SB-0267, As Passed Senate, June 14, 2005

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SUBSTITUTE FOR

 

SENATE BILL NO. 267

 

 

 

 

 

 

 

 

 

 

 

 

     A bill to make appropriations for the department of community

 

health and certain state purposes related to mental health, public

 

health, and medical services for the fiscal year ending September

 

30, 2006; to provide for the expenditure of those appropriations;

 

to create funds; to require and provide for reports; to prescribe

 

the powers and duties of certain local and state agencies and

 

departments; and to provide for disposition of fees and other

 

income received by the various state agencies.

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

PART 1

 

LINE-ITEM APPROPRIATIONS

 

     Sec. 101. Subject to the conditions set forth in this act, the

 


Senate Bill No. 267 as amended June 14, 2005

     amounts listed in this part are appropriated for the department of

 

community health for the fiscal year ending September 30, 2006,

 

from the funds indicated in this part. The following is a summary

 

of the appropriations in this part:

 

DEPARTMENT OF COMMUNITY HEALTH

 

APPROPRIATION SUMMARY:

 

   Full-time equated unclassified positions.......... 6.0

 

   Full-time equated classified positions........ 4,695.1

 

   Average population............................ 1,135.0

 

GROSS APPROPRIATION . . . . . . . . . . . . . . . . <<$10,011,634,500>>

 

   Interdepartmental grant revenues:

 

Total interdepartmental grants and intradepartmental

 

   transfers............................................        34,485,400

 

ADJUSTED GROSS APPROPRIATION. . . . . . . . . . . . .<<$9,977,149,100>>

 

   Federal revenues:

 

Total federal revenues. . . . . . . . . . . . . . . . <<5,310,618,600>>

 

   Special revenue funds:

 

Total local revenues...................................       235,280,800

 

Total private revenues.................................        59,073,800

 

Merit award trust fund.................................        50,300,000

 

Tobacco settlement trust fund..........................        72,000,000

 

Total other state restricted revenues. . . . . . . . .<<1,383,527,200>>

 

State general fund/general purpose. . . . . . . . . .$<<2,866,348,700>>

 

   Sec. 102. DEPARTMENTWIDE ADMINISTRATION

 

   Full-time equated unclassified positions.......... 6.0

 

   Full-time equated classified positions.......... 220.0

 

Director and other unclassified--6.0 FTE positions..... $        581,500

 


Community health advisory council......................             8,000

 

Departmental administration and management--210.0

 

   FTE positions........................................        21,899,800

 

Worker's compensation program..........................         8,558,700

 

Rent and building occupancy............................         8,259,300

 

Developmental disabilities council and

 

   projects--10.0 FTE positions.........................         2,679,800

 

GROSS APPROPRIATION.................................... $     41,987,100

 

    Appropriated from:

 

   Federal revenues:

 

Total federal revenues.................................        11,518,800

 

   Special revenue funds:

 

Total private revenues.................................            35,900

 

Total other state restricted revenues..................         2,978,200

 

State general fund/general purpose..................... $     27,454,200

 

   Sec. 103. MENTAL HEALTH/SUBSTANCE ABUSE SERVICES

 

ADMINISTRATION AND SPECIAL PROJECTS

 

   Full-time equated classified positions.......... 112.0

 

Mental health/substance abuse program

 

   administration--111.0 FTE positions.................. $     12,590,600

 

Consumer involvement program...........................           189,100

 

Gambling addiction.....................................         3,500,000

 

Protection and advocacy services support...............           746,400

 

Mental health initiatives for older persons............         1,049,200

 

Community residential and support services.............         2,971,200

 

Highway safety projects................................           750,000

 

Federal and other special projects.....................         3,895,400

 


Family support subsidy.................................        17,935,000

 

Housing and support services...........................         7,237,200

 

GROSS APPROPRIATION.................................... $     50,864,100

 

   Federal revenues:

 

Total federal revenues.................................        32,310,500

 

   Special revenue funds:

 

Total private revenues.................................           190,000

 

Total other state restricted revenues..................         4,127,900

 

State general fund/general purpose..................... $     14,235,700

 

   Sec. 104. COMMUNITY MENTAL HEALTH/SUBSTANCE ABUSE

 

SERVICES PROGRAMS

 

   Full-time equated classified positions............ 9.5

 

Medicaid mental health services. . . . . . . . . . . .<$1,569,659,500>>

 

Community mental health non-Medicaid services..........   <<292,598,200>>

 

Medicaid adult benefits waiver.........................        40,000,000

 

Multicultural services.................................         3,663,800

 

Medicaid substance abuse services......................        33,321,400

 

Respite services.......................................         1,000,000

 

CMHSP, purchase of state services contracts............       129,483,700

 

Civil service charges..................................         1,765,500

 

Federal mental health block grant--2.5 FTE positions...        15,345,200

 

State disability assistance program substance abuse

 

   services.............................................         2,509,800

 

Community substance abuse prevention, education and

 

   treatment programs...................................        85,219,100

 

Children's waiver home care program....................        19,549,800

 

Omnibus reconciliation act implementation--7.0 FTE

 


   positions............................................        13,466,200

 

GROSS APPROPRIATION.................................... $  2,207,582,200

 

    Appropriated from:

 

   Federal revenues:

 

Total federal revenues.................................     1,037,401,100

 

   Special revenue funds:

 

Total local revenues...................................        26,072,100

 

Total other state restricted revenues..................        90,533,900

 

State general fund/general purpose..................... $  1,053,575,100

 

   Sec. 105. STATE PSYCHIATRIC HOSPITALS, CENTERS FOR

 

PERSONS WITH DEVELOPMENTAL DISABILITIES, AND

 

FORENSIC AND PRISON MENTAL HEALTH SERVICES

 

   Total average population...................... 1,135.0

 

   Full-time equated classified positions........ 2,976.2

 

Caro regional mental health center-psychiatric

 

   hospital-adult--475.7 FTE positions.................. $     41,042,600

 

   Average population.............................. 205.0

 

Kalamazoo psychiatric hospital-adult--518.1 FTE

 

   positions............................................        41,925,900

 

   Average population.............................. 200.0

 

Walter P. Reuther psychiatric hospital-adult--444.6

 

   FTE positions........................................        41,123,100

 

   Average population.............................. 240.0

 

Hawthorn center-psychiatric hospital-children and

 

   adolescents--224.4 FTE positions.....................        20,542,300

 

   Average population............................... 66.0

 

Mount Pleasant center-developmental

 


   disabilities--496.0 FTE positions....................        39,558,100

 

   Average population.............................. 199.0

 

Center for forensic psychiatry--493.0 FTE positions....        47,418,400

 

   Average population.............................. 225.0

 

Forensic mental health services provided to the

 

   department of corrections--313.4 FTE positions.......        33,240,200

 

Revenue recapture......................................           750,000

 

IDEA, federal special education........................           120,000

 

Special maintenance and equipment......................           335,300

 

Purchase of medical services for residents of

 

   hospitals and centers................................         2,045,600

 

Closed site, transition, and related costs--11.0 FTE

 

   positions............................................           641,400

 

Severance pay..........................................           216,900

 

Gifts and bequests for patient living and treatment

 

   environment..........................................         1,000,000

 

GROSS APPROPRIATION.................................... $    269,959,800

 

    Appropriated from:

 

   Interdepartmental grant revenues:

 

Interdepartmental grant from the department of

 

   corrections..........................................        33,240,200

 

   Federal revenues:

 

Total federal revenues.................................        34,070,500

 

   Special revenue funds:

 

CMHSP, purchase of state services contracts............       129,483,700

 

Other local revenues...................................        15,146,200

 

Total private revenues.................................         1,000,000

 


Total other state restricted revenues..................        10,157,100

 

State general fund/general purpose..................... $     46,862,100

 

   Sec. 106. PUBLIC HEALTH ADMINISTRATION

 

   Full-time equated classified positions........... 83.4

 

Public health administration--11.0 FTE positions....... $      1,729,000

 

Minority health grants and contracts...................           650,000

 

Vital records and health statistics--72.4 FTE

 

   positions............................................         7,458,800

 

GROSS APPROPRIATION.................................... $      9,837,800

 

    Appropriated from:

 

   Interdepartmental grant revenues:

 

Interdepartmental grant from family independence

 

   agency...............................................           710,500

 

   Federal revenues:

 

Total federal revenues.................................         2,765,100

 

   Special revenue funds:

 

Total other state restricted revenues..................         4,864,600

 

State general fund/general purpose..................... $      1,497,600

 

   Sec. 107. HEALTH POLICY, REGULATION, AND

 

PROFESSIONS

 

   Full-time equated classified positions.......... 396.2

 

Health systems administration--193.6 FTE positions..... $     20,828,100

 

Emergency medical services program--5.5 FTE positions..         2,041,200

 

Radiological health administration--25.0 FTE positions.         2,372,100

 

Substance abuse program administration--4.0 FTE

 

   positions............................................           433,400

 

Health professions--123.0 FTE positions................        13,030,400

 


Health policy, regulation, and professions

 

   administration--25.7 FTE positions...................         2,571,700

 

Nurse scholarship, education, and research

 

   program--3.0 FTE positions...........................           823,100

 

Certificate of need program administration--14.0 FTE

 

   positions............................................         1,683,400

 

Rural health services--1.0 FTE positions...............         1,377,900

 

Michigan essential health provider.....................         1,391,700

 

Primary care services--1.4 FTE positions...............         2,296,000

 

GROSS APPROPRIATION.................................... $     48,849,000

 

    Appropriated from:

 

   Interdepartmental grant revenues:

 

Interdepartmental grant from the department of

 

   treasury, Michigan state hospital finance authority..           113,900

 

   Federal revenues:

 

Total federal revenues.................................        19,614,400

 

   Special revenue funds:

 

Total private revenues.................................           150,000

 

Total other state restricted revenues..................        21,581,900

 

State general fund/general purpose..................... $      7,388,800

 

   Sec. 108. INFECTIOUS DISEASE CONTROL

 

   Full-time equated classified positions........... 49.0

 

AIDS prevention, testing, and care programs--12.0

 

   FTE positions........................................ $     31,502,000

 

Immunization local agreements..........................        14,010,300

 

Immunization program management and field

 

   support--15.0 FTE positions..........................         1,862,800

 


Sexually transmitted disease control local agreements..         3,494,900

 

Sexually transmitted disease control management and

 

   field support--22.0 FTE positions....................         3,563,300

 

GROSS APPROPRIATION.................................... $     54,433,300

 

    Appropriated from:

 

   Federal revenues:

 

Total federal revenues.................................        38,623,300

 

   Special revenue funds:

 

Total private revenues.................................         3,250,500

 

Total other state restricted revenues..................         8,441,400

 

State general fund/general purpose..................... $      4,118,100

 

   Sec. 109. LABORATORY SERVICES

 

   Full-time equated classified positions.......... 121.0

 

Bovine tuberculosis--2.0 FTE positions................. $        500,000

 

Laboratory services--119.0 FTE positions...............        15,376,900

 

GROSS APPROPRIATION.................................... $     15,876,900

 

    Appropriated from:

 

   Interdepartmental grant revenues:

 

Interdepartmental grant from environmental quality.....           420,800

 

   Federal revenues:

 

Total federal revenues.................................         3,058,000

 

   Special revenue funds:

 

Total other state restricted revenues..................         5,232,800

 

State general fund/general purpose..................... $      7,165,300

 

   Sec. 110. EPIDEMIOLOGY

 

   Full-time equated classified positions.......... 141.0

 

AIDS surveillance and prevention program............... $      2,513,200

 


Asthma prevention and control--2.3 FTE positions.......         1,047,300

 

Bioterrorism preparedness--76.1 FTE positions..........        50,357,000

 

Epidemiology administration--54.6 FTE positions........        10,221,800

 

Newborn screening follow-up and treatment

 

   services--8.0 FTE positions..........................         3,586,200

 

Tuberculosis control and recalcitrant AIDS program.....           867,000

 

GROSS APPROPRIATION.................................... $     68,592,500

 

    Appropriated from:

 

   Federal revenues:

 

Total federal revenues.................................        62,712,600

 

   Special revenue funds:

 

Total private revenues.................................            25,000

 

Total other state restricted revenues..................         3,774,700

 

State general fund/general purpose..................... $      2,080,200

 

   Sec. 111. LOCAL HEALTH ADMINISTRATION AND GRANTS

 

   Full-time equated classified positions............ 7.0

 

Implementation of 1993 PA 133, MCL 333.17015........... $        100,000

 

Lead abatement program--7.0 FTE positions..............         1,783,100

 

Local health services..................................           220,000

 

Local public health operations.........................        38,043,400

 

Medical services cost reimbursement to local health

 

   departments..........................................         3,110,000

 

GROSS APPROPRIATION.................................... $     43,256,500

 

    Appropriated from:

 

   Federal revenues:

 

Total federal revenues.................................         4,645,500

 

   Special revenue funds:

 


Total other state restricted revenues..................           491,100

 

State general fund/general purpose..................... $     38,119,900

 

   Sec. 112. CHRONIC DISEASE AND INJURY PREVENTION AND

 

HEALTH PROMOTION

 

   Full-time equated classified positions........... 51.5

 

African-American male health initiative................ $        106,700

 

AIDS and risk reduction clearinghouse and media

 

   campaign.............................................         1,576,000

 

Alzheimer's information network........................           440,000

 

Cancer prevention and control program--14.3 FTE

 

   positions............................................        13,310,900

 

Chronic disease prevention--1.0 FTE positions..........         3,202,500

 

Diabetes and kidney program--9.1 FTE positions.........         3,526,100

 

Health education, promotion, and research

 

   programs--9.3 FTE positions..........................         1,082,900

 

Injury control intervention project--1.0 FTE positions.           527,900

 

Michigan Parkinson's foundation........................           100,000

 

Morris Hood Wayne State University diabetes outreach...           200,000

 

Physical fitness, nutrition, and health................           325,000

 

Public health traffic safety coordination--1.7 FTE

 

   positions............................................           584,900

 

Smoking prevention program--13.1 FTE positions.........         5,026,600

 

Tobacco tax collection and enforcement.................           610,000

 

Violence prevention--2.0 FTE positions.................         1,892,300

 

GROSS APPROPRIATION.................................... $     32,511,800

 

    Appropriated from:

 

   Federal revenues:

 


Total federal revenues.................................        19,655,800

 

   Special revenue funds:

 

Total private revenues.................................            85,000

 

Total other state restricted revenues..................        11,662,900

 

State general fund/general purpose..................... $      1,108,100

 

   Sec. 113. FAMILY, MATERNAL, AND CHILDREN'S HEALTH

 

SERVICES

 

   Full-time equated classified positions .......... 45.4

 

Childhood lead program--5.8 FTE positions.............. $      2,022,300

 

Dental programs........................................           485,400

 

Dental program for persons with developmental

 

   disabilities.........................................           151,000

 

Early childhood collaborative secondary prevention.....           524,000

 

Family, maternal, and children's health services

 

   administration--39.6 FTE positions...................         4,648,800

 

Family planning local agreements.......................        12,270,300

 

Local MCH services.....................................         7,264,200

 

Migrant health care....................................           272,200

 

Pediatric AIDS prevention and control..................         1,176,800

 

Pregnancy prevention program...........................         5,846,100

 

Prenatal care outreach and service delivery support....         3,049,300

 

School health and education programs...................           500,000

 

Special projects.......................................         5,284,900

 

Sudden infant death syndrome program...................           321,300

 

GROSS APPROPRIATION.................................... $     43,816,600

 

    Appropriated from:

 

   Federal revenues:

 


Senate Bill No. 267 as amended June 14, 2005

Total federal revenues.................................        31,205,600

 

   Special revenue funds:

 

Total other state restricted revenues..................         7,564,000

 

State general fund/general purpose..................... $      5,047,000

 

   Sec. 114. WOMEN, INFANTS, AND CHILDREN FOOD AND

 

NUTRITION PROGRAM

 

   Full-time equated classified positions........... 41.0

 

Women, infants, and children program administration

 

   and special projects--41.0 FTE positions............. $      6,498,800

 

