitation services act, 1974 PA 150, MCL 803.301 to 803.309, 25 and county juvenile agency services as defined in section 117a. 26 (i)To assistASSIST other departments, agencies, and 27 institutions of the federal, state, and county governments,when04079'99 b 18 1soIF requested, in performing services in conformity withthe2purposes ofthis act. 3 (j)To assistASSIST in the development of sound programs 4 and standards of child welfare, and promote programs and policies 5 lookingtoward the prevention ofTO PREVENT dependency, 6 neglect, and delinquency and other conditions affecting adversely 7 the welfare of families and children. 8 (k)To createCREATE within the county department a divi- 9 sion of medical care. The county board may appoint a properly 10 qualified and licensed doctor of medicine as the head of the 11 division and an advisory committee. The advisory committee shall 12 consist of 1 doctor of medicine, nominated by the county medical 13 society; 1 dentist, nominated by the district dental society; and 14 1 pharmacist, nominated by the district pharmaceutical associa- 15 tion, to assist in formulating policies of medical care and 16 auditing and reviewing bills. "Medical care" as used in this act 17 means medical care rendered under the supervision of a licensed 18 physician in an organizedout-patientOUTPATIENT department of 19 a hospital licensed by the department ofpublicCOMMUNITY 20 health under article 17 of the public health code, 1978 PA 368, 21 MCL 333.20101 to 333.22260, or home and office attendance by a 22 physician, osteopathic physician and surgeon, or podiatrist 23 licensed under article 15 of the public health code, 1978 PA 368, 24 MCL 333.16101 to 333.18838; and when prescribed by the physician, 25 osteopathic physician and surgeon, or podiatrist, diagnostic 26servicesSERVICE requiring the use of equipment not available 27 in his or herofficesOFFICE, if theservices doSERVICE DOES 04079'99 b 19 1 not require overnight care, dental service, optometric service, 2 bedside nursing service in the home, or pharmaceutical service. 3 The private physician-patient relationship shall be maintained. 4 The normal relationships between the recipients of dental, opto- 5 metric, nursing, and pharmaceutical services, and the services 6 furnished by a physician, osteopathic physician and surgeon, 7 podiatrist, or a chiropractor licensed under article 15 of the 8 public health code, 1978 PA 368, MCL 333.16101 to 333.18838, and 9 the persons furnishing these services shall be maintained. This 10 sectionshallDOES not affect the office of a city physician or 11 city pharmacist established under a city charter, a county health 12 officer, or the medical superintendent of a county hospital. 13 This sectionshall permitPERMITS the use of a case management 14 system, a patient care management system, or other alternative 15 system for providing medical care. 16 (l)To causeCAUSE to be suitably buried the body of a 17 deceased indigent person who has a domicile in the county,when18 IF requested by the person's relative or friend, or of a 19 stranger,whenIF requested by a public official following an 20 inquest. 21 (m)To administerADMINISTER additional welfare functions 22as arevested in the department, including hospitalization. 23 (n)To actACT as an agent for the state department in 24 matters requested by the state department under the rules of the 25 state department. 04079'99 b 20 1(o) To provide temporary general assistance for each family2found ineligible for aid to dependent children assistance by3reason of unsuitable family home as provided in section 56.4 Sec. 58. (1)TheEXCEPT AS OTHERWISE PROVIDED IN SUBSEC- 5 TION (2), THE countysocial welfareFAMILY INDEPENDENCE AGENCY 6 board isherebyauthorized, with the approval of the COUNTY 7 board ofsupervisorsCOMMISSIONERS, to supervise and be respon- 8 sible for the operation of a county medical care facility.which9is now or may hereafter be established within or auxiliary to or10independent of the county infirmary: Provided, That in any11 (2) IN A county having a board of county institutions, 12suchTHE COUNTY MEDICAL CARE facilities shall be supervised and 13 operated bysuchTHE board OF COUNTY INSTITUTIONS and all ref- 14 erenceshereinafterto the county social welfare board OR 15 COUNTY FAMILY INDEPENDENCE AGENCY BOARD insuch counties in16relationTHAT COUNTY RELATING to the operation ofsuchTHE 17 COUNTY MEDICAL CARE facilities shall be construed to refer to the 18 board of county institutions. Thesocial welfareFAMILY INDE- 19 PENDENCE AGENCY board insuchTHAT countyshall have the20authority toMAY collect