March 2, 2005, Introduced by Senators CHERRY and EMERSON and referred to the Committee on Appropriations.
EXECUTIVE BUDGET BILL
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 bill, the
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.......... 4,693.1
Average population.............................. 1,135.0
GROSS APPROPRIATION.................................... $ 10,240,883,200
Interdepartmental grant revenues:
Total interdepartmental grants and intradepartmental
transfers............................................ 34,485,400
ADJUSTED GROSS APPROPRIATION........................... $ 10,206,397,800
Federal revenues:
Total federal revenues................................. 5,467,496,800
Special revenue funds:
Total local revenues................................... 235,430,800
Total private revenues................................. 59,470,100
Merit award trust fund................................. 50,300,000
Tobacco settlement trust fund.......................... 72,000,000
Total other state restricted revenues.................. 1,401,060,600
State general fund/general purpose..................... $ 2,920,639,500
Sec. 102. DEPARTMENTWIDE ADMINISTRATION
Full-time equated unclassified positions.......... 6.0
Full-time equated classified positions.......... 218.0
Director and other unclassified--6.0 FTE positions..... $ 581,500
Community health advisory council...................... 8,000
Departmental administration and management--208.0
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--1.0 FTE position................... 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........................ $ 1,569,659,400
Community mental health non-Medicaid services.......... 312,598,300
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.................................... $ 2,227,582,200
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..................... $ 1,073,575,100
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................... 1,550,000
Vital records and health statistics--72.4 FTE
positions............................................ 7,458,800
GROSS APPROPRIATION.................................... $ 10,737,800
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.................. 5,764,600
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--8.5 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--120.0 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 position................ 1,251,900
Michigan essential health provider..................... 1,392,600
Primary care services--1.4 FTE positions............... 2,296,000
GROSS APPROPRIATION.................................... $ 48,723,900
Appropriated from:
Interdepartmental grant revenues:
Interdepartmental grant from treasury.................. 113,900
Federal revenues:
Total federal revenues................................. 19,614,400
Special revenue funds:
Total local revenues................................... 150,000
Total private revenues................................. 546,300
Total other state restricted revenues.................. 21,581,900
State general fund/general purpose..................... $ 6,717,400
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.......................... 3,986,200
Tuberculosis control and recalcitrant AIDS program..... 867,000
GROSS APPROPRIATION.................................... $ 68,992,500
Appropriated from:
Federal revenues:
Total federal revenues................................. 62,712,600
Special revenue funds:
Total private revenues................................. 25,000
Total other state restricted revenues.................. 4,174,700
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......................... 35,468,400
Medical services cost reimbursement to local health
departments.......................................... 3,110,000
GROSS APPROPRIATION.................................... $ 40,681,500
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..................... $ 35,544,900
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............................................ 14,824,200
Chronic disease prevention--1.0 FTE position........... 5,375,700
Diabetes and kidney program--9.1 FTE positions......... 3,640,000
Health education, promotion, and research
programs--9.3 FTE positions.......................... 1,082,900
Injury control intervention project--1.0 FTE
position............................................. 527,900
Michigan Parkinson's foundation........................ 100,000
Morris Hood Wayne State University diabetes outreach... 400,000
Physical fitness, nutrition, and health................ 1,000,000
Public health traffic safety coordination--1.7 FTE
positions............................................ 584,900
Smoking prevention program--13.1 FTE positions......... 6,277,500
Tobacco tax collection and enforcement................. 610,000
Violence prevention--2.0 FTE positions................. 1,892,300
GROSS APPROPRIATION.................................... $ 38,438,100
Appropriated from:
Federal revenues:
Total federal revenues................................. 19,655,800
Special revenue funds:
Total private revenues................................. 85,000
Total other state restricted revenues.................. 17,589,200
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.............. $ 2,522,300
Dental programs........................................ 335,400
Dental program for persons with developmental
disabilities......................................... 151,000
Early childhood collaborative secondary prevention..... 524,000
Family, maternal, and children's health
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....................................... 5,784,900
Sudden infant death syndrome program................... 321,300
GROSS APPROPRIATION.................................... $ 44,666,600
Appropriated from:
Federal revenues:
Total federal revenues................................. 31,205,600
Special revenue funds:
Total other state restricted revenues.................. 8,414,000
