SB-0950, As Passed Senate, April 24, 2012

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SUBSTITUTE FOR

 

SENATE BILL NO. 950

 

 

 

 

 

 

 

 

 

 

 

     A bill to make appropriations for the department of community

 

health for the fiscal year ending September 30, 2013; and to

 

provide for the expenditure of the appropriations.

 

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 

PART 1

 

LINE-ITEM APPROPRIATIONS

 

FOR FISCAL YEAR 2012-2013

 

     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, 2013,

 

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........ 3,533.6

 

   Average population.............................. 893.0

 

GROSS APPROPRIATION.................................... $ 15,035,513,000

 

   Interdepartmental grant revenues:

 

Total interdepartmental grants and intradepartmental

 

   transfers............................................        10,023,800

 

ADJUSTED GROSS APPROPRIATION........................... $ 15,025,489,200

 

   Federal revenues:

 

Total other federal revenues...........................     9,702,741,100

 

   Special revenue funds:

 

Total local revenues...................................       257,214,300

 

Total private revenues.................................        93,364,000

 

Merit award trust fund.................................        81,202,200

 

Total other state restricted revenues..................     2,065,355,300

 

State general fund/general purpose..................... $  2,825,612,300

 

    State general fund/general purpose schedule:

 

   Ongoing state general fund/general

 

    purpose................................ 2,816,040,100

 

   One-time state general fund/general

 

    purpose.................................... 9,572,200

 

   Sec. 102. DEPARTMENTWIDE ADMINISTRATION

 

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

 

   Full-time equated classified positions.......... 171.7

 

Director and other unclassified--6.0 FTE positions..... $        583,900

 

Departmental administration and management--161.7


 

   FTE positions........................................        23,953,300

 

Worker's compensation program..........................         7,612,800

 

Rent and building occupancy............................         9,386,500

 

Developmental disabilities council and

 

   projects--10.0 FTE positions.........................         2,986,900

 

GROSS APPROPRIATION.................................... $     44,523,400

 

    Appropriated from:

 

   Interdepartmental grant revenues:

 

   Federal revenues:

 

Total federal revenues.................................        14,547,300

 

   Special revenue funds:

 

Total private revenues.................................            34,600

 

Total other state restricted revenues..................           780,500

 

State general fund/general purpose..................... $     29,161,000

 

   Sec. 103. BEHAVIORAL HEALTH ADMINISTRATION

 

   Full-time equated classified positions........... 99.0

 

Behavioral health program administration--98.0 FTE

 

   positions............................................ $     17,310,400

 

Gambling addiction--1.0 FTE positions..................         3,000,000

 

Protection and advocacy services support...............           194,400

 

Community residential and support services.............         1,549,100

 

Federal and other special projects.....................         3,541,600

 

Family support subsidy.................................        19,161,000

 

Housing and support services...........................        11,322,500

 

GROSS APPROPRIATION.................................... $     56,079,000

 

    Appropriated from:

 

   Federal revenues:


 

Total federal revenues.................................        39,551,500

 

   Special revenue funds:

 

Total private revenues.................................           400,000

 

Total other state restricted revenues..................         3,000,000

 

State general fund/general purpose..................... $     13,127,500

 

   Sec. 104. COMMUNITY MENTAL HEALTH/SUBSTANCE ABUSE

 

SERVICES PROGRAMS

 

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

 

Medicaid mental health services........................ $  2,193,680,100

 

Community mental health non-Medicaid services..........       274,136,200

 

Medicaid adult benefits waiver.........................        32,056,100

 

Mental health services for special populations.........         5,842,800

 

Medicaid substance abuse services......................        48,071,700

 

CMHSP, purchase of state services contracts............       144,662,600

 

Civil service charges..................................         1,499,300

 

Federal mental health block grant--2.5 FTE positions...        15,424,900

 

State disability assistance program substance abuse

 

   services.............................................         2,018,800

 

Community substance abuse prevention, education, and

 

   treatment programs...................................        80,093,000

 

Children's waiver home care program....................        19,444,800

 

Nursing home PAS/ARR-OBRA--7.0 FTE positions...........        12,233,600

 

Children with serious emotional disturbance waiver.....        12,651,000

 

GROSS APPROPRIATION.................................... $  2,841,814,900

 

    Appropriated from:

 

   Interdepartmental grant revenues:

 

Interdepartmental grant from the department of human


 

   services.............................................         6,194,900

 

   Federal revenues:

 

Total federal revenues.................................     1,622,885,500

 

   Special revenue funds:

 

Total local revenues...................................        25,228,900

 

Total other state restricted revenues..................        22,261,900

 

State general fund/general purpose..................... $  1,165,243,700

 

   Sec. 105. STATE PSYCHIATRIC HOSPITALS AND FORENSIC

 

MENTAL HEALTH SERVICES

 

   Total average population........................ 893.0

 

   Full-time equated classified positions........ 2,130.9

 

Caro Regional Mental Health Center - psychiatric

 

   hospital - adult--461.3 FTE positions................ $     62,314,100

 

   Average population.............................. 185.0

 

Kalamazoo Psychiatric Hospital - adult--466.1 FTE

 

   positions............................................        60,153,200

 

   Average population.............................. 189.0

 

Walter P. Reuther Psychiatric Hospital -

 

   adult--420.8 FTE positions...........................        55,687,500

 

   Average population.............................. 234.0

 

Hawthorn Center - psychiatric hospital - children

 

   and adolescents--226.4 FTE positions.................        28,636,900

 

   Average population............................... 75.0

 

Center for forensic psychiatry--556.3 FTE positions....        69,151,200

 

   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.................................... $    278,591,000

 

    Appropriated from:

 

   Federal revenues:

 

Total federal revenues.................................        33,737,000

 

   Special revenue funds:

 

CMHSP, purchase of state services contracts............       144,662,600

 

Other local revenues...................................        18,713,000

 

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

 

Total other state restricted revenues..................        16,542,000

 

State general fund/general purpose..................... $     63,936,400

 

   Sec. 106. PUBLIC HEALTH ADMINISTRATION

 

   Full-time equated classified positions.......... 101.9

 

Public health administration--7.3 FTE positions........ $      1,594,000

 

Health and wellness initiatives--10.7 FTE positions....         5,146,700

 

Minority health grants and contracts--2.5 FTE

 

   positions............................................           612,700

 