from any available source for the cost 21 of care giventherein and suchIN THE COUNTY MEDICAL CARE 22 FACILITY. THE FAMILY INDEPENDENCE AGENCY BOARD SHALL DEPOSIT 23 collectionsshall be depositedin the social welfare fund. 24Such25 (3) A COUNTY MEDICAL CARE facility shall provide a program 26 of planned and continuing medical treatment and nursing care 27 under the general direction and supervision of a licensed 04079'99 b 21 1 physician employed full- or part-timewho shall be knownas the 2 medical director. Medical treatment and nursing careshall3 consist ofthose servicesSERVICE given topersonsA PERSON 4 whoareIS suffering from prolonged illness, defect, infirmity, 5 or senility, or who may be recovering from injury or illness.6Such services shallAND include anyor allof the procedures 7 commonly employed, such as physical examination, diagnosis, minor 8 surgical treatment,administration of medicines, provision of9special dietsADMINISTERING MEDICINE, PROVIDING A SPECIAL DIET, 10 givingofbedside care, andthecarrying outof any11 required treatment prescribed by adulylicensed physician 12andTHAT IS within the ability of the facility to provide. 13 (4)These servicesMEDICAL TREATMENT AND NURSING CARE PRO- 14 VIDED PURSUANT TO SUBSECTION (3) shall be consistent with the 15needsNEED of the type of patient admitted and cared for and 16 must be on a professionally supervised, planned, and continuing 17 basis.: Provided, however, ThatHOWEVER, no person shall be 18 admitted or retained for care who requires special medical or 19 surgical treatment, treatment for a psychosis, tuberculosis, or 20 contagious disease, except that the facility may contain a super- 21 vised psychiatric ward for the temporary detention of mentally 22disturbedILL patients: Provided, That suchIF THAT ward 23 has been inspected and approved by thestatedepartment of 24mentalCOMMUNITY health andsocertified byitTHE DEPART- 25 MENT OF COMMUNITY HEALTH to the countysocial welfareFAMILY 26 INDEPENDENCE AGENCY board: And provided further, ThatAND IF 27 no othersuchfacility for temporary detention of mentally 04079'99 b 22 1disturbedILL patients exists within the county.: And2provided further, That aA county department may provide for the 3 support of poor persons who may befeeble-minded ormentally 4 ill at some other place or places and insuchA manneras5shallTHAT bestpromotePROMOTES the interests of the county 6 andbe forthe comfort and recovery ofsuchTHOSE persons,7 at the expense of the county. 8 (5) The countysocial welfareFAMILY INDEPENDENCE AGENCY 9 board, in seeking approval to establish, extend, and operate a 10 county medical care facility in an existing building, shallmake11applicationAPPLY in writing to the state department submitting 12therewithits proposed plan with specifications, including13 AND standards of operation., for the examination and recommen-14dations of the state department.15 (6) The COUNTY board ofsupervisorsCOMMISSIONERS ofany16 A county may determine to erecta county infirmary orcounty 17 medical care facilities for the reception and care of the poor 18 and unfortunate of the county.which medical facilities may be19on different sites than the infirmary.Upon filingsuchA 20 determination with the clerk of the county,theyTHE COUNTY 21 BOARD OF COMMISSIONERS may direct the countysocial welfare22 FAMILY INDEPENDENCE AGENCY board to purchase 1 or more tracts of 23 land, not exceeding 320 acres, and to erectthereonON THAT 24 LAND 1 or more suitable buildings for that purpose. Beforeany25county infirmary orA medical care facility is erected orany26 AN existingbuildings areBUILDING IS remodeled, added to, or 27 substantially altered,underthe provisions ofthis section 04079'99 b 23 1 and before the plansthereofare finally accepted,orany2 A contract IS entered into for construction, the plans shall be 3 submitted to the state department for examination and approval. 4 The determination reached shall be certified to the county clerk 5of the countyandshall beplaced before the COUNTY board of 6supervisorsCOMMISSIONERS at the next regular meeting. 7thereof.Nocounty infirmary ormedical care facility shall 8 be constructed without the CERTIFIED approval of the plans. 9thereof having been duly certified as herein provided.No con- 10 tract for the erection ofan infirmary orA medical care facil- 11 ityshall beIS valid or binding unless the plansthereby12 contemplated and actually followedshall have beenARE 13 approved., nor shall any moneyMONEY SHALL NOT be paid out of 14 the treasury of the county foranyconstructionunless and15 until the plansthereofFOR THAT CONSTRUCTION have been 16 approved and the determination filed. 