State general fund/general purpose..................... $ 5,047,000
Sec. 114. WOMEN, INFANTS, AND CHILDREN FOOD AND
NUTRITION PROGRAMS
Full-time equated classified positions........... 41.0
Women, infants, and children administration and
special projects--41.0 FTE positions................. $ 6,498,800
Women, infants, and children 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............................. 207,800,900
GROSS APPROPRIATION.................................... $ 218,730,200
Appropriated from:
Federal revenues:
Total federal revenues................................. 106,499,000
Special revenue funds:
Total private revenues................................. 1,000,000
Total other state restricted revenues.................. 4,070,200
State general fund/general purpose..................... $ 107,161,000
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
Special revenue funds:
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:
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
Employment assistance.................................. 2,818,300
Respite care program................................... 7,600,000
GROSS APPROPRIATION.................................... $ 93,542,500
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..................... $ 33,507,800
Sec. 119. MEDICAL SERVICES ADMINISTRATION
Full-time equated classified positions.......... 336.4
Medical services administration--336.4 FTE positions... $ 54,588,200
Facility inspection contract - state police............ 132,800
MIChild administration................................. 4,327,800
GROSS APPROPRIATION.................................... $ 59,048,800
Appropriated from:
Federal revenues:
Total federal revenues................................. 41,640,700
Special revenue funds:
State general fund/general purpose..................... $ 17,408,100
Sec. 120. MEDICAL SERVICES
Hospital services and therapy.......................... $ 1,223,365,400
Hospital disproportionate share payments............... 50,000,000
Physician services..................................... 289,875,100
Medicare premium payments.............................. 272,705,600
Pharmaceutical services................................ 347,223,400
Home health services................................... 55,777,200
Transportation......................................... 8,738,300
Auxiliary medical services............................. 115,379,700
Long-term care services................................ 1,677,952,600
Elder prescription insurance coverage.................. 3,900,000
Health plan services................................... 1,890,668,400
MIChild program........................................ 47,875,600
Medicaid adult benefits waiver......................... 95,696,400
Maternal and child health.............................. 20,279,500
Social services to the physically disabled............. 1,344,900
Federal Medicare pharmaceutical program................ 174,855,500
Third share program.................................... 10,000,000
Subtotal basic medical services program................ 6,285,637,600
School-based services.................................. 68,621,100
Special adjustor payments.............................. 332,856,900
Subtotal special medical services payments............. 401,478,000
GROSS APPROPRIATION.................................... $ 6,687,115,600
Appropriated from:
Federal revenues:
Total federal revenues................................. 3,775,332,500
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.................. 1,202,643,900
State general fund/general purpose..................... $ 1,527,260,400
Sec. 121. INFORMATION TECHNOLOGY
Information technology services and projects........... 31,155,000
Michigan Medicaid information system................... $ 100
GROSS APPROPRIATION.................................... $ 31,155,100
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..................... $ 9,536,500
PART 2
PROVISIONS CONCERNING APPROPRIATIONS
GENERAL SECTIONS
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 $4,444,000,100.00 and
state spending from state resources to be paid to units of local
government for fiscal year 2005-2006 is $1,022,374,900.00. The
itemized statement below identifies appropriations from which
spending to units of local 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........................ 568,411,300
Community mental health non-Medicaid services.......... 312,598,300
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 PROFESIONS
Health professions..................................... 275,000
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......................... 35,468,400
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
School health and education programs................... 500,000
Local MCH services..................................... 246,100
Pregnancy prevention program........................... 2,300,000
Prenatal care outreach and service delivery support.... 636,000
CHILDREN'S SPECIAL HEALTH CARE SERVICES
Outreach and advocacy.................................. 1,283,200
CRIME VICTIM SERVICES COMMISSION
Crime victim rights services grants.................... 5,432,100
OFFICE OF SERVICES TO THE AGING
Community services..................................... 14,689,800
Nutrition services..................................... 11,447,300
Senior volunteer services.............................. 1,153,400
Respite care program................................... 4,400,000
MEDICAL SERVICES
Transportation......................................... 1,275,300
TOTAL OF PAYMENTS TO LOCAL UNITS OF GOVERNMENT......... $ 1,022,374,900
Sec. 202. (1) The appropriations authorized under this bill 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 bill:
(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 full-time 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 necessitate additional expenditures that exceed any
savings from maintaining a 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. 206. (1) In addition to the funds appropriated in part 1,
