September 15, 2005, Introduced by Reps. Baxter, Vander Veen, Hoogendyk, Marleau, Rocca, Amos, Shaffer, Hummel, Green, Gosselin, Stahl, Taub, Robertson, Hildenbrand, Caswell, Ball and Nitz and referred to the Committee on Family and Children Services.
A bill to amend 1939 PA 280, entitled
"The social welfare act,"
by amending sections 57b and 106 (MCL 400.57b and 400.106), section
57b as amended by 1999 PA 9 and section 106 as amended by 2004 PA
409.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
Sec. 57b. (1) Subject to section 57l, an individual who meets
all of the following requirements is eligible for family
independence assistance:
(a) Is a member of a family or a family independence
assistance group.
(b) Is a member of a program group whose income and assets are
less
than the income and asset limits set by the family
independence
agency department.
(c) In the case of a minor parent, meets the requirements of
subsection (2).
(d) Is a United States citizen, a permanent resident alien, or
a refugee.
(e) Is a resident of this state as described in section 32.
(f) Provides proof of identification and proof of United
States citizenship.
(g) (f)
Meets any other eligibility criterion required for
the
receipt of federal or state funds or determined by the family
independence
agency department to be necessary for the
accomplishment of the goals of the family independence program.
(2) A minor parent and the minor parent's child shall not
receive family independence assistance unless they live in an
adult-supervised household. The family independence assistance
shall be paid on behalf of the minor parent and child to an adult
in the adult-supervised household. Child care in conjunction with
participation in education, employment readiness, training, or
employment
programs, which that
have been approved by the family
independence
agency department, shall be provided for the minor
parent's child. The minor parent and child shall live with the
minor parent's parent, stepparent, or legal guardian unless the
family
independence agency department
determines that there is
good cause for not requiring the minor parent and child to live
with
a parent, stepparent, or legal guardian. The family
independence
agency department shall determine the circumstances
that constitute good cause, based on a parent's, stepparent's, or
guardian's unavailability or unwillingness or based on a reasonable
belief that there is physical, sexual, or substance abuse, or
domestic violence, occurring in the household, or that there is
other risk to the physical or emotional health or safety of the
minor
parent or child. If the family independence agency
department determines that there is good cause for not requiring a
minor parent to live with a parent, stepparent, or legal guardian,
the minor parent and child shall live in another adult-supervised
household. A local office director may waive the requirement set
forth in this subsection with respect to a minor parent who is at
least 17 years of age, attending secondary school full-time, and
participating
in a department service
plan of the family
independence
agency or a teen parenting program, if moving would
require the minor parent to change schools.
Sec. 106. (1) A medically indigent individual is defined as:
(a) An individual receiving family independence program
benefits or an individual receiving supplemental security income
under title XVI or state supplementation under title XVI subject to
limitations imposed by the director according to title XIX.
(b) Except as provided in section 106a, an individual who
meets all of the following conditions:
(i) The individual has applied in the manner the family
independence
agency department prescribes.
(ii) The individual's need for the type of medical assistance
available under this act for which the individual applied has been
professionally established and payment for it is not available
through the legal obligation of a public or private contractor to
pay or provide for the care without regard to the income or
resources
of the patient. The state department is subrogated to
any right of recovery that a patient may have for the cost of
hospitalization, pharmaceutical services, physician services,
nursing services, and other medical services not to exceed the
amount
of funds expended by the state department for the care and
treatment of the patient. The patient or other person acting in the
patient's behalf shall execute and deliver an assignment of claim
or other authorizations as necessary to secure the right of
recovery to the department. A payment may be withheld under this
act for medical assistance for an injury or disability for which
the individual is entitled to medical care or reimbursement for the
cost of medical care under sections 3101 to 3179 of the insurance
code of 1956, 1956 PA 218, MCL 500.3101 to 500.3179, or under
another policy of insurance providing medical or hospital benefits,
or both, for the individual unless the individual's entitlement
to that medical care or reimbursement is at issue. If a payment is
made,
the state department, to enforce its subrogation right, may
do either of the following: (a) intervene or join in an action or
proceeding brought by the injured, diseased, or disabled
individual, the individual's guardian, personal representative,
estate, dependents, or survivors, against the third person who may
be liable for the injury, disease, or disability, or against
contractors, public or private, who may be liable to pay or provide
medical care and services rendered to an injured, diseased, or
disabled individual; (b) institute and prosecute a legal
proceeding against a third person who may be liable for the injury,
disease, or disability, or against contractors, public or private,
who may be liable to pay or provide medical care and services
rendered to an injured, diseased, or disabled individual, in state
or federal court, either alone or in conjunction with the injured,
diseased, or disabled individual, the individual's guardian,
personal representative, estate, dependents, or survivors. The
state department may institute the proceedings in its own name or
in the name of the injured, diseased, or disabled individual, the
individual's guardian, personal representative, estate, dependents,
or survivors. As provided in section 6023 of the revised judicature
act
of 1961, 1961 PA 236, MCL 600.6023, the
state department,
in
enforcing its subrogation right, shall not satisfy a judgment
against the third person's property that is exempt from levy and
sale. The injured, diseased, or disabled individual may proceed in
his or her own name, collecting the costs without the necessity of
joining
the state department or the state as a named party. The
injured,
diseased, or disabled individual shall notify the state
department of the action or proceeding entered into upon
commencement of the action or proceeding. An action taken by the
state
or the state department in connection with the right of
recovery afforded by this section does not deny the injured,
diseased, or disabled individual any part of the recovery beyond
the
costs expended on the individual's behalf by the state
department. The costs of legal action initiated by the state shall
be paid by the state. A payment shall not be made under this act
for medical assistance for an injury, disease, or disability for
which the individual is entitled to medical care or the cost of
medical care under the worker's disability compensation act of
1969, 1969 PA 317, MCL 418.101 to 418.941; except that payment may
be made if an appropriate application for medical care or the cost
of the medical care has been made under the worker's disability
compensation act of 1969, 1969 PA 317, MCL 418.101 to 418.941,
entitlement has not been finally determined, and an arrangement
satisfactory
to the state department has been made for
reimbursement if the claim under the worker's disability
compensation act of 1969, 1969 PA 317, MCL 418.101 to 418.941, is
finally sustained.
