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FY 2023-24 HEALTH AND HUMAN
SERVICES BUDGET
S.B. 190 (S-2): SENATE-PASSED
|
FULL-TIME EQUATED (FTE) CLASSIFIED POSITIONS/FUNDING SOURCE |
FY 2022-23 YEAR-TO-DATE* |
FY 2023-24 |
CHANGES FROM FY 2022-23 YEAR-TO-DATE |
|
|
AMOUNT |
PERCENT |
|||
|
FTE Positions............................................................. |
15,684.5 |
15,728.0 |
43.5 |
0.3 |
|
GROSS...................................................................... |
33,438,302,800 |
35,499,363,300 |
2,061,060,500 |
6.2 |
|
Less: |
|
|
|
|
|
Interdepartmental Grants Received............................ |
14,696,000 |
14,676,900 |
(19,100) |
(0.1) |
|
ADJUSTED GROSS................................................... |
33,423,606,800 |
35,484,686,400 |
2,061,079,600 |
6.2 |
|
Less: |
|
|
|
|
|
Federal Funds.......................................................... |
23,693,049,100 |
25,741,217,300 |
2,048,168,200 |
8.6 |
|
Local and Private...................................................... |
355,599,100 |
340,378,800 |
(15,220,300) |
(4.3) |
|
TOTAL STATE SPENDING......................................... |
9,374,958,600 |
9,403,090,300 |
28,131,700 |
0.3 |
|
Less: |
|
|
|
|
|
Other State Restricted Funds.................................... |
3,132,592,800 |
3,050,326,400 |
(82,266,400) |
(2.6) |
|
GENERAL FUND/GENERAL PURPOSE..................... |
6,242,365,800 |
6,352,763,900 |
110,398,100 |
1.8 |
|
PAYMENTS TO LOCALS............................................ |
1,900,152,400 |
1,824,131,800 |
(76,020,600) |
(4.0) |
*As of February 7, 2023.
|
Major Boilerplate Changes from FY 2022-23 Year-to-Date: |
|
1. Deletions. The Senate removed sections 225, 233, 237, 250, 251, 288, 299, 301, 451, 452, 462, 509, 527, 545, 553, 555, 558, 559, 573, 578, 580, 595, 618, 690, 809, 908, 916, 970, 1013, 1142, 1146, 1148, 1184, 1185, 1225, 1240, 1303, 1304, 1305, 1309, 1320, 1322, 1347, 1403, 1501, 1511, 1513, 1514, 1515, 1673, 1698, 1704, 1763, 1803, 1851, 1860, 1871, 1873, 1875, 1881, 1894, 1904, 1950, 1951, 1952, 1953, 1955, 1956, 1957, 1958, 1959, 1960, 1962, 1963, 1964, 1965, 1967, 1968, 1969, 1970, 1971, 1972, 1973, 1974, 1975, 1977, 1978, 1979, 1980, 1981, 1982, 1984, 1985, 1986, 1987, 1988, 1991, 1992, 1993, 1994, 1995, 1996, 1997, 1998, 1999, 2000, 2001, 2002, 2003. |
|
2. Renumbering. The Senate renumbered section 457 to 1155 (Uniform Statewide SAE Kit Tracking), 458 to 1156 (Crime Victims Rights Services Grants), 459 to 1157 (CACs-Supplemental Grants), 464 to 1254 (Diaper Assistance Program), 929 as 1253 (Flint Drinking Water Emergency MC3), 1312 to 1255 (Strong Beginnings Grant), and 1348 to 1256 (Healthy Moms, Healthy Babies Report). |
|
3. New Sections. The Senate added Sec. 461 (NationOutside), 466 (Runaway and Homeless Youth Capacity Expansion), 518 (Child Care Fund Reimbursement Rates), 527 (Foster Care and JJ Transitional Costs), 660 (Food Bank Council of Michigan), 670 (FAP- State Supplementation), 805 (Cherry Health/YMCA), 806 (Equity and Minority Health Office and Genesee County), 1152 (Authority Health Food Access), 1160 (Socially Vulnerable Community Grants), 1161 (VOCA Prioritization), 1162 (Trauma Recovery Center Pilot Programs), 1187 (Highland Park Water Debt), 1250 (CenteringPregnancy), 1251 (MI-AIM), 1252 (Perinatal Quality Collaboratives), 1808 (Medicaid Rebid Preference), 1815 (Hospital Services Increase), 1821 (Level I and II Trauma Centers), and 1950 through 2000 (45 New Sections to Implement One-Time Funding Items). |