17 (7)It shall be the duty of theTHE state departmentto18 SHALL review the proposals and plans of the countysocial19welfareFAMILY INDEPENDENCE AGENCY board submitted in connection 20 with the establishment, extension, and operation of the medical 21 care facilityor the county infirmaryandtoconsult with and 22 give advice to the county department as to plans, procedures, and 23 programs required in theproperestablishment, extension, and 24 operation of the medical care facility.or the county25infirmary.26 (8) The state department shall approvetheA medical care 27facilitiesFACILITY bypropernotice to the county 04079'99 b 24 1 department.Subsequent to its approvalAFTER APPROVING A 2 MEDICAL CARE FACILITY, the state department shall inspectsuch3 THE MEDICAL CARE facility as frequently as itdeemsCONSIDERS 4 necessary, but at least 1 annual inspection shall be made. 5County departments shall beA COUNTY DEPARTMENT IS governed by 6 and shall adhere to any reasonable order issued by the state 7 department. The county department may appealsuchTHE order in 8 writing, within 30 daysofAFTER receipt ofsameTHE ORDER, 9 to theMichigan social welfare commissionFAMILY INDEPENDENCE 10 AGENCY. 11 (9)AnyA reasonable order of thecommissionFAMILY 12 INDEPENDENCE AGENCY governing the establishment, extension, 13 operation, ortheclosing ofan infirmary orA medical care 14 facility, if circumstancessowarrant, may be enforced through 15 mandamus or injunction in the circuit court for the county 16whereIN WHICH the facility is located through proper proceed- 17 ings instituted by the attorney general on behalf of the 18commissionFAMILY INDEPENDENCE AGENCY. 19 (10)NoA medical care facility shallbe openedNOT OPEN 20 for operation until it has been inspected and approved in writing 21 to the state department by the state fire marshal and the state 22 health commissioner. The county department shall abide byany23 A reasonable directive issued by the state fire marshal or the 24 state health commissioner with regard to the fire safety and san- 25 itation ofsaid institutionTHE MEDICAL CARE FACILITY.Said26 THE FAMILY INDEPENDENCE AGENCY MAY ENFORCE THE directivesmay be27enforced by the social welfare commissionin the same manner as 04079'99 b 25 1areTHE orders of thecommissionFAMILY INDEPENDENCE AGENCY. 2 Upon receipt of the approval of the state department, the county 3 department shallthereafterrepresentsuchTHE MEDICAL CARE 4 facility to the public as the county medical care facility and 5 shall make reasonable and continuing effort to divorcesuchTHE 6 MEDICAL CARE facility from an association in the public mind with 7 the words "poor house" or "poor farm." 8 Sec. 68a. (1) The county department furnishing general 9 relief, including medical care,OR hospitalizationor infir-10mary caretoanyA poor person at the expense of another 11 county in this state, shall present to thedepartment of social12welfareFAMILY INDEPENDENCE AGENCY of the county liable for the 13aid and infirmary careGENERAL RELIEF, from time to time as the 14 case might be, a sworn, itemized statement of the expensewhich15 THAT shall be allowed and paid by thedepartment of social16welfareFAMILY INDEPENDENCE AGENCY of the county liable 17thereforFOR THAT GENERAL RELIEF, within 60 days after being 18 presented.No19 (2) AN item of the itemized statement of expenseshall be20 IS NOT a proper and collectible charge against the countywhich21 THAT has been determined to be or has agreed to be liable 22thereforunless submitted within 180 days from the end of the 23 monthduring whichTHAT THE services covered by the item were 24 rendered.In the case of an item, the exact amount of whichIF 25 the county department furnishing care is unable to determine THE 26 EXACT AMOUNT OF AN ITEM BEFORE OR during the180 days180-DAY 27 period,or prior thereto,notice of the existence ofsuch an04079'99 b 26 1 THAT item of undetermined amount shall be given the county liable 2 during the 180 dayswhereuponAND the county furnishing care 3 shall have an additional 180 daysin whichto include the 4 amount of the item in an itemized statement. 5 Enacting section 1. This amendatory act does not take 6 effect unless all of the following bills of the 90th Legislature 7 are enacted into law: 8 (a) Senate Bill No. _____ or House Bill No. 5000(request 9 no. 04079'99). 10 (b) Senate Bill No. _____ or House Bill No. 5001(request 11 no. 04079'99 a). 12 (c) Senate Bill No. _____ or House Bill No. 5003(request 13 no. 04079'99 c). 14 (d) Senate Bill No. _____ or House Bill No. 5004(request 15 no. 04079'99 d). 04079'99 b Final page. LTB