there is appropriated an amount not to exceed $100,000,000.00 for
federal contingency funds. These funds are not available for
expenditure until they have been transferred to another line item
in this bill under section 393(2) of the management and budget act,
1984 PA 431, MCL 18.1393.
(2) In addition to the funds appropriated in part 1, there is
appropriated an amount not to exceed $20,000,000.00 for state
restricted contingency funds. These funds are not available for
expenditure until they have been transferred to another line item
in this bill under section 393(2) of the management and budget act,
1984 PA 431, MCL 18.1393.
(3) In addition to the funds appropriated in part 1, there is
appropriated an amount not to exceed $20,000,000.00 for local
contingency funds. These funds are not available for expenditure
until they have been transferred to another line item in this bill
under section 393(2) of the management and budget act, 1984 PA 431,
MCL 18.1393.
(4) In addition to the funds appropriated in part 1, there is
appropriated an amount not to exceed $10,000,000.00 for private
contingency funds. These funds are not available for expenditure
until they have been transferred to another line item in this bill
under section 393(2) of the management and budget act, 1984 PA 431,
MCL 18.1393.
Sec. 208. Unless otherwise specified, the department shall use
the Internet to fulfill the reporting requirements of this bill.
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, 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. 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.
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. 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.
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.
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. 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. 405. It is the intent of the legislature that the employee
wage pass-through funded in previous years to the community mental
health services programs for direct care workers in local
residential settings and for paraprofessional and other
nonprofessional direct care workers in day programs, supported
employment, and other vocational programs shall continue to be paid
to direct care workers.
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 each
substance abuse coordinating agency 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. 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. 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) The department, in conjunction with CMHSPs, may
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. The department shall assure that persons enrolled in
the adult benefit waiver shall receive mental health services under
the priority population sections of the mental health code, 1974 PA
258, MCL 330.1001 to 330.2106.
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 POLICY, REGULATION AND PROFESSIONS
Sec. 704. 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. 705. 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.
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. 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, may be used to increase
the number of nurses practicing in Michigan. The board of nursing
is encouraged to structure scholarships funded under this bill in a
manner that rewards recipients who intend to practice nursing in
Michigan. In addition, the department and the board of nursing
shall 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.
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.
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, 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.
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. 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 P.A. 164 of 2004,
$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.
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. 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.
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 and who are
not otherwise covered by health insurance.
(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 and who are not otherwise covered
by health insurance.
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.
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
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.
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 level, 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. 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. 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 and $3.00 for a
brand-name drug, 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. 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 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.
(2) The department 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, vision, and hearing aid services provided to Medicaid
recipients, except as prohibited by federal or state law or
regulation.
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. 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 upon 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) 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.
(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 may 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
their 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. 1663. If a Medicaid provider participates in the quality
assurance assessment program, additional assessment revenues may be
used to offset the provider rate reductions in effect in fiscal
year 2005-2006.
Sec. 1664. Of the appropriations in part 1 for health plan
services and physician services, Medicaid physician rates shall be
increased upon implementation of a physician quality assurance
assessment program. With additional quality assurance assessment
program revenues and the matching federal Medicaid funds above the
part 1 appropriations, Medicaid physician rates may be increased up
to one hundred percent of Medicare fee screens, in accordance with
related legislation passed during the 2005-2006 legislative
session.
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
bill. 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 HMO, dental care corporation, or any other entity
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. (1) 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.
(2) The department shall not require copayments under the
MIChild program.
Sec. 1680. Payment increases for enhanced wages and new or
enhanced employee benefits provided in previous years through the
Medicaid nursing home wage pass-through program shall be continued
in fiscal year 2005-2006.
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.
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. 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 in a timely manner, 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. 1686. The department shall limit the annual increase in
the variable cost component of the Medicaid reimbursement rate for
privately-owned and publicly-owned nursing facilities and
privately-owned and publicly-owned hospital long-term care units to
no more than the annual increase in the "Total" line of the centers
for Medicare and Medicaid services’ Nursing Home without Capital
Market Basket index as reported by Global Insight in the Health-
Care Cost Review.
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. 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 in the amount of $50,000,000.00, and to hospitals
providing graduate medical education training programs. If direct
payment for GME and DSH is made to qualifying hospitals for
services to Medicaid clients, hospitals will not include GME costs
or DSH payments in their contracts with HMOs.
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. 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.