Vital records and health statistics--81.4 FTE

 

   positions............................................         9,643,300

 

GROSS APPROPRIATION.................................... $     16,996,700

 

    Appropriated from:

 

   Interdepartmental grant revenues:

 

Interdepartmental grant from the department of human


 

   services.............................................         1,181,200

 

   Federal revenues:

 

Total federal revenues.................................         4,229,700

 

   Special revenue funds:

 

Total other state restricted revenues..................        10,301,600

 

State general fund/general purpose..................... $      1,284,200

 

   Sec. 107. HEALTH POLICY

 

   Full-time equated classified positions........... 64.8

 

Emergency medical services program state staff--23.0

 

   FTE positions........................................ $      4,502,400

 

Emergency medical services grants and services.........           660,000

 

Health policy administration--24.1 FTE positions.......         4,304,600

 

Nurse scholarship, education, and research

 

   program--3.0 FTE positions...........................           762,300

 

Certificate of need program administration--12.3 FTE

 

   positions............................................         2,021,900

 

Rural health services--1.0 FTE positions...............         1,504,100

 

Michigan essential health provider.....................           491,400

 

Primary care services--1.4 FTE positions...............         3,236,000

 

GROSS APPROPRIATION.................................... $     17,482,700

 

    Appropriated from:

 

   Interdepartmental grant revenues:

 

Interdepartmental grant from the department of

 

   licensing and regulatory affairs.....................         2,058,800

 

Interdepartmental grant from the department of

 

   treasury, Michigan state hospital finance authority..           112,400

 

   Federal revenues:


 

Total federal revenues.................................         5,645,800

 

   Special revenue funds:

 

Total private revenues.................................           255,000

 

Total other state restricted revenues..................         5,783,000

 

State general fund/general purpose..................... $      3,627,700

 

   Sec. 108. INFECTIOUS DISEASE CONTROL

 

   Full-time equated classified positions........... 44.5

 

AIDS prevention, testing, and care programs--12.7

 

   FTE positions........................................ $     58,558,700

 

Immunization local agreements..........................        11,975,200

 

Immunization program management and field

 

   support--12.8 FTE positions..........................         1,835,300

 

Pediatric AIDS prevention and control--1.0 FTE

 

   positions............................................         1,233,100

 

Sexually transmitted disease control local agreements..         3,360,700

 

Sexually transmitted disease control management and

 

   field support--18.0 FTE positions....................         3,794,100

 

GROSS APPROPRIATION.................................... $     80,757,100

 

    Appropriated from:

 

   Federal revenues:

 

Total federal revenues.................................        42,597,900

 

   Special revenue funds:

 

Total private revenues.................................        27,707,700

 

Total other state restricted revenues..................         7,605,200

 

State general fund/general purpose..................... $      2,846,300

 

   Sec. 109. LABORATORY SERVICES

 

   Full-time equated classified positions.......... 100.0


 

Laboratory services--100.0 FTE positions............... $      18,023,400

 

GROSS APPROPRIATION.................................... $     18,023,400

 

    Appropriated from:

 

   Interdepartmental grant revenues:

 

Interdepartmental grant from the department of

 

   environmental quality................................           456,800

 

   Federal revenues:

 

Total federal revenues.................................         2,730,500

 

   Special revenue funds:

 

Total other state restricted revenues..................         8,310,400

 

State general fund/general purpose..................... $      6,525,700

 

   Sec. 110. EPIDEMIOLOGY

 

   Full-time equated classified positions.......... 115.1

 

AIDS surveillance and prevention program............... $      2,254,100

 

Bioterrorism preparedness--55.0 FTE positions..........        35,201,400

 

Epidemiology administration--41.6 FTE positions........         9,253,000

 

Healthy homes program--8.0 FTE positions...............         2,932,100

 

Lead abatement program.................................               100

 

Newborn screening follow-up and treatment

 

   services--10.5 FTE positions.........................         5,629,000

 

Tuberculosis control and prevention....................           867,000

 

GROSS APPROPRIATION.................................... $     56,136,700

 

    Appropriated from:

 

   Federal revenues:

 

Total federal revenues.................................        47,078,200

 

   Special revenue funds:

 

Total private revenues.................................           100,000


 

Total other state restricted revenues..................         7,007,500

 

State general fund/general purpose..................... $      1,951,000

 

   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...............           524,400

 

Medicaid outreach cost reimbursement to local health

 

   departments..........................................         9,000,000

 

GROSS APPROPRIATION.................................... $     46,930,500

 

    Appropriated from:

 

   Federal revenues:

 

Total federal revenues.................................         9,524,400

 

   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........... 64.3

 

Cancer prevention and control program--11.0 FTE

 

   positions............................................ $     14,932,600

 

Chronic disease control and health promotion

 

   administration--29.4 FTE positions...................         6,833,800

 

Diabetes and kidney program--8.0 FTE positions.........         1,855,700

 

Injury control intervention project....................               100

 

Public health traffic safety coordination--1.0 FTE

 

   positions............................................            93,800


 

Smoking prevention program--12.0 FTE positions.........         2,172,100

 

Violence prevention--2.9 FTE positions.................         2,158,000

 

GROSS APPROPRIATION.................................... $     28,046,100

 

    Appropriated from:

 

   Interdepartmental grant revenues:

 

   Federal revenues:

 

Total federal revenues.................................        25,083,400

 

   Special revenue funds:

 

Total private revenues.................................           500,000

 

Total other state restricted revenues..................           721,200

 

State general fund/general purpose..................... $      1,741,500

 

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

 

SERVICES

 

   Full-time equated classified positions........... 49.6

 

Childhood lead program--2.5 FTE positions.............. $        653,900

 

Dental programs--3.0 FTE positions.....................         1,109,400

 

Dental program for persons with developmental

 

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

 

Family, maternal, and children's health services

 

   administration--41.6 FTE positions...................         6,654,000

 

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....         3,794,200

 

Special projects--2.5 FTE positions....................        12,228,900

 

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

 

GROSS APPROPRIATION.................................... $     41,618,600


 

    Appropriated from:

 

   Federal revenues:

 

Total federal revenues.................................        35,518,100

 

   Special revenue funds:

 

Total local revenues...................................            75,000

 

Total private revenues.................................           873,200

 

State general fund/general purpose..................... $      5,152,300

 

