SB-0172, As Passed Senate, April 26, 2011
SUBSTITUTE FOR
SENATE BILL NO. 172
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, 2012; to provide for the expenditure of those appropriations;
to provide anticipated appropriations for the fiscal year ending
September 30, 2013; 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
FOR FISCAL YEAR 2011-2012
Sec. 101. Subject to the conditions set forth in this act, the
amounts listed in this part are appropriated for the department of
community health for the fiscal year ending September 30, 2012,
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........ 4,029.5
Average population.............................. 893.0
GROSS APPROPRIATION.................................... $ 13,833,859,600
Interdepartmental grant revenues:
Total interdepartmental grants and intradepartmental
transfers............................................ 4,528,700
ADJUSTED GROSS APPROPRIATION........................... $ 13,829,330,900
Federal revenues:
Total other federal revenues........................... 8,686,999,400
Special revenue funds:
Total local revenues................................... 248,426,200
Total private revenues................................. 96,494,700
Merit award trust fund................................. 86,744,500
Total other state restricted revenues.................. 2,069,581,200
State general fund/general purpose..................... $ 2,641,084,900
Sec. 102. DEPARTMENTWIDE ADMINISTRATION
Full-time equated unclassified positions.......... 6.0
Full-time equated classified positions.......... 175.2
Director and other unclassified--6.0 FTE positions..... $ 583,900
Departmental administration and management--165.2
FTE positions........................................ 16,667,000
Worker's compensation program.......................... 8,772,300
Rent and building occupancy............................ 10,628,100
Developmental disabilities council and
projects--10.0 FTE positions......................... 2,855,700
GROSS APPROPRIATION.................................... $ 39,507,000
Appropriated from:
Federal revenues:
Total other federal revenues........................... 14,092,400
Special revenue funds:
Total private revenues................................. 35,100
Total other state restricted revenues.................. 2,502,900
State general fund/general purpose..................... $ 22,876,600
Sec. 103. MENTAL HEALTH/SUBSTANCE ABUSE SERVICES
ADMINISTRATION AND SPECIAL PROJECTS
Full-time equated classified positions.......... 111.5
Mental health/substance abuse program
administration--110.5 FTE positions.................. $ 17,386,800
Gambling addiction--1.0 FTE position................... 3,000,000
Protection and advocacy services support............... 194,400
Community residential and support services............. 1,777,200
Federal and other special projects..................... 2,697,200
Family support subsidy................................. 19,470,500
Housing and support services........................... 9,306,800
GROSS APPROPRIATION.................................... $ 53,832,900
Appropriated from:
Federal revenues:
Total federal revenues................................. 37,301,600
Special revenue funds:
Total private revenues................................. 190,000
Total other state restricted revenues.................. 3,000,000
State general fund/general purpose..................... $ 13,341,300
Sec. 104. COMMUNITY MENTAL HEALTH/SUBSTANCE ABUSE
SERVICES PROGRAMS
Full-time equated classified positions............ 9.5
Medicaid mental health services........................ $ 2,055,796,700
Community mental health non-Medicaid services.......... 268,839,200
Medicaid adult benefits waiver......................... 32,056,100
Mental health services for special populations......... 6,873,800
Medicaid substance abuse services...................... 42,410,600
CMHSP, purchase of state services contracts............ 134,201,900
Civil service charges.................................. 1,499,300
Federal mental health block grant--2.5 FTE positions... 15,397,500
Community substance abuse prevention, education, and
treatment programs................................... 81,737,500
Children's waiver home care program.................... 18,944,800
Nursing home PAS/ARR-OBRA--7.0 FTE positions........... 12,179,300
Children with serious emotional disturbance waiver..... 8,188,000
GROSS APPROPRIATION.................................... $ 2,678,124,700
Appropriated from:
Interdepartmental grant revenues:
Interdepartmental grant from the department of human
services............................................. 2,769,000
Federal revenues:
Total other federal revenues........................... 1,519,433,700
Special revenue funds:
Total local revenues................................... 25,228,900
Total other state restricted revenues.................. 22,314,900
State general fund/general purpose..................... $ 1,108,378,200
Sec. 105. STATE PSYCHIATRIC HOSPITALS, CENTERS FOR
PERSONS WITH DEVELOPMENTAL DISABILITIES, AND
FORENSIC AND PRISON MENTAL HEALTH SERVICES
Total average population........................ 893.0
Full-time equated classified positions........ 2,194.2
Caro regional mental health center - psychiatric
hospital - adult--468.3 FTE positions................ $ 56,772,200
Average population.............................. 185.0
Kalamazoo psychiatric hospital - adult--483.1 FTE
positions............................................ 54,782,400
Average population.............................. 189.0
Walter P. Reuther psychiatric hospital -
adult--433.3 FTE positions........................... 52,297,800
Average population.............................. 234.0
Hawthorn center - psychiatric hospital - children
and adolescents--230.9 FTE positions................. 27,075,900
Average population............................... 75.0
Center for forensic psychiatry--578.6 FTE positions.... 66,767,900
Average population.............................. 210.0
Revenue recapture...................................... 750,000
IDEA, federal special education........................ 120,000
Special maintenance.................................... 332,500
Purchase of medical services for residents of
hospitals and centers................................ 445,600
Gifts and bequests for patient living and treatment
environment.......................................... 1,000,000
GROSS APPROPRIATION.................................... $ 260,344,300
Appropriated from:
Interdepartmental grant revenues:
Federal revenues:
Total other federal revenues........................... 29,921,200
Special revenue funds:
CMHSP, purchase of state services contracts............ 134,201,900
Other local revenues................................... 17,494,500
Total private revenues................................. 1,000,000
Total other state restricted revenues.................. 15,948,400
State general fund/general purpose..................... $ 61,778,300
Sec. 106. PUBLIC HEALTH ADMINISTRATION
Full-time equated classified positions........... 91.7
Public health administration--7.3 FTE positions........ $ 1,557,200
Minority health grants and contracts--3.0 FTE
positions............................................ 612,700
Promotion of healthy behaviors......................... 975,900
Vital records and health statistics--81.4 FTE
positions............................................ 9,442,800
GROSS APPROPRIATION.................................... $ 12,588,600
Appropriated from:
Interdepartmental grant revenues:
Interdepartmental grant from the department of human
services............................................. 1,171,500
Federal revenues:
Total other federal revenues........................... 4,887,900
Special revenue funds:
Total private revenues................................. 300,000
Total other state restricted revenues.................. 4,974,700
State general fund/general purpose..................... $ 1,254,500
Sec. 107. HEALTH POLICY, REGULATION, AND
PROFESSIONS
Full-time equated classified positions.......... 462.1
Health systems administration--199.6 FTE positions..... $ 22,369,300
Emergency medical services program state staff--23.0
FTE positions........................................ 4,850,300
Radiological health administration--21.4 FTE positions. 3,179,700
Emergency medical services grants and services......... 660,000
Health professions--163.0 FTE positions................ 26,945,900
Background check program--5.5 FTE positions............ 2,720,500
Health policy and regulation administration--30.2
FTE positions........................................ 3,756,600
Nurse scholarship, education, and research
program--3.0 FTE positions........................... 1,744,200
Certificate of need program administration--14.0 FTE
positions............................................ 2,071,100
Rural health services--1.0 FTE position................ 1,410,300
Michigan essential health provider..................... 872,700
Primary care services--1.4 FTE positions............... 3,086,600
GROSS APPROPRIATION.................................... $ 73,667,200
Appropriated from:
Interdepartmental grant revenues:
Interdepartmental grant from the department of
treasury, Michigan state hospital finance authority.. 116,300
Federal revenues:
Total other federal revenues........................... 25,410,200
Special revenue funds:
Total local revenues................................... 100,000
Total private revenues................................. 455,000
Total other state restricted revenues.................. 41,793,400
State general fund/general purpose..................... $ 5,792,300
Sec. 108. INFECTIOUS DISEASE CONTROL
Full-time equated classified positions........... 50.7
AIDS prevention, testing, and care programs--12.7
FTE positions........................................ $ 59,449,300
Immunization local agreements.......................... 11,975,200
Immunization program management and field
support--15.0 FTE positions.......................... 1,786,300
Pediatric AIDS prevention and control--1.0 FTE
position............................................. 1,231,400
Sexually transmitted disease control local agreements.. 3,360,700
Sexually transmitted disease control management and
field support--22.0 FTE positions.................... 3,743,300
GROSS APPROPRIATION.................................... $ 81,546,200
Appropriated from:
Federal revenues:
Total other federal revenues........................... 43,490,200
Special revenue funds:
Total private revenues................................. 27,707,700
Total other state restricted revenues.................. 7,470,600
State general fund/general purpose..................... $ 2,877,700
Sec. 109. LABORATORY SERVICES
Full-time equated classified positions.......... 111.0
Laboratory services--111.0 FTE positions............... $ 17,183,900
GROSS APPROPRIATION.................................... $ 17,183,900
Appropriated from:
Interdepartmental grant revenues:
Interdepartmental grant from the department of
environmental quality................................ 471,900
Federal revenues:
Total federal revenues................................. 2,092,300
Special revenue funds:
Total other state restricted revenues.................. 8,267,600
State general fund/general purpose..................... $ 6,352,100
Sec. 110. EPIDEMIOLOGY
Full-time equated classified positions.......... 126.7
AIDS surveillance and prevention program............... 2,254,100
Asthma prevention and control--2.6 FTE positions....... 856,900
Bioterrorism preparedness--66.6 FTE positions.......... 49,286,900
Epidemiology administration--40.0 FTE positions........ 8,202,000
Lead abatement program--7.0 FTE positions.............. 2,647,700
Newborn screening follow-up and treatment
services--10.5 FTE positions......................... 5,337,800
Tuberculosis control and prevention.................... 867,000
GROSS APPROPRIATION.................................... $ 69,452,400
Appropriated from:
Federal revenues:
Total federal revenues................................. 61,271,300
Special revenue funds:
Total private revenues................................. 25,000
Total other state restricted revenues.................. 6,367,900
State general fund/general purpose..................... $ 1,788,200
Sec. 111. LOCAL HEALTH ADMINISTRATION AND GRANTS
Full-time equated classified positions............ 2.0
Essential local public health services................. $ 37,386,100
Implementation of 1993 PA 133, MCL 333.17015........... 20,000
Local health services--2.0 FTE positions............... 500,000
Medicaid outreach cost reimbursement to local health
departments.......................................... 9,000,000
GROSS APPROPRIATION.................................... $ 46,906,100
Appropriated from:
Federal revenues:
Total federal revenues................................. 9,500,000
Special revenue funds:
Total local revenues................................... 5,150,000
State general fund/general purpose..................... $ 32,256,100
Sec. 112. CHRONIC DISEASE AND INJURY PREVENTION AND
HEALTH PROMOTION
Full-time equated classified positions........... 75.5
Cancer prevention and control program--12.0 FTE
positions............................................ $ 14,298,200
Chronic disease control and health promotion
administration--33.4 FTE positions................... 5,950,100
Diabetes and kidney program--12.2 FTE positions........ 1,777,600
Injury control intervention project.................... 170,000
Public health traffic safety coordination--1.0 FTE
position............................................. 87,500