Women, infants, and children program local

 

   agreements and food costs............................       179,272,000

 

GROSS APPROPRIATION.................................... $    185,770,800

 

    Appropriated from:

 

   Federal revenues:

 

Total federal revenues.................................       132,538,400

 

   Special revenue funds:

 

Total private revenues.................................        53,232,400

 

State general fund/general purpose..................... $              0

 

   Sec. 115. CHILDREN'S SPECIAL HEALTH CARE SERVICES

 

   Full-time equated classified positions........... 43.0

 

Children's special health care services

 

   administration--43.0 FTE positions................... $      3,846,800

 

Amputee program........................................           184,600

 

Bequests for care and services.........................         1,889,100

 

Outreach and advocacy..................................         3,773,500

 

Conveyor contract......................................         1,235,300

 

Medical care and treatment.............................   <<208,668,600>>

 


Senate Bill No. 267 as amended June 14, 2005

GROSS APPROPRIATION.................................... $ <<219,597,900>>

 

    Appropriated from:

 

   Federal revenues:

 

Total federal revenues.................................   <<104,386,900>>

 

   Special revenue funds:

 

Total private revenues.................................         1,000,000

 

Total other state restricted revenues..................     <<2,458,000>>

 

State general fund/general purpose..................... $    111,761,000

 

   Sec. 116. OFFICE OF DRUG CONTROL POLICY

 

   Full-time equated classified positions........... 16.0

 

Drug control policy--16.0 FTE positions................ $      2,105,900

 

Anti-drug abuse grants.................................        24,970,300

 

Interdepartmental grant to judiciary for drug

 

   treatment courts.....................................         1,800,000

 

GROSS APPROPRIATION.................................... $     28,876,200

 

    Appropriated from:

 

   Federal revenues:

 

Total federal revenues.................................        28,516,200

 

State general fund/general purpose..................... $        360,000

 

   Sec. 117. CRIME VICTIM SERVICES COMMISSION

 

   Full-time equated classified positions........... 10.0

 

Grants administration services--10.0 FTE positions..... $      1,044,900

 

Justice assistance grants..............................        13,000,000

 

Crime victim rights services grants....................         9,655,300

 

GROSS APPROPRIATION.................................... $     23,700,200

 

    Appropriated from:

 

   Federal revenues:

 


Senate Bill No. 267 as amended June 14, 2005

Total federal revenues.................................        14,622,200

 

   Special revenue funds:

 

Total other state restricted revenues..................         9,078,000

 

State general fund/general purpose..................... $              0

 

   Sec. 118. OFFICE OF SERVICES TO THE AGING

 

   Full-time equated classified positions........... 36.5

 

Commission (per diem $50.00)........................... $         10,500

 

Office of services to aging administration--36.5 FTE

 

   positions............................................         5,188,600

 

Community services.....................................        35,059,700

 

Nutrition services.....................................        37,290,500

 

Senior volunteer services..............................         5,574,900

 

Senior citizen centers staffing and equipment..........           100,000

 

Employment assistance..................................         2,818,300

 

Respite care program...................................         7,600,000

 

GROSS APPROPRIATION.................................... $     93,642,500

 

    Appropriated from:

 

   Federal revenues:

 

Total federal revenues.................................        52,162,700

 

   Special revenue funds:

 

Total private revenues.................................           105,000

 

Tobacco settlement trust fund..........................         5,000,000

 

Total other state restricted revenues..................         2,767,000

 

State general fund/general purpose..................... $     33,607,800

 

   Sec. 119. MEDICAL SERVICES ADMINISTRATION

 

   Full-time equated classified positions.......... 336.4

 

Medical services administration--336.4 FTE positions... $ <<46,988,200>>

 

 


Senate Bill No. 267 as amended June 14, 2005

Facility inspection contract - state police............           132,800

 

MIChild administration.................................         4,327,800

 

GROSS APPROPRIATION.................................... $ <<51,448,800>>

 

    Appropriated from:

 

   Federal revenues:

 

Total federal revenues.................................    <<37,840,700>>

 

   Special revenue funds:

 

State general fund/general purpose..................... $ <<13,608,100>>

 

   Sec. 120. MEDICAL SERVICES

 

Hospital services and therapy.......................... $  1,044,040,100

 

Hospital disproportionate share payments...............        50,000,000

 

Physician services.....................................       249,472,500

 

Medicare premium payments..............................       272,705,600

 

Pharmaceutical services................................       328,794,400

 

Home health services...................................        55,777,200

 

Transportation.........................................         7,738,300

 

Auxiliary medical services.............................       122,290,500

 

Long-term care services . . . . . . . . . . . . . . . <<1,668,277,300>>

 

Elder prescription insurance coverage..................         3,900,000

 

Health plan services. . . . . . . . . . . . . . . . . <<2,009,740,400>>

 

Medicaid adult benefits waiver.........................        69,372,000

 

Third share plan.......................................        10,000,000

 

Federal Medicare pharmaceutical program................       174,855,500

 

Maternal and child health..............................        20,279,500

 

Social services to the physically disabled.............         1,344,900

 

Subtotal basic medical services program. . . . . . . . <<6,088,588,200>>

 

School-based services..................................        68,621,100

 


Senate Bill No. 267 as amended June 14, 2005

Special adjustor payments..............................       332,856,900

 

Subtotal special medical services payments.............       401,478,000

 

GROSS APPROPRIATION. . . . . . . . . . . . . . . . . $<<6,490,066,200>>

 

    Appropriated from:

 

   Federal revenues:

 

Total federal revenues. . . . . . . . . . . . . . . . <<3,624,366,400>>

 

   Special revenue funds:

 

Total local revenues...................................        64,578,800

 

Merit award trust fund.................................        50,300,000

 

Tobacco settlement trust fund..........................        67,000,000

 

Total other state restricted revenues..................     1,194,807,000

 

State general fund/general purpose. . . . . . . . . .$<<1,489,014,000>>

 

   Sec. 121. INFORMATION TECHNOLOGY

 

Information technology services and projects........... $ <<30,964,200>>

 

Michigan Medicaid information system...................               100

 

GROSS APPROPRIATION.................................... <<$30,964,300>>

 

    Appropriated from:

 

   Federal revenues:

 

Total federal revenues.................................        18,603,900

 

   Special revenue funds:

 

Total other state restricted revenues..................         3,014,700

 

State general fund/general purpose.....................   <<$9,345,700>>

 

 

 

 

 

PART 2

 

PROVISIONS CONCERNING APPROPRIATIONS

 

GENERAL SECTIONS

 


Senate Bill No. 267 as amended June 14, 2005

     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 2005-2006 is <<$4,372,175,900.00>> and

 

state spending from state resources to be paid to local units of

 

government for fiscal year 2005-2006 is $1,000,784,900.00. The

 

itemized statement below identifies appropriations from which

 

spending to local units of government will occur:

 

DEPARTMENT OF COMMUNITY HEALTH

 

MENTAL HEALTH/SUBSTANCE ABUSE SERVICES ADMINISTRATION AND SPECIAL

 

PROJECTS

 

Mental health initiatives for older persons............        1,049,200

 

COMMUNITY MENTAL HEALTH/SUBSTANCE ABUSE SERVICES PROGRAMS

 

State disability assistance program substance abuse

 

services................................................         2,509,800

 

Community substance abuse prevention, education, and treatment

 

programs................................................        18,790,700

 

Medicaid mental health services........................   <<568,411,400>>

 

Community mental health non-Medicaid services..........   <<292,598,200>>

 

Medicaid adult benefits waiver.........................       12,156,000

 

Multicultural services.................................         3,663,800

 

Medicaid substance abuse services......................        12,620,900

 

Respite services.......................................         1,000,000

 

Omnibus budget reconciliation act implementation.......         3,873,000

 

HEALTH POLICY, REGULATION AND PROFESSIONS

 

Health professions.....................................           275,000

 

Rural health...........................................            35,000

 

INFECTIOUS DISEASE CONTROL

 


AIDS prevention, testing and care programs.............        1,400,000

 

Immunization local agreements..........................        2,200,000

 

Sexually transmitted disease control local agreements..          421,800

 

LABORATORY SERVICES

 

Laboratory services....................................            54,000

 

LOCAL HEALTH ADMINISTRATION AND GRANTS

 

Implementation of 1993 PA 133, MCL 333.17015...........             7,700

 

Local public health operations.........................        38,243,400

 

CHRONIC DISEASE AND INJURY PREVENTION AND HEALTH PROMOTION

 

Cancer prevention and control program..................           120,700

 

Diabetes and kidney program............................           295,800

 

Smoking prevention program.............................        1,660,300

 

FAMILY, MATERNAL, AND CHILDREN'S HEALTH SERVICES

 

Childhood lead program.................................           50,000

 

Dental programs........................................            25,000

 

Family planning local agreements.......................          360,000

 

Local MCH services.....................................          246,100

 

Pregnancy prevention program...........................         2,300,000

 

Prenatal care outreach and service delivery support....          636,000

 

School health and education programs...................          500,000

 

CHILDREN'S SPECIAL HEALTH CARE SERVICES

 

Outreach and advocacy..................................        1,283,200

 

MEDICAL SERVICES

 

Transportation.........................................        1,275,300

 

OFFICE OF SERVICES TO THE AGING

 

Community services.....................................       14,689,800

 

Nutrition services.....................................       11,447,300

 


Senior volunteer services..............................        1,153,400

 

CRIME VICTIM SERVICES COMMISSION

 

Crime victim rights services grants....................        5,432,100

 

TOTAL OF PAYMENTS TO LOCAL UNITS

 

  OF GOVERNMENT........................................ $ 1,000,784,900

 

     Sec. 202. (1) The appropriations authorized under this act are

 

subject to the management and budget act, 1984 PA 431, MCL 18.1101

 

to 18.1594.

 

     (2) Funds for which the state is acting as the custodian or

 

agent are not subject to annual appropriation.

 

     Sec. 203. As used in this act:

 

     (a) "AIDS" means acquired immunodeficiency syndrome.

 

     (b) "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) "Department" means the Michigan department of community

 

health.

 

     (d) "DSH" means disproportionate share hospital.

 

     (e) "EPIC" means elder prescription insurance coverage

 

program.

 

     (f) "EPSDT" means early and periodic screening, diagnosis, and

 

treatment.

 

     (g) "FTE" means full-time equated.

 

     (h) "GME" means graduate medical education.

 

     (i) "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.

 


     (j) "HIV/AIDS" means human immunodeficiency virus/acquired

 

immune deficiency syndrome.

 

     (k) "HMO" means health maintenance organization.

 

     (l) "IDEA" means individuals with disabilities education act.

 

     (m) "IDG" means interdepartmental grant.

 

     (n) "MCH" means maternal and child health.

 

     (o) "MIChild" means the program described in section 1670.

 

     (p) "MSS/ISS" means maternal and infant support services.

 

     (q) "Specialty prepaid health plan" means a program described

 

in section 232b of the mental health code, 1974 PA 258, MCL

 

330.1232b.

 

     (r) "Title XVIII" means title XVIII of the social security

 

act, 42 USC 1395 to 1395hhh.

 

     (s) "Title XIX" means title XIX of the social security act, 42

 

USC 1396 to 1396v.

 

     (t) "Title XX" means title XX of the social security act, 49

 

USC 1397 to 1397f.

 

     (u) "WIC" means women, infants, and children supplemental

 

nutrition program.

 

     Sec. 204. The department of civil service shall bill the

 

department at the end of the first fiscal quarter for the 1% charge

 

authorized by section 5 of article XI of the state constitution of

 

1963. Payments shall be made for the total amount of the billing by

 

the end of the second fiscal quarter.

 

     Sec. 205. (1) A hiring freeze is imposed on the state

 

classified civil service. State departments and agencies are

 

prohibited from hiring any new state classified civil service

 


employees and prohibited from filling any vacant state classified

 

civil service positions. This hiring freeze does not apply to

 

internal transfers of classified employees from 1 position to

 

another within a department.

 

     (2) The state budget director may grant exceptions to this

 

hiring freeze when the state budget director believes that the

 

hiring freeze will result in rendering a state department or agency

 

unable to deliver basic services, cause loss of revenue to the

 

state, result in the inability of the state to receive federal

 

funds, or would necessitate additional expenditures that exceed any

 

savings from maintaining the vacancy. The state budget director

 

shall report quarterly to the chairpersons of the senate and house

 

of representatives standing committees on appropriations the number

 

of exceptions to the hiring freeze approved during the previous

 

quarter and the reasons to justify the exception.

 

     Sec. 208. Unless otherwise specified, the department shall use

 

the Internet to fulfill the reporting requirements of this act.

 

This requirement may include transmission of reports via electronic

 

mail to the recipients identified for each reporting requirement or

 

it may include placement of reports on the Internet or Intranet

 

site.

 

     Sec. 209. Funds appropriated in part 1 shall not be used for

 

the purchase of foreign goods or services, or both, if

 

competitively priced and of comparable quality American goods or

 

services, or both, are available. Preference should be given to

 

goods or services, or both, that are manufactured or provided by

 

Michigan businesses if they are competitively priced and of

 


comparable quality.

 

   Sec. 210.  The director shall take all reasonable steps to

 

ensure businesses in deprived and depressed communities compete for

 

and perform contracts to provide services or supplies, or both. 

 

The director shall strongly encourage firms with which the

 

department contracts to subcontract with certified businesses in

 

depressed and deprived communities for services, supplies, or both.

 

     Sec. 211. If the revenue collected by the department from fees

 

and collections exceeds the amount appropriated in part 1, the

 

revenue may be carried forward with the approval of the state

 

budget director into the subsequent fiscal year. The revenue

 

carried forward under this section shall be used as the first

 

source of funds in the subsequent fiscal year.

 

     Sec. 212. (1) From the amounts appropriated in part 1, no

 

greater than the following amounts are supported with federal

 

maternal and child health block grant, preventive health and health

 

services block grant, substance abuse block grant, healthy Michigan

 

fund, and Michigan health initiative funds:

 

(a) Maternal and child health block grant.............. $    21,162,400

 

(b) Preventive health and health services block grant..        5,617,500

 

(c) Substance abuse block grant........................       60,509,900

 

(d) Healthy Michigan fund..............................       43,400,000

 

(e) Michigan health initiative.........................       10,121,200

 

     (2) On or before February 1, 2006, the department shall report

 

to the house of representatives and senate appropriations

 

subcommittees on community health, the house and senate fiscal

 

agencies, and the state budget director on the detailed name and

 


amounts of federal, restricted, private, and local sources of

 

revenue that support the appropriations in each of the line items

 

in part 1 of this act.

 

     (3) Upon the release of the fiscal year 2005-2006 executive

 

budget recommendation, the department shall report to the same

 

parties in subsection (2) on the amounts and detailed sources of

 

federal, restricted, private, and local revenue proposed to support

 

the total funds appropriated in each of the line items in part 1 of

 

the fiscal year 2005-2006 executive budget proposal.

 

     (4) The department shall provide to the same parties in

 

subsection (2) all revenue source detail for consolidated revenue

 

line item detail upon request to the department.

 

     Sec. 213. The state departments, agencies, and commissions

 

receiving tobacco tax funds from part 1 shall report by January 1,

 

2006 to the senate and house of representatives 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.

 

     (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 to be used to evaluate programs.

 

     (e) Any other information considered necessary by the house of

 

representatives or senate appropriations committees or the state

 

budget director.

 


     Sec. 214. The use of state-restricted tobacco tax revenue

 

received for the purpose of tobacco prevention, education, and

 

reduction efforts and deposited in the healthy Michigan fund shall

 

not be used for lobbying as defined in 1978 PA 472, MCL 4.411 to

 

4.431, and shall not be used in attempting to influence the

 

decisions of the legislature, the governor, or any state agency.

 

     Sec. 216. (1) In addition to funds appropriated in part 1 for

 

all programs and services, there is appropriated for write-offs of

 

accounts receivable, deferrals, and for prior year obligations in

 

excess of applicable prior year appropriations, an amount equal to

 

total write-offs and prior year obligations, but not to exceed

 

amounts available in prior year revenues.