   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............. $     16,294,500

 

Women, infants, and children program local

 

   agreements and food costs............................       253,825,500

 

GROSS APPROPRIATION.................................... $    270,120,000

 

    Appropriated from:

 

   Federal revenues:

 

Total federal revenues.................................       211,501,600

 

   Special revenue funds:

 

Total private revenues.................................        58,618,400

 

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

 

   Sec. 115. CHILDREN'S SPECIAL HEALTH CARE SERVICES

 

   Full-time equated classified positions........... 46.8

 

Children's special health care services

 

   administration--44.0 FTE positions................... $      5,385,600

 

Bequests for care and services--2.8 FTE positions......         1,511,400

 

Outreach and advocacy..................................         5,510,000


 

Nonemergency medical transportation....................         2,679,300

 

Medical care and treatment.............................       286,029,400

 

GROSS APPROPRIATION.................................... $    301,115,700

 

    Appropriated from:

 

   Federal revenues:

 

Total federal revenues.................................       167,886,700

 

   Special revenue funds:

 

Total private revenues.................................           996,800

 

Total other state restricted revenues..................         3,848,500

 

State general fund/general purpose..................... $    128,383,700

 

   Sec. 116. CRIME VICTIM SERVICES COMMISSION

 

   Full-time equated classified positions........... 13.0

 

Grants administration services--13.0 FTE positions..... $      2,460,000

 

Justice assistance grants..............................        19,106,100

 

Crime victim rights services grants....................        16,570,000

 

GROSS APPROPRIATION.................................... $     38,136,100

 

    Appropriated from:

 

   Federal revenues:

 

Total federal revenues.................................        24,083,800

 

   Special revenue funds:

 

Total other state restricted revenues..................        14,052,300

 

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

 

   Sec. 117. OFFICE OF SERVICES TO THE AGING

 

   Full-time equated classified positions........... 40.0

 

Office of services to aging administration--40.0 FTE

 

   positions............................................ $      6,724,200

 

Community services.....................................        35,314,600


 

Nutrition services.....................................        35,430,200

 

Foster grandparent volunteer program...................         2,233,600

 

Retired and senior volunteer program...................           627,300

 

Senior companion volunteer program.....................         1,604,400

 

Employment assistance..................................         3,500,000

 

Respite care program...................................         5,868,700

 

GROSS APPROPRIATION.................................... $     91,303,000

 

    Appropriated from:

 

   Federal revenues:

 

Total federal revenues.................................        57,029,700

 

   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..................... $     27,727,100

 

   Sec. 118. MEDICAL SERVICES ADMINISTRATION

 

   Full-time equated classified positions.......... 435.5

 

Medical services administration--411.5 FTE positions... $     66,277,400

 

Facility inspection contract...........................           132,800

 

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

 

Electronic health record incentive program--24.0 FTE

 

   positions............................................       144,081,400

 

GROSS APPROPRIATION.................................... $    214,819,400

 

    Appropriated from:

 

   Federal revenues:

 

Total federal revenues.................................       190,394,900

 

   Special revenue funds:


 

Total local revenues...................................           105,900

 

Total private revenues.................................           100,000

 

Total other state restricted revenues..................           115,400

 

State general fund/general purpose..................... $     24,103,200

 

   Sec. 119. MEDICAL SERVICES

 

Hospital services and therapy.......................... $  1,317,201,300

 

Hospital disproportionate share payments...............       45,000,100

 

Physician services.....................................       363,599,600

 

Medicare premium payments..............................       412,142,400

 

Pharmaceutical services................................       287,141,800

 

Home health services...................................         4,385,000

 

Hospice services.......................................       103,278,800

 

Transportation.........................................        18,868,900

 

Auxiliary medical services.............................         3,596,400

 

Dental services........................................       175,357,300

 

Ambulance services.....................................        12,790,000

 

Long-term care services................................     1,731,358,900

 

Medicaid home- and community-based services waiver.....       232,991,100

 

Adult home help services...............................       295,217,600

 

Personal care services.................................        13,682,800

 

Program of all-inclusive care for the elderly..........        34,792,800

 

Autism services........................................               100

 

Health plan services...................................     4,410,770,700

 

MIChild program........................................        67,461,400

 

Plan first family planning waiver......................        14,295,500

 

Medicaid adult benefits waiver.........................       105,877,700

 

Special indigent care payments.........................        95,738,900


 

Federal Medicare pharmaceutical program................       192,209,800

 

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

 

Subtotal basic medical services program................     9,958,038,400

 

School-based services..................................      131,502,700

 

Special Medicaid reimbursement.........................       390,962,100

 

Subtotal special medical services payments.............       522,464,800

 

GROSS APPROPRIATION.................................... $ 10,480,503,200

 

    Appropriated from:

 

   Federal revenues:

 

Total federal revenues.................................     7,086,654,900

 

   Special revenue funds:

 

Total local revenues...................................        63,128,500

 

Total private revenues.................................         2,100,000

 

Merit award trust fund.................................        76,733,500

 

Total other state restricted revenues..................     1,961,421,700

 

State general fund/general purpose..................... $  1,290,464,600

 

   Sec. 120. INFORMATION TECHNOLOGY

 

Information technology services and projects........... $     35,028,400

 

Michigan Medicaid information system...................        30,201,100

 

GROSS APPROPRIATION.................................... $     65,229,500

 

    Appropriated from:

 

   Federal revenues:

 

Total federal revenues.................................        44,780,800

 

   Special revenue funds:

 

Total other state restricted revenues..................         1,940,600

 

State general fund/general purpose..................... $     18,508,100

 

   Sec. 121. ONE-TIME BASIS ONLY APPROPRIATIONS


 

State employee lump-sum payments....................... $      4,285,300

 

Health and wellness initiatives........................         3,000,100

 

Hospital services and therapy - graduate medical

 

   education............................................               100

 

Hospital services and therapy - rural and sole

 

   community hospitals..................................               100

 

Laboratory services....................................               100

 

Mental health services for special populations.........               100

 

Michigan Medicaid information system...................        40,000,000

 

Office of services to the aging administration.........               100

 

Primary care services -- island clinics................               100

 

GROSS APPROPRIATION.................................... $     47,286,000

 

    Appropriated from:

 

   Interdepartmental grant revenues:

 

Total interdepartmental grant revenues.................            19,700

 