Smoking prevention program--14.0 FTE positions......... 2,075,000
Violence prevention--2.9 FTE positions................. 2,123,200
GROSS APPROPRIATION.................................... $ 26,481,600
Appropriated from:
Federal revenues:
Total federal revenues................................. 23,969,200
Special revenue funds:
Total private revenues................................. 61,600
Total other state restricted revenues.................. 649,700
State general fund/general purpose..................... $ 1,801,100
Sec. 113. FAMILY, MATERNAL, AND CHILDREN'S HEALTH
SERVICES
Full-time equated classified positions........... 55.1
Childhood lead program--6.0 FTE positions.............. $ 1,598,400
Dental programs--3.0 FTE positions..................... 992,000
Dental program for persons with developmental
disabilities......................................... 151,000
Family, maternal, and children's health services
administration--43.6 FTE positions................... 6,047,700
Family planning local agreements....................... 9,085,700
Local MCH services..................................... 7,018,100
Pregnancy prevention program........................... 602,100
Prenatal care outreach and service delivery support.... 42,500
Special projects--2.5 FTE positions.................... 8,546,500
Sudden infant death syndrome program................... 321,300
GROSS APPROPRIATION.................................... $ 34,405,300
Appropriated from:
Federal revenues:
Total federal revenues................................. 30,552,600
Special revenue funds:
Total local revenues................................... 75,000
State general fund/general purpose..................... $ 3,777,700
Sec. 114. WOMEN, INFANTS, AND CHILDREN FOOD AND
NUTRITION PROGRAM
Full-time equated classified positions........... 45.0
Women, infants, and children program administration
and special projects--45.0 FTE positions............. $ 13,825,200
Women, infants, and children program local
agreements and food costs............................ 254,200,800
GROSS APPROPRIATION.................................... $ 268,026,000
Appropriated from:
Federal revenues:
Total federal revenues................................. 209,412,200
Special revenue funds:
Total private revenues................................. 58,613,800
State general fund/general purpose..................... $ 0
Sec. 115. CHILDREN'S SPECIAL HEALTH CARE SERVICES
Full-time equated classified positions........... 47.8
Children's special health care services
administration--45.0 FTE positions................... $ 5,245,700
Bequests for care and services--2.8 FTE positions...... 1,511,400
Outreach and advocacy.................................. 3,773,500
Nonemergency medical transportation.................... 2,679,300
Medical care and treatment............................. 278,471,300
GROSS APPROPRIATION.................................... $ 291,681,200
Appropriated from:
Federal revenues:
Total other federal revenues........................... 166,222,000
Special revenue funds:
Total private revenues................................. 996,800
Total other state restricted revenues.................. 3,843,600
State general fund/general purpose..................... $ 120,618,800
Sec. 116. CRIME VICTIM SERVICES COMMISSION
Full-time equated classified positions........... 13.0
Grants administration services--13.0 FTE positions..... $ 1,811,300
Justice assistance grants.............................. 19,106,100
Crime victim rights services grants.................... 16,570,000
GROSS APPROPRIATION.................................... $ 37,487,400
Appropriated from:
Federal revenues:
Total federal revenues................................. 23,467,200
Special revenue funds:
Total other state restricted revenues.................. 14,020,200
State general fund/general purpose..................... $ 0
Sec. 117. OFFICE OF SERVICES TO THE AGING
Full-time equated classified positions........... 43.5
Office of services to aging administration--43.5 FTE
positions............................................ $ 6,408,800
Community services..................................... 34,289,000
Nutrition services..................................... 35,430,200
Foster grandparent volunteer program................... 1,898,600
Retired and senior volunteer program................... 533,300
Senior companion volunteer program..................... 1,363,700
Employment assistance.................................. 3,792,500
Respite care program................................... 5,868,700
GROSS APPROPRIATION.................................... $ 89,584,800
Appropriated from:
Federal revenues:
Total federal revenues................................. 57,159,200
Special revenue funds:
Total private revenues................................. 677,500
Merit award trust fund................................. 4,468,700
Total other state restricted revenues.................. 1,400,000
State general fund/general purpose..................... $ 25,879,400
Sec. 118. MEDICAL SERVICES ADMINISTRATION
Full-time equated classified positions.......... 415.0
Medical services administration--415.0 FTE positions... $ 65,057,000
Facility inspection contract........................... 132,800
MIChild administration................................. 4,327,800
GROSS APPROPRIATION.................................... $ 69,517,600
Appropriated from:
Federal revenues:
Total other federal revenues........................... 47,476,900
Special revenue funds:
Total local revenues................................... 105,900
Total private revenues................................. 100,000
Total other state restricted revenues.................. 110,100
State general fund/general purpose..................... $ 21,724,700
Sec. 119. MEDICAL SERVICES
Hospital services and therapy.......................... $ 1,138,897,800
Hospital disproportionate share payments............... 45,000,100
Physician services..................................... 290,369,500
Medicare premium payments.............................. 409,169,400
Pharmaceutical services................................ 318,717,600
Home health services................................... 6,791,100
Hospice services....................................... 144,637,700
Transportation......................................... 15,009,800
Auxiliary medical services............................. 6,252,200
Dental services........................................ 158,500,800
Ambulance services..................................... 9,271,600
Long-term care services................................ 1,717,837,500
Medicaid home- and community-based services waiver..... 205,940,500
Adult home help services............................... 289,032,900
Personal care services................................. 14,421,500
Program of all-inclusive care for the elderly.......... 30,707,800
Health plan services................................... 3,936,122,200
MIChild program........................................ 51,753,100
Plan first family planning waiver...................... 13,089,200
Medicaid adult benefits waiver......................... 105,877,700
Special indigent care payments......................... 88,518,500
Federal Medicare pharmaceutical program................ 185,599,300
Maternal and child health.............................. 20,279,500
Subtotal basic medical services program................ 9,201,797,300
School-based services.................................. 91,296,500
Special Medicaid reimbursement......................... 329,823,200
Subtotal special medical services payments............. 421,119,700
GROSS APPROPRIATION.................................... $ 9,622,917,000
Appropriated from:
Federal revenues:
Total other federal revenues........................... 6,337,148,100
Special revenue funds:
Total local revenues................................... 66,070,000
Total private revenues................................. 6,332,200
Merit award trust fund................................. 82,275,800
Total other state restricted revenues.................. 1,933,691,000
State general fund/general purpose..................... $ 1,197,399,900
Sec. 120. INFORMATION TECHNOLOGY
Information technology services and projects........... $ 34,881,700
Michigan Medicaid information system................... 25,723,700
GROSS APPROPRIATION.................................... $ 60,605,400
Appropriated from:
Federal revenues:
Total federal revenues................................. 44,191,200
Special revenue funds:
Total other state restricted revenues.................. 3,226,200
State general fund/general purpose..................... $ 13,188,000
PART 2
PROVISIONS CONCERNING APPROPRIATIONS
FOR FISCAL YEAR 2011-2012
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 2011-2012 is $4,797,410,600.00 and
state spending from state resources to be paid to local units of
government for fiscal year 2011-2012 is $1,333,598,700.00. The
itemized statement below identifies appropriations from which
spending to local units of government will occur:
DEPARTMENT OF COMMUNITY HEALTH
MENTAL HEALTH/SUBSTANCE ABUSE SERVICES ADMINISTRATION
AND SPECIAL PROJECTS
Community residential and support services............. $ 170,100
Housing and support services........................... 599,800
COMMUNITY MENTAL HEALTH/SUBSTANCE ABUSE SERVICES PROGRAMS
Community substance abuse prevention, education, and
treatment programs.................................. $ 12,792,500
Medicaid mental health services........................ 650,333,100
Community mental health non-Medicaid services.......... 268,839,200
Medicaid adult benefits waiver......................... 10,854,200
Mental health services for special populations......... 6,873,800
Medicaid substance abuse services...................... 14,360,200
Children's waiver home care program.................... 5,906,800
Nursing home PASARR.................................... 2,717,200
Health policy, regulation, and professions
Primary care services.................................. $ 88,900
INFECTIOUS DISEASE CONTROL
AIDS prevention, testing, and care programs............ $ 1,000,000
Sexually transmitted disease control local agreements.. 226,200
LABORATORY SERVICES
Laboratory services.................................... $ 13,700
LOCAL HEALTH ADMINISTRATION AND GRANTS
Implementation of 1993 PA 133, MCL 333.17015........... $ 8,000
Essential local public health services................. 32,236,100
CHRONIC DISEASE AND INJURY PREVENTION AND HEALTH PROMOTION
Cancer prevention and control program.................. $ 450,000
Chronic disease control and health promotion
administration ........................................ 261,600
Diabetes and kidney program............................ 54,500
Smoking prevention program............................. 800,000
FAMILY, MATERNAL, AND CHILDREN'S HEALTH SERVICES
Childhood lead program................................. $ 51,100
Pregnancy prevention program........................... 90,000
CHILDREN'S SPECIAL HEALTH CARE SERVICES
Medical care and treatment............................. $ 895,700
Outreach and advocacy.................................. 1,237,500
MEDICAL SERVICES
Dental services........................................ $ 2,005,600
Long-term care services................................ 269,214,200
Transportation......................................... 2,572,700
Medicaid adult benefits waiver......................... 6,186,600
Hospital services and therapy.......................... 5,316,800
Physician services..................................... 4,251,500
OFFICE OF SERVICES TO THE AGING
Community services..................................... $ 11,310,000
Nutrition services..................................... 8,787,000
Foster grandparent volunteer program................... 577,800
Retired and senior volunteer program................... 148,800
Senior companion volunteer program..................... 182,700
Respite care program................................... 5,384,800
CRIME VICTIM SERVICES COMMISSION
Crime victim rights services grants.................... $ 6,800,000
TOTAL OF PAYMENTS TO LOCAL UNITS
OF GOVERNMENT.......................................... $ 1,333,598,700
Sec. 202. (1) The appropriations authorized under this act are
subject to the management and budget act, 1984 PA 431, MCL 18.1101
to 18.1594.
(2) Funds for which the state is acting as the custodian or
agent are not subject to annual appropriation.
Sec. 203. As used in this act:
(a) "AIDS" means acquired immunodeficiency syndrome.
(b) "ARRA" means the American recovery and reinvestment act of
2009, Public Law 111-5.
(c) "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.
(d) "Current fiscal year" means the fiscal year ending
September 30, 2012.
(e) "Department" means the department of community health.
(f) "Director" means the director of the department.
(g) "DSH" means disproportionate share hospital.
(h) "EPSDT" means early and periodic screening, diagnosis, and
treatment.
(i) "Federal health care reform legislation" means the patient
protection and affordable care act, Public Law 111-148, and the
health care and education reconciliation act of 2010, Public Law
111-152.
(j) "Federal poverty level" means the poverty guidelines
published annually in the federal register by the United States
department of health and human services under its authority to
revise the poverty line under 42 USC 9902.
(k) "FMAP" means federal medical assistance percentages.
(l) "FTE" means full-time equated.
(m) "GME" means graduate medical education.
(n) "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.
(o) "HEDIS" means healthcare effectiveness data and
information set.