 

     (2) The department's ability to satisfy appropriation

 

deductions in part 1 shall not be limited to collections and

 

accruals pertaining to services provided in the current fiscal

 

year, but shall also include reimbursements, refunds, adjustments,

 

and settlements from prior years.

 

     (3) The department shall report by March 15, 2006 to the house

 

of representatives and senate appropriations subcommittees on

 

community health on all reimbursements, refunds, adjustments, and

 

settlements from prior years.

 

     Sec. 218. Basic health services for the purpose of part 23 of

 

the public health code, 1978 PA 368, MCL 333.2301 to 333.2321, are:

 

immunizations, communicable disease control, sexually transmitted

 

disease control, tuberculosis control, prevention of gonorrhea eye

 

infection in newborns, screening newborns for the 8 conditions

 

listed in section 5431(1)(a) through (h) of the public health code,

 


1978 PA 368, MCL 333.5431, community health annex of the Michigan

 

emergency management plan, and prenatal care.

 

     Sec. 219. The department may contract with the Michigan public

 

health institute for the design and implementation of projects and

 

for other public health related activities prescribed in section

 

2611 of the public health code, 1978 PA 368, MCL 333.2611. The

 

department may develop a master agreement with the institute to

 

carry out these purposes for up to a 3-year period. The department

 

shall report to the house of representatives and senate

 

appropriations subcommittees on community health, the house and

 

senate fiscal agencies, and the state budget director on or before

 

November 1, 2005 and May 1, 2006 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.

 

     Sec. 220. All contracts with the Michigan public health

 

institute funded with appropriations in part 1 shall include a

 

requirement that the Michigan public health institute submit to

 

financial and performance audits by the state auditor general of

 

projects funded with state appropriations.

 

     Sec. 223. The department of community health may establish and

 

collect fees for publications, videos and related materials,

 


conferences, and workshops. Collected fees shall be used to offset

 

expenditures to pay for printing and mailing costs of the

 

publications, videos and related materials, and costs of the

 

workshops and conferences. The costs shall not exceed fees

 

collected.

 

     Sec. 259. From the funds appropriated in part 1 for

 

information technology, the department shall pay user fees to the

 

department of information technology for technology-related

 

services and projects. Such user fees shall be subject to

 

provisions of an interagency agreement between the department and

 

the department of information technology.

 

     Sec. 260. Amounts appropriated in part 1 for information

 

technology may be designated as work projects and carried forward

 

to support technology projects under the direction of the

 

department of information technology. Funds designated in this

 

manner are not available for expenditure until approved as work

 

projects under section 451a of the management and budget act, 1984

 

PA 431, MCL 18.1451a.

 

   Sec. 261.  Funds appropriated in part 1 for the Medicaid

 

management information system upgrade are contingent upon approval

 

of an advanced planning document from the centers for Medicare and

 

Medicaid services.  If the necessary matching funds are identified

 

and legislatively transferred to this line item, the corresponding

 

federal Medicaid revenue shall be appropriated at a 90/10

 

federal/state match rate.  This appropriation may be designated as

 

a work project and carried forward to support completion of this

 

project.

 


     Sec. 264. Upon submission of a Medicaid waiver, a Medicaid

 

state plan amendment, or a similar proposal to the centers for

 

Medicare and Medicaid services, the department shall notify the

 

house of representatives and senate appropriations subcommittees on

 

community health and the house and senate fiscal agencies of the

 

submission.

 

     Sec. 265. The departments and agencies receiving

 

appropriations in part 1 shall receive and retain copies of all

 

reports funded from appropriations in part 1. Federal and state

 

guidelines for short-term and long-term retention of records shall

 

be followed.

 

     Sec. 266. (1) Due to the current budgetary problems in this

 

state, out-of-state travel for the fiscal year ending September 30,

 

2006 shall be limited to situations in which 1 or more of the

 

following conditions apply:

 

     (a) The travel is required by legal mandate or court order or

 

for law enforcement purposes.

 

     (b) The travel is necessary to protect the health or safety of

 

Michigan citizens or visitors or to assist other states in similar

 

circumstances.

 

     (c) The travel is necessary to produce budgetary savings or to

 

increase state revenues, including protecting existing federal

 

funds or securing additional federal funds.

 

     (d) The travel is necessary to comply with federal

 

requirements.

 

     (e) The travel is necessary to secure specialized training for

 

staff that is not available within this state.

 


     (f) The travel is financed entirely by federal or nonstate

 

funds.

 

     (2) If out-of-state travel is necessary but does not meet 1 or

 

more of the conditions in subsection (1), the state budget director

 

may grant an exception to allow the travel. Any exceptions granted

 

by the state budget director shall be reported on a monthly basis

 

to the senate and house of representatives standing committees on

 

appropriations.

 

     (3) Not later than January 1 of each year, each department

 

shall prepare a travel report listing all travel by classified and

 

unclassified employees outside this state in the immediately

 

preceding fiscal year that was funded in whole or in part with

 

funds appropriated in the department's budget. The report shall be

 

submitted to the chairs and members of the senate and house of

 

representatives standing committees on appropriations, the fiscal

 

agencies, and the state budget director. The report shall include

 

the following information:

 

     (a) The name of each person receiving reimbursement for travel

 

outside this state or whose travel costs were paid by this state.

 

     (b) The destination of each travel occurrence.

 

     (c) The dates of each travel occurrence.

 

     (d) A brief statement of the reason for each travel

 

occurrence.

 

     (e) The transportation and related costs of each travel

 

occurrence, including the proportion funded with state general

 

fund/general purpose revenues, the proportion funded with state

 

restricted revenues, the proportion funded with federal revenues,

 


and the proportion funded with other revenues.

 

     (f) A total of all out-of-state travel funded for the

 

immediately preceding fiscal year.

 

     Sec. 267. A department or state agency shall not take

 

disciplinary action against an employee for communicating with a

 

member of the legislature or his or her staff.

 

 

 

DEPARTMENTWIDE ADMINISTRATION

 

     Sec. 301. From funds appropriated for worker's compensation,

 

the department may make payments in lieu of worker's compensation

 

payments for wage and salary and related fringe benefits for

 

employees who return to work under limited duty assignments.

 

     Sec. 303. The department is prohibited from requiring first-

 

party payment from individuals or families with a taxable income of

 

$10,000.00 or less for mental health services for determinations

 

made in accordance with section 818 of the mental health code, 1974

 

PA 258, MCL 330.1818.

 

     Sec. 305. The department is directed to continue support of

 

multicultural agencies that provide primary care services from the

 

funds appropriated in part 1.

 

 

 

COMMUNITY MENTAL HEALTH/SUBSTANCE ABUSE SERVICES PROGRAMS

 

     Sec. 401. Funds appropriated in part 1 are intended to support

 

a system of comprehensive community mental health services under

 

the full authority and responsibility of local CMHSPs or specialty

 

prepaid health plans. The department shall ensure that each CMHSP

 

or specialty prepaid health plan provides all of the following:

 


     (a) A system of single entry and single exit.

 

     (b) A complete array of mental health services which shall

 

include, but shall not be limited to, all of the following

 

services: residential and other individualized living arrangements,

 

outpatient services, acute inpatient services, and long-term, 24-

 

hour inpatient care in a structured, secure environment.

 

     (c) The coordination of inpatient and outpatient hospital

 

services through agreements with state-operated psychiatric

 

hospitals, units, and centers in facilities owned or leased by the

 

state, and privately-owned hospitals, units, and centers licensed

 

by the state pursuant to sections 134 through 149b of the mental

 

health code, 1974 PA 258, MCL 330.1134 to 330.1149b.

 

     (d) Individualized plans of service that are sufficient to

 

meet the needs of individuals, including those discharged from

 

psychiatric hospitals or centers, and that ensure the full range of

 

recipient needs is addressed through the CMHSP's or specialty

 

prepaid health plan's program or through assistance with locating

 

and obtaining services to meet these needs.

 

     (e) A system of case management to monitor and ensure the

 

provision of services consistent with the individualized plan of

 

services or supports.

 

     (f) A system of continuous quality improvement.

 

     (g) A system to monitor and evaluate the mental health

 

services provided.

 

     (h) A system that serves at-risk and delinquent youth as

 

required under the provisions of the mental health code, 1974 PA

 

258, MCL 330.1001 to 330.2106.

 


     Sec. 402. (1) From funds appropriated in part 1, final

 

authorizations to CMHSPs or specialty prepaid health plans shall be

 

made upon the execution of contracts between the department and

 

CMHSPs or specialty prepaid health plans. 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 specialty

 

prepaid health plan 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 specialty

 

prepaid health plans entered into under this subsection for fiscal

 

year 2005-2006 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 of representatives appropriations subcommittees on community

 

health, the senate and house fiscal agencies, and the state budget

 

director if either of the following occurs:

 

     (a) Any new contracts with CMHSPs or specialty prepaid health

 

plans that would affect rates or expenditures are enacted.

 

     (b) Any amendments to contracts with CMHSPs or specialty

 

prepaid health plans that would affect rates or expenditures are

 

enacted.

 

     (3) The report required by subsection (2) shall include

 

information about the changes and their effects on rates and

 

expenditures.

 

     Sec. 403. From the funds appropriated in part 1 for

 


multicultural services, the department shall ensure that CMHSPs or

 

specialty prepaid health plans continue contracts with

 

multicultural services providers.

 

     Sec. 404. (1) Not later than May 31 of each fiscal year, the

 

department shall provide a report on the community mental health

 

services programs to the members of the house of representatives

 

and senate appropriations subcommittees on community health, the

 

house and senate fiscal agencies, and the state budget director

 

that includes the information required by this section.

 

     (2) The report shall contain information for each CMHSP or

 

specialty prepaid health plan and a statewide summary, each of

 

which shall include at least the following information:

 

     (a) A demographic description of service recipients which,

 

minimally, shall include reimbursement eligibility, client

 

population, age, ethnicity, housing arrangements, and diagnosis.

 

     (b) When the encounter data is available, a breakdown of

 

clients served, by diagnosis. As used in this subdivision,

 

"diagnosis" means a recipient's primary diagnosis, stated as a

 

specifically named mental illness, emotional disorder, or

 

developmental disability corresponding to terminology employed in

 

the latest edition of the American psychiatric association's

 

diagnostic and statistical manual.

 

     (c) Per capita expenditures by client population group.

 

     (d) Financial information which, minimally, shall include a

 

description of funding authorized; expenditures by client group and

 

fund source; and cost information by service category, including

 

administration. Service category shall include all department

 


approved services.

 

     (e) Data describing service outcomes which shall include, but

 

not be limited to, an evaluation of consumer satisfaction, consumer

 

choice, and quality of life concerns including, but not limited to,

 

housing and employment.

 

     (f) Information about access to community mental health

 

services programs which shall include, but not be 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.

 

     (iii) The number of people requesting services who are on

 

waiting lists for services.

 

     (iv) The average length of time that people remained on waiting

 

lists for services.

 

     (g) The number of second opinions requested under the code and

 

the determination of any appeals.

 

     (h) An analysis of information provided by community mental

 

health service programs in response to the needs assessment

 

requirements of the mental health code, including information about

 

the number of persons in the service delivery system who have

 

requested and are clinically appropriate for different services.

 

     (i) An estimate of the number of FTEs employed by the CMHSPs

 

or specialty prepaid health plans or contracted with directly by

 

the CMHSPs or specialty prepaid health plans as of September 30,

 

2005 and an estimate of the number of FTEs employed through

 

contracts with provider organizations as of September 30, 2005.

 


     (j) Lapses and carryforwards during fiscal year 2004-2005 for

 

CMHSPs or specialty prepaid health plans.

 

     (k) Contracts for mental health services entered into by

 

CMHSPs or specialty prepaid health plans with providers, including

 

amount and rates, organized by type of service provided.

 

     (l) Information on the community mental health Medicaid managed

 

care program, including, but not limited to, both of the following:

 

     (i) Expenditures by each CMHSP or specialty prepaid health plan

 

organized by Medicaid eligibility group, including per eligible

 

individual expenditure averages.

 

     (ii) Performance indicator information required to be submitted

 

to the department in the contracts with CMHSPs or specialty prepaid

 

health plans.

 

     (3) The department shall include data reporting requirements

 

listed in subsection (2) in the annual contract with each

 

individual CMHSP or specialty prepaid health plan.

 

     (4) The department shall take all reasonable actions to ensure

 

that the data required are complete and consistent among all CMHSPs

 

or specialty prepaid health plans.

 

     Sec. 406. (1) The funds appropriated in part 1 for the state

 

disability assistance substance abuse services program shall be

 

used to support per diem room and board payments in substance abuse

 

residential facilities. Eligibility of clients for the state

 

disability assistance substance abuse services program shall

 

include needy persons 18 years of age or older, or emancipated

 

minors, who reside in a substance abuse treatment center.

 

     (2) The department shall reimburse all licensed substance

 


abuse programs eligible to participate in the program at a rate

 

equivalent to that paid by the family independence agency to adult

 

foster care providers. Programs accredited by department-approved

 

accrediting organizations shall be reimbursed at the personal care

 

rate, while all other eligible programs shall be reimbursed at the

 

domiciliary care rate.

 

     Sec. 407. (1) The amount appropriated in part 1 for substance

 

abuse prevention, education, and treatment grants shall be expended

 

for contracting with coordinating agencies. Coordinating agencies

 

shall work with the CMHSPs or specialty prepaid health plans to

 

coordinate the care and services provided to individuals with both

 

mental illness and substance abuse diagnoses.

 

     (2) The department shall approve a fee schedule for providing

 

substance abuse services and charge participants in accordance with

 

their ability to pay.

 

     Sec. 408. (1) By April 15, 2006, the department shall report

 

the following data from fiscal year 2004-2005 on substance abuse

 

prevention, education, and treatment programs to the senate and

 

house of representatives appropriations subcommittees on community

 

health, the senate and house fiscal agencies, and the state budget

 

office:

 

     (a) Expenditures stratified by coordinating agency, by central

 

diagnosis and referral agency, by fund source, by subcontractor, by

 

population served, and by service type. Additionally, data on

 

administrative expenditures by coordinating agency and by

 

subcontractor shall be reported.

 

     (b) Expenditures per state client, with data on the

 


distribution of expenditures reported using a histogram approach.

 

     (c) Number of services provided by central diagnosis and

 

referral agency, by subcontractor, and by service type.

 

Additionally, data on length of stay, referral source, and

 

participation in other state programs.

 

     (d) Collections from other first- or third-party payers,

 

private donations, or other state or local programs, by

 

coordinating agency, by subcontractor, by population served, and by

 

service type.

 

     (2) The department shall take all reasonable actions to ensure

 

that the required data reported are complete and consistent among

 

all coordinating agencies.

 

     Sec. 409. The funding in part 1 for substance abuse services

 

shall be distributed in a manner that provides priority to service

 

providers that furnish child care services to clients with

 

children.

 

     Sec. 410. The department shall assure that substance abuse

 

treatment is provided to applicants and recipients of public

 

assistance through the family independence agency who are required

 

to obtain substance abuse treatment as a condition of eligibility

 

for public assistance.

 

     Sec. 411. (1) The department shall ensure that each contract

 

with a CMHSP or specialty prepaid health plan requires the CMHSP or

 

specialty prepaid health plan to implement programs to encourage

 

diversion of persons with serious mental illness, serious emotional

 

disturbance, or developmental disability from possible jail

 

incarceration when appropriate.

 


     (2) Each CMHSP or specialty prepaid health plan shall have

 

jail diversion services and shall work toward establishing working

 

relationships with representative staff of local law enforcement

 

agencies, including county prosecutors' offices, county sheriffs'

 

offices, county jails, municipal police agencies, municipal

 

detention facilities, and the courts. Written interagency

 

agreements describing what services each participating agency is

 

prepared to commit to the local jail diversion effort and the

 

procedures to be used by local law enforcement agencies to access

 

mental health jail diversion services are strongly encouraged.