   Federal revenues:

 

Total federal revenues.................................        37,279,400

 

   Special revenue funds:

 

Total local revenues...................................           150,400

 

Total private revenues.................................               800

 

Total other state restricted revenues..................           263,500

 

State general fund/general purpose..................... $      9,572,200

 

 

 

 

 

PART 2

 

PROVISIONS CONCERNING APPROPRIATIONS

 

FOR FISCAL YEAR 2012-2013


 

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 2012-2013 is $4,972,169,800.00 and

 

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

 

government for fiscal year 2012-2013 is $1,424,679,200.00. 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............. $        258,500

 

Housing and support services...........................           599,800

 

COMMUNITY MENTAL HEALTH/SUBSTANCE ABUSE SERVICES PROGRAMS

 

State disability assistance program substance abuse

 

    services............................................ $      2,018,000

 

Community substance abuse prevention, education, and

 

    treatment programs..................................        14,556,800

 

Medicaid mental health services........................       709,306,800

 

Community mental health non-Medicaid services..........       274,136,200

 

Mental health services for special populations.........         5,842,800

 

Medicaid adult benefits waiver.........................        10,774,100

 

Medicaid substance abuse services......................        16,156,900

 

Children's waiver home care program....................         5,857,500

 

Nursing home PAS/ARR-OBRA..............................         2,703,800

 

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..           175,200

 

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 ........................................            75,000

 

FAMILY, MATERNAL, AND CHILDREN'S HEALTH SERVICES

 

Childhood lead program................................. $         51,100

 

Prenatal care outreach and service delivery support....         1,500,000

 

CHILDREN'S SPECIAL HEALTH CARE SERVICES

 

Medical care and treatment............................. $      1,409,900

 

Outreach and advocacy..................................         1,237,500

 

MEDICAL SERVICES

 

Dental services........................................ $      2,536,000

 

Long-term care services................................       285,952,300

 

Transportation.........................................         2,971,900

 

Medicaid adult benefits waiver.........................         6,246,800

 

Hospital services and therapy..........................         4,965,500

 

Physician services.....................................         3,774,800

 

OFFICE OF SERVICES TO THE AGING

 

Community services..................................... $     12,233,700


 

Nutrition services.....................................         8,787,000

 

Foster grandparent volunteer program...................           679,800

 

Retired and senior volunteer program...................           175,000

 

Senior companion volunteer program.....................           215,000

 

Respite care program...................................         5,384,800

 

CRIME VICTIM SERVICES COMMISSION

 

Crime victim rights services grants.................... $     10,300,000

 

TOTAL OF PAYMENTS TO LOCAL UNITS

 

OF GOVERNMENT.......................................... $  1,424,679,200

 

     Sec. 202. The appropriations authorized under this article are

 

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

 

to 18.1594.

 

     Sec. 203. As used in this article:

 

     (a) "AIDS" means acquired immunodeficiency syndrome.

 

     (b) "CMHSP" means a community mental health services program

 

as that term is defined in section 100a of the mental health code,

 

1974 PA 258, MCL 330.1100a.

 

     (c) "Current fiscal year" means the fiscal year ending

 

September 30, 2013.

 

     (d) "Department" means the department of community health.

 

     (e) "Director" means the director of the department.

 

     (f) "DSH" means disproportionate share hospital.

 

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

 

treatment.

 

     (h) "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.

 

     (i) "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.

 

     (j) "GME" means graduate medical education.

 

     (k) "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.

 

     (l) "HEDIS" means healthcare effectiveness data and information

 

set.

 

     (m) "HIV" means human immunodeficiency virus.

 

     (n) "HMO" means health maintenance organization.

 

     (o) "IDEA" means the individuals with disabilities education

 

act, 20 USC 1400 to 1482.

 

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

 

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

 

     (r) "PAS/ARR-OBRA" 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.

 

     (s) "PIHP" means a specialty prepaid inpatient health plan for

 

Medicaid mental health services, services to individuals with

 

developmental disabilities, and substance abuse services. Specialty

 

prepaid inpatient health plans are described in section 232b of the

 

mental health code, 1974 PA 258, MCL 330.1232b.

 

     (t) "Title XVIII" and "Medicare" mean title XVIII of the


 

social security act, 42 USC 1395 to 1395kkk-1.

 

     (u) "Title XIX" and "Medicaid" mean title XIX of the social

 

security act, 42 USC 1396 to 1396w-5.

 

     (v) "Title XX" means title XX of the social security act, 42

 

USC 1397 to 1397m-5.

 

     Sec. 206. (1) In addition to the funds appropriated in part 1,

 

there is appropriated an amount not to exceed $200,000,000.00 for

 

federal contingency funds. These funds are not available for

 

expenditure until they have been transferred to another line item

 

in this article 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 $40,000,000.00 for state

 

restricted contingency funds. These funds are not available for

 

expenditure until they have been transferred to another line item

 

in this article 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

 

article 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 $20,000,000.00 for private

 

contingency funds. These funds are not available for expenditure

 

until they have been transferred to another line item in this


 

article under section 393(2) of the management and budget act, 1984

 

PA 431, MCL 18.1393.

 

     Sec. 208. Unless otherwise specified, the departments shall

 

use the Internet to fulfill the reporting requirements of this

 

article. 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 that businesses in deprived and depressed communities

 

compete for and perform contracts to provide services or supplies,

 

or both. The director shall strongly encourage firms with which the

 

department contracts to subcontract with certified businesses in

 

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

 

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

 

and collections exceeds the amount appropriated in part 1, the

 

revenue may be carried forward with the approval of the state


 

budget director into the subsequent fiscal year. The revenue

 

carried forward under this section shall be used as the first

 

source of funds in the subsequent fiscal year.

 

     Sec. 212. (1) 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.

 

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

 

receiving tobacco tax funds and healthy Michigan funds from part 1

 

shall report by April 1 of the current fiscal year to the senate

 

and house appropriations committees, the senate and house fiscal

 

agencies, and the state budget director on the following:

 

     (a) Detailed spending plan by appropriation line item

 

including description of programs and a summary of organizations

 

receiving these funds.

 

     (b) Description of allocations or bid processes including need

 

or demand indicators used to determine allocations.

 

     (c) Eligibility criteria for program participation and maximum


 

benefit levels where applicable.