(p) "HIV/AIDS" means human immunodeficiency virus/acquired
immune deficiency syndrome.
(q) "HMO" means health maintenance organization.
(r) "IDEA" means the individuals with disabilities education
act, 20 USC 1400 to 1482.
(s) "IDG" means interdepartmental grant.
(t) "MCH" means maternal and child health.
(u) "MIChild" means the program described in section 1670.
(v) "MIHP" means the maternal infant health program.
(w) "PASARR" means the preadmission screening and annual
resident review required under the omnibus budget reconciliation
act of 1987, section 1919(e)(7) of the social security act, and 42
USC 1396r.
(x) "PIHP" means a specialty prepaid inpatient health plan for
Medicaid mental health services, services to individuals with
developmental disabilities, and substance abuse services as
described in section 232b of the mental health code, 1974 PA 258,
MCL 330.1232b.
(y) "Title XVIII" and "Medicare" mean title XVIII of the
social security act, 42 USC 1395 to 1395iii.
(z) "Title XIX" and "Medicaid" mean title XIX of the social
security act, 42 USC 1396 to 1396w-2.
(aa) "Title XX" means title XX of the social security act, 42
USC 1397 to 1397f.
(bb) "WIC program" means the women, infants, and children
supplemental nutrition program.
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 render a state department or agency unable to
deliver basic services, will cause loss of revenue to the state,
will result in the inability of the state to receive federal funds,
or will necessitate additional expenditures that exceed any savings
from maintaining a vacancy. The state budget director shall report
annually to the chairpersons of the senate and house 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 act 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 act 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 act
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 act
under section 393(2) of the management and budget act, 1984 PA 431,
MCL 18.1393.
Sec. 208. The department shall use the Internet to fulfill the
reporting requirements of this act. This requirement may include
transmission of reports via electronic mail to the recipients
identified for each reporting requirement, or it may include
placement of reports on the Internet or Intranet site.
Sec. 209. Funds appropriated in part 1 shall not be used for
the purchase of foreign goods or services, or both, if
competitively priced and of comparable quality American goods or
services, or both, are available. Preference shall be given to
goods or services, or both, manufactured or provided by Michigan
businesses if they are competitively priced and of comparable
quality. In addition, preference shall be given to goods or
services, or both, that are manufactured or provided by Michigan
businesses owned and operated by veterans 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. (1) 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.
(2) The department shall provide a report to the senate and
house appropriations subcommittees on community health and the
senate and house fiscal agencies on the balance of each of the
restricted funds administered by the department as of September 30
of the current fiscal year.
Sec. 212. (1) On or before February 1 of the current fiscal
year, the department shall report to the house and senate
appropriations subcommittees on community health, the house and
senate fiscal agencies, and the state budget director on the
detailed name and amounts of federal, restricted, private, and
local sources of revenue that support the appropriations in each of
the line items in part 1 of this act.
(2) Upon the release of the next fiscal year executive budget
recommendation, the department shall report to the same parties in
subsection (1) on the amounts and detailed sources of federal,
restricted, private, and local revenue proposed to support the
total funds appropriated in each of the line items in part 1 of the
next fiscal year executive budget proposal.
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 section 5 of 1978 PA 472,
MCL 4.415, and shall not be used in attempting to influence the
decisions of the legislature, the governor, or any state agency.
Sec. 215. (1) The department shall report to the house and
senate appropriations subcommittees on the budget for the
department, the joint committee on administrative rules, and the
senate and house fiscal agencies by no later than April 1 of the
current fiscal year on each specific policy change made by the
department to implement a public act affecting that department that
took effect during the preceding calendar year.
(2) Funds appropriated in part 1 shall not be used by the
department to adopt a rule that will apply to a small business and
that will have a disproportionate economic impact on small
businesses because of the size of those businesses if the
department fails to reduce the disproportionate economic impact of
the rule on small businesses as provided under section 40 of the
administrative procedures act of 1969, 1969 PA 306, MCL 24.240.
(3) As used in this section:
(a) "Rule" means that term as defined under section 7 of the
administrative procedures act of 1969, 1969 PA 306, MCL 24.207.
(b) "Small business" means that term as defined under section
7a of the administrative procedures act of 1969, 1969 PA 306, MCL
24.207a.
Sec. 216. (1) In addition to funds appropriated in part 1 for
all programs and services, there is appropriated for write-offs of
accounts receivable, deferrals, and for prior year obligations in
excess of applicable prior year appropriations, an amount equal to
total write-offs and prior year obligations, but not to exceed
amounts available in prior year revenues.
(2) The department's ability to satisfy appropriation
deductions in part 1 shall not be limited to collections and
accruals pertaining to services provided in the current fiscal
year, but shall also include reimbursements, refunds, adjustments,
and settlements from prior years.
(3) The department shall report by March 15 of the current
fiscal year to the house of representatives and senate
appropriations subcommittees on community health on all
reimbursements, refunds, adjustments, and settlements from prior
years.
Sec. 218. The department shall include the following in its
annual list of proposed basic health services as required in part
23 of the public health code, 1978 PA 368, MCL 333.2301 to
333.2321:
(a) Immunizations.
(b) Communicable disease control.
(c) Sexually transmitted disease control.
(d) Tuberculosis control.
(e) Prevention of gonorrhea eye infection in newborns.
(f) Screening newborns for the conditions listed in section
5431 of the public health code, 1978 PA 368, MCL 333.5431, or
recommended by the newborn screening quality assurance advisory
committee created under section 5430 of the public health code,
1978 PA 368, MCL 333.5430.
(g) Community health annex of the Michigan emergency
management plan.
(h) Prenatal care.
Sec. 219. (1) 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 and senate appropriations
subcommittees on community health, the house and senate fiscal
agencies, and the state budget director on or before November 1 and
May 1 of the current fiscal year 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.
(2) On or before September 30 of the current fiscal year, the
department shall provide to the same parties listed in subsection
(1) a copy of all reports, studies, and publications produced by
the Michigan public health institute, its subcontractors, or the
department with the funds appropriated in part 1 and allocated to
the Michigan public health institute.
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 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
department shall not collect fees under this section that exceed
the cost of the expenditures.
Sec. 264. (1) Upon submission of a Medicaid waiver, a Medicaid
state plan amendment, or a similar proposal to the centers for
Medicare and Medicaid services, the department shall notify the
house and senate appropriations subcommittees on community health
and the house and senate fiscal agencies of the submission.
(2) The department shall provide written or verbal biannual
reports to the senate and house appropriations subcommittees on
community health and the senate and house fiscal agencies
summarizing the status of any new or ongoing discussions with the
centers for Medicare and Medicaid services or the federal
department of health and human services regarding potential or
future Medicaid waiver applications.
Sec. 265. The departments and agencies receiving
appropriations in part 1 shall receive and retain copies of all
reports funded from appropriations in part 1. Federal and state
guidelines for short-term and long-term retention of records shall
be followed.
Sec. 266. (1) Due to the current budgetary problems in this
state, out-of-state travel 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) 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 senate and house standing committees on
appropriations, the senate and house fiscal agencies, and the state
budget director. The report shall include the following
information:
(a) The name of each individual receiving reimbursement for
travel outside this state or whose travel costs were paid by this
state.
(b) The destination of each travel occurrence.
(c) The dates of each travel occurrence.
(d) A brief statement of the reason for each travel
occurrence.
(e) The transportation and related costs of each travel
occurrence, including the proportion funded with state general
fund/general purpose revenues, the proportion funded with state
restricted revenues, the proportion funded with federal revenues,
and the proportion funded with other revenues.
(f) A total of all out-of-state travel funded for the
immediately preceding fiscal year.
Sec. 267. A department or state agency shall not take
disciplinary action against an employee for communicating with a
member of the legislature or his or her staff.
Sec. 270. Within 180 days after receipt of the notification
from the attorney general's office of a legal action in which
expenses had been recovered pursuant to section 106(4) of the
social welfare act, 1939 PA 280, MCL 400.106, or any other statute
under which the department has the right to recover expenses, the
department shall submit a written report to the house and senate
appropriations subcommittees on community health, the house and
senate fiscal agencies, and the state budget office which includes,
at a minimum, all of the following:
(a) The total amount recovered from the legal action.
(b) The program or service for which the money was originally
expended.
(c) Details on the disposition of the funds recovered such as
the appropriation or revenue account in which the money was
deposited.
(d) A description of the facts involved in the legal action.
Sec. 276. Funds appropriated in part 1 shall not be used by a
principal executive department, state agency, or authority to hire
a person to provide legal services that are the responsibility of
the attorney general. This prohibition does not apply to legal
services for bonding activities and for those activities that the
attorney general authorizes.
Sec. 282. (1) The department, through its organizational units
responsible for departmental administration, operation, and
finance, shall establish uniform definitions, standards, and
instructions for the classification, allocation, assignment,
calculation, recording, and reporting of administrative costs by
the following entities:
(a) Coordinating agencies on substance abuse and the Salvation
Army harbor light program that receive payment or reimbursement
from funds appropriated under section 104.
(b) Area agencies on aging and local providers that receive
payment or reimbursement from funds appropriated under section 117.
(2) By May 15 of the current fiscal year, the department shall
provide a written draft of its proposed definitions, standards, and
instructions to the house of representatives and senate
appropriations subcommittees on community health, the house and
senate fiscal agencies, and the state budget director.
Sec. 287. Not later than December 1, 2011, the department
shall prepare and transmit a report that provides for estimates of
the total general fund/general purpose appropriation lapses at the
close of the previous fiscal year. This report shall summarize the
projected year-end general fund/general purpose appropriation
lapses by major departmental program or program areas. The report
shall be transmitted to the office of the state budget, the
chairpersons of the senate and house appropriations committees, and
the fiscal agencies.
Sec. 292. (1) On a quarterly basis, the department shall
report on the number of full-time equated positions in pay status
by civil service classification to the senate and house of
representatives standing committees on appropriations subcommittees
on community health and the senate and house fiscal agencies.
(2) From the funds appropriated in part 1, the department
shall develop, post, and maintain on a user-friendly and publicly
accessible Internet website all expenditures made by the department
within a fiscal year. The posting must include the purpose for
which each expenditure is made. Funds appropriated in part 1 from
the ARRA shall also be included on a publicly accessible website
maintained by the Michigan economic recovery office. The department
shall not provide financial information on its website under this
section if doing so would violate a federal or state law, rule,
regulation, or guideline that establishes privacy or security
standards applicable to that section.
Sec. 294. (1) It is the intent of the legislature that, in
fiscal year 2012-2013, funding appropriated in fiscal year 2011-
2012 for all of the following line items and programs shall be
allocated on a competitive basis:
(a) The mental health services for special populations line
item.
(b) The multicultural grants and clinic grants funded from the
primary care services line item.
(c) The GF/GP grants funded from the special projects line
item.
(d) The injury control intervention line item.
(e) School health centers funded from the health plan services
line item.
(2) Each program identified in subsection (1) shall only be
eligible for the funding described in subsection (1) if it provides
information to the department on program allocations, goals, and
outcomes by July 1 of the current fiscal year.
Sec. 295. It is the intent of the legislature that funds
appropriated in this act shall not be spent on efforts to implement
the federal health care reform legislation.