|
|
|
FY 2022-23 Year-to-Date Appropriation.................................................. |
$33,438,302,800 |
$6,242,365,800 |
|
|
CHANGE
FROM |
FY 2023-24 RECOMMENDED |
|||
|
Gross |
GF/GP |
Gross |
GF/GP |
||
|
Baseline Adjustments |
|
|
|
|
|
|
1. Medicaid and Title XXI Match Rate Adjustment. The base Medicaid match rate will increase from 64.71% to 64.94% and the CHIP match rate will increase from 75.30% to 75.46%. |
0 |
(34,541,700) |
NA |
NA |
|
|
2. Medicaid Actuarial Soundness Adjustments. Senate included increases for managed care entities that provide Medicaid services to reflect the Federal requirement that capitation rates be actuarially sound. |
346,629,200 |
92,495,000 |
NA |
NA |
|
|
3. Base and Caseload. Senate included funding for projected caseload costs in the Medicaid, Public Assistance, and Child Welfare programs. |
918,435,800 |
(7,991,700) |
NA |
NA |
|
|
4. Medicaid Special Financing and Provider Tax Adjustments. Senate included adjustments to special payments to hospitals that are funded with provider tax revenue. |
(126,897,100) |
26,663,500 |
NA |
NA |
|
|
5. Reversal of FY 23 Medicaid Redetermination Savings. Senate reversed savings assumed in FY 23 for the resumption of Medicaid redeterminations. FY 24 savings estimates developed by SBO were rolled into the caseload estimates in Item 3. |
583,102,800 |
119,626,600 |
NA |
NA |
|
|
6. Other CSB Items. Senate included funding to support other current services baseline adjustments, comprised mainly of the recognition of Federal Dental Redesign match ($80.0 million Gross and $0 GF/GP), recognition of Federal MiCAL match ($12.4 million Gross and $0 GF/GP), a rate increase for Medicaid Ambulance Services ($13.9 million Gross and $3.5 million GF/GP), and the expiration of the temporary FMAP ($1.7 million Gross and negative $50.3 million GF/GP). |
179,300,700 |
(22,251,900) |
NA |
NA |
|
|
7. Economic Adjustments. Includes a reduction of $8,508,000 Gross and $4,191,700 GF/GP for total economic adjustments. |
(8,508,000) |
(4,191,700) |
NA |
NA |
|
|
New Programs/Program Increases |
|
|
|
|
|
|
8. Wage Increases. Senate included funding to provide a $0.65/hour increase in direct care worker wages ($91.0 million Gross and $32.3 million GF/GP), and to provide a $3.00/hour wage increase to non-direct care staff at long-term care facilities ($70.1 million Gross and $24.7 million GF/GP. |
161,178,800 |
57,000,100 |
NA |
NA |
|
|
9. Medicaid Health Access and Equity. Senate included funding to expand coverage of the Children's Special Health Care program ($4.0 million Gross and $3.3 million GF/GP), establishes a Medicaid recuperative care benefit ($5.0 million Gross and $2.2 million GF/GP), and increase reimbursement rates for specific Medicaid services ($102.3 million Gross and $27.9 million GF/GP). |
111,210,000 |
33,308,000 |
NA |
NA |
|
|
10. Healthy Moms, Healthy Babies. Senate included funding to remove the 5-year Medicaid waiting period for lawfully residing children and pregnant women ($32.1 million Gross and $6.4 million GF/GP), support Perinatal Quality Collaboratives ($5.0 million Gross and GF/GP), provide grants to CenteringPregnancy sites ($5.0 million Gross and $2.5 million GF/GP), strengthen hospital maternal health incentives ($10.0 million Gross and GF/GP), and re-establish the Medicaid Family Planning benefit ($6.2 million Gross and $1.0 million GF/GP). Senate moved funding for all Healthy Moms, Healthy Babies related initiatives into a new unit. |