 

     (d) Outcome measures used to evaluate programs, including

 

measures of the effectiveness of these programs in improving the

 

health of Michigan residents.

 

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

 

representatives or senate appropriations committees or the state

 

budget director.

 

     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.

 

     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 January 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. 223. The department may establish and collect fees for

 

publications, videos and related materials, conferences, and


Senate Bill No. 950 as amended April 24, 2012

 

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. 224. From the funds appropriated in part 1, the

department shall not expend any funds to enforce the ban on smoking in public places under part 126 of the public health code, 1978 PA 368,

MCL 333.12601 to 333.12616, on annual charitable fundraising dinners

that have been in existence for at least 10 years.>>

     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.

 

     (3) The department shall inform the senate and house

 

appropriations subcommittees on community health and the senate and

 

house fiscal agencies of any alterations or adjustments made to the

 

published plan for integrated care for individuals who are dual

 

Medicare/Medicaid eligibles when the final version of the plan has

 

been submitted to the federal centers for Medicare and Medicaid

 

services or the federal department of health and human services.

 

     (4) At least 30 days before implementation of the plan for

 

integrated care for individuals who are dual Medicare/Medicaid

 

eligibles, the department shall submit the plan to the legislature


 

for review.

 

     Sec. 265. The department 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.

 

The department may electronically retain copies of reports unless

 

otherwise required by federal and state guidelines.

 

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

 

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

 

2012 shall be limited to situations in which 1 or more of the

 

following conditions apply:

 

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

 

for law enforcement purposes.

 

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

 

Michigan citizens or visitors or to assist other states in similar

 

circumstances.

 

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

 

increase state revenues, including protecting existing federal

 

funds or securing additional federal funds.

 

     (d) The travel is necessary to comply with federal

 

requirements.

 

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

 

staff that is not available within this state.

 

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

 

funds.

 

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

 

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


 

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

 

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

 

to the senate and house of representatives standing committees on

 

appropriations.

 

     Sec. 267. The department 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 outside services 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 November 30, 2012, 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 of representatives standing

 

appropriations committees, and the senate and house fiscal


 

agencies.

 

     Sec. 292. The department shall maintain a searchable website

 

accessible by the public at no cost that includes, but is not

 

limited to, all of the following:

 

     (a) Fiscal year-to-date expenditures by category.

 

     (b) Fiscal year-to-date expenditures by appropriation unit.

 

     (c) Fiscal year-to-date payments to a selected vendor,

 

including the vendor name, payment date, payment amount, and

 

payment description.

 

     (d) The number of active department employees by job

 

classification.

 

     (e) Job specifications and wage rates.

 

     Sec. 295. The department shall explore program and other

 

service areas, including eligibility determination, where

 

privatization may lead to increased efficiencies and budgetary

 

savings.

 

     Sec. 296. Within 14 days after the release of the executive

 

budget recommendation, the department shall provide the state

 

budget director, the senate and house appropriations chairs, the

 

senate and house appropriations subcommittees on community health,

 

respectively, and the senate and house fiscal agencies with an

 

annual report on estimated state restricted fund balances, state

 

restricted fund projected revenues, and state restricted fund

 

expenditures for the fiscal years ending September 30, 2011 and

 

September 30, 2012.

 

 

 

BEHAVIORAL HEALTH SERVICES


 

     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 wraparound

 

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. 410. The department shall assure that substance abuse

 

treatment is provided to applicants and recipients of public

 

assistance through the department of human services who are

 

required to obtain substance abuse treatment as a condition of

 

eligibility for public assistance.

 

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

 

with a CMHSP or PIHP requires the CMHSP or PIHP to implement

 

programs to encourage diversion of individuals with serious mental

 

illness, serious emotional disturbance, or developmental disability

 

from possible jail incarceration when appropriate.

 

     (2) Each CMHSP or PIHP shall have jail diversion services and

 

shall work toward establishing working relationships with

 

representative staff of local law enforcement agencies, including

 

county prosecutors' offices, county sheriffs' offices, county

 

jails, municipal police agencies, municipal detention facilities,

 

and the courts. Written interagency agreements describing what

 

services each participating agency is prepared to commit to the

 

local jail diversion effort and the procedures to be used by local

 

law enforcement agencies to access mental health jail diversion

 

services are strongly encouraged.

 

     Sec. 412. The department shall contract directly with the

 

Salvation Army harbor light program to provide non-Medicaid

 

substance abuse services.


 

     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. 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. The department shall further implement the funding

 

formula that was partially implemented during fiscal year 2009-2010

 

under the condition that no CMHSP shall see a funding increase or a

 

funding reduction in excess of 2%.

 

     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. 490. (1) The department shall continue 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. (1) In order to avoid duplication of efforts, the

 

department shall utilize applicable national accreditation review

 

criteria to determine compliance with corresponding state

 

requirements for CMHSPs, PIHPs, or subcontracting provider agencies

 

that have been reviewed and accredited by a national accrediting

 

entity for behavioral health care services.

 

     (2) Upon a coordinated submission by the CMHSPs, PIHPs, or

 

subcontracting provider agencies, a listing of program requirements

 

that are part of the state program review criteria but are not

 

reviewed by an applicable national accrediting entity, the

 

department shall review the listing and provide a recommendation to

 

the house and senate appropriations subcommittees on community

 

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

 

office as to whether or not state program review should continue.

 

The CMHSPs, PIHPs, or subcontracting agencies may request the

 

department to convene a workgroup to fulfill this section.

 

     (3) The department shall continue to comply with state and


 

federal law and shall not initiate an action that negatively

 

impacts beneficiary safety.

 

     (4) As used in this section, "national accrediting entity"

 

means the joint commission on accreditation of healthcare

 

organizations, the commission on accreditation of rehabilitation

 

facilities, the council of accreditation, or other appropriate

 

entity, as approved by the department.

 

     (5) By July 1 of the current fiscal year, the department shall

 

provide a progress report to the house and senate appropriations

 

subcommittees on community health, the house and senate fiscal

 

agencies, and the state budget office on implementation of this

 

section.

 

     Sec. 495. It is the intent of the legislature that the

 

department begin working with the centers for Medicare and Medicaid

 

services to develop a program that creates a medical home for the

 

individuals receiving Medicaid mental health benefits.

 

     Sec. 496. CMHSPs and PIHPs are permitted to offset state

 

funding reductions by limiting the administrative component of

 

their contracts with providers and case management to a maximum of

 

9%.