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 PIHPs. The
department shall ensure that each CMHSP or PIHP provides all of the
following:
(a) A system of single entry and single exit.
(b) A complete array of mental health services that includes,
but is not 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 PIHP's program
or through assistance with locating and obtaining services to meet
these needs.
(e) A system of case management or care 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 PIHPs shall be made upon the execution
of contracts between the department and CMHSPs or PIHPs. 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 PIHP 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 PIHPs
entered into under this subsection for the current fiscal year 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 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 PIHPs that would affect
rates or expenditures are enacted.
(b) Any amendments to contracts with CMHSPs or PIHPs that
would affect rates or expenditures are enacted.
(3) The report required by subsection (2) shall include
information about the changes and their effects on rates and
expenditures.
Sec. 403. (1) From the funds appropriated in part 1 for mental
health services for special populations, the department shall
ensure that CMHSPs or PIHPs meet with multicultural service
providers to develop a workable framework for contracting, service
delivery, and reimbursement.
(2) Funds appropriated in part 1 for mental health services
for special populations shall not be utilized for services provided
to illegal immigrants, fugitive felons, and individuals who are not
residents of this state. The department shall maintain contracts
with recipients of multicultural services grants that mandate
grantees establish that recipients of services are legally residing
in the United States. An exception to the contractual provision
shall be allowed to address individuals presenting with emergent
mental health conditions.
(3) The department shall require an annual report from the
independent organizations that receive mental health services for
special populations funding. The annual report, due January 1 of
the current fiscal year, shall include specific information on
services and programs provided, the client base to which the
services and programs were provided, information on any wrap around
services provided, and the expenditures for those services. The
department shall provide the annual reports to the senate and house
appropriations subcommittees on community health and the senate and
house fiscal agencies.
Sec. 404. (1) Not later than May 31 of the current fiscal
year, the department shall provide a report on the community mental
health services programs to the members of the house 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
PIHP 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) Per capita expenditures by client population group.
(c) Financial information that, minimally, includes a
description of funding authorized; expenditures by client group and
fund source; and cost information by service category, including
administration. Service category includes all department-approved
services.
(d) Data describing service outcomes that includes, but is not
limited to, an evaluation of consumer satisfaction, consumer
choice, and quality of life concerns including, but not limited to,
housing and employment.
(e) Information about access to community mental health
services programs that includes, but is not 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.
(f) The number of second opinions requested under the code and
the determination of any appeals.
(g) An analysis of information provided by CMHSPs in response
to the needs assessment requirements of the mental health code,
1974 PA 258, MCL 330.1001 to 330.2106, including information about
the number of individuals in the service delivery system who have
requested and are clinically appropriate for different services.
(h) Lapses and carryforwards during the immediately preceding
fiscal year for CMHSPs or PIHPs.
(i) Information about contracts for mental health services
entered into by CMHSPs or PIHPs with providers, including, but not
limited to, all of the following:
(i) The amount of the contract, organized by type of service
provided.
(ii) Payment rates, organized by the type of service provided.
(iii) Administrative costs for services provided to CMHSPs or
PIHPs.
(j) 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 PIHP 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 PIHPs.
(k) An estimate of the number of direct care workers in local
residential settings and paraprofessional and other nonprofessional
direct care workers in settings where skill building, community
living supports and training, and personal care services are
provided by CMHSPs or PIHPs as of September 30 of the prior fiscal
year employed directly or through contracts with provider
organizations.
(3) The department shall include data reporting requirements
listed in subsection (2) in the annual contract with each
individual CMHSP or PIHP.
(4) The department shall take all reasonable actions to ensure
that the data required are complete and consistent among all CMHSPs
or PIHPs.
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 CMHSPs or PIHPs to coordinate care and services
provided to individuals with severe and persistent mental illness
and substance abuse diagnoses.
(2) The department shall approve coordinating agency fee
schedules for providing substance abuse services and charge
participants in accordance with their ability to pay.
(3) It is the intent of the legislature that the coordinating
agencies continue current efforts to collaborate on the delivery of
services to those clients with mental illness and substance abuse
diagnoses.
(4) Coordinating agencies that are located completely within
the boundary of a PIHP shall conduct a study of the administrative
costs and efficiencies associated with consolidation with that
PIHP. If that coordinating agency realizes an administrative cost
savings of 5% or greater of their current costs, then that
coordinating agency shall initiate discussions regarding a
potential merger in accordance with section 6226 of the public
health code, 1978 PA 368, MCL 333.6226. The department shall report
to the legislature by April 1 of the current fiscal year on any
such discussions.
Sec. 408. (1) By April 1 of the current fiscal year, the
department shall report the following data from the prior fiscal
year on substance abuse prevention, education, and treatment
programs to the senate and house 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 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. 412. The department shall contract directly with the
Salvation Army harbor light program to provide non-Medicaid
substance abuse services.
Sec. 418. On or before the tenth of each month, the department
shall report to the senate and house appropriations subcommittees
on community health, the senate and house fiscal agencies, and the
state budget director on the amount of funding paid to PIHPs to
support the Medicaid managed mental health care program in the
preceding month. The information shall include the total paid to
each PIHP, per capita rate paid for each eligibility group for each
PIHP, and number of cases in each eligibility group for each PIHP,
and year-to-date summary of eligibles and expenditures for the
Medicaid managed mental health care program.
Sec. 424. Each PIHP 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, shall be paid within 45
days after receipt of the claim by the PIHP. A clean claim that is
not paid within this time frame shall bear simple interest at a
rate of 12% per annum.
(b) A PIHP shall 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 PIHP shall pay
the claim within 30 days after the defect is corrected.
Sec. 428. Each PIHP 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 PIHPs. 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 PIHP.
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 of the
current fiscal year.
Sec. 442. (1) It is the intent of the legislature that the
$32,056,100.00 in funding transferred from the community mental
health non-Medicaid services line to support the Medicaid adult
benefits waiver program shall be used to provide state match for
increases in federal funding for primary care and specialty
services provided to Medicaid adult benefits waiver enrollees and
for economic increases for the Medicaid specialty services and
supports program.
(2) The department shall assure that individuals enrolled in
the Medicaid adult benefits waiver program shall receive mental
health services as approved in the state plan amendment.
(3) Capitation payments to CMHSPs for individuals who become
enrolled in the Medicaid adult benefits waiver program shall be
made using the same rate methodology as payments for the current
Medicaid beneficiaries.
(4) If enrollment in the Medicaid adult benefits waiver
program does not achieve expectations and the funding appropriated
for the Medicaid adult benefits waiver program for specialty
services is not expended, the general fund balance shall be
transferred back to the community mental health non-Medicaid
services line. The department shall report quarterly to the senate
and house appropriations subcommittees on community health a
summary of eligible expenditures for the Medicaid adult benefits
waiver program by CMHSPs.
Sec. 458. By April 15 of the current fiscal year, the
department shall provide each of the following to the house and
senate appropriations subcommittees on community health, the house
and senate fiscal agencies, and the state budget director:
(a) An updated plan for implementing each of the
recommendations of the Michigan mental health commission made in
the commission's report dated October 15, 2004.
(b) A report that evaluates the cost-benefit of establishing
secure residential facilities of fewer than 17 beds for adults with
serious mental illness, modeled after such programming in Oregon or
other states. This report shall examine the potential impact that
utilization of secure residential facilities would have upon the
state's need for adult mental health facilities.
(c) In conjunction with the state court administrator's
office, a report that evaluates the cost-benefit of establishing a
specialized mental health court program that diverts adults with
serious mental illness alleged to have committed an offense deemed
nonserious into treatment prior to the filing of any charges.
Sec. 462. (1) In order to implement the fiscal year 2011-2012
funding reduction to the community mental health non-Medicaid
services line, the department shall further implement the funding
formula that was partially implemented during fiscal year 2009-
2010.
(2) The department shall report to the senate and house
appropriations subcommittees on community health and the senate and
house fiscal agencies on the parameters used to make the fiscal
year 2011-2012 funding formula adjustments as well as the impact of
the formula on each CMHSP.
(3) In redetermining capitation rates for PIHPs in fiscal year
2011-2012, the department shall minimize the use of geographic
factors.
Sec. 468. To foster a more efficient administration of and to
integrate care in publicly funded mental health and substance abuse
services, the department shall maintain criteria for the
incorporation of a city, county, or regional substance abuse
coordinating agency into a local community mental health authority
that will encourage those city, county, or regional coordinating
agencies to incorporate as local community mental health
authorities. If necessary, the department may make accommodations
or adjustments in formula distribution to address administrative
costs related to the maintenance of the criteria under this section
and to the incorporation of the additional coordinating agencies
into local community mental health authorities provided that all of
the following are satisfied:
(a) The department provides funding for the administrative
costs incurred by coordinating agencies incorporating into
community mental health authorities. The department shall not
provide more than $75,000.00 to any coordinating agency for
administrative costs.
(b) The accommodations or adjustments favor coordinating
agencies who voluntarily elect to integrate with local community
mental health authorities.
(c) The accommodations or adjustments do not negatively affect
other coordinating agencies.
Sec. 470. (1) For those substance abuse coordinating agencies
that have voluntarily incorporated into community mental health
authorities and accepted funding from the department for
administrative costs incurred pursuant to section 468, the
department shall establish written expectations for those CMHSPs,
PIHPs, and substance abuse coordinating agencies and counties with
respect to the integration of mental health and substance abuse
services. At a minimum, the written expectations shall provide for
the integration of those services as follows:
(a) Coordination and consolidation of administrative functions
and redirection of efficiencies into service enhancements.
(b) Consolidation of points of 24-hour access for mental
health and substance abuse services in every community.
(c) Alignment of coordinating agencies and PIHPs boundaries to
maximize opportunities for collaboration and integration of
administrative functions and clinical activities.
(2) By May 1 of the current fiscal year, the department shall
report to the house and senate appropriations subcommittees on
community health, the house and senate fiscal agencies, and the
state budget office on the impact and effectiveness of this section
and the status of the integration of mental health and substance
abuse services.
Sec. 474. The department shall ensure that each contract with
a CMHSP or PIHP requires the CMHSP or PIHP to provide each
recipient and his or her family with information regarding the
different types of guardianship and the alternatives to
guardianship. A CMHSP or PIHP shall not, in any manner, attempt to
reduce or restrict the ability of a recipient or his or her family
from seeking to obtain any form of legal guardianship without just
cause.
Sec. 480. The department shall provide to the senate and house
appropriations subcommittees on community health and the senate and
house fiscal agencies by March 30 of the current fiscal year a
report on the number and reimbursement cost of atypical
antipsychotic prescriptions by each PIHP for Medicaid
beneficiaries.
Sec. 489. The department shall work with the Michigan
association of community mental health boards and individual CMHSPs
in an effort to mitigate necessary reductions to the community
mental health non-Medicaid services line by seeking alternative
funding sources.
Sec. 490. (1) The department shall establish a workgroup to
develop a plan to maximize uniformity and consistency in the
standards required of providers contracting directly with PIHPs,
CMHSPs, and substance abuse coordinating agencies. These standards
shall apply to community living supports, personal care services,
substance abuse services, skill-building services, and other
similar supports and services providers who contract with PIHPs,
CMHSPs, and substance abuse coordinating agencies or their
contractors.
