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.