 

     Sec. 412. The department shall contract directly with the

 

Salvation Army harbor light program to provide non-Medicaid

 

substance abuse services at not less than the amount contracted for

 

in fiscal year 2004-2005.

 

     Sec. 414. Medicaid substance abuse treatment services shall be

 

managed by selected CMHSPs or specialty prepaid health plans

 

pursuant to the centers for Medicare and Medicaid services'

 

approval of Michigan's 1915(b) waiver request to implement a

 

managed care plan for specialized substance abuse services. The

 

selected CMHSPs or specialty prepaid health plans shall receive a

 

capitated payment on a per eligible per month basis to assure

 

provision of medically necessary substance abuse services to all

 

beneficiaries who require those services. The selected CMHSPs or

 

specialty prepaid health plans shall be responsible for the

 

reimbursement of claims for specialized substance abuse services.

 

The CMHSPs or specialty prepaid health plans that are not

 

coordinating agencies may continue to contract with a coordinating

 


agency. Any alternative arrangement must be based on client service

 

needs and have prior approval from the department.

 

     Sec. 418. On or before the tenth of each month, the department

 

shall report to the senate and house of representatives

 

appropriations subcommittees on community health, the senate and

 

house fiscal agencies, and the state budget director on the amount

 

of funding paid to the CMHSPs or specialty prepaid health plans to

 

support the Medicaid managed mental health care program in that

 

month. The information shall include the total paid to each CMHSP

 

or specialty prepaid health plan, per capita rate paid for each

 

eligibility group for each CMHSP or specialty prepaid health plan,

 

and number of cases in each eligibility group for each CMHSP or

 

specialty prepaid health plan, and year-to-date summary of

 

eligibles and expenditures for the Medicaid managed mental health

 

care program.

 

     Sec. 424. Each community mental health services program or

 

specialty prepaid health plan that contracts with the department to

 

provide services to the Medicaid population shall adhere to the

 

following timely claims processing and payment procedure for claims

 

submitted by health professionals and facilities:

 

     (a) A "clean claim" as described in section 111i of the social

 

welfare act, 1939 PA 280, MCL 400.111i, must be paid within 45 days

 

after receipt of the claim by the community mental health services

 

program or specialty prepaid health plan. A clean claim that is not

 

paid within this time frame shall bear simple interest at a rate of

 

12% per annum.

 

     (b) A community mental health services program or specialty

 


prepaid health plan must state in writing to the health

 

professional or facility any defect in the claim within 30 days

 

after receipt of the claim.

 

     (c) A health professional and a health facility have 30 days

 

after receipt of a notice that a claim or a portion of a claim is

 

defective within which to correct the defect. The community mental

 

health services program or specialty prepaid health plan shall pay

 

the claim within 30 days after the defect is corrected.

 

     Sec. 425. By April 1, 2006, the department, in conjunction

 

with the department of corrections, shall report the following data

 

from fiscal year 2004-2005 on mental health and substance abuse

 

services to the house of representatives and senate appropriations

 

subcommittees on community health and corrections, the house and

 

senate fiscal agencies, and the state budget director:

 

     (a) The number of prisoners receiving substance abuse

 

services, which shall include a description and breakdown of the

 

type of substance abuse services provided to those prisoners.

 

     (b) The number of prisoners with a primary diagnosis of mental

 

illness and the number of such prisoners receiving mental health

 

services, which shall include a description and breakdown,

 

minimally encompassing the categories of inpatient, residential,

 

and outpatient care, of the type of mental health services provided

 

to those prisoners.

 

     (c) The number of prisoners with a diagnosis of co-occurring

 

mental illness and substance abuse and the number of such prisoners

 

receiving treatment for this dual disorder, which shall include a

 

description and breakdown, minimally encompassing the categories of

 


inpatient, residential, and outpatient care, of the type of

 

treatment provided to those prisoners.

 

     (d) Data indicating if prisoners receiving mental health

 

services for a primary diagnosis of mental illness or a diagnosis

 

of co-occurring mental illness and substance abuse were previously

 

hospitalized in a state psychiatric hospital for persons with

 

mental illness.

 

     Sec. 428. (1) Each CMHSP and affiliation of CMHSPs shall

 

provide, from internal resources, local funds to be used as a bona

 

fide part of the state match required under the Medicaid program in

 

order to increase capitation rates for CMHSPs and affiliations of

 

CMHSPs. 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 CMHSP or an affiliation of CMHSPs.

 

     (2) The distribution of the aforementioned increases in the

 

capitation payment rates, if any, shall be based on a formula

 

developed by a committee established by the department, including

 

representatives from CMHSPs or affiliations of CMHSPs and

 

department staff.

 

     Sec. 435. A county required under the provisions of the mental

 

health code, 1974 PA 258, MCL 330.1001 to 330.2106, to provide

 

matching funds to a CMHSP for mental health services rendered to

 

residents in its jurisdiction shall pay the matching funds in equal

 

installments on not less than a quarterly basis throughout the

 

fiscal year, with the first payment being made by October 1, 2005.

 

     Sec. 439. (1) It is the intent of the legislature that the

 


department, in conjunction with CMHSPs, support pilot projects that

 

facilitate the movement of adults with mental illness from state

 

psychiatric hospitals to community residential settings.

 

     (2) The purpose of the pilot projects is to encourage the

 

placement of persons with mental illness in community residential

 

settings who may require any of the following:

 

     (a) A secured and supervised living environment.

 

     (b) Assistance in taking prescribed medications.

 

     (c) Intensive case management services.

 

     (d) Assertive community treatment team services.

 

     (e) Alcohol or substance abuse treatment and counseling.

 

     (f) Individual or group therapy.

 

     (g) Day or partial day programming activities.

 

     (h) Vocational, educational, or self-help training or

 

activities.

 

     (i) Other services prescribed to treat a person's mental

 

illness to prevent the need for hospitalization.

 

     (3) The pilot projects described in this section shall be

 

completely voluntary.

 

     (4) The department shall provide semiannual reports to the

 

house of representatives and senate appropriations subcommittees on

 

community health, the state budget office, and the house and senate

 

fiscal agencies as to any activities undertaken by the department

 

and CMHSPs for pilot projects implemented under this section.

 

     Sec. 442. (1) It is the intent of the legislature that the

 

$40,000,000.00 in funding transferred from the community mental

 

health non-Medicaid services line to support the Medicaid adult

 


benefits waiver program be used to provide state match for

 

increases in federal funding for primary care and specialty

 

services provided to Medicaid adult benefits waiver enrollees and

 

for economic increases for the Medicaid specialty services and

 

supports program.

 

     (2) The department shall assure that persons eligible for

 

mental health services under the priority population sections of

 

the mental health code, 1974 PA 258, MCL 330.1001 to 330.2106, will

 

receive mandated services under this plan.

 

     (3) Capitation payments to CMHSPs or specialty prepaid health

 

plans for persons who become enrolled in the Medicaid adult

 

benefits waiver program shall be made using the same rate

 

methodology as payments for the current Medicaid beneficiaries.

 

     (4) If enrollment in the Medicaid adult benefits waiver

 

program does not achieve expectations and the funding appropriated

 

for the Medicaid adult benefits waiver program for specialty

 

services is not expended, the general fund balance shall be

 

transferred back to the community mental health non-Medicaid

 

services line. The department shall report quarterly to the senate

 

and house of representatives appropriations subcommittees on

 

community health a summary of eligible expenditures for the

 

Medicaid adult benefits waiver program by CMHSPs or specialty

 

prepaid health plans.

 

     (5) In the waiver renewal application the department submits

 

to the centers for Medicare and Medicaid services for continuation

 

of the state's 1915(b) specialty services waiver, the department

 

will request that the amount of savings that may be retained by a

 


specialty prepaid health plan be changed from 5% to 7.5% of

 

aggregate capitation payments. If the department is unable to

 

secure centers for Medicare and Medicaid services approval for this

 

change, the department shall allow specialty prepaid health plans

 

and their affiliate CMHSP members to retain 50% of the unspent

 

general fund/general purpose portion of the funds allocated to the

 

specialty prepaid health plan for services to be provided under the

 

Medicaid specialty services waiver. Any such general fund/general

 

purpose portion retained by the specialty prepaid health plan and

 

its CMHSP affiliates under this section shall be considered as

 

state revenues for purposes of determining the amount of state

 

funds that the CMHSP may carry forward under section 226(2)(c) of

 

the mental health code, 1974 PA 258, MCL 330.1226.

 

     Sec. 443. It is the intent of the legislature that the

 

implementation of the quality assurance assessment program (QAAP)

 

for community mental health prepaid inpatient health plans (PIHP)

 

shall not result in any net reduction in revenue for community

 

mental health services. If the QAAP is not implemented, generates

 

revenue below the amount budgeted in fiscal year 2005-2006, or is

 

eliminated at a later date, the department shall present a plan to

 

the senate and house of representatives standing committees on

 

appropriations assuring no net reduction in funding for community

 

mental health services.

 

     Sec. 450. The department shall continue a work group comprised

 

of CMHSPs or specialty prepaid health plans and departmental staff

 

to recommend strategies to streamline audit and reporting

 

requirements for CMHSPs or specialty prepaid health plans. The

 


Senate Bill No. 267 as amended June 14, 2005

department shall report on the recommendations of the work group by

 

March 31, 2006 to the house of representatives and senate

 

appropriations subcommittees on community health, the house fiscal

 

agency, the senate fiscal agency, and the state budget director.

 

     Sec. 452. Unless otherwise authorized by law, the department

 

shall not implement retroactively any policy that would lead to a

 

negative financial impact on community mental health services

 

programs or prepaid inpatient health plans.

 

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     Sec. 457. (1) Any CMSHP located in a county with a population

 

exceeding 1,500,000 that is not recognized as a community mental

 

health authority created under section 205 of the mental health

 

code, 1974 PA 258, MCL 330.1205, by July 1, 2005 shall have its

 

fiscal year 2005-2006 community mental health non-Medicaid services

 

allotment reduced by $20,000,000.00 from its fiscal year 2004-2005

 

allotment.

 

     (2) It is the intent of the legislature that if any CMHSP

 


subject to the funding reduction outlined in subsection (1) becomes

 

an authority by July 1, 2006, its allotment for community mental

 

health non-Medicaid services in fiscal year 2006-2007 shall be

 

increased by $10,000,000.00 above its fiscal year 2005-2006

 

allotment.

 

     (3) If a CMHSP as described in subsection (1) does not become

 

an authority by July 1, 2006, it is the intent of the legislature

 

to pursue alternative means for its administration, including, but

 

not limited, to behavioral health managed care organizations.

 

     Sec. 458. (1) The department shall produce a report detailing

 

the steps necessary to implement a pilot program testing the

 

effectiveness of a recovery-oriented secure residential facility

 

for adults with serious mental illness. This facility would have

 

less than 17 beds and have locking doors and windows or a secure

 

perimeter that is designed and operated to prevent a resident from

 

leaving without permission of the facility staff or appropriate

 

officials.

 

     (2) This report shall include:

 

     (a) A 12-month projection of costs, staffing, operational

 

procedures, eligibility criteria, admission processes, evaluation

 

methods, and available sources of funding.

 

     (b) A description of necessary changes in state law, policy,

 

or licensing procedures for a pilot project to be implemented.

 

     (3) The report shall be completed by June 30, 2006 and shall

 

be submitted to the senate and house of representatives

 

appropriations subcommittees on community health, the senate and

 

house fiscal agencies, and the state budget director.

 


     Sec. 459. (1) The department and state court administrator

 

shall produce a report that details the steps necessary to

 

implement a pilot program testing the effectiveness of a

 

specialized mental health court. This court would have the ability

 

to divert into treatment, prior to the filing of charges, an adult

 

with mental illness alleged to have committed a nonviolent offense.

 

     (2) The report shall include each of the following:

 

     (a) A 12-month projection of costs, staffing, operational

 

procedures, identification of necessary local involvement,

 

evaluation methods, and available sources of funding.

 

     (b) Identification of any necessary changes required in state

 

law, rule, or policy to implement the pilot program.

 

     (c) A list of the offenses deemed nonviolent and eligible for

 

intervention by the mental health court.

 

     (3) The report shall be completed by June 30, 2006 and shall

 

be submitted to the house and senate appropriations subcommittees

 

on community health and judiciary, the house and senate fiscal

 

agencies, and the state budget director.

 

 

 

STATE PSYCHIATRIC HOSPITALS, CENTERS FOR PERSONS WITH DEVELOPMENTAL

 

DISABILITIES, AND FORENSIC AND PRISON MENTAL HEALTH SERVICES

 

     Sec. 601. (1) In funding of staff in the financial support

 

division, reimbursement, and billing and collection sections,

 

priority shall be given to obtaining third-party payments for

 

services. Collection from individual recipients of services and

 

their families shall be handled in a sensitive and nonharassing

 

manner.

 


     (2) The department shall continue a revenue recapture project

 

to generate additional revenues from third parties related to cases

 

that have been closed or are inactive. Upon approval by the state

 

budget director, such revenues may be allotted and spent for

 

departmental costs and contractual fees associated with these

 

retroactive collections and to improve ongoing departmental

 

reimbursement management functions.

 

     Sec. 602. Unexpended and unencumbered amounts and accompanying

 

expenditure authorizations up to $1,000,000.00 remaining on

 

September 30, 2006 from the amounts appropriated in part 1 for

 

gifts and bequests for patient living and treatment environments

 

shall be carried forward for 1 fiscal year. The purpose of gifts

 

and bequests for patient living and treatment environments is to

 

use additional private funds to provide specific enhancements for

 

individuals residing at state-operated facilities. Use of the gifts

 

and bequests shall be consistent with the stipulation of the donor.

 

The expected completion date for the use of gifts and bequests

 

donations is within 3 years unless otherwise stipulated by the

 

donor.

 

     Sec. 603. The funds appropriated in part 1 for forensic mental

 

health services provided to the department of corrections are in

 

accordance with the interdepartmental plan developed in cooperation

 

with the department of corrections. The department is authorized to

 

receive and expend funds from the department of corrections in

 

addition to the appropriations in part 1 to fulfill the obligations

 

outlined in the interdepartmental agreements.

 

     Sec. 604. (1) The CMHSPs or specialty prepaid health plans

 


shall provide semiannual reports to the department on the following

 

information:

 

     (a) The number of days of care purchased from state hospitals

 

and centers.

 

     (b) The number of days of care purchased from private

 

hospitals in lieu of purchasing days of care from state hospitals

 

and centers.

 

     (c) The number and type of alternative placements to state

 

hospitals and centers other than private hospitals.

 

     (d) Waiting lists for placements in state hospitals and

 

centers.

 

     (2) The department shall semiannually report the information

 

in subsection (1) to the house of representatives and senate

 

appropriations subcommittees on community health, the house and

 

senate fiscal agencies, and the state budget director.

 

     Sec. 605. (1) The department shall not implement any closures

 

or consolidations of state hospitals, centers, or agencies until

 

CMHSPs or specialty prepaid health plans have programs and services

 

in place for those persons currently in those facilities and a plan

 

for service provision for those persons who would have been

 

admitted to those facilities.

 

     (2) All closures or consolidations are dependent upon adequate

 

department-approved CMHSP plans that include a discharge and

 

aftercare plan for each person currently in the facility. A

 

discharge and aftercare plan shall address the person's housing

 

needs. A homeless shelter or similar temporary shelter arrangements

 

are inadequate to meet the person's housing needs.

 


     (3) Four months after the certification of closure required in

 

section 19(6) of the state employees' retirement act, 1943 PA 240,

 

MCL 38.19, the department shall provide a closure plan to the house

 

of representatives and senate appropriations subcommittees on

 

community health and the state budget director.

 

     (4) Upon the closure of state-run operations and after

 

transitional costs have been paid, the remaining balances of funds

 

appropriated for that operation shall be transferred to CMHSPs or

 

specialty prepaid health plans responsible for providing services

 

for persons previously served by the operations.

 

     Sec. 606. The department may collect revenue for patient

 

reimbursement from first- and third-party payers, including

 

Medicaid and local county and 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.