(2) The workgroup shall include representatives of the
department, PIHPs, CMHSPs, substance abuse coordinating agencies,
and affected providers. The standards shall include, but are not
limited to, contract language, training requirements for direct
support staff, performance indicators, financial and program
audits, and billing procedures.
(3) The department shall provide a status report on the
workgroup's efforts to the senate and house appropriations
subcommittees on community health, the senate and house fiscal
agencies, and the state budget director by June 1 of the current
fiscal year.
Sec. 491. The department shall explore changes in program
policy in the habilitation supports waiver for persons with
developmental disabilities that would permit the movement of a slot
that has become available to a county that has demonstrated a
greater need for the services.
Sec. 492. If a CMHSP has entered into an agreement with a
county or county sheriff to provide mental health services to the
inmates of the county jail, the department shall not prohibit the
use of state general fund/general purpose dollars by CMHSPs to
provide mental health services to inmates of a county jail.
Sec. 494. The department shall work with state approved
national accrediting organizations, CMHSPs, and provider agencies
to minimize the number of gaps between state requirements and
national accrediting reviews during the accreditation process. The
department shall report to the legislature by March 1 of the
current fiscal year on the outcome of this effort.
Sec. 495. The population data used in determining the
distribution of substance abuse block grant funds shall be from the
most recent federal census.
Sec. 496. CMHSPs and PIHPs are permitted to offset state
funding reductions by limiting the administrative component of
their contracts with providers to a maximum of 9%.
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. Revenues collected through
project efforts shall be used 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 of the current fiscal year 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. 604. (1) The CMHSPs or PIHPs shall provide annual 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 annually report the information in
subsection (1) to the house 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 PIHPs have programs and services in place for those
individuals currently in those facilities and a plan for service
provision for those individuals who would have been admitted to
those facilities.
(2) All closures or consolidations are dependent upon adequate
department-approved CMHSP and PIHP plans that include a discharge
and aftercare plan for each individual currently in the facility. A
discharge and aftercare plan shall address the individual's housing
needs. A homeless shelter or similar temporary shelter arrangements
are inadequate to meet the individual'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
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
PIHPs responsible for providing services for individuals 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 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.
Sec. 608. Effective October 1, 2010, the department, in
consultation with the department of technology, management, and
budget, shall establish and implement a bid process to identify 1
or more private contractors to provide food service and custodial
services for the administrative areas at any state hospital
identified by the department as capable of generating a minimum of
7.5% savings through the outsourcing of such services.
PUBLIC HEALTH ADMINISTRATION
Sec. 653. The department shall develop plans to address
potential state public health emergencies.
HEALTH POLICY, REGULATION, AND PROFESSIONS
Sec. 704. The department shall continue to contract with
grantees supported through the appropriation in part 1 for the
emergency medical services grants and contracts to ensure that a
sufficient number of qualified emergency medical services personnel
exist to serve rural areas of the state.
Sec. 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 funds appropriated in part 1 for the Michigan
essential health care provider program may also provide loan
repayment for dentists that fit the criteria established by part 27
of the public health code, 1978 PA 368, MCL 333.2701 to 333.2727.
Sec. 711. The department may make available to interested
entities customized listings of nonconfidential information in its
possession, such as names and addresses of licensees. The
department may establish and collect a reasonable charge to provide
this service. The revenue received from this service shall be used
to offset expenses to provide the service. Any balance of this
revenue collected and unexpended at the end of the fiscal year
shall revert to the appropriate restricted fund.
Sec. 714. The department shall report by April 1 of the
current fiscal year to the legislature on the timeliness of nursing
facility complaint investigations and the number of allegations
that are substantiated on an annual basis. The report shall consist
of the number of allegations filed by consumers and the number of
facility-reported incidents. The department shall make every effort
to contact every complainant and the subject of a complaint during
an investigation.
Sec. 716. The department shall give priority in investigations
of alleged wrongdoing by licensed health care professionals to
instances that are alleged to have occurred within 2 years of the
initial complaint.
Sec. 718. The department shall gather information on its most
frequently cited complaint deficiencies for the prior 3 fiscal
years. The department shall determine whether there is an increase
in the number of citations from 1 year to the next and assess the
cause of the increase, if any, and whether education and training
of nursing facility staff or department staff is needed. The
department shall implement any training indicated by the study. The
department shall provide the results of the study to the senate and
house appropriations subcommittees on community health and the
senate and house fiscal agencies by May 1 of the current fiscal
year.
Sec. 722. A medical professional who was newly accepted into
the Michigan essential health provider program in fiscal year 2008-
2009 is eligible for 4 years of loan repayments.
Sec. 726. (1) The department shall submit a report by April 1
of the current fiscal year to the house and senate appropriations
subcommittees on community health, the house and senate fiscal
agencies, and the state budget director, on an annual basis, that
includes all data on the amount collected from medical marihuana
program application and renewal fees along with the cost of
administering the medical marihuana program under the Michigan
medical marihuana act, 2008 IL 1, MCL 333.26421 to 333.26430.
(2) If the required fees are shown to be insufficient to
offset all expenses of implementing and administering the medical
marihuana program, the department shall review and revise the
application and renewal fees accordingly to ensure that all
expenses of implementing and administering the medical marihuana
program are offset as is permitted under section 5 of the Michigan
medical marihuana act, 2008 IL 1, MCL 333.26425.
Sec. 727. By October 1, 2011, the department shall establish
and implement a bid process to identify a private or public
contractor to provide management of the medical marihuana program.
By January 1 of the current fiscal year, the department shall
transfer responsibility for management of the medical marihuana
program to the contractor identified by the bid process.
Sec. 729. The department shall identify counties in which
there are an insufficient number of health professionals providing
obstetrical and gynecological services. In addition, the department
shall identify the reasons why there are an insufficient number of
health professionals providing obstetrical and gynecological
services and identify possible policy or fiscal, or both, measures
considered necessary to address the shortage. The department shall
submit a report of its findings under this section to the house and
senate appropriations subcommittees on community health, house and
senate fiscal agencies, and state budget director no later than
December 1 of the current fiscal year.
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 high-risk individuals ages 9 through 18 receive
priority for prevention, education, and outreach services.
Sec. 803. The department shall continue the AIDS drug
assistance program maintaining the prior year eligibility criteria
and drug formulary. This section does not prohibit the department
from providing assistance for improved AIDS treatment medications.
If the appropriation in part 1 or actual revenue is not sufficient
to maintain the prior year eligibility criteria and drug formulary,
the department may revise the eligibility criteria and drug
formulary in a manner that is consistent with federal program
guidelines.
Sec. 805. The department shall continue to fund the Michigan
care improvement registry at the same level as in fiscal year 2010-
2011.
EPIDEMIOLOGY
Sec. 851. The department shall provide a report annually to
the house 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.
LOCAL HEALTH ADMINISTRATION AND GRANTS
Sec. 901. The amount appropriated in part 1 for implementation
of the 1993 additions of or 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 be used to 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. (1) 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 of the current fiscal year, 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 6.25% of the local health department's essential
local public health services funding. This penalty shall only be
assessed to the local county that requests the dissolution of the
health department.
(2) The department shall explore changes in program policy
that would permit enhanced grants provided through the essential
local public health services line to local public health
departments that have successfully consolidated after October 1 of
the current fiscal year.
Sec. 904. (1) Funds appropriated in part 1 for essential local
public health services shall be prospectively allocated to local
health departments to support immunizations, infectious disease
control, sexually transmitted disease control and prevention,
hearing screening, vision services, food protection, public water
supply, private groundwater supply, and on-site sewage management.
Food protection shall be provided in consultation with the
department of agriculture and rural development. Public water
supply, private groundwater supply, and on-site sewage management
shall be provided in consultation with the department of
environmental quality.
(2) Local public health departments shall 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 the current fiscal year of
at least the amount expended in fiscal year 1992-1993 for the
services described in subsection (1).
(4) By April 1 of the current fiscal year, the department
shall make available a report to the senate and house
appropriations subcommittees on community health, the senate and
house fiscal agencies, and the state budget director on the planned
allocation of the funds appropriated for essential local public
health services.
CHRONIC DISEASE AND INJURY PREVENTION AND HEALTH PROMOTION
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.
Sec. 1031. (1) From the funds appropriated in part 1 for the
injury control intervention project, $170,000.00 shall be used to
continue 2 incentive-based pilot programs for level I and level II
trauma hospitals to ensure greater state utilization of an
interactive, evidence-based treatment guideline model for traumatic
brain injury.
(2) One pilot program shall be placed in a county with a
population of less than 225,000. The other pilot program shall be
placed in a county with a population over 1,000,000.
FAMILY, MATERNAL, AND CHILDREN'S HEALTH SERVICES
Sec. 1103. (1) It is the intent of the legislature that,
beginning March 31, 2013, the department shall issue a report to
the legislature detailing user rates and public expenditures for
family planning and sexual health. The report shall include at
least the following expenditures of state and federal funds for the
direct medical and clinical costs, as determined by the department,
due to out-of-wedlock sexual activity:
(a) The percent of clients or users who are unmarried and
access family planning, pregnancy prevention, or sexually
transmitted disease prevention services.
(b) The approximate expenditure of state and federal funds,
based on marital status, to provide family planning, pregnancy
prevention, and sexually transmitted disease prevention services.
(c) The total annual public expenditure by the state, based on
marital status, on medical care to persons who have contracted
sexually transmitted diseases.
(d) The total annual public expenditure by the state for out-
of-wedlock pregnancy, including prenatal care, birth expenses,
abortion expenses, and any expenditures the department determines
may reasonably be related to pregnancy or pregnancy outcome for a
period of 30 days after the date of delivery or termination of the
pregnancy.
(2) Beginning on January 1 of the current fiscal year, the
department shall begin gathering the data necessary to create the
report described in subsection (1).
(3) The department may utilize or amend any other existing
report to comply with the reporting requirement described in
subsection (1) unless prohibited by law. It is the intent of the
legislature that a service provider or agency that fails to comply
with the reporting requirements in this section shall not be
considered for funding for a period of at least 2 years.
Sec. 1104. (1) Before April 1 of the current fiscal year, 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 adolescents served
and amounts expended for each group for the immediately preceding
fiscal year.
(c) A breakdown of the expenditure of these funds between
urban and rural communities.
(2) The department shall ensure that the distribution of funds
through the programs described in subsection (1) takes into account
the needs of rural communities.
(3) For the purposes of this section, "rural" means a county,
city, village, or township with a population of 30,000 or less,
including those entities if located within a metropolitan
statistical area.
Sec. 1106. Each family planning program receiving federal
title X family planning funds under 42 USC 300 to 300a-8 shall be
in compliance with all performance and quality assurance indicators
that the office of family planning within the United States
department of health and human services specifies in the family
planning annual report. An agency not in compliance with the
indicators shall not receive supplemental or reallocated funds.
Sec. 1108. The funds appropriated in part 1 for pregnancy
prevention programs shall not be used to provide abortion
counseling, referrals, or services.