 

     Sec. 497. The population data used in determining the

 

distribution of substance abuse block grant funds shall be from the

 

most recent federal census.

 

     Sec. 499. The department shall explore ways to use mental

 

health funding to create a statewide system to address the mental

 

health needs of deaf and hard-of-hearing persons. The department

 

shall report to the senate and house appropriations subcommittees


 

on community health on the results of this process by March 1 of

 

the current fiscal year.

 

 

 

STATE PSYCHIATRIC HOSPITALS AND FORENSIC MENTAL HEALTH SERVICES

 

     Sec. 601. 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. A portion of

 

revenues collected through project efforts may be used for

 

departmental costs and contractual fees associated with these

 

retroactive collections and to improve ongoing departmental

 

reimbursement management functions.

 

     Sec. 602. 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. 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, 2012, the department, in

 

consultation with the department of technology, management, and

 

budget, may maintain 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 savings through the outsourcing

 

of such services.

 

 

 

PUBLIC HEALTH ADMINISTRATION

 

     Sec. 650. The department shall report to the senate and house

 

appropriations subcommittees on community health by April 1 of the

 

current fiscal year on its criteria and methodology used to derive

 

the information provided to residents in the annual Michigan fish

 

advisory.

 

     Sec. 653. The department shall maintain plans to address

 

potential state public health emergencies.

 

 

 

HEALTH POLICY

 

     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. 709. (1) 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.

 

     (2) From the funds appropriated in part 1 for the Michigan

 

essential health provider program, the department may reduce the

 

local and private share of the loan repayment costs to 25% for

 

obstetricians and gynecologists working in underserved areas.


 

     Sec. 712. From the funds appropriated in part 1 for primary

 

care services, $250,000.00 shall be allocated to free health

 

clinics operating in the state. The department shall distribute the

 

funds equally to each free health clinic. For the purpose of this

 

appropriation, "free health clinics" means nonprofit organizations

 

that use volunteer health professionals to provide care to

 

uninsured individuals.

 

     Sec. 713. The department shall continue support of

 

multicultural agencies that provide primary care services from the

 

funds appropriated in part 1.

 

 

 

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. 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.

 

     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).

 

 

 

CHRONIC DISEASE AND INJURY PREVENTION AND HEALTH PROMOTION

 

     Sec. 1004. It is the intent of the legislature that the

 

department continue to collaborate with the county of St. Clair and

 

the city of Detroit southwest community to investigate and evaluate

 

cancer rates.

 

 

 

FAMILY, MATERNAL, AND CHILDREN'S HEALTH SERVICES


 

     Sec. 1103. Beginning January 3, 2013, the department shall

 

annually issue to the legislature, and to the public on the

 

Internet, a report providing estimated public funds administered by

 

the department for family planning, sexually transmitted infection

 

prevention and treatment, and pregnancies and births, as well as

 

demographics collected by the department as self-reported by

 

individuals utilizing those services. The department shall provide

 

the actual expenditures by marital status or, where actual

 

expenditures are not available, shall provide estimated

 

expenditures by marital status. The department may utilize the Plan

 

First application (Form MSA 1582), MIChild, and Healthy Kids

 

application (DCH 0373) or Assistance Application (DHS 1171) or any

 

other official application for public assistance for medical

 

coverage to determine the actual or estimated public expenditures

 

based on marital status.

 

     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 or family planning local agreements 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. 1117. Contingent upon the availability of federal or

 

state restricted funds, the department may pursue efforts to reduce

 

the incidence of stillbirth. Efforts shall include the

 

establishment of a program to increase public awareness of

 

stillbirth, promote education to monitor fetal movements counting

 

kicks, promote a uniform definition of stillbirth, standardize data

 

collection of stillbirths, and collaborate with appropriate federal

 

agencies and statewide organizations. The department shall seek

 

federal or other grant funds to assist in implementing this

 

program.

 

     Sec. 1119. From the funds appropriated in part 1 for family

 

planning local agreements or pregnancy prevention programs, no

 

state funds shall be used to encourage or support abortion

 

services.

 

     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.

 

 

 

CHILDREN'S SPECIAL HEALTH CARE SERVICES

 

     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.

 

     (d) Provide human growth hormone to eligible patients.

 

     (e) Subject to the availability of funds and the enactment of

 

Senate Bill No. 414 and Senate Bill No. 415 of the 96th

 

Legislature, cover services for those with autism spectrum

 

disorders.

 

 

 

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.

 

 

 

OFFICE OF SERVICES TO THE AGING

 

     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. 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. 1420. If funds become available, 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 ADMINISTRATION

 

     Sec. 1501. The unexpended funds appropriated in part 1 for the

 

electronic health records incentive program are considered work


 

project appropriations, and any unencumbered or unallotted funds

 

are carried forward into the following fiscal year. The following

 

is in compliance with section 451a(1) of the management and budget

 

act, 1984 PA 431, MCL 18.1451a:

 

     (a) The purpose of the project to be carried forward is to

 

implement the Medicaid electronic health record program that

 

provides financial incentive payments to Medicaid health care

 

providers to encourage the adoption and meaningful use of

 

electronic health records to improve quality, increase efficiency,

 

and promote safety.

 

     (b) The projects will be accomplished according to the

 

approved federal advanced planning document.

 

     (c) The estimated cost of this project phase is identified in

 

the appropriation line item.

 

     (d) The tentative completion date of the work project is

 

September 30, 2017.

 

 

 

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. 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. 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.

 

     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. (1) 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.

 

     (2) Subject to the availability of funds, Medicaid coverage

 

for adult chiropractic and vision 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. 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. 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. 1659. The following sections of this article 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: 404, 411, 418, 428, 474, 494, 1607,

 

1657, 1662, 1689, 1699, 1764, 1787, 1815, 1820, 1835, 1850, and

 

1853.

 

     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.

 

     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

 

article. 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.

 

     (10) Subject to the availability of funds, MIChild services

 

shall include treatment for autism spectrum disorders for children

 

who are eligible for MIChild and are less than 6 years of age. This

 

subsection shall not take effect unless Senate Bill No. 414 and

 

Senate Bill No. 415 of the 96th Legislature are enacted into law.