 

 

 

PUBLIC HEALTH ADMINISTRATION

 

     Sec. 650. The department shall communicate the annual public

 

health consumption advisory for sportfish. The department shall, at

 

a minimum, post the advisory on the Internet and make the

 

information in the advisory available to the clients of the women,

 

infants, and children special supplemental nutrition program.

 

 

 


HEALTH REGULATORY SYSTEMS

 

     Sec. 704. The department shall continue to work with grantees

 

supported through the appropriation in part 1 for emergency medical

 

services grants and contracts to ensure that a sufficient number of

 

qualified emergency medical services personnel exist to serve rural

 

areas of the state.

 

     Sec. 705. The department shall post on the Internet the

 

executive summary of the latest inspection for each licensed

 

nursing home.

 

     Sec. 706. When hiring any new nursing home inspectors funded

 

through appropriations in part 1, the department shall make every

 

effort to hire individuals with past experience in the long-term

 

care industry.

 

     Sec. 707. It is the intent of the legislature that the funds

 

appropriated in part 1 for the nurse scholarship program,

 

established in section 16315 of the public health code, 1978 PA

 

368, MCL 333.16315, are used to increase the number of nurses

 

practicing in Michigan. The board of nursing is encouraged to

 

structure scholarships funded under this act in a manner that

 

rewards recipients who intend to practice nursing in Michigan. In

 

addition, it is the intent of the legislature that the department

 

and the board of nursing work cooperatively with the Michigan

 

higher education assistance authority to coordinate scholarship

 

assistance with scholarships provided pursuant to the Michigan

 

nursing scholarship act, 2002 PA 591, MCL 390.1181 to 390.1189.

 

     Sec. 708. Nursing facilities shall report in the quarterly

 

staff report to the department, the total patient care hours

 


provided each month, by state licensure and certification

 

classification, and the percentage of pool staff, by state

 

licensure and certification classification, used each month during

 

the preceding quarter. The department shall make available to the

 

public, the quarterly staff report compiled for all facilities

 

including the total patient care hours and the percentage of pool

 

staff used, by classification.

 

   Sec. 709.  The department may make available to interested

 

entities customized listings of nonconfidential information in its

 

possession, such as names and addresses of licensees.  The

 

department may establish and collect a reasonable charge to provide

 

this service.  The revenue received from this service shall be used

 

to offset expenses to provide the service.  Any balance of this

 

revenue collected and unexpended at the end of the fiscal year

 

shall revert to the appropriate restricted fund.

 

     Sec. 710. The funds appropriated in part 1 for the Michigan

 

essential health care provider program may also provide loan

 

repayment for dentists that fit the criteria established by part 27

 

of the public health code, 1978 PA 368, MCL 333.2701 to 333.2727.

 

     Sec. 711. From the funds appropriated in part 1 for primary

 

care services, an amount not to exceed $2,296,000.00 is

 

appropriated to enhance the service capacity of the federally

 

qualified health centers and other health centers which are similar

 

to federally qualified health centers.

 

 

 

 

 

INFECTIOUS DISEASE CONTROL

 


     Sec. 801. In the expenditure of funds appropriated in part 1

 

for AIDS programs, the department and its subcontractors shall

 

ensure that adolescents receive priority for prevention, education,

 

and outreach services.

 

     Sec. 802. In developing and implementing AIDS provider

 

education activities, the department may provide funding to the

 

Michigan state medical society to serve as lead agency to convene a

 

consortium of health care providers, to design needed educational

 

efforts, to fund other statewide provider groups, and to assure

 

implementation of these efforts, in accordance with a plan approved

 

by the department.

 

     Sec. 803. The department shall continue the AIDS drug

 

assistance program maintaining the prior year eligibility criteria

 

and drug formulary. This section is not intended to prohibit the

 

department from providing assistance for improved AIDS treatment

 

medications.

 

     Sec. 804. The department shall require that the tetanus and

 

diphtheria immunization be offered annually at the same time that

 

the influenza immunization is offered to patients 65 years of age

 

or older who are residents of long-term care facilities.

 

 

 

LOCAL HEALTH ADMINISTRATION AND GRANTS

 

     Sec. 901. The amount appropriated in part 1 for implementation

 

of the 1993 amendments to sections 9161, 16221, 16226, 17014,

 

17015, and 17515 of the public health code, 1978 PA 368, MCL

 

333.9161, 333.16221, 333.16226, 333.17014, 333.17015, and

 

333.17515, shall reimburse local health departments for costs

 


incurred related to implementation of section 17015(18) of the

 

public health code, 1978 PA 368, MCL 333.17015.

 

     Sec. 902. If a county that has participated in a district

 

health department or an associated arrangement with other local

 

health departments takes action to cease to participate in such an

 

arrangement after October 1, 2005, 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 5% of the

 

local health department's local public health operations funding.

 

This penalty shall only be assessed to the local county that

 

requests the dissolution of the health department.

 

     Sec. 903. The department shall provide a report annually to

 

the house of representatives and senate appropriations

 

subcommittees on community health, the senate and house fiscal

 

agencies, and the state budget director on the expenditures and

 

activities undertaken by the lead abatement program. The report

 

shall include, but is not limited to, a funding allocation

 

schedule, expenditures by category of expenditure and by

 

subcontractor, revenues received, description of program elements,

 

and description of program accomplishments and progress.

 

     Sec. 904. (1) Funds appropriated in part 1 for local public

 

health operations shall be prospectively allocated to local health

 

departments to support immunizations, infectious disease control,

 

sexually transmitted disease control and prevention, hearing

 

screening, vision services, food protection, public water supply,

 

private groundwater supply, and on-site sewage management. Food

 

protection shall be provided in consultation with the Michigan

 


department of agriculture. Public water supply, private groundwater

 

supply, and on-site sewage management shall be provided in

 

consultation with the Michigan department of environmental quality.

 

     (2) Local public health departments will 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 fiscal year 2005-2006 of

 

at least the amount expended in fiscal year 1992-1993 for the

 

services described in subsection (1).

 

     (4) By April 1, 2006, the department shall make available upon

 

request a report to the senate or house of representatives

 

appropriations subcommittee on community health, the senate or

 

house fiscal agency, or the state budget director on the planned

 

allocation of the funds appropriated for local public health

 

operations.

 

     Sec. 905. From the funds appropriated in part 1 for local

 

public health operations, local health departments shall offer

 

hearing screening and vision services at a reduced level than that

 

provided in fiscal year 2004-2005. Local health departments shall

 

target these services to preschool and early elementary aged

 

schoolchildren.

 

 

 

CHRONIC DISEASE AND INJURY PREVENTION AND HEALTH PROMOTION

 

     Sec. 1003. Funds appropriated in part 1 for the Alzheimer's

 

information network shall be used to provide information and

 

referral services through regional networks for persons with

 

Alzheimer's disease or related disorders, their families, and

 


health care providers.

 

     Sec. 1006. (1) In spending the funds appropriated in part 1

 

for the smoking prevention program, priority shall be given to

 

prevention and smoking cessation programs for pregnant women, women

 

with young children, and adolescents.

 

     (2) For purposes of complying with 2004 PA 164, $1,200,000.00

 

of the funds appropriated in part 1 for the smoking prevention

 

program shall be used for the quit kit program that includes the

 

nicotine patch or nicotine gum.

 

     Sec. 1007. (1) The funds appropriated in part 1 for violence

 

prevention shall be used for, but not be limited to, the following:

 

     (a) Programs aimed at the prevention of spouse, partner, or

 

child abuse and rape.

 

     (b) Programs aimed at the prevention of workplace violence.

 

     (2) In awarding grants from the amounts appropriated in part 1

 

for violence prevention, the department shall give equal

 

consideration to public and private nonprofit applicants.

 

     (3) From the funds appropriated in part 1 for violence

 

prevention, the department may include local school districts as

 

recipients of the funds for family violence prevention programs.

 

     Sec. 1009. From the funds appropriated in part 1 for the

 

diabetes and kidney program, a portion of the funds may be

 

allocated to the National Kidney Foundation of Michigan for kidney

 

disease prevention programming including early identification and

 

education programs and kidney disease prevention demonstration

 

projects.

 

     Sec. 1010. From the funds appropriated in part 1 for chronic

 


disease prevention, $400,000.00 may be allocated for osteoporosis

 

prevention and treatment education.

 

     Sec. 1019. From the funds appropriated in part 1 for chronic

 

disease prevention, $50,000.00 may be allocated for stroke

 

prevention, education, and outreach. The objectives of the program

 

shall include education to assist persons in identifying risk

 

factors, and education to assist persons in the early

 

identification of the occurrence of a stroke in order to minimize

 

stroke damage.

 

     Sec. 1028. Contingent on the availability of state restricted

 

healthy Michigan fund money or federal preventive health and health

 

services block grant fund money, funds may be appropriated for the

 

African-American male health initiative.

 

     Sec. 1029. From the funds appropriated in part 1 for the

 

Michigan Parkinson's foundation, $100,000.00 may be appropriated

 

for programs related to Parkinson's disease.

 

     Sec. 1030. (1) From the funds appropriated in part 1, there is

 

allocated an amount not to exceed $0.00 for a statewide before- or

 

after-school program to provide youth with a safe, engaging

 

environment to motivate and inspire learning outside the

 

traditional classroom setting. Before-school programs are limited

 

to elementary school-aged children. Effective before- or after-

 

school programs combine academic, enrichment, and recreation

 

activities to guide learning and inspire children and youth in

 

various activities. The before- or after-school programs can meet

 

the needs of the communities served by the programs.

 

     (2) The department shall work in collaboration with the

 


department of human services and the state board of education.

 

     (3) The department shall, through a competitive bid process,

 

provide grants or contracts up to $0.00 in funds for the program

 

based on community needs. A county shall receive no more than 20%

 

of the funds allocated under this section for this program. The use

 

of funds under this section should not be considered an ongoing

 

commitment of funding.

 

     (4) The before- or after-school programs funded under this

 

section shall include, at a minimum, at least 3 of the following

 

topics:

 

     (a) Abstinence-based pregnancy prevention.

 

     (b) Chemical abuse and dependency including nonmedical

 

services.

 

     (c) Obesity prevention.

 

     (d) Gang violence prevention.

 

     (e) Academic assistance, including assistance with reading and

 

writing.

 

     (f) Preparation toward future self-sufficiency.

 

     (g) Leadership development.

 

     (h) Case management or mentoring.

 

     (i) Parental involvement.

 

     (j) Anger management.

 

     (5) The department may enter into grants or contracts with

 

independent contractors including, but not limited to, faith-based

 

organizations, boys or girls clubs, schools, or nonprofit

 

organizations. The department shall grant priority in funding to

 

independent contractors who secure at least 25% in matching funds.

 


The matching funds may either be fulfilled through local, state, or

 

federal funds or through in-kind or other donations.

 

     (6) A referral to a program may be made by, but is not limited

 

to, any of the following:

 

     (a) A teacher.

 

     (b) A counselor.

 

     (c) A parent.

 

     (d) A police officer.

 

     (e) A judge.

 

     (f) A social worker.

 

     (7) By August 30, 2006, the department before- or after-school

 

expenditures shall be audited and the department shall work in

 

collaboration with independent contractors to provide a report on

 

the before- or after-school program to the senate and house

 

standing committees dealing with community health, human services,

 

and education, the senate and house appropriations subcommittees on

 

community health, the senate and house fiscal agencies, and the

 

senate and house policy offices. The report shall include the

 

number of participants and the average cost per participant, as

 

well as changes noted in program participants in any of the

 

following categories:

 

     (a) Juvenile crime.

 

     (b) Aggressive behavior.

 

     (c) Physical health, nutrition, and conditioning.

 

     (d) Development of new skills and interests.

 

     (e) School attendance and dropout rates.

 

     (f) Behavioral changes in school.

 


     (8) Private foundations may contribute funding to this

 

program, as determined by the department.

 

     Sec. 1031. (1) The department shall collaborate with the state

 

board of education and the department of human services to extend

 

the duration of the Michigan after-school partnership and oversee

 

its efforts to implement the policy recommendations and strategic

 

next steps identified in the Michigan after-school initiative's

 

report of December 15, 2003.

 

     (2) Funds shall be used to leverage other private and public

 

funding to engage the public and private sectors in building and

 

sustaining high-quality and out-of-school-time programs and

 

resources. The cochairs, representing the department, the state

 

board of education, and the department of human services, shall

 

name a fiduciary agent and may authorize the fiduciary agent to

 

expend funds and hire people to accomplish the work of the Michigan

 

after-school partnership.

 

     (3) Participation in the Michigan after-school partnership

 

shall be expanded beyond the membership of the initial Michigan

 

after-school initiative to increase the representation of parents,

 

youth, foundations, employers, and others with experience in

 

education, child care, after-school and youth development services,

 

and crime and violence prevention and to include representation

 

from the Michigan department of labor and economic growth. Each

 

year, on or before December 31, the Michigan after-school

 

partnership shall report its progress in reaching the

 

recommendations set forth in the Michigan after-school initiative's

 

report to the legislature and the governor.

 


 

 

FAMILY, MATERNAL, AND CHILDREN'S HEALTH SERVICES

 

     Sec. 1101. The department shall review the basis for the

 

distribution of funds to local health departments and other public

 

and private agencies for the women, infants, and children food

 

supplement program; family planning; and prenatal care outreach and

 

service delivery support program and indicate the basis upon which

 

any projected underexpenditures by local public and private

 

agencies shall be reallocated to other local agencies that

 

demonstrate need.

 

     Sec. 1104. Before April 1, 2006, the department shall submit a

 

report to the house and senate fiscal agencies and the state budget

 

director on planned allocations from the amounts appropriated in

 

part 1 for local MCH services, prenatal care outreach and service

 

delivery support, family planning local agreements, and pregnancy

 

prevention programs. Using applicable federal definitions, the

 

report shall include information on all of the following:

 

     (a) Funding allocations.

 

     (b) Actual number of women, children, and/or adolescents

 

served and amounts expended for each group for the fiscal year

 

2004-2005.

 

     Sec. 1105. For all programs for which an appropriation is made

 

in part 1, the department shall contract with those local agencies

 

best able to serve clients. Factors to be used by the department in

 

evaluating agencies under this section shall include ability to

 

serve high-risk population groups; ability to serve low-income

 

clients, where applicable; availability of, and access to, service

 


sites; management efficiency; and ability to meet federal

 

standards, when applicable.

 

     Sec. 1106. Each family planning program receiving federal

 

title X family planning funds shall be in compliance with all

 

performance and quality assurance indicators that the United States

 

bureau of community health services specifies in the family

 

planning annual report. An agency not in compliance with the

 

indicators shall not receive supplemental or reallocated funds.

 

     Sec. 1106a. (1) Federal abstinence money expended in part 1

 

for the purpose of promoting abstinence education shall provide

 

abstinence education to teenagers most likely to engage in high-

 

risk behavior as their primary focus, and may include programs that

 

include 9- to 17-year-olds. Programs funded must meet all of the

 

following guidelines:

 

     (a) Teaches the gains to be realized by abstaining from sexual

 

activity.

 

     (b) Teaches abstinence from sexual activity outside of

 

marriage as the expected standard for all school-age children.

 

     (c) Teaches that abstinence is the only certain way to avoid

 

out-of-wedlock pregnancy, sexually transmitted diseases, and other

 

health problems.

 

     (d) Teaches that a monogamous relationship in the context of

 

marriage is the expected standard of human sexual activity.

 

     (e) Teaches that sexual activity outside of marriage is likely

 

to have harmful effects.

 

     (f) Teaches that bearing children out of wedlock is likely to

 

have harmful consequences.

 


     (g) Teaches young people how to avoid sexual advances and how

 

alcohol and drug use increases vulnerability to sexual advances.

 

     (h) Teaches the importance of attaining self-sufficiency

 

before engaging in sexual activity.

 

     (2) Coalitions, organizations, and programs that do not

 

provide contraceptives to minors and demonstrate efforts to include

 

parental involvement as a means of reducing the risk of teens

 

becoming pregnant shall be given priority in the allocations of

 

funds.