Sec. 1109. (1) From the amounts appropriated in part 1 for
dental programs, funds shall be allocated to the Michigan dental
association for the administration of a volunteer dental program
that provides dental services to the uninsured.
(2) Not later than December 1 of the current fiscal year, the
department shall report to the senate and house appropriations
subcommittees on community health and the senate and house standing
committees on health policy the number of individual patients
treated, number of procedures performed, and approximate total
market value of those procedures from the immediately preceding
fiscal year.
Sec. 1129. The department shall provide a report annually to
the house 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 72 hours or more before
releasing infant mortality rate data to the public.
Sec. 1135. (1) If funds become available, provision of the
school health education curriculum, such as the Michigan model for
health or another comprehensive school health education curriculum,
shall be in accordance with the health education goals established
by the Michigan model steering committee. The steering committee
shall be composed 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 mental health and substance abuse administration in
the department of community health.
(e) The department of human services.
(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. 1153. The department shall ensure that individuals
residing in rural communities have sufficient access to the
services offered through the WIC program. The department shall
report to the legislature on its efforts to increase access to the
WIC program in rural areas.
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 and published by the
Michigan medical services administration.
Sec. 1202. The department may do 1 or more of the following:
(a) Provide special formula for eligible clients with
specified metabolic and allergic disorders.
(b) Provide medical care and treatment to eligible patients
with cystic fibrosis who are 21 years of age or older.
(c) Provide medical care and treatment to eligible patients
with hereditary coagulation defects, commonly known as hemophilia,
who are 21 years of age or older.
Sec. 1204. By October 1, 2011, the department shall report to
the senate and house appropriations committees on community health
and the senate and house fiscal agencies on its plan for enrolling
Medicaid eligible children's special health care services
recipients in the Medicaid health plans. The report shall include
information on which Medicaid health plans are participating, the
methods used to assure continuity of care and continuity of ongoing
relationships with providers, and projected savings from the
implementation of the proposal.
CRIME VICTIM SERVICES COMMISSION
Sec. 1302. From the funds appropriated in part 1 for justice
assistance grants, up to $200,000.00 shall be allocated for
expansion of forensic nurse examiner programs to facilitate
training for improved evidence collection for the prosecution of
sexual assault. The funds shall be used for program coordination
and training.
Sec. 1304. The department shall work with the department of
state police, the Michigan health and hospital association, the
Michigan state medical society, and the Michigan nurses association
to ensure that the recommendations included in the "Standard
Recommended Procedures for the Emergency Treatment of Sexual
Assault Victims" are followed in the collection of evidence.
OFFICE OF SERVICES TO THE AGING
Sec. 1401. The appropriation in part 1 to the office of
services to the aging for community services and nutrition 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. (1) The office of services to the aging shall
require each region to report to the office of services to the
aging and to the legislature 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.
(2) Data required in subsection (1) shall be recorded only for
individuals who have applied for participation in the home-
delivered meals program and who are initially determined as likely
to be eligible for home-delivered meals.
Sec. 1413. Local counties may request to change membership in
the area agencies on aging if the change is to an area agency on
aging that is contiguous to that county pursuant to office of
services to the aging policies and procedures for area agency on
aging designation. The office of services to the aging shall adjust
allocations to area agencies on aging to account for any changes in
county membership. The office of services to the aging shall ensure
annually that county boards of commissioners are aware that county
membership in area agencies on aging can be changed subject to
office of services to the aging policies and procedures for area
agency on aging designation.
Sec. 1417. The department shall provide to the senate and
house appropriations subcommittees on community health, senate and
house fiscal agencies, and state budget director a report by March
30 of the current fiscal year that contains all of the following:
(a) The total allocation of state resources made to each area
agency on aging by individual program and administration.
(b) Detail expenditure by each area agency on aging by
individual program and administration including both state-funded
resources and locally-funded resources.
Sec. 1418. From the funds appropriated in part 1 for nutrition
services, the department shall maximize funding for home-delivered
meals to the extent allowable under federal law and regulation.
Sec. 1420. The department shall create a pilot project to
establish an aging care management services program with services
provided solely by nurses. This pilot project shall be established
in a county with a population greater than 150,000 but less than
250,000.
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. 1603. (1) The department may establish a program for
individuals 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.
(4) The department shall modify program policies to permit
individuals eligible for the transitional medical assistance plus
program, as structured in fiscal year 2009-2010, to access medical
assistance coverage through a 100% cost share.
Sec. 1604. (1) A Medicaid recipient shall remain eligible and
a qualifying applicant shall be determined eligible for medical
assistance during a period of incarceration or detention. Medicaid
coverage is limited during such a period to off-site inpatient
hospitalization only.
(2) A Medicaid recipient is considered incarcerated or
detained until released on bail, released as not guilty, released
on parole, released on probation, released on pardon, released upon
completing a sentence, or released under home detention or tether.
Sec. 1605. 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.
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.
(6) The department shall mandate enrollment of women, whose
qualifying condition is pregnancy, into Medicaid managed care
plans.
(7) The department shall encourage physicians to provide
women, whose qualifying condition for Medicaid is pregnancy, with a
referral to a Medicaid participating dentist at the first
pregnancy-related appointment.
Sec. 1610. The department shall provide an administrative
procedure for the review of cost report grievances by medical
services providers with regard to reimbursement under the medical
services program. Settlements of properly submitted cost reports
shall be paid not later than 9 months from receipt of the final
report.
Sec. 1611. (1) For care provided to medical services
recipients with other third-party sources of payment, medical
services reimbursement shall not exceed, in combination with such
other resources, including Medicare, those amounts established for
medical services-only patients. The medical services payment rate
shall be accepted as payment in full. Other than an approved
medical services co-payment, 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
$2.75 or the pharmacy's usual or customary cash charge, whichever
is less. For nursing home residents, the pharmaceutical dispensing
fee shall be $3.00 or the pharmacy's usual or customary cash
charge, whichever is less.
(2) The department shall require a prescription co-payment 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) It is the intent of the legislature that if the department
realizes savings as a result of the implementation of average
manufacturer's price for reimbursement of multiple source generic
medication dispensing as imposed pursuant to the federal deficit
reduction act of 2005, Public Law 109-171, the savings shall be
returned to pharmacies in the form of an increased dispensing fee
for medications not to exceed $2.00. The savings shall be
calculated as the difference in state expenditure between the
current methodology of payment, which is maximum allowable cost,
and the proposed new reimbursement method of average manufacturer's
price.
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. 1627. (1) The department shall use procedures and rebate
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, and children's
special health care services.
(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. Medicaid coverage for adult dental and 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.
Sec. 1631. (1) The department shall require co-payments on
dental, podiatric, and vision services provided to Medicaid
recipients, except as prohibited by federal or state law or
regulation.
(2) Except as otherwise prohibited by federal or state law or
regulations, the department shall require Medicaid recipients to
pay the following co-payments:
(a) Two dollars for a physician office visit.
(b) Three dollars for a hospital emergency room visit.
(c) Fifty dollars for the first day of an inpatient hospital
stay.
(d) One dollar for an outpatient hospital visit.
Sec. 1635. From the funds appropriated in part 1 for physician
services and health plan services, the department shall continue
the increase in Medicaid reimbursement rates for obstetrical
services implemented in fiscal year 2005-2006.
Sec. 1636. From the funds appropriated in part 1 for physician
services and health plan services, the department shall continue
the increase in Medicaid reimbursement rates for physician well
child procedure codes and primary care procedure codes implemented
in fiscal year 2006-2007 and fiscal year 2008-2009. The increased
reimbursement rates in this section shall not exceed the comparable
Medicare payment rate for the same services.
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. 1642. The department shall allow ambulatory surgery
centers in this state to fully participate in the Medicaid program.
Sec. 1648. The department shall maintain and make available an
online resource to enable medical providers to obtain enrollment
and benefit information of Medicaid recipients. There shall be no
charge to providers for the use of the online resource.
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 and prevention
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.
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. Individuals not expressing a preference may be assigned
to a managed care provider.
(2) Individuals 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 individual 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. 1652. Any new contracts with Medicaid health plans
negotiated or signed, or both, during the current fiscal year shall
include the following provisions regarding expansion of services by
the Medicaid HMOs to counties not previously served by that
Medicaid HMO:
(a) The Medicaid HMO shall not sell, transfer, or otherwise
convey to any person all or any portion of the HMO's assets or
business, whether in the form of equity, debt or otherwise, for a
period of 3 years from the date the Medicaid HMO commences
operations in a new service area.
(b) That any Medicaid HMOs that expand into a county with a
population of at least 1,500,000 shall also expand its coverage to
a county with a population of less than 100,000 which has 1 or
fewer HMOs participating in the Medicaid program.
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 continue to be voluntary for those enrolled
in the children's special health care services program. Children's
special health care services recipients shall be informed of the
opportunity to enroll in HMOs.
(e) The department shall develop a case adjustment to its rate
methodology that considers the costs of individuals 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 shall be budget neutral.
(f) 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 regulation 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. 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 recipients 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 HMOs to assist with
resolving problems and complaints. If warranted, the department
shall immediately disenroll individuals from HMOs and approve fee-
for-service coverage.
Sec. 1657. (1) Reimbursement for medical services to screen
and stabilize a Medicaid recipient, including stabilization of a
psychiatric crisis, in a hospital emergency room shall not be made
contingent on obtaining prior authorization from the recipient's
HMO. If the recipient is discharged from the emergency room, the
hospital shall notify the recipient's HMO within 24 hours of the
diagnosis and treatment received.
(2) If the treating hospital determines that the recipient
will require further medical service or hospitalization beyond the
point of stabilization, that hospital shall receive authorization
from the recipient's HMO prior to admitting the recipient.
(3) Subsections (1) and (2) do not require an alteration to an
existing agreement between an HMO and its contracting hospitals and
do not require an HMO to reimburse for services that are not
considered to be medically necessary.
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 Medical
Services Administration 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 of this act are the only
ones that shall apply to the following Medicaid managed care
programs, including the comprehensive plan, MIChoice long-term care
plan, and the mental health, substance abuse, and developmentally
disabled services program: 401, 402, 404, 418, 424, 428, 474, 1204,
1607, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1660,
1661, 1662, 1684, 1689, 1690, 1699, 1711, 1764, 1787, 1815, 1819,
1822, 1826, 1835, 1850, and 1853.
Sec. 1660. (1) The department shall assure that all Medicaid
children have timely access to EPSDT services as required by
federal law. Medicaid HMOs shall provide EPSDT services to their
child members in accordance with Medicaid EPSDT policy.
(2) The primary responsibility of assuring a child's hearing
and vision screening is with the child's primary care provider. The
primary care provider shall provide age-appropriate screening or
arrange for these tests through referrals to local health
departments. Local health departments shall provide preschool
hearing and vision screening services and accept referrals for
these tests from physicians or from Head Start programs in order to
assure all preschool children have appropriate access to hearing
and vision screening. Local health departments shall be reimbursed
for the cost of providing these tests for Medicaid eligible
children by the Medicaid program.
(3) The department shall prohibit HMOs from requiring prior
authorization of their contracted providers for any EPSDT screening
and diagnosis services.