(iii) The individual has an annual income that is below, or
because of medical expenses falls below, the protected basic
maintenance level. The protected basic maintenance level for 1-
person and 2-person families shall be at least 100% of the higher
of the payment standards generally used to determine eligibility in
the family independence program and the supplemental security
income program under title XVI, including state supplementation.
For families of 3 or more persons, the protected basic maintenance
level shall be at least 100% of the payment standard generally used
to determine eligibility in the family independence program. These
levels shall recognize regional variations and shall not exceed
133-1/3% of the payment standard generally used to determine
eligibility in the family independence program.
(iv) The individual, if a family independence program related
individual and living alone, has liquid or marketable assets of not
more than $2,000.00 in value, or, if a 2-person family, the family
has liquid or marketable assets of not more than $3,000.00 in
value.
The family independence agency department shall establish
comparable liquid or marketable asset amounts for larger family
groups. Excluded in making the determination of the value of liquid
or marketable assets are the values of: the homestead; clothing;
household effects; $1,000.00 of cash surrender value of life
insurance, except that if the health of the insured makes
continuance of the insurance desirable, the entire cash surrender
value of life insurance is excluded from consideration, up to the
maximum provided or allowed by federal regulations and in
accordance
with the department's rules of the family independence
agency;
the fair market value of tangible personal property
used
in earning income; an amount paid as judgment or settlement for
damages suffered as a result of exposure to agent orange, as
defined in section 5701 of the public health code, 1978 PA 368, MCL
333.5701; and a space or plot purchased for the purposes of burial
for the person. For individuals related to the title XVI program,
the appropriate resource levels and property exemptions specified
in title XVI shall be used.
(v) The individual is not an inmate of a public institution
except as a patient in a medical institution.
(vi) The individual meets the eligibility standards for
supplemental security income under title XVI or for state
supplementation under the act, subject to limitations imposed by
the director according to title XIX; or meets the eligibility
standards for family independence program benefits, except for
income or income and resources; or is a child from 18 to 21 years
of age and his or her adult caretaker would be eligible for family
independence program benefits except for age, income, or income and
resources; or is a child under 21 years of age and is from a family
whose income is below the basic maintenance level.
(2) As used in this act:
(a) "Medicaid contracted health plan" means a managed care
organization
with whom the state department contracts to provide
or arrange for the delivery of comprehensive health care services
as authorized under this act.
(b) "Medical institution" means a state licensed or approved
hospital, nursing home, medical care facility, psychiatric
hospital, or other facility or identifiable unit of a listed
institution certified as meeting established standards for a
nursing home or hospital in accordance with the laws of this state.
(c) "Title XVI" means title XVI of the social security act,
42 USC 1381 to 1382j and 1383 to 1383f.
(3) An individual receiving medical assistance under this act
or
his or her legal counsel shall notify the state department
when
filing an action in which the state department may have a
right to recover expenses paid under this act. If the individual is
enrolled in a medicaid contracted health plan, the individual or
his or her legal counsel shall provide notice to the contracted
health
plan in addition to providing notice to the state
department.
(4)
If a legal action in which the state department, a
medicaid contracted health plan, or both has a right to recover
expenses
paid under this act is filed and settled after the date
of
the amendatory act that added this subsection November 29, 2004
without
notice to the state department or the medicaid contracted
health
plan, the state department or the medicaid contracted
health plan may file a legal action against the individual or his
or her legal counsel, or both, to recover expenses paid under this
act. The attorney general shall recover any cost or attorney fees
associated with a recovery under this subsection.
(5)
The state department has first priority against the
proceeds of the net recovery from the settlement or judgment in an
action settled in which notice has been provided under subsection
(3). A medicaid contracted health plan has priority immediately
after
the state department in an action settled in which notice
has
been provided under subsection (3). The
state department
and
a medicaid contracted health plan shall recover the full cost of
expenses
paid under this act unless the state department or the
medicaid contracted health plan agrees to accept an amount less
than the full amount. If the individual would recover less against
the proceeds of the net recovery than the expenses paid under this
act,
the state department or medicaid contracted health plan, and
the individual shall share equally in the proceeds of the net
recovery. As used in this subsection, "net recovery" means the
total settlement or judgment less the costs and fees incurred by or
on behalf of the individual who obtains the settlement or judgment.
(6) In order for an individual to be eligible for medical
assistance benefits under this act, the individual must provide
proof of identification and proof of United States citizenship.