 

     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. It is the intent of

 

the legislature that when an individual is transferred from a

 

nursing home to the home- and community-based services waiver

 

program, the funding to cover that individual's home- and

 

community-based services waiver program costs shall be transferred

 

from the long-term care services line item to the Medicaid home-

 

and community-based services waiver line item. These funds are not

 

available for expenditure until they have been transferred to

 

another line item in this article under section 393(2) of the

 

management and budget act, 1984 PA 431, MCL 18.1393.

 

     (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. 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. 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.

 

     Sec. 1694. (1) 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.

 

     (2) By March 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 fiscal agencies on the

 

adequacy of the payment described in subsection (1).

 

     Sec. 1699. (1) The department may make separate payments in

 

the amount of $45,000,000.00 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) 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.

 

     (4) 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. 1700. (1) If allowable room exists within the federal

 

disproportionate share hospital allotment and the centers for

 

Medicare and Medicaid services approves the distribution

 

methodology specified in this section, then the funding in the

 

disproportionate share hospital line in excess of $45,000,000.00 is

 

appropriated for special Medicaid reimbursement, of which 33.61%


 

shall be from general fund/general purpose revenue, in order to

 

increase hospital uncompensated care payments. The distribution of

 

those payments shall be allocated to make payments to hospitals and

 

hospital systems meeting the criteria outlined in subsection (2).

 

     (2) Hospitals and hospital systems eligible for payments under

 

subsection (1) shall receive their Medicaid reimbursements via

 

diagnosis related group payments, shall meet the medical services

 

administration disproportionate share hospital requirements for

 

obstetrical services, shall have received less than $1,800,000.00

 

in disproportionate share hospital payments in fiscal year 2010-

 

2011 from the $45,000,000.00 disproportionate share hospital pool,

 

and shall have at least 1.0% of the statewide total indigent

 

volume.

 

     (3) As used in this section, "indigent volume" means the

 

indigent volume reported by hospitals in their cost reports

 

provided to the department of community health for reporting

 

periods ending during fiscal year 2009-2010.

 

     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. 1741. The department shall continue to provide nursing

 

homes the opportunity to receive interim payments upon their

 

request. The department may disapprove requests or discontinue

 

interim payments that result in financial risk to this state. The

 

department shall make reasonable efforts to ensure that the interim

 

payments are as similar in amount to expected cost-settled


 

payments.

 

     Sec. 1756. The department shall develop a plan to expand and

 

improve the beneficiary monitoring program. 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. 1757. 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.

 

     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. 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 eligibles is

 

approved by the federal government, the department shall provide

 

quarterly reports to the senate and house appropriations

 

subcommittees on community health and the senate and house fiscal

 

agencies on progress in implementing the waiver.

 

     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. 1820. (1) In order to avoid duplication of efforts, the

 

department shall utilize applicable national accreditation review

 

criteria to determine compliance with corresponding state

 

requirements for Medicaid health plans that have been reviewed and

 

accredited by a national accrediting entity for health care

 

services.

 

     (2) Upon submission by Medicaid health plans of a listing of

 

program requirements that are part of the state program review

 

criteria but are not reviewed by an applicable national

 

accreditating entity, the department shall review the listing and

 

provide a recommendation to the house and senate appropriations

 

subcommittees on community health, the house and senate fiscal

 

agencies, and the state budget office as to whether or not state

 

program review should continue. The Medicaid health plans may

 

request the department to convene a workgroup to fulfill this

 

section.

 

     (3) The department shall continue to comply with state and

 

federal law and shall not initiate an action that negatively

 

impacts beneficiary safety.

 

     (4) As used in this section, "national accrediting entity"

 

means the national committee for quality assurance, the utilization


 

review accreditation committee, or other appropriate entity, as

 

approved by the department.

 

     (5) By July 1 of the current fiscal year, the department shall

 

provide a progress report to the house and senate appropriations

 

subcommittees on community health, the house and senate fiscal

 

agencies, and the state budget office on implementation of this

 

section.

 

     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. 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 2012-2013.

 

     Sec. 1835. The department shall develop and implement

 

processes to report rejected and accepted encounters to Medicaid

 

health plans. The department shall further enhance encounter data

 

reporting processes and program rules that make each health plan's

 

encounter data as complete as possible, provide a fair measure of

 

acuity for each health plan's enrolled population for risk

 

adjustment purposes, and minimize health plan administrative

 

expenses.

 

     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 and telepsychiatry as strategies to increase access to

 

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. 1846. (1) By October 1, 2012, the department shall revise

 

its methodology for Medicaid funding provided to health systems for

 

graduate medical education. The methodology shall provide

 

additional funding for systems that continue or establish

 

residencies focusing on primary care providers, including

 

pediatrics, family practice, internal medicine, and obstetrics,

 

recruit residency candidates who commit to stay in Michigan, and

 

contain practice opportunities through collaborative agreements

 

with safety net providers for residents to practice in underserved

 

areas or serve historically underserved populations. The department

 

shall report the measures and tracking mechanisms to be used in

 

this new methodology by November 1, 2012 and shall report the

 

measures and tracking mechanisms to the senate and house

 

appropriations subcommittees on community health by that date.

 

     (2) The department shall implement the new methodology by

 

April 1, 2013.

 

     Sec. 1847. The department shall meet with the Michigan

 

association of ambulance services to discuss the possible structure


 

of an ambulance quality assurance assessment program.

 

     Sec. 1849. (1) The department shall use at least 50% of the

 

funds allocated for voluntary in-home visiting services for

 

evidence-based models or models that conform to a promising

 

approach that are in the process of being evaluated through a

 

process that meets the requirements described in subsection (2)

 

with the goal of being evidence-based by January 1, 2013.

 

     (2) As used in this section:

 

     (a) "Evidence-based" means a model or practice that meets all

 

of the following requirements:

 

     (i) The model or practice is governed by a program manual or

 

protocol that specifies the purpose, rigorous evaluation

 

requirements, and duration and frequency of service that

 

constitutes the model.

 

     (ii) Scientific research using methods that meet scientific

 

standards, evaluated using either randomized controlled research

 

designs, or quasi-experimental research designs with equivalent

 

comparison groups. The effects of such programs must have been

 

demonstrated with 2 or more separate client samples that the

 

program improves client outcomes central to the purpose of the

 

program; and the model or practice monitors program implementation

 

for fidelity to the specified model.

 

     (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 or

 

paraprofessionals 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.