(4) The department shall require HMOs to be responsible for
well child visits as described in Medicaid policy. These
responsibilities shall be specified in the information distributed
by the HMOs to their members.
(5) The department shall provide, on an annual basis, budget-
neutral incentives to Medicaid HMOs and local health departments to
improve performance on measures related to the care of children.
Sec. 1661. (1) The department shall assure that all Medicaid
eligible children and pregnant women have timely access to MIHP
services. Medicaid HMOs shall assure that MIHP screening is
available to their pregnant members and that those women found to
meet the MIHP high-risk criteria are offered maternal support
services. Local health departments shall assure that MIHP screening
is available for Medicaid pregnant women and that those women found
to meet the MIHP high-risk criteria are offered MIHP services or
are referred to a certified MIHP provider.
(2) The department shall require HMOs to be responsible for
the coordination of MIHP services as described in Medicaid policy.
These responsibilities shall be specified in the information
distributed by the HMOs to their members.
(3) The department shall assure the coordination of MIHP
services with the WIC program, state-supported substance abuse,
smoking prevention, and violence prevention programs, the
department of human services, and any other state or local program
with a focus on preventing adverse birth outcomes and child abuse
and neglect.
(4) The department shall provide, on an annual basis, budget-
neutral incentives to Medicaid HMOs and local health departments to
improve performance on measures related to the care of pregnant
women.
Sec. 1662. (1) The department shall assure that an external
quality review of each contracting HMO is performed that results in
an analysis and evaluation of aggregated information on quality,
timeliness, and access to health care services that the HMO or its
contractors furnish to Medicaid beneficiaries.
(2) The department shall require Medicaid HMOs to provide
EPSDT utilization data through the encounter data system, and HEDIS
well child health measures in accordance with the National
Committee for Quality Assurance prescribed methodology.
(3) The department shall provide a copy of the analysis of the
Medicaid HMO annual audited HEDIS 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.
(4) 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 MIHP and EPSDT
programs.
(5) The department shall assure that training and technical
assistance are available for EPSDT and MIHP for Medicaid health
plans, local health departments, and MIHP contractors.
Sec. 1670. (1) The appropriation in part 1 for the MIChild
program is to be used to provide comprehensive health care to all
children under age 19 who reside in families with income at or
below 200% of the federal poverty level, who are uninsured and have
not had coverage by other comprehensive health insurance within 6
months of making application for MIChild benefits, and who are
residents of this state. The department shall develop detailed
eligibility criteria through the medical services administration
public concurrence process, consistent with the provisions of this
act. Health 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.
(8) The department shall assure that an external quality
review of each MIChild contractor, as described in subsection (5),
is performed, which analyzes and evaluates the aggregated
information on quality, timeliness, and access to health care
services that the contractor furnished to MIChild beneficiaries.
(9) The department shall develop an automatic enrollment
algorithm that is based on quality and performance factors.
Sec. 1673. The department may establish premiums for MIChild
eligible individuals in families with income above 150% of the
federal poverty level. The monthly premiums shall not be less than
$10.00 or exceed $15.00 for a family.
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) In addition to the appropriations in part 1, 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) The department is authorized to provide civil monetary
penalty funds to the disability network/Michigan to be distributed
to the 15 centers for independent living for the purpose of
assisting individuals with disabilities who reside in nursing homes
to return to their own homes.
(4) The department is authorized to use civil monetary penalty
funds to conduct a survey evaluating consumer satisfaction and the
quality of care at nursing homes. Factors can include, but are not
limited to, the level of satisfaction of nursing home residents,
their families, and employees. The department may use an
independent contractor to conduct the survey.
(5) Any unexpended penalty money, at the end of the year,
shall carry forward to the following year.
Sec. 1684. The department shall submit a report by September
30 of the current fiscal year to the house and senate
appropriations subcommittees on community health, the house and
senate fiscal agencies, and the state budget director that will
identify by waiver agent, Medicaid home- and community-based
services waiver costs by administration, case management, and
direct services.
Sec. 1685. All nursing home rates, class I and class III,
shall have their respective fiscal year rate set 30 days prior to
the beginning of their rate year. Rates may take into account the
most recent cost report prepared and certified by the preparer,
provider corporate owner or representative as being true and
accurate, and filed timely, within 5 months of the fiscal year end
in accordance with Medicaid policy. If the audited version of the
last report is available, it shall be used. Any rate factors based
on the filed cost report may be retroactively adjusted upon
completion of the audit of that cost report.
Sec. 1689. (1) Priority in enrolling additional individuals in
the Medicaid home- and community-based services waiver program
shall be given to those who are currently residing in nursing homes
or who are eligible to be admitted to a nursing home if they are
not provided home- and community-based services. The department
shall use screening and assessment procedures to assure that no
additional Medicaid eligible individuals are admitted to nursing
homes who would be more appropriately served by the Medicaid home-
and community-based services waiver program.
(2) Within 60 days of the end of each fiscal year, the
department shall provide a report to the senate and house
appropriations subcommittees on community health and the senate and
house fiscal agencies that details existing and future allocations
for the home- and community-based services waiver program by
regions as well as the associated expenditures. The report shall
include information regarding the net cost savings from moving
individuals from a nursing home to the home- and community-based
services waiver program, the number of individuals transitioned
from nursing homes to the home- and community-based services waiver
program, the number of individuals on waiting lists by region for
the program, and the amount of funds transferred during the fiscal
year. The report shall also include the number of Medicaid
individuals served and the number of days of care for the home- and
community-based services waiver program and in nursing homes.
(3) The department shall develop a system to collect and
analyze information regarding individuals on the home- and
community-based services waiver program waiting list to identify
the community supports they receive, including, but not limited to,
adult home help, food assistance, and housing assistance services
and to determine the extent to which these community supports help
individuals remain in their home and avoid entry into a nursing
home. The department shall provide a progress report on
implementation to the senate and house appropriations subcommittees
on community health and the senate and house fiscal agencies by
June 1 of the current fiscal year.
(4) The department shall maintain any policies, guidelines,
procedures, standards, and regulations in order to limit the self-
determination option with respect to the home- and community-based
services waiver program to those services furnished by approved
home-based service providers meeting provider qualifications
established in the waiver and approved by the centers for Medicare
and Medicaid services.
Sec. 1690. (1) The department shall submit a report to the
house and senate appropriations subcommittees on community health,
the house and senate fiscal agencies, and the state budget director
by April 1 of the current fiscal year, to include all data
collected on the quality assurance indicators in the preceding
fiscal year for the home- and community-based services waiver
program, as well as quality improvement plans and data collected on
critical incidents in the waiver program and their resolutions.
(2) The department shall submit a report to the house and
senate appropriations subcommittees on community health, the house
and senate fiscal agencies, and the state budget director by April
1 of the current fiscal year, to include all data collected on the
quality assurance indicators in the preceding fiscal year for the
adult home help program, as well as quality improvement plans and
data collected on critical incidents in the adult home help program
and their resolutions.
Sec. 1692. (1) The department 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-based 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. (1) The special Medicaid reimbursement
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.
(2) The department shall ensure that all public entities
eligible for special Medicaid reimbursement that participate in the
Medicaid program are aware of the existence of these programs.
Sec. 1694. The department shall distribute $1,122,300.00 to an
academic health care system that includes a children's hospital
that has a high indigent care volume.
Sec. 1699. (1) The department may make separate payments in
the amount of $45,000,100.00 directly to qualifying hospitals
serving a disproportionate share of indigent patients and to
hospitals providing GME training programs. If direct payment for
GME and DSH is made to qualifying hospitals for services to
Medicaid clients, hospitals shall not include GME costs or DSH
payments in their contracts with HMOs.
(2) The department shall allocate $45,000,000.00 in DSH
funding using the distribution methodology used in fiscal year
2003-2004.
(3) The department shall allocate $100.00 in DSH funding to
unaffiliated hospitals and hospital systems that received less than
$900,000.00 in DSH payments in fiscal year 2007-2008 based on a
formula that is weighted proportional to the product of each
eligible system's Medicaid revenue and each eligible system's
Medicaid utilization, except that no payment of less than $1,000.00
shall be made.
(4) By September 30 of the current fiscal year, the department
shall report to the senate and house appropriations subcommittees
on community health and the senate and house fiscal agencies on the
new distribution of funding to each eligible hospital from the GME
and DSH pools.
(5) The department shall form a workgroup on DSH funding
consisting of representatives from hospitals and hospital systems
receiving DSH funding and the Michigan health and hospital
association. The workgroup shall work to derive a new DSH formula
or formulas designed to provide equitable payments to qualifying
hospitals. The department shall report to the senate and house
appropriations subcommittees on community health and the senate and
house fiscal agencies on the results of the workgroup's efforts by
March 1 of the current fiscal year.
Sec. 1711. The department shall maintain the 2-tier
reimbursement methodology for Medicaid emergency physicians
professional services that was in effect on September 30, 2002.
Sec. 1712. (1) Subject to the availability of funds, the
department shall implement a rural health initiative. Available
funds shall first be allocated as an outpatient adjustor payment to
be paid directly to hospitals in rural counties in proportion to
each hospital's Medicaid and indigent patient population.
Additional funds, if available, shall be allocated for
defibrillator grants, emergency medical technician training and
support, or other similar programs.
(2) Except as otherwise specified in this section, "rural"
means a county, city, village, or township with a population of not
more than 30,000, including those entities if located within a
metropolitan statistical area.
Sec. 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. 1724. The department shall allow licensed pharmacies to
purchase injectable drugs for the treatment of respiratory
syncytial virus for shipment to physicians' offices to be
administered to specific patients. If the affected patients are
Medicaid eligible, the department shall reimburse pharmacies for
the dispensing of the injectable drugs and reimburse physicians for
the administration of the injectable drugs.
Sec. 1731. The department shall continue an asset test to
determine Medicaid eligibility for individuals who are parents,
caretaker relatives, or individuals between the ages of 18 and 21
and who are not required to be covered under federal Medicaid
requirements.
Sec. 1741. The department shall continue to provide nursing
homes the opportunity to receive interim payments upon their
request. The department shall make efforts to ensure that the
interim payments are as similar to expected cost-settled payments
as possible.
Sec. 1757. (1) The department shall direct the department of
human services to obtain proof from all Medicaid recipients that
they are legal United States citizens or otherwise legally residing
in this country and that they are residents of this state before
approving Medicaid eligibility.
(2) It is the intent of the legislature that the department
seek clarification from the federal government on whether states
can deny Medicaid eligibility to fugitive felons through a state
plan amendment or waiver. The department shall report to the
legislature on the results of this effort.
Sec. 1764. The department shall annually certify rates paid to
Medicaid health plans as being actuarially sound in accordance with
federal requirements and shall provide a copy of the rate
certification and approval immediately to the house and senate
appropriations subcommittees on community health and the house and
senate fiscal agencies.