52,559,200 |
24,900,700 |
NA |
NA |
|
|
11. Other New Programs and Program Increases. Senate included other funding increases, mainly comprised of an increase in Medicaid Hospital Reimbursement Rates ($43.9 million Gross and $10.0 million GF/GP), for Level I and II Trauma Centers ($34.2 million Gross and $6.5 million GF/GP), Child Care Fund Reimbursement Rates ($31.5 million Gross and GF/GP), support for the State's share of Essential Local Public Health Services ($30.0 million Gross and GF/GP), to pay off Highland Park's Water Debt ($20.3 million Gross and GF/GP), an increase in Child Welfare Family Maintenance Payments ($19.3 million Gross and $7.8 million GF/GP), and an increase for the Food Bank Council's MASS Program ($10.0 million Gross and GF/GP). |
243,175,600 |
161,954,600 |
NA |
NA |
|
|
Eliminations/Reductions |
|
|
|
|
|
|
12. Program Eliminations. Senate included a number of program eliminations mainly comprised of funding for a Predictive Modeling Program ($1.2 million Gross and $300,000 GF/GP), the Stroke/STEMI System of Care ($1.0 million Gross and GF/GP), a Child Legal Representation/Indigent Defense Pilot ($500,000 Gross and GF/GP), funding for the Adoptive Family Support Network ($250,000 Gross and GF/GP), a Medicaid-to-Medicare Rate Comparison Study ($200,000 Gross and $100,000 GF/GP), a Human Embryo Constitutional Information Awareness Program ($100,000 Gross and GF/GP), and a Rare Disease Panel Grant ($70,000 Gross and GF/GP). |
(5,597,500) |
(3,597,500) |
0 |
0 |
|
|
One-Time Appropriations |
|
|
|
|
|
|
13. Removal of FY 2022-23 One-Time Projects. |
(555,543,300) |
(495,837,200) |
0 |
0 |
|
|
14. Continuation of FY 2022-23 One-Time Projects. Senate maintained funding for projects including Multicultural Integration Services ($8.6 million Gross and GF/GP), First Responder Mental Health and Safety Grants ($5.0 million Gross and GF/GP), Sickle Cell Center ($2.5 million Gross and GF/GP), and CCWIS modules ($100 Gross and GF/GP). |
16,100,100 |
16,100,100 |
16,100,100 |
16,100,100 |
|
|
15. New FY 2023-24 One-Time Projects. Senate included funding for costs for a new FQHC Payment Model ($15.0 million Gross and GF/GP), a Permanent Supportive Housing Pilot ($13.0 million Gross and GF/GP), Unpaid Medical Debt Forgiveness (10.0 million Gross and GF/GP), the ACCESS SUD Center ($10.0 million Gross and GF/GP), creation of Caregiver Resource Centers ($9.4 million Gross and GF/GP), operation of a Psych GME Program ($8.0 million Gross and GF/GP), Opioid Biomarker Testing ($7.0 million Gross and GF/GP), Mary Free Bed ($5.0 million Gross and GF/GP), and a deposit into the Jail Diversion Fund ($5.0 million Gross and GF/GP). |
145,761,200 |
145,761,200 |
145,761,200 |
145,761,200 |
|
|
Other |
|
|
|
|
|
|
16. Other Changes. Senate included other changes that resulted in a small increase in GF/GP. |
153,000 |
1,000,000 |
NA |
NA |
|
|
|
|
|
|
|
|
|
$2,061,060,500 |
$110,398,100 |
|
|
|
FY 2023-24 SENATE-PASSED...................................................................... |
$35,499,363,300 |
$6,352,763,900 |
|
Date Completed: 5-11-23 Fiscal Analyst: Ellyn Ackerman, Humphrey Akujobi, and John Maxwell