 

     (3) Programs and organizations that meet the guidelines of

 

subsection (1) and criteria of subsection (2) shall have the option

 

of receiving all or part of their funds directly from the

 

department of community health.

 

     Sec. 1107. Of the amount appropriated in part 1 for prenatal

 

care outreach and service delivery support, not more than 10% shall

 

be expended for local administration, data processing, and

 

evaluation.

 

     Sec. 1108. The funds appropriated in part 1 for pregnancy

 

prevention programs shall not be used to provide abortion

 

counseling, referrals, or services.

 

     Sec. 1109. (1) From the amounts appropriated in part 1 for

 

dental programs, funds shall be allocated to the Michigan dental

 

association for the administration of a volunteer dental program

 

that would provide dental services to the uninsured in an amount

 

that is no less than the amount allocated to that program in fiscal

 

year 1996-1997.

 

     (2) Not later than December 1 of the current fiscal year, the

 


department shall make available upon request a report to the senate

 

or house of representatives appropriations subcommittee on

 

community health or the senate or house of representatives standing

 

committee on health policy the number of individual patients

 

treated, number of procedures performed, and approximate total

 

market value of those procedures through September 30, 2005.

 

     Sec. 1110. Agencies that currently receive pregnancy

 

prevention funds and either receive or are eligible for other

 

family planning funds shall have the option of receiving all of

 

their family planning funds directly from the department of

 

community health and be designated as delegate agencies.

 

     Sec. 1111. The department shall allocate no less than 87% of

 

the funds appropriated in part 1 for family planning local

 

agreements and the pregnancy prevention program for the direct

 

provision of family planning/pregnancy prevention services.

 

     Sec. 1112. From the funds appropriated in part 1 for prenatal

 

care outreach and service delivery support, the department shall

 

allocate at least $1,000,000.00 to communities with high infant

 

mortality rates.

 

     Sec. 1129. The department shall provide a report annually to

 

the house of representatives and senate appropriations

 

subcommittees on community health, the house and senate fiscal

 

agencies, and the state budget director on the number of children

 

with elevated blood lead levels from information available to the

 

department. The report shall provide the information by county,

 

shall include the level of blood lead reported, and shall indicate

 

the sources of the information.

 


     Sec. 1133. The department shall release infant mortality rate

 

data to all local public health departments no later than 48 hours

 

prior to releasing infant mortality rate data to the public.

 

     Sec. 1135. (1) Provision of the school health education

 

curriculum, such as the Michigan model or another comprehensive

 

school health education curriculum, shall be in accordance with the

 

health education goals established by the Michigan model for the

 

comprehensive school health education state steering committee. The

 

state steering committee shall be comprised of a representative

 

from each of the following offices and departments:

 

     (a) The department of education.

 

     (b) The department of community health.

 

     (c) The health administration in the department of community

 

health.

 

     (d) The bureau of mental health and substance abuse services

 

in the department of community health.

 

     (e) The family independence agency.

 

     (f) The department of state police.

 

     (2) Upon written or oral request, a pupil not less than 18

 

years of age or a parent or legal guardian of a pupil less than 18

 

years of age, within a reasonable period of time after the request

 

is made, shall be informed of the content of a course in the health

 

education curriculum and may examine textbooks and other classroom

 

materials that are provided to the pupil or materials that are

 

presented to the pupil in the classroom. This subsection does not

 

require a school board to permit pupil or parental examination of

 

test questions and answers, scoring keys, or other examination

 


instruments or data used to administer an academic examination.

 

     Sec. 1136. Contingent on the availability of state funds,

 

funds shall be allocated for child advocacy centers.

 

 

 

WOMEN, INFANTS, AND CHILDREN FOOD AND NUTRITION PROGRAM

 

     Sec. 1151. The department may work with local participating

 

agencies to define local annual contributions for the farmer's

 

market nutrition program, project FRESH, to enable the department

 

to request federal matching funds based on local commitment of

 

funds.

 

 

 

CHILDREN'S SPECIAL HEALTH CARE SERVICES

 

     Sec. 1201. Funds appropriated in part 1 for medical care and

 

treatment of children with special health care needs shall be paid

 

according to reimbursement policies determined by the Michigan

 

medical services program. Exceptions to these policies may be taken

 

with the prior approval of the state budget director.

 

     Sec. 1202. The department may do 1 or more of the following:

 

     (a) Provide special formula for eligible clients with

 

specified metabolic and allergic disorders.

 

     (b) Provide medical care and treatment to eligible patients

 

with cystic fibrosis who are 21 years of age or older.

 

     (c) Provide genetic diagnostic and counseling services for

 

eligible families.

 

     (d) Provide medical care and treatment to eligible patients

 

with hereditary coagulation defects, commonly known as hemophilia,

 

who are 21 years of age or older.

 


     Sec. 1203. All children who are determined medically eligible

 

for the children's special health care services program shall be

 

referred to the appropriate locally-based services program in their

 

community.

 

 

 

OFFICE OF DRUG CONTROL POLICY

 

     Sec. 1250. In addition to the $1,800,000.00 in Byrne formula

 

grant program funding the department provides to local drug

 

treatment courts, the department shall provide $1,800,000.00 in

 

Byrne formula grant program funding to the judiciary by

 

interdepartmental grant.

 

 

 

CRIME VICTIM SERVICES COMMISSION

 

     Sec. 1302. From the funds appropriated in part 1 for justice

 

assistance grants, up to $50,000.00 shall be allocated for

 

expansion of forensic nurse examiner programs to facilitate

 

training for improved evidence collection for the prosecution of

 

sexual assault. The funds shall be used for program coordination,

 

training, and counseling. Unexpended funds shall be carried

 

forward.

 

     Sec. 1304. The department shall work with the department of

 

state police, the Michigan hospital association, the Michigan state

 

medical society, and the Michigan nurses association to ensure that

 

the recommendations included in the "Standard Recommended

 

Procedures for the Emergency Treatment of Sexual Assault Victims"

 

are followed in the collection of evidence.

 

 

 


OFFICE OF SERVICES TO THE AGING

 

     Sec. 1401. The appropriation in part 1 to the office of

 

services to the aging, for community and nutrition services and

 

home services, shall be restricted to eligible individuals at least

 

60 years of age who fail to qualify for home care services under

 

title XVIII, XIX, or XX.

 

     Sec. 1403. The office of services to the aging shall require

 

each region to report to the office of services to the aging 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.

 

     Sec. 1404. The area agencies and local providers may receive

 

and expend fees for the provision of day care, care management,

 

respite care, and certain eligible home and community-based

 

services. The fees shall be based on a sliding scale, taking client

 

income into consideration. The fees shall be used to expand

 

services.

 

     Sec. 1406. The appropriation of $5,000,000.00 of tobacco

 

settlement funds to the office of services to the aging for the

 

respite care program shall be allocated in accordance with a long-

 

term care plan developed by the long-term care working group

 

established in section 1657 of 1998 PA 336 upon implementation of

 


Senate Bill No. 267 as amended June 14, 2005

     the plan. The use of the funds shall be for direct respite care or

 

adult respite care center services. Not more than 10% of the amount

 

allocated under this section shall be expended for administration

 

and administrative purposes.

 

     Sec. 1413. The legislature affirms the commitment to locally-

 

based services. The legislature supports the role of local county

 

board of commissioners in the approval of area agency on aging

 

plans. The legislature supports choice and the right of local

 

counties to change membership in the area agencies on aging if the

 

change is to an area agency on aging that is contiguous to that

 

county. The legislature supports the office of services to the

 

aging working with others to provide training to commissions to

 

better understand and advocate for aging issues. It is the intent

 

of the legislature to prohibit area agencies on aging from

 

providing direct services, including home and community-based

 

waiver services, unless they receive a waiver from the department.

 

The legislature's intent in this section is conditioned on

 

compliance with federal and state laws, rules, and policies.

 

     Sec. 1416. The legislature affirms the commitment to provide

 

in-home services, resources, and assistance for the frail elderly

 

who are not being served by the Medicaid home and community-based

 

services waiver program.

<<MEDICAL SERVICES ADMINISTRATION

     Sec. 1501.  Contingent upon recoveries of Medicaid managed care and fee-for-service payments as noted in the auditor general's performance audit of the medical services administration published April 2005, $7,600,000.00, of which $3,800,000.00 is general fund/general purpose funds, shall be authorized within the medical services administration line.>>

 

 

MEDICAL SERVICES

 

     Sec. 1601. The cost of remedial services incurred by residents

 

of licensed adult foster care homes and licensed homes for the aged

 

shall be used in determining financial eligibility for the

 


medically needy. Remedial services include basic self-care and

 

rehabilitation training for a resident.

 

     Sec. 1602. Medical services shall be provided to elderly and

 

disabled persons with incomes less than or equal to 100% of the

 

official poverty line, pursuant to the state's option to elect such

 

coverage set out at section 1902(a)(10)(A)(ii) and (m) of title XIX,

 

42 USC 1396a.

 

     Sec. 1603. (1) The department may establish a program for

 

persons to purchase medical coverage at a rate determined by the

 

department.

 

     (2) The department may receive and expend premiums for the

 

buy-in of medical coverage in addition to the amounts appropriated

 

in part 1.

 

     (3) The premiums described in this section shall be classified

 

as private funds.

 

     Sec. 1605. (1) The protected income level for Medicaid

 

coverage determined pursuant to section 106(1)(b)(iii) of the social

 

welfare act, 1939 PA 280, MCL 400.106, shall be 100% of the related

 

public assistance standard.

 

     (2) The department shall notify the senate and house of

 

representatives appropriations subcommittees on community health

 

and the state budget director of any proposed revisions to the

 

protected income level for Medicaid coverage related to the public

 

assistance standard 90 days prior to implementation.

 

     Sec. 1606. For the purpose of guardian and conservator

 

charges, the department of community health may deduct up to $60.00

 

per month as an allowable expense against a recipient's income when

 


determining medical services eligibility and patient pay amounts.

 

     Sec. 1607. (1) An applicant for Medicaid, whose qualifying

 

condition is pregnancy, shall immediately be presumed to be

 

eligible for Medicaid coverage unless the preponderance of evidence

 

in her application indicates otherwise. The applicant who is

 

qualified as described in this subsection shall be allowed to

 

select or remain with the Medicaid participating obstetrician of

 

her choice.

 

     (2) An applicant qualified as described in subsection (1)

 

shall be given a letter of authorization to receive Medicaid

 

covered services related to her pregnancy. All qualifying

 

applicants shall be entitled to receive all medically necessary

 

obstetrical and prenatal care without preauthorization from a

 

health plan. All claims submitted for payment for obstetrical and

 

prenatal care shall be paid at the Medicaid fee-for-service rate in

 

the event a contract does not exist between the Medicaid

 

participating obstetrical or prenatal care provider and the managed

 

care plan. The applicant shall receive a listing of Medicaid

 

physicians and managed care plans in the immediate vicinity of the

 

applicant's residence.

 

     (3) In the event that an applicant, presumed to be eligible

 

pursuant to subsection (1), is subsequently found to be ineligible,

 

a Medicaid physician or managed care plan that has been providing

 

pregnancy services to an applicant under this section is entitled

 

to reimbursement for those services until such time as they are

 

notified by the department that the applicant was found to be

 

ineligible for Medicaid.

 


     (4) If the preponderance of evidence in an application

 

indicates that the applicant is not eligible for Medicaid, the

 

department shall refer that applicant to the nearest public health

 

clinic or similar entity as a potential source for receiving

 

pregnancy-related services.

 

     (5) The department shall develop an enrollment process for

 

pregnant women covered under this section that facilitates the

 

selection of a managed care plan at the time of application.

 

     Sec. 1610. The department of community health shall provide an

 

administrative procedure for the review of cost report grievances

 

by medical services providers with regard to reimbursement under

 

the medical services program. Settlements of properly submitted

 

cost reports shall be paid not later than 9 months from receipt of

 

the final report.

 

     Sec. 1611. (1) For care provided to medical services

 

recipients with other third-party sources of payment, medical

 

services reimbursement shall not exceed, in combination with such

 

other resources, including Medicare, those amounts established for

 

medical services-only patients. The medical services payment rate

 

shall be accepted as payment in full. Other than an approved

 

medical services copayment, 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. 1615. Unless prohibited by federal or state law or

 

regulation, the department shall require enrolled Medicaid

 

providers to submit their billings for services electronically.

 

     Sec. 1620. (1) For fee-for-service recipients who do not

 

reside in nursing homes, the pharmaceutical dispensing fee shall be

 

$2.50 or the pharmacy's usual or customary cash charge, whichever

 

is less. For nursing home residents, the pharmaceutical dispensing

 

fee shall be $2.75 or the pharmacy's usual or customary cash

 

charge, whichever is less.

 

     (2) The department shall require a prescription copayment for

 

Medicaid recipients of $1.00 for a generic drug, $3.00 for a brand-

 

name drug that has no generic equivalent, and $10.00 for a brand-

 

name drug where a generic equivalent is available, except as

 

prohibited by federal or state law or regulation.

 

     (3) For fee-for-service recipients, an optional mail order

 

pharmacy program shall be available.

 

     Sec. 1623. (1) The department shall continue the Medicaid

 

policy that allows for the dispensing of a 100-day supply for

 

maintenance drugs.

 

     (2) The department shall notify all HMOs, physicians,

 

pharmacies, and other medical providers that are enrolled in the

 


Medicaid program that Medicaid policy allows for the dispensing of

 

a 100-day supply for maintenance drugs.

 

     (3) The notice in subsection (2) shall also clarify that a

 

pharmacy shall fill a prescription written for maintenance drugs in

 

the quantity specified by the physician, but not more than the

 

maximum allowed under Medicaid, unless subsequent consultation with

 

the prescribing physician indicates otherwise.

 

     Sec. 1625. The department shall continue its practice of

 

placing all atypical antipsychotic medications on the Medicaid

 

preferred drug list.

 

     Sec. 1627. (1) The department shall use procedures and rebates

 

amounts specified under section 1927 of title XIX, 42 USC 1396r-8,

 

to secure quarterly rebates from pharmaceutical manufacturers for

 

outpatient drugs dispensed to participants in the MIChild program,

 

maternal outpatient medical services program, state medical

 

program, children's special health care services, and EPIC.

 

     (2) For products distributed by pharmaceutical manufacturers

 

not providing quarterly rebates as listed in subsection (1), the

 

department may require preauthorization.

 

     Sec. 1628. (1) The department shall convene by October 2005 a

 

committee to study the implementation of psychotropic pharmacy

 

administration under Medicare part D for individuals dually

 

enrolled in the Medicare and Medicaid programs. This committee

 

shall study and evaluate the effectiveness of mental health

 

consumer enrollment and medication access through the Medicare part

 

D procedures for pharmaceutical management for dual eligibles.

 

     (2) The committee shall include a representative from each of

 


the following organizations: the medical services administration,

 

the office of services to the aging, the department's mental health

 

and substance abuse services division, mental health association of

 

Michigan, national alliance for the mentally ill of Michigan,

 

Michigan psychiatric society, Michigan association of community 

 

mental health boards, Michigan pharmacists association, Michigan

 

protection and advocacy service, international association of

 

psychosocial rehabilitation services, and the pharmaceutical

 

industry. The committee shall elect a chairperson who is not

 

employed by state government.

 

     (3) The committee shall produce a report by June 15, 2006 to

 

the senate and house of representatives appropriations

 

subcommittees on community health and the senate and house fiscal

 

agencies.

 

     Sec. 1629. The department shall utilize maximum allowable cost

 

pricing for generic drugs that is based on wholesaler pricing to

 

providers that is available from at least 2 wholesalers who deliver

 

in the state of Michigan.

 

     Sec. 1630. (1) Medicaid coverage for podiatric services, adult

 

dental services, and chiropractic services shall continue at not

 

less than the level in effect on October 1, 2002, except that

 

reasonable utilization limitations may be adopted in order to

 

prevent excess utilization. The department shall not impose

 

utilization restrictions on chiropractic services unless a

 

recipient has exceeded 18 office visits within 1 year.