Sec. 1767. The department shall study and evaluate the impact
of the change in the way in which the Medicaid program pays
pharmacists for prescriptions from average wholesale price to
average manufacturer price as required by the federal deficit
reduction act of 2005, Public Law 109-171. Upon release of the data
by the centers for Medicare and Medicaid services, the department
shall submit a report of its study to the senate and house
appropriations subcommittees on community health and the senate and
house fiscal agencies. If the department finds that there is a
negative impact on the pharmacists, the department shall reexamine
the current pharmaceutical dispensing fee structure established
under section 1620 and include in the report recommendations and
proposals to counter the negative impact of that federal
legislation.
Sec. 1770. In conjunction with the consultation requirements
of the social welfare act, 1939 PA 280, MCL 400.1 to 400.119b, and
except as otherwise provided in this section, the department shall
attempt to make the effective date for a proposed Medicaid policy
bulletin or adjustment to the Medicaid provider manual on October
1, January 1, April 1, or July 1 after the end of the consultation
period. The department may provide an effective date for a proposed
Medicaid policy bulletin or adjustment to the Medicaid provider
manual other than provided for in this section if necessary to be
in compliance with federal or state law, regulations, or rules or
with an executive order of the governor.
Sec. 1775. If the state's application for a waiver to
implement managed care for dual Medicare/Medicaid eligible is
approved by the federal government, by April 1, 2012 the department
shall provide a report to the senate and house appropriations
subcommittees on community health and the senate and house fiscal
agencies. This report shall include information on the amount of
Medicare funding that would be provided to the state as a block
grant, the number of individuals who would be enrolled in the
program, which Medicaid health plans that would be participating,
and the estimated savings from the new program.
Sec. 1777. From the funds appropriated in part 1 for long-term
care services, the department shall permit, in accordance with
applicable federal and state law, nursing homes to use dining
assistants to feed eligible residents if legislation to permit the
use of dining assistants is enacted into law. The department shall
not be responsible for costs associated with training dining
assistants.
Sec. 1787. The department shall require the managed care
enrollment broker to maintain telephone numbers of Medicaid
beneficiaries and provide each Medicaid health plan with the
telephone number of that health plan's enrollees on a monthly
basis.
Sec. 1793. The department shall consider the development of a
pilot project that focuses on the prevention of preventable
hospitalizations from nursing homes.
Sec. 1804. The department, in cooperation with the department
of human services, shall work with the federal public assistance
reporting information system to identify Medicaid recipients who
are veterans and who may be eligible for federal veterans health
care benefits or other benefits.
Sec. 1815. From the funds appropriated in part 1 for health
plan services, the department shall not implement a capitation
withhold as part of the overall capitation rate schedule that
exceeds the 0.19% withhold administered during fiscal year 2008-
2009.
Sec. 1817. The department shall report to the legislature on
implementation of a policy that will prohibit billing for care made
necessary by preventable medical errors or adverse health events no
later than April 1 of the current fiscal year.
Sec. 1819. The department shall use Medicaid health plan
encounter data in the development and revision of hospital
diagnosis related group pricing policy.
Sec. 1822. The department, the department's contracted
Medicaid pharmacy benefit manager, and all Medicaid health plans
shall implement coverage for a mental health prescription drug
within 30 days of that drug's approval by the department's pharmacy
and therapeutics committee.
Sec. 1826. The department shall develop a plan to expand and
improve the beneficiary monitoring program. This plan shall include
cost-effective methods to monitor and reduce unnecessary health
care services, including prescription drugs, improve coordination
of services between the primary care physician and mental health
and substance abuse service providers, and improve compliance with
prescribed medical management to reduce more costly use of
emergency services. The department shall submit this plan to the
house and senate appropriations subcommittees on community health,
the house and senate fiscal agencies, and the state budget director
by April 1 of the current fiscal year.
Sec. 1829. Notwithstanding the removal of coverage for certain
optional Medicaid services, the department shall continue its
policy of providing coverage for emergency services. For this
purpose, the department shall continue to adhere to the guidelines
outlined in Medical Services Administration Bulletin MSA 09-28.
Sec. 1832. (1) The department shall continue efforts to
standardize billing formats, referral forms, electronic
credentialing, primary source verification, electronic billing and
attachments, claims status, eligibility verification, and reporting
of accepted and rejected encounter records received in the
department data warehouse.
(2) The department shall convene a workgroup on making e-
billing mandatory for the Medicaid program. The workgroup shall
include representatives from medical provider organizations,
Medicaid HMOs, and the department. The department shall report to
the legislature on the findings of the workgroup by April 1 of the
current fiscal year.
(3) The department shall provide a report by April 1 of the
current fiscal year to the senate and house appropriations
subcommittees on community health and the senate and house fiscal
agencies detailing the percentage of claims for Medicaid
reimbursement provided to the department that were initially
rejected in the first quarter of fiscal year 2011-2012.
Sec. 1835. The department shall develop and implement
processes to report rejected and accepted encounters to Medicaid
health plans. Medicaid health plans shall be permitted to report
additional medical records data obtained during medical record
audits to the encounter warehouse consistent with Medicare
guidelines.
Sec. 1836. In addition to the guidelines established in
Medical Services Administration Bulletin MSA 09-28, medically
necessary optical devices and other treatment services for adult
Medicaid patients shall be covered when conventional treatments do
not provide functional vision correction. Such ocular conditions
include, but are not limited to, congenital or acquired ocular
disease or eye trauma.
Sec. 1837. The department shall explore utilization of
telemedicine as a strategy to increase access to primary care
services for Medicaid recipients in medically underserved areas.
Sec. 1842. (1) Subject to the availability of funds, the
department shall adjust the hospital outpatient Medicaid
reimbursement rate for qualifying hospitals as provided in this
section. The Medicaid reimbursement rate for qualifying hospitals
shall be adjusted to provide each qualifying hospital with its
actual cost of delivering outpatient services to Medicaid
recipients.
(2) As used in this section, "qualifying hospital" means a
hospital that has not more than 50 staffed beds and is either
located outside a metropolitan statistical area or in a
metropolitan statistical area but within a city, village, or
township with a population of not more than 12,000 according to the
official 2000 federal decennial census and within a county with a
population of not more than 165,000 according to the official 2000
federal decennial census.
Sec. 1847. (1) The department shall collect and report to the
senate and house appropriations subcommittees on community health
and the senate and house fiscal agencies the following information
by March 1 of the current fiscal year:
(a) The number and percentage of medical residents by hospital
who were residents of Michigan prior to beginning their residency.
(b) The number and percentage of medical residents by hospital
who took positions in the state of Michigan during 2011 immediately
following completion of their residency.
(c) The distribution of these in-state placements by county
and by specialty.
(d) The distribution of graduated medical residents in
medically underserved areas by physician specialty.
(2) It is the intent of the legislature that Medicaid graduate
medical education payments in fiscal year 2012-2013 shall be made
using a formula that incorporates the data reported in subsection
(1).
Sec. 1848. (1) A hospital or freestanding surgical outpatient
facility may report whether a registered nurse, qualified by
training and experience in operating room nursing, is present as a
circulating nurse in each separate operating room where surgery is
being performed for the duration of the operative procedure. This
section does not preclude a circulating nurse from leaving the
operating room as part of the procedure, leaving the operating room
as part of the operative procedure, leaving the operating room for
short periods, or, in accordance with employer rules or
regulations, being relieved during an operative procedure by
another circulating nurse assigned to continue the operative
procedure.
(2) The department shall report any data collected pursuant to
subsection (1) on the use of a circulating nurse in the operating
room of hospitals and freestanding surgical outpatient facilities
to the legislature on an annual basis. The circulating nurse shall
assist administration in assuring regulatory compliance data are
collected, including the verification of the circulating nurse.
Sec. 1849. (1) The department may use 50% of the funds
allocated for voluntary in-home visiting services for evidence-
based models.
(2) As used in this section:
(a) "Evidence-based" means a program or practice that meets
both of the following requirements:
(i) The program or practice is governed by a program manual or
protocol that specifies the nature, quality, and amount of service
that constitutes the program.
(ii) Scientific research using methods that meet high
scientific standards for evaluating the effects of the program must
have demonstrated, with 2 or more separate client samples, that the
program improves client outcomes central to the purpose of the
program.
(b) "In-home visiting services" means a service delivery
strategy that is carried out in the homes of families or children
from conception to school age that provides culturally sensitive
face-to-face visits by nurses or other professionals trained to
promote positive parenting practices, enhance the socio-emotional
and cognitive development of children, improve health of the
family, and empower the family to be self-sufficient.
Sec. 1850. The department shall allow Medicaid health plans to
assist with the redetermination process through outreach activities
to ensure continuation of Medicaid eligibility and enrollment in
managed care. This may include mailings, telephone contact, or
face-to-face contact with beneficiaries enrolled in the individual
Medicaid health plan. Health plans may offer assistance in
completing paperwork for beneficiaries enrolled in their plan.
Sec. 1851. The department is encouraged to consider seeking
bids for statewide or regional contracts for Medicaid durable
medical equipment services.
Sec. 1852. The department shall work with the department of
energy, labor, and economic growth to integrate fully state
inspections of nursing facilities.
Sec. 1853. The department shall form a workgroup composed of
representatives from the Medicaid HMOs and the Michigan association
of health plans to develop revisions to the process of
automatically assigning new Medicaid recipients to HMOs if they do
not choose an HMO upon enrollment. The department shall report on
the results of the workgroup's findings to the senate and house
appropriations subcommittees on community health and the senate and
house fiscal agencies by March 1 of the current fiscal year.
Sec. 1854. The department shall work with a provider of kidney
dialysis services and renal care products that has completed a
centers for Medicare and Medicaid services end stage renal disease
management demonstration project to design and implement a
statewide chronic kidney disease management program as authorized
under section 2703 of the patient protection and affordable care
act, Public Law 111-148. The department shall work with the
provider to develop a chronic condition health home program for
Medicaid enrollees identified with chronic kidney disease and
transitioning through the first 3 months of dialysis. The
department and the provider will create metrics for the measurement
of the program that include both cost savings and clinical
improvement. The department shall report to the senate and house
appropriations subcommittees on community health to provide
progress updates on compliance with this section.
Sec. 1855. The department is encouraged to consider the
feasibility of a revenue-neutral, financially risk-averse Medicaid
patient optimization solution for the support of emergency
department redirection for non-emergent patients.
Sec. 1856. If funds become available it is the intent of the
legislature that funding for graduate medical education be
increased.
PART 2A
PROVISIONS CONCERNING ANTICIPATED APPROPRIATIONS
FOR FISCAL YEAR 2012-2013
GENERAL SECTIONS
Sec. 1901. It is the intent of the legislature to provide
appropriations for the fiscal year ending on September 30, 2013 for
the line items listed in part 1. The fiscal year 2012-2013
appropriations are anticipated to be the same as those for fiscal
year 2011-2012, except that the line items will be adjusted for
changes in caseload and related costs, federal fund match rates,
economic factors, and available revenue. These adjustments will be
determined after the January 2012 consensus revenue estimating
conference. The January 2012 consensus revenue estimating
conference shall include estimates for fiscal year 2011-2012,
fiscal year 2012-2013, and fiscal year 2013-2014 for the following:
(a) State revenue.
(b) Prison population and correction expenditures.
(c) Annual percentage growth in the school aid basic
foundation allowance.
(d) Medicaid expenditures.
(e) Human service caseloads and expenditures.