 

     (3) By February 1 of the current fiscal year, the department

 

shall submit to the house and senate appropriations subcommittees

 

on community health an annual report on evidence-based voluntary

 

in-home visiting services, including a full accounting of

 

administrative expenditures from the prior fiscal year, and a

 

summary detailing the demographic characteristics of Medicaid

 

families served.

 

     (4) No later than September 30, 2012, the department shall

 

submit a report to the senate and house appropriations

 

subcommittees on community health on its plan to establish an

 

integrated benefit for Medicaid evidence-based home visitation

 

services to be provided by Medicaid health plans for eligible

 

beneficiaries. The report shall include information on the

 

potential methods used to assure continuity of care and continuity

 

of ongoing relationships with providers and their potential

 

effectiveness. It is the intent of the legislature that the

 

integrated benefit must be provided by evidence-based service

 

delivery models or practices in a manner that achieves fidelity to

 

the evidence-based model.

 

     Sec. 1850. The department may 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. 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 may work with a provider of kidney

 

dialysis services and renal care as authorized under section 2703

 

of the patient protection and affordable care act, Public Law 111-

 

148, to develop a chronic condition health home program for

 

Medicaid enrollees identified with chronic kidney disease and who

 

are beginning dialysis. If initiated, the department shall develop

 

metrics that evaluate program effectiveness and submit a report to

 

the senate and house appropriations subcommittees on community

 

health. Metrics shall include cost savings and clinical outcomes.

 

     Sec. 1855. The department may 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. 1857. It is the intent of the legislature that the

 

department not reduce Medicaid reimbursement for wheelchairs.

 

     Sec. 1858. Subject to the availability of funds, Medicaid

 

services shall include treatment for autism spectrum disorders for


 

children who are eligible for Medicaid and are less than 6 years of

 

age. This section shall not take effect unless Senate Bill No. 414

 

and Senate Bill No. 415 of the 96th Legislature are enacted into

 

law.

 

     Sec. 1859. From the funds appropriated in part 1, the

 

department shall increase Medicaid ambulance reimbursement rates.

 

     Sec. 1860. The legislature encourages the department to

 

actively participate in a collaborative workgroup formed by the

 

health care association of Michigan, the Michigan county medical

 

care facility council, and aging services of Michigan, with the

 

purpose to design and implement a Medicaid reimbursement payment

 

system for nursing facilities that incorporates changes to both the

 

plant and variable components. The variable operating component

 

will include case mix adjustments, price based component, and

 

incentives for quality, efficiency, and Medicaid access. The plant

 

component will encourage continued new construction and renovations

 

and offer administrative simplification for the department. The

 

system will include a timeline for implementation beginning October

 

1, 2013. The workgroup will provide quarterly reports of its

 

progress to the senate and house appropriations subcommittees on

 

community health.

 

     Sec. 1861. Nonemergency medical transportation services

 

offered to Medicaid recipients may be competitively bid and may

 

take into consideration a minimum of 2 bids by qualified vendors, 1

 

of which must be a public transportation agency where such agencies

 

offer service. For the purpose of this section, "qualified vendor"

 

means a transportation provider that either meets or exceeds the


 

quality and safety standards of public transportation agencies,

 

including, but not limited to, ongoing training requirements for

 

motor vehicle operators including training on passenger safety,

 

passenger assistance, and assistive devices, including wheelchair

 

lifts, tie-down equipment, and child safety seats. In addition, a

 

qualified vendor shall be able to document that all drivers have

 

complied with all state licensing regulations and that they have

 

passed a criminal background check and successfully passed a drug

 

screening test.

 

     Sec. 1862. From the funds appropriated in part 1, the

 

department shall increase reimbursement rates for obstetrical

 

services.

 

     Sec. 1863. For the purposes of the next rebidding of contracts

 

with Medicaid health plans, the department shall study the

 

possibility of excluding health plans that score in the lowest

 

quartile on quality indicators from eligibility to bid.

 

     Sec. 1864. (1) From the funds appropriated in part 1, the

 

department shall create and implement a pilot program limited to

 

rural counties to incentivize students attending medical schools in

 

Michigan through a scholarship program or financial stipend for

 

committing to provide medical services in rural counties with a

 

medically underserved population. The program shall be limited to

 

those students or individuals performing primary care or specialty

 

services as identified by the department.

 

     (2) By no later than September 30 of the current fiscal year,

 

the department shall prepare a report and submit it to the senate

 

and house appropriations subcommittees on community health, the


 

senate and house fiscal agencies, and the state budget director.

 

The department shall evaluate the effectiveness of the pilot

 

program, identify potential changes to improve the program, and

 

make recommendations for statewide implementation in its report

 

under this subsection.

 

     Sec. 1865. Upon federal approval of the department's proposal

 

for integrated care for individuals who are dual Medicare/Medicaid

 

eligibles, the department shall provide the senate and house

 

appropriations subcommittees on community health and the senate and

 

house fiscal agencies its plan and organizational chart for

 

administering and providing oversight of this proposal. The plan

 

shall include information on how the department intends to organize

 

staff in an integrated manner to ensure that key components of the

 

proposal are implemented effectively.

 

 

 

ONE-TIME BASIS ONLY

 

     Sec. 1903. (1) From the funds appropriated in section 1901 for

 

hospital services and therapy – rural and sole community hospitals,

 

general fund/general purpose revenue and any associated federal

 

match shall be awarded to hospitals that meet criteria established

 

by the department for services to low-income rural residents.

 

     (2) No hospital or hospital system shall receive more than

 

5.0% of the total funding referenced in subsection (1).

 

     (3) The department shall report to the senate and house

 

appropriations subcommittees on community health and the senate and

 

house fiscal agencies on the distribution of funds referenced in

 

subsection (1) by April 1 of the current fiscal year.


 

 

 

 

 

PART 2A

 

PROVISIONS CONCERNING ANTICIPATED APPROPRIATIONS

 

FOR FISCAL YEAR 2013-2014

 

GENERAL SECTIONS

 

     Sec. 2001. It is the intent of the legislature to provide

 

appropriations for the fiscal year ending on September 30, 2014 for

 

the line items listed in part 1. The fiscal year 2013-2014

 

appropriations are anticipated to be the same as those for fiscal

 

year 2012-2013, 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 2013 consensus revenue estimating

 

conference.