 

     (2) The department shall continue Medicaid coverage for

 

hearing aid services, but may implement the bulk purchase of

 


hearing aids, impose limitations on binaural hearing aid benefits,

 

and limit the replacement of hearing aids to once every 3 years.

 

     Sec. 1631. The department shall require copayments on dental,

 

podiatric, chiropractic, vision, and hearing aid services provided

 

to Medicaid recipients, except as prohibited by federal or state

 

law or regulation.

 

     Sec. 1633. From the funds appropriated in part 1 for auxiliary

 

medical services, the department shall expand the healthy kids

 

dental program statewide if funds become available specifically for

 

expansion of the program.

 

     Sec. 1634. From the funds appropriated in part 1 for ambulance

 

services, the department shall continue the 5% increase in payment

 

rates for ambulance services implemented in fiscal year 2000-2001.

 

     Sec. 1635. (1) Effective October 1, 2005 and subject to

 

federal approval of the necessary waivers, the department shall

 

implement copayments and deductibles for Medicaid fee-for-services

 

based on the following criteria:

 

     (a) A $25.00 copayment for nonemergency use of emergency

 

department services.

 

     (b) A copayment on fee-for-service physician services

 

sufficient to lead to a $3,000,000.00 general fund/general purpose

 

funds reduction in expenditures.

 

     (c) A copayment on the first day of fee-for-service hospital

 

services sufficient to lead to a $500,000.00 general fund/general

 

purpose funds reduction in expenditures.

 

     (d) A copayment on durable medical equipment sufficient to

 

lead to a $1,500,000.00 general fund/general purpose funds

 


reduction in expenditures.

 

     (e) A deductible for nonemergency transportation services

 

sufficient to produce a $500,000.00 general fund/general purpose

 

funds reduction in expenditures.

 

     (2) The department may establish disease management programs

 

with lower copayments and deductibles than those described in

 

subsection (1).

 

     (3) By August 1, 2005, the department shall submit a waiver

 

request to the centers for Medicare and Medicaid services to allow

 

for the implementation of the copayments and deductibles described

 

in subsection (1).

 

     Sec. 1636. (1) Effective October 1, 2005 and subject to

 

federal approval of the necessary waivers, the department shall

 

implement a system of premiums for Medicaid clients subject to the

 

following conditions:

 

     (a) Disabled individuals, nursing home residents, and pregnant

 

women shall be exempt from any premiums.

 

     (b) Premiums shall be assessed on a sliding scale based on

 

family income.

 

     (c) Adults who sign a personal responsibility agreement as

 

described in section 1637 shall be charged premiums that are 25% as

 

large as the premiums paid by adults who do not sign a personal

 

responsibility agreement or who have violated the terms of their

 

personal responsibility agreement.

 

     (d) The overall premium package shall be set so that the

 

average premium paid by or on behalf of a Medicaid client not

 

exempted in subdivision (a) shall be $5.00 per month.

 


Senate Bill No. 267 as amended June 9, 2005

     (2) By August 1, 2005, the department shall submit a waiver

 

request to the centers for Medicare and Medicaid services to allow

 

for the implementation of the premium system described in

 

subsection (1).

 

     Sec. 1637. (1) All adult Medicaid recipients shall be offered

 

the opportunity to sign a Medicaid personal responsibility

 

agreement.

 

     (2) Those adult Medicaid recipients who sign such a personal

 

responsibility agreement shall be charged lower premiums subject to

 

the conditions of section 1636(1)(c).

 

     (3) The personal responsibility agreement may include at

 

minimum the following requirements:

 

     (a) That the recipient shall not smoke.

 

     (b) That the recipient shall attend all scheduled medical

 

appointments.

 

     (c) That the recipient shall exercise regularly.

 

     (d) That if the recipient has children, those children shall

 

be up-to-date on their immunizations.

     <<(e) That the recipient shall abstain from abusing controlled substances and narcotics.>>

     (4) All adult Medicaid recipients, whether or not they have

 

signed a personal responsibility agreement, shall have an annual

 

health assessment with a physician.

 

     (5) At the annual health assessment, all adult Medicaid

 

recipients who have signed a personal responsibility agreement

 

shall be required to submit to a test to determine whether or not

 

they have smoked.

 

     (6) If an adult Medicaid recipient who has signed a personal

 

responsibility agreement is found to have smoked, to have not

 


attended all scheduled medical appointments, or if his or her

 

children are not up-to-date on their immunizations, he or she shall

 

be subject to the higher premium scale set for those who did not

 

sign the personal responsibility agreement, as described in section

 

1636(1)(c).

 

     Sec. 1639. The department in cooperation with the department

 

of human services may produce a survey by July 1, 2006 identifying

 

the businesses in this state that have the highest number of their

 

employees enrolled in the state Medicaid and MIChild programs. If a

 

survey is produced, the survey shall be provided to the senate and

 

house standing committees on appropriations, the senate and house

 

fiscal agencies, and the state budget director.

 

     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. 1643. Of the funds appropriated in part 1 for graduate

 

medical education in the hospital services and therapy line item

 

appropriation, the federal share and the allowable Medicaid

 

matching funds shall be allocated for the psychiatric residency

 

training program that establishes and maintains collaborative

 

relations with the schools of medicine at Michigan State University

 

and Wayne State University if the necessary allowable Medicaid

 

matching funds are provided by the universities.

 

     Sec. 1647. From the funds appropriated in part 1 for medical

 

services, the department shall allocate for graduate medical

 

education not less than the level of rates and payments in effect

 


on May 1, 2005.

 

     Sec. 1648. The department shall maintain an automated toll-

 

free phone line to enable medical providers to verify the

 

eligibility status of Medicaid recipients. There shall be no charge

 

to providers for the use of the toll-free phone line.

 

     Sec. 1649. From the funds appropriated in part 1 for medical

 

services, the department shall continue breast and cervical cancer

 

treatment coverage for women up to 250% of the federal poverty

 

level, who are under age 65, and who are not otherwise covered by

 

insurance. This coverage shall be provided to women who have been

 

screened through the centers for disease control breast and

 

cervical cancer early detection program, and are found to have

 

breast or cervical cancer, pursuant to the breast and cervical

 

cancer prevention and treatment act of 2000, Public Law 106-354,

 

114 Stat. 1381.

 

     Sec. 1650. (1) The department may require medical services

 

recipients residing in counties offering managed care options to

 

choose the particular managed care plan in which they wish to be

 

enrolled. Persons not expressing a preference may be assigned to a

 

managed care provider.

 

     (2) Persons to be assigned a managed care provider shall be

 

informed in writing of the criteria for exceptions to capitated

 

managed care enrollment, their right to change HMOs for any reason

 

within the initial 90 days of enrollment, the toll-free telephone

 

number for problems and complaints, and information regarding

 

grievance and appeals rights.

 

     (3) The criteria for medical exceptions to HMO enrollment

 


shall be based on submitted documentation that indicates a

 

recipient has a serious medical condition, and is undergoing active

 

treatment for that condition with a physician who does not

 

participate in 1 of the HMOs. If the person meets the criteria

 

established by this subsection, the department shall grant an

 

exception to mandatory enrollment at least through the current

 

prescribed course of treatment, subject to periodic review of

 

continued eligibility.

 

     Sec. 1651. (1) Medical services patients who are enrolled in

 

HMOs have the choice to elect hospice services or other services

 

for the terminally ill that are offered by the HMOs. If the patient

 

elects hospice services, those services shall be provided in

 

accordance with part 214 of the public health code, 1978 PA 368,

 

MCL 333.21401 to 333.21420.

 

     (2) The department shall not amend the medical services

 

hospice manual in a manner that would allow hospice services to be

 

provided without making available all comprehensive hospice

 

services described in 42 CFR part 418.

 

     Sec. 1653. Implementation and contracting for managed care by

 

the department through HMOs shall be subject to the following

 

conditions:

 

     (a) Continuity of care is assured by allowing enrollees to

 

continue receiving required medically necessary services from their

 

current providers for a period not to exceed 1 year if enrollees

 

meet the managed care medical exception criteria.

 

     (b) The department shall require contracted HMOs to submit

 

data determined necessary for evaluation on a timely basis.

 


     (c) Mandatory enrollment of Medicaid beneficiaries living in

 

counties defined as rural by the federal government, which is any

 

nonurban standard metropolitan statistical area, is allowed if

 

there is only 1 HMO serving the Medicaid population, as long as

 

each Medicaid beneficiary is assured of having a choice of at least

 

2 physicians by the HMO.

 

     (d) Enrollment of recipients of children's special health care

 

services in HMOs shall be voluntary.

 

     (e) The department shall develop a case adjustment to its rate

 

methodology that considers the costs of persons with HIV/AIDS, end

 

stage renal disease, organ transplants, and other high-cost

 

diseases or conditions and shall implement the case adjustment when

 

it is proven to be actuarially and fiscally sound. Implementation

 

of the case adjustment must be budget neutral.

 

     Sec. 1654. Medicaid HMOs shall provide for reimbursement of

 

HMO covered services delivered other than through the HMO's

 

providers if medically necessary and approved by the HMO,

 

immediately required, and that could not be reasonably obtained

 

through the HMO's providers on a timely basis. Such services shall

 

be considered approved if the HMO does not respond to a request for

 

authorization within 24 hours of the request. Reimbursement shall

 

not exceed the Medicaid fee-for-service payment for those services.

 

     Sec. 1655. (1) The department may require a 12-month lock-in

 

to the HMO selected by the recipient during the initial and

 

subsequent open enrollment periods, but allow for good cause

 

exceptions during the lock-in period.

 

     (2) Medicaid recipients shall be allowed to change HMOs for

 


any reason within the initial 90 days of enrollment.

 

     Sec. 1656. (1) The department shall provide an expedited

 

complaint review procedure for Medicaid eligible persons enrolled

 

in HMOs for situations in which failure to receive any health care

 

service would result in significant harm to the enrollee.

 

     (2) The department shall provide for a toll-free telephone

 

number for Medicaid recipients enrolled in managed care to assist

 

with resolving problems and complaints. If warranted, the

 

department shall immediately disenroll persons from managed care

 

and approve fee-for-service coverage.

 

     (3) Annual reports summarizing the problems and complaints

 

reported and their resolution shall be provided to the house of

 

representatives and senate appropriations subcommittees on

 

community health, the house and senate fiscal agencies, and the

 

state budget office.

 

     Sec. 1657. (1) Reimbursement for medical services to screen

 

and stabilize a Medicaid recipient, including stabilization of a

 

psychiatric crisis, in a hospital emergency room shall not be made

 

contingent on obtaining prior authorization from the recipient's

 

HMO. If the recipient is discharged from the emergency room, the

 

hospital shall notify the recipient's HMO within 24 hours of the

 

diagnosis and treatment received.

 

     (2) If the treating hospital determines that the recipient

 

will require further medical service or hospitalization beyond the

 

point of stabilization, that hospital must receive authorization

 

from the recipient's HMO prior to admitting the recipient.

 

     (3) Subsections (1) and (2) shall not be construed as a

 


requirement to alter an existing agreement between an HMO and their

 

contracting hospitals nor as a requirement that an HMO must

 

reimburse for services that are not considered to be medically

 

necessary.

 

     (4) Prior to contracting with an HMO for managed care services

 

that did not have a contract with the department before October 1,

 

2002, the department shall receive assurances from the office of

 

financial and insurance services that the HMO meets the net worth

 

and financial solvency requirements contained in chapter 35 of the

 

insurance code of 1956, 1956 PA 218, MCL 500.3501 to 500.3580.

 

     Sec. 1658. (1) It is the intent of the legislature that HMOs

 

shall have contracts with hospitals within a reasonable distance

 

from their enrollees. If a hospital does not contract with the HMO,

 

in its service area, that hospital shall enter into a hospital

 

access agreement as specified in the MSA bulletin Hospital 01-19.

 

     (2) A hospital access agreement specified in subsection (1)

 

shall be considered an affiliated provider contract pursuant to the

 

requirements contained in chapter 35 of the insurance code of 1956,

 

1956 PA 218, MCL 500.3501 to 500.3580.

 

     Sec. 1659. The following sections are the only ones that shall

 

apply to the following Medicaid managed care programs, including

 

the comprehensive plan, children's special health care services

 

plan, MIChoice long-term care plan, and the mental health,

 

substance abuse, and developmentally disabled services program:

 

401, 402, 404, 414, 418, 424, 428, 1650, 1651, 1653, 1654, 1655,

 

1656, 1657, 1658, 1660, 1661, 1662, 1664, and 1699.

 

     Sec. 1660. (1) The department shall assure that all Medicaid

 


children have timely access to EPSDT services as required by

 

federal law. Medicaid HMOs shall provide EPSDT services to their

 

child members in accordance with Medicaid EPSDT policy.

 

     (2) The primary responsibility of assuring a child's hearing

 

and vision screening is with the child's primary care provider. The

 

primary care provider shall provide age appropriate screening or

 

arrange for these tests through referrals to local health

 

departments. Local health departments shall provide preschool

 

hearing and vision screening services and accept referrals for

 

these tests from physicians or from Head Start programs in order to

 

assure all preschool children have appropriate access to hearing

 

and vision screening. Local health departments shall be reimbursed

 

for the cost of providing these tests for Medicaid eligible

 

children by the Medicaid program.

 

     (3) The department shall require Medicaid HMOs to provide

 

EPSDT utilization data through the encounter data system, and

 

health employer data and information set well child health measures

 

in accordance with the National Committee on Quality Assurance

 

prescribed methodology.

 

     (4) The department shall require HMOs to be responsible for

 

well child visits and maternal and infant support services as

 

described in Medicaid policy. These responsibilities shall be

 

specified in the information distributed by the HMOs to their

 

members.

 

     (5) The department shall provide, on an annual basis, budget

 

neutral incentives to Medicaid HMOs and local health departments to

 

improve performance on measures related to the care of children and

 


pregnant women.

 

     Sec. 1661. (1) The department shall assure that all Medicaid

 

eligible children and pregnant women have timely access to MSS/ISS

 

services. Medicaid HMOs shall assure that maternal support service

 

screening is available to their pregnant members and that those

 

women found to meet the maternal support service high-risk criteria

 

are offered maternal support services. Local health departments

 

shall assure that maternal support service screening is available

 

for Medicaid pregnant women not enrolled in an HMO and that those

 

women found to meet the maternal support service high-risk criteria

 

are offered maternal support services or are referred to a

 

certified maternal support service provider.

 

     (2) The department shall prohibit HMOs from requiring prior

 

authorization of their contracted providers for any EPSDT screening

 

and diagnosis service, for any MSS/ISS screening referral, or for

 

up to 3 MSS/ISS service visits.

 

     (3) The department shall assure the coordination of MSS/ISS

 

services with the WIC program, state-supported substance abuse,

 

smoking prevention, and violence prevention programs, the family

 

independence agency, and any other state or local program with a

 

focus on preventing adverse birth outcomes and child abuse and

 

neglect.

 

   Sec. 1662. (1) The department shall assure that an external

 

quality review of each contracting HMO is performed that results in

 

an analysis and evaluation of aggregated information on quality,

 

timeliness, and access to health care services that the HMO or its

 

contractors furnish to Medicaid beneficiaries.

 


   (2) The department shall provide a copy of the analysis of the

 

Medicaid HMO annual audited health employer data and information

 

set reports and the annual external quality review report to the

 

senate and house of representatives appropriations subcommittees on

 

community health, the senate and house fiscal agencies, and the

 

state budget director, within 30 days of the department's receipt

 

of the final reports from the contractors.

 

   (3) The department shall work with the Michigan association of

 

health plans and the Michigan association for local public health

 

to improve service delivery and coordination in the MSS/ISS and

 

EPSDT programs.

 

   (4) The department shall assure that training and technical

 

assistance are available for EPSDT and MSS/ISS for Medicaid health

 

plans, local health departments, and MSS/ISS contractors.

 

   Sec. 1670.  (1) The appropriation in part 1 for the MIChild

 

program is to be used to provide comprehensive health care to all

 

children under age 19 who reside in families with income at or

 

below 200% of the federal poverty level, who are uninsured and have

 

not had coverage by other comprehensive health insurance within 6

 

months of making application for MIChild benefits, and who are

 

residents of this state.  The department shall develop detailed

 

eligibility criteria through the medical services administration

 

public concurrence process, consistent with the provisions of this

 

act.  Health care coverage for children in families below 150% of

 

the federal poverty level shall be provided through expanded

 

eligibility under the state's Medicaid program.  Health coverage

 

for children in families between 150% and 200% of the federal

 


poverty level shall be provided through a state-based private

 

health care program.

 

   (2) The department may provide up to 1 year of continuous

 

eligibility to children eligible for the MIChild program unless the

 

family fails to pay the monthly premium, a child reaches age 19, or

 

the status of the children’s family changes and its members no

 

longer meet the eligibility criteria as specified in the federally

 

approved MIChild state plan.

 

   (3) Children whose category of eligibility changes between the

 

Medicaid and MIChild programs shall be assured of keeping their

 

current health care providers through the current prescribed course

 

of treatment for up to 1 year, subject to periodic reviews by the

 

department if the beneficiary has a serious medical condition and

 

is undergoing active treatment for that condition.

 

   (4) To be eligible for the MIChild program, a child must be

 

residing in a family with an adjusted gross income of less than or

 

equal to 200% of the federal poverty level.  The department’s

 

verification policy shall be used to determine eligibility.

 

   (5) The department shall enter into a contract to obtain MIChild

 

services from any Medicaid HMO or dental care corporation that

 

offers to provide the managed health care benefits for MIChild

 

services at the MIChild capitated rate.  As used in this

 

subsection:

 

   (a) "Dental care corporation", "health care corporation",

 

"insurer", and "prudent purchaser agreement" mean those terms as

 

defined in section 2 of the prudent purchaser act, 1984 PA 233, MCL

 

550.52.

 


   (b) "Entity" means a health care corporation or insurer

 

operating in accordance with a prudent purchaser agreement.

 

   (6) The department may enter into contracts to obtain certain

 

MIChild services from community mental health service programs.

 

   (7) The department may make payments on behalf of children

 

enrolled in the MIChild program from the line-item appropriation

 

associated with the program as described in the MIChild state plan

 

approved by the United States department of health and human

 

services, or from other medical services line-item appropriations

 

providing for specific health care services.

 

     Sec. 1671. From the funds appropriated in part 1, the

 

department shall continue a comprehensive approach to the marketing

 

and outreach of the MIChild program. The marketing and outreach

 

required under this section shall be coordinated with current

 

outreach, information dissemination, and marketing efforts and

 

activities conducted by the department.

 

     Sec. 1673. The department may establish premiums for MIChild

 

eligible persons in families with income above 150% of the federal

 

poverty level. The monthly premiums shall not exceed $15.00 for a

 

family.

 

     Sec. 1680. (1) It is the intent of the legislature that

 

payment increases for enhanced wages and new or enhanced employee

 

benefits provided in previous years through the Medicaid nursing

 

home wage pass-through program be continued in fiscal year 2005-

 

2006.

 

     (2) The department shall provide a report to the house and

 

senate appropriations subcommittees on community health and the

 


house and senate fiscal agencies regarding the amount of nursing

 

home employee wage and benefit increases provided in fiscal year

 

2004-2005 through the Medicaid nursing home wage pass-through

 

program implemented in previous years.

 

     (3) The department shall not implement any increase or

 

decrease in the Medicaid nursing home wage pass-through program in

 

fiscal year 2004-2005.

 

     Sec. 1681. From the funds appropriated in part 1 for home and

 

community-based services, the department and local waiver agents

 

shall encourage the use of family members, friends, and neighbors

 

of home and community-based services participants, where

 

appropriate, to provide homemaker services, meal preparation,

 

transportation, chore services, and other nonmedical covered

 

services to participants in the Medicaid home and community-based

 

services program. This section shall not be construed as allowing

 

for the payment of family members, friends, or neighbors for these

 

services unless explicitly provided for in federal or state law.

 

     Sec. 1682. (1) The department shall implement enforcement

 

actions as specified in the nursing facility enforcement provisions

 

of section 1919 of title XIX, 42 USC 1396r.

 

     (2) The department is authorized to receive and spend penalty

 

money received as the result of noncompliance with medical services

 

certification regulations. Penalty money, characterized as private

 

funds, received by the department shall increase authorizations and

 

allotments in the long-term care accounts.

 

     (3) Any unexpended penalty money, at the end of the year,

 

shall carry forward to the following year.

 


Senate Bill No. 267 as amended June 14, 2005

     Sec. 1683. The department shall promote activities that

 

preserve the dignity and rights of terminally ill and chronically

 

ill individuals. Priority shall be given to programs, such as

 

hospice, that focus on individual dignity and quality of care

 

provided persons with terminal illness and programs serving persons

 

with chronic illnesses that reduce the rate of suicide through the

 

advancement of the knowledge and use of improved, appropriate pain

 

management for these persons; and initiatives that train health

 

care practitioners and faculty in managing pain, providing

 

palliative care, and suicide prevention.

     <<Sec. 1684.  Of the funds appropriated in part 1 for the Medicaid home- and community-based services waiver program, no more than $6.30 per person per day shall be allocated for administrative expenses.>>

     Sec. 1685. All nursing home rates, class I and class III, must

 

have their respective fiscal year rate set 30 days prior to the

 

beginning of their rate year. Rates may take into account the most

 

recent cost report prepared and certified by the preparer, provider

 

corporate owner or representative as being true and accurate, and

 

filed timely, within 5 months of the fiscal year end in accordance

 

with Medicaid policy. If the audited version of the last report is

 

available, it shall be used. Any rate factors based on the filed

 

cost report may be retroactively adjusted upon completion of the

 

audit of that cost report.

 

     Sec. 1687. (1) From the funds appropriated in part 1 for long-

 

term care services, the department shall contract with a stand

 

alone psychiatric facility that provides at least 20% of its total

 

care to Medicaid recipients to provide access to Medicaid

 

recipients who require specialized Alzheimer's disease or dementia

 

care.

 

     (2) The department shall report to the senate and house

 


appropriations subcommittees on community health and the senate and

 

house fiscal agencies on the effectiveness of the contract required

 

under subsection (1) to improve the quality of services to Medicaid

 

recipients.

 

     Sec. 1688. The department shall not impose a limit on per unit

 

reimbursements to service providers that provide personal care or

 

other services under the Medicaid home and community-based waiver

 

program for the elderly and disabled. The department's per day per

 

client reimbursement cap calculated in the aggregate for all

 

services provided under the Medicaid home and community-based

 

waiver is not a violation of this section.

 

     Sec. 1689. (1) Priority in enrolling additional persons in the

 

Medicaid home and community-based services program shall be given

 

to those who are currently residing in nursing homes or who are

 

eligible to be admitted to a nursing home if they are not provided

 

home and community-based services. The department shall implement

 

screening and assessment procedures to assure that no additional

 

Medicaid eligible persons are admitted to nursing homes who would

 

be more appropriately served by the Medicaid home and community-

 

based services program. If there is a net decrease in the number of

 

Medicaid nursing home days of care during the most recent quarter

 

in comparison with the previous quarter and a net cost savings

 

attributable to moving individuals from a nursing home to the home

 

and community-based services waiver program, the department shall

 

transfer the net cost savings to the home and community-based

 

services waiver program. If a transfer is required, it shall be

 

done on a quarterly basis.

 


Senate Bill No. 267 as amended June 14, 2005

     (2) Within 30 days of the end of each fiscal quarter, the

 

department shall provide a report to the senate and house

 

appropriations subcommittees on community health and the senate and

 

house fiscal agencies that details existing and future allocations

 

for the home and community-based waiver program by regions as well

 

as the associated expenditures. The report shall include

 

information regarding the net cost savings from moving individuals

 

from a nursing home to the home and community-based services waiver

 

program and the amount of funds transferred.

 

     (3) The department shall utilize a competitive bid process to

 

award funds for the implementation of the new screening process to

 

be applied to home and community-based services and nursing

 

facility services provided by Medicaid.

     <<Sec. 1690. The department may work with the federal government to establish an estate preservation program as recommended by the Michigan Medicaid long-term care task force.>>

     Sec. 1692. (1) The department of community health 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 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 adjustor payments appropriation in part

 

1 may be increased if the department submits a medical services

 

state plan amendment pertaining to this line item at a level higher

 

than the appropriation. The department is authorized to

 

appropriately adjust financing sources in accordance with the

 

increased appropriation.

 

     Sec. 1694. The department of community health shall distribute

 

$695,000.00 to children's hospitals that have a high indigent care

 

volume. The amount to be distributed to any given hospital shall be

 

based on a formula determined by the department of community

 

health.

 

     Sec. 1697. (1) As may be allowed by federal law or regulation,

 

the department may use funds provided by a local or intermediate

 

school district, which have been obtained from a qualifying health

 

system, as the state match required for receiving federal Medicaid

 

or children health insurance program funds. Any such funds received

 

shall be used only to support new school-based or school-linked

 

health services.

 

     (2) A qualifying health system is defined as any health care

 

entity licensed to provide health care services in the state of

 

Michigan, that has entered into a contractual relationship with a

 


local or intermediate school district to provide or manage school-

 

based or school-linked health services.

 

     Sec. 1699. The department may make separate payments directly

 

to qualifying hospitals serving a disproportionate share of

 

indigent patients. If direct payment for DSH is made to qualifying

 

hospitals for services to Medicaid clients, hospitals will not

 

include DSH payments in their contracts with HMOs.

 

     Sec. 1710. Any proposed changes by the department to the

 

MIChoice home and community-based services waiver program screening

 

process shall be provided to the members of the house and senate

 

appropriations subcommittees on community health prior to

 

implementation of the proposed changes.

 

     Sec. 1711. (1) The department shall maintain the 2-tier

 

reimbursement methodology for Medicaid emergency physicians

 

professional services that was in effect on September 30, 2002,

 

subject to the following conditions:

 

     (a) Payments by case and in the aggregate shall not exceed 70%

 

of Medicare payment rates.

 

     (b) Total expenditures for these services shall not exceed the

 

level of total payments made during fiscal year 2001-2002, after

 

adjusting for Medicare copayments and deductibles and for changes

 

in utilization.

 

     (2) To ensure that total expenditures stay within the spending

 

constraints of subsection (1)(b), the department shall develop a

 

utilization adjustor for the basic 2-tier payment methodology. The

 

adjustor shall be based on a good faith estimate by the department

 

as to what the expected utilization of emergency room services will

 


be during fiscal year 2005-2006, given changes in the number and

 

category of Medicaid recipients. If expenditure and utilization

 

data indicate that the amount and/or type of emergency physician

 

professional services are exceeding the department's estimate, the

 

utilization adjustor shall be applied to the 2-tier reimbursement

 

methodology in such a manner as to reduce aggregate expenditures to

 

the fiscal year 2001-2002 adjusted expenditure target.

 

     Sec. 1712. (1) Subject to the availability of funds, the

 

department shall implement a rural health initiative. Available

 

funds shall first be allocated as an outpatient adjustor payment to

 

be paid directly to hospitals in rural counties in proportion to

 

each hospital's Medicaid and indigent patient population.

 

Additional funds, if available, shall be allocated for

 

defibrillator grants, EMT training and support, or other similar

 

programs.

 

     (2) Except as otherwise specified in this section, "rural"

 

means a county, city, village, or township with a population of not

 

more than 30,000, including those entities if located within a

 

metropolitan statistical area.

 

     Sec. 1713. (1) The department, in conjunction with the

 

Michigan dental association, shall undertake a study to determine

 

the level of participation by Michigan licensed dentists in the

 

state's Medicaid program. The study shall identify the distribution

 

of dentists throughout the state, the volume of Medicaid recipients

 

served by each participating dentist, and areas in the state

 

underserved for dental services.

 

     (2) The study described in subsection (1) shall also include

 


an assessment of what factors may be related to the apparent low

 

participation by dentists in the Medicaid program, and the study

 

shall make recommendations as to how these barriers to

 

participation may be reduced or eliminated.

 

     (3) This study shall be provided to the senate and house

 

appropriations subcommittees on community health and the senate and

 

house fiscal agencies no later than April 1, 2006.

 

     Sec. 1717. (1) The department shall create 2 pools for

 

distribution of disproportionate share hospital funding. The first

 

pool, totaling $45,000,000.00, shall be distributed using the

 

distribution methodology used in fiscal year 2003-2004. The second

 

pool, totaling $5,000,000.00, shall be distributed to unaffiliated

 

hospitals and hospital systems that received less than $900,000.00

 

in disproportionate share hospital payments in fiscal year 2003-

 

2004 based on a formula that is weighted proportional to the

 

product of each eligible system's Medicaid revenue and each

 

eligible system's Medicaid utilization.

 

     (2) By November 1, 2005, the department shall report to the

 

senate and house appropriations subcommittees on community health

 

and the senate and house fiscal agencies on the new distribution of

 

funding to each eligible hospital from the 2 pools.

 

     Sec. 1718. The department shall provide each Medicaid adult

 

home help beneficiary or applicant with the right to a fair hearing

 

when the department or its agent reduces, suspends, terminates, or

 

denies adult home help services. If the department takes action to

 

reduce, suspend, terminate, or deny adult home help services, it

 

shall provide the beneficiary or applicant with a written notice

 


that states what action the department proposes to take, the

 

reasons for the intended action, the specific regulations that

 

support the action, and an explanation of the beneficiary's or

 

applicant's right to an evidentiary hearing and the circumstances

 

under which those services will be continued if a hearing is

 

requested.

 

     Sec. 1722. The department is authorized to make a

 

disproportionate share payment to a hospital above the

 

appropriation in part 1 if the necessary Medicaid matching funds

 

are provided by, or on behalf of, the hospital as allowable state

 

match.

 

     Sec. 1724. The department shall allow licensed pharmacies to

 

purchase injectable drugs for the treatment of respiratory

 

syncytial virus for shipment to physicians' offices to be

 

administered to specific patients. If the affected patients are

 

Medicaid eligible, the department shall reimburse pharmacies for

 

the dispensing of the injectable drugs and reimburse physicians for

 

the administration of the injectable drugs.

 

     Sec. 1725. Effective on October 1, 2005, a licensed hospital

 

bed that is under contract with this state for ventilator dependent

 

care shall be considered an acute care bed for purposes of the

 

hospital quality assessment program and shall be assessed and

 

reimbursed under the quality assessment program the same as an

 

acute care bed regardless of payment methodology. This policy

 

change shall be implemented after the department of community

 

health secures the necessary state plan amendment from the federal

 

government.

 


     Sec. 1726. Any clinical laboratory performing a creatinine

 

test on a Medicaid client shall report the glomerular filtration

 

rate (eGFR) of the patient and shall report it as a percent of

 

kidney function remaining.

 

     Sec. 1727. In order to increase tetanus/diphtheria

 

immunization compliance for those 65 years of age or older, the

 

department shall offer tetanus/diphtheria immunization in

 

conjunction with its mandatory annual provision of influenza

 

immunization to those residing in long-term care facilities.

 

     Sec. 1728. The department shall make available to qualifying

 

Medicaid recipients, not based on Medicare guidelines,

 

freestanding, electric, lifting, and transferring devices.

 

     Sec. 1729. From the funds appropriated in part 1 for health

 

plan services, the department shall assure that GME funds are

 

distributed to qualifying hospitals using a methodology developed

 

in consultation with the graduate medical education advisory group.

 

The advisory group shall include representatives of the Michigan

 

health and hospital association and Michigan association of health

 

plans. If the department and the advisory group are unable to reach

 

a consensus on the distribution methodology, the department shall

 

initiate a legislative transfer to transfer the GME funds from

 

health plan services to hospital services and therapy and

 

distribute the GME funds using the mechanism in place in fiscal

 

year 2003-2004.