HOUSE BILL No. 5286
February 3, 2000, Introduced by Reps. Geiger, Pappageorge, Kukuk, Byl, Mead, Jellema, Pumford, Cameron Brown, Jelinek, Caul, LaSata, Mortimer, Scranton, Godchaux and Jansen and referred to the Committee on Appropriations.
EXECUTIVE BUDGET BILL
A bill to make appropriations for the department of community health and certain state purposes related to aging, mental health, public health, and medical services for the fiscal year ending September 30, 2001; to provide for the expenditure of such appropriations; to create funds; to provide for reports; to prescribe the powers and duties of certain local and state agencies and departments; and to provide for disposition of fees and other income received by the various state agencies.
Sec. 101. Subject to the conditions set forth in this bill, the amounts listed in this part are appropriated for the department of community health for the fiscal year ending September 30, 2001, 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 6,256.1
Average population 1,528.0
GROSS APPROPRIATION $ 6,186,113,000
Interdepartmental grant revenues:
Total interdepartmental grants and
intradepartmental transfers 72,087,300
ADJUSTED GROSS APPROPRIATION $ 6,114,025,700
Federal revenues:
Total federal revenues 3,136,326,100
Special revenue funds:
Total local revenues 910,110,400
Total private funds 49,649,300
Total other state restricted revenues 348,689,500
State general fund/general purpose $ 1,669,250,400
Sec. 102. DEPARTMENTWIDE ADMINISTRATION
Full-time equated unclassified positions 6.0
Full-time equated classified positions 514.7
Director and other unclassified--6.0 FTE
positions $ 570,100
Community health advisory council 28,900
Departmental administration and management--491.7
FTE positions 55,428,000
Certificate of need program administration-13.0
FTE positions 918,400
Workers' compensation program-1.0 FTE position 11,512,500
Rent and building occupancy 8,715,200
Developmental disabilities council and
projects--9.0 FTE positions 2,734,200
GROSS APPROPRIATION $ 79,907,300 Appropriated from:
Interdepartmental grant revenues:
Interdepartmental grant from the department of treasury,
Michigan state hospital finance authority 98,800
Federal revenues:
Total federal revenues 24,409,600
Special revenue funds:
Private funds 35,900
Total other state restricted revenues 3,559,900
State general fund/general purpose $ 51,803,100
Sec. 103. MENTAL HEALTH/SUBSTANCE ABUSE SERVICES ADMINISTRATION AND SPECIAL PROJECTS
Full-time equated classified positions 103.0
Mental health/substance abuse program
administration--103.0 FTE positions $ 10,510,500
Consumer involvement program 314,100
Gambling addiction 3,000,000
Protection and advocacy services support 818,300
Mental health initiatives for older persons 1,615,800
Community residential and support services 5,646,800
Highway safety projects 2,337,200
Federal and other special projects 6,977,200
GROSS APPROPRIATION $ 31,219,900
Appropriated from:
Federal revenues:
Total federal revenues: 11,548,100
Special revenue funds:
Total private revenues 125,000
Total other state restricted revenues 3,182,300
State general fund/general purpose $ 16,364,500
Sec. 104. COMMUNITY MENTAL HEALTH/SUBSTANCE ABUSE SERVICES PROGRAMS
Full-time equated classified positions 4.0
Medicaid mental health services $ 1,190,201,500
Community mental health non-Medicaid services 311,801,500
Multicultural services 3,560,000
Medicaid substance abuse services 24,851,000
Respite services 3,318,600
CMHSP, purchase of state services contracts 166,152,500 Civil service charges 2,606,400
Federal mental health block grant--2.0 FTE
positions 10,849,900
Pilot projects in prevention for
adults and children--2.0 FTE positions 994,700
State disability assistance program substance
abuse services 6,600,000
Community substance abuse prevention, education
and treatment programs 83,740,400
GROSS APPROPRIATION $ 1,804,676,500
Appropriated from:
Federal revenues:
Total federal revenues 757,393,500
Special revenue funds:
Total other state restricted revenues 6,342,400
State general fund/general purpose $ 1,040,940,600
Sec. 105. STATE PSYCHIATRIC HOSPITALS, CENTERS FOR PERSONS WITH DEVELOPMENTAL DISABILITIES, AND FORENSIC AND PRISON MENTAL HEALTH SERVICES
Total average population 1,528.0
Full-time equated classified positions 4,699.0
Caro regional mental health center-psychiatric hospital-
adult--518.0 FTE positions $ 35,643,500
Average population 200.0
Kalamazoo psychiatric hospital-adult--376.0 FTE
positions 27,080,300
Average population 125.0
Northville psychiatric hospital-adult--862.0 FTE
positions 63,889,500
Average population 385.0
Walter P. Reuther psychiatric hospital-adult--440.0
FTE positions 33,666,800
Average population 215.0
Hawthorn center-psychiatric hospital-children
and adolescents--330.0 FTE positions 23,098,800
Average population 118.0
Mount Pleasant center-developmental disabilities--
472.0 FTE positions 29,878,000
Average population 195.0
Southgate center-developmental disabilities--228.0
FTE positions 15,589,900
Average population 80.0
Center for forensic psychiatry--522.0 FTE positions 39,151,000
Average population 210.0
Forensic mental health services provided to the
department of corrections---938.0 FTE positions 71,380,700
Revenue recapture 750,000
IDEA, federal special education 92,000
Special maintenance and equipment 879,000
Purchase of medical services for residents of
hospitals and centers 1,700,000
Closed site, transition, and related costs--13.0 510,300
FTE positions
Severance pay 896,000
Gifts and bequests for patient living and treatment
environment 2,000,000
GROSS APPROPRIATION $ 346,205,800
Appropriated from:
Interdepartmental grant revenues:
Interdepartmental grant from the department of
corrections 71,380,700
Federal revenues:
Total federal revenues 32,733,700
Special revenue funds:
CMHSP-Purchase of state services contracts 166,152,500
Other local revenues 16,503,700 Private funds 2,000,000
Total other state restricted revenues 16,405,300
State general fund/general purpose $ 41,029,900
Sec. 106. PUBLIC HEALTH ADMINISTRATION
Full-time equated classified positions 88.3
Executive administration----15.5 FTE positions $ 1,367,100
Minority health grants and contracts 650,000
Vital records and health statistics--72.8 FTE
positions 6,167,700 GROSS APPROPRIATION $ 8,184,800
Appropriated from:
Interdepartmental grant revenues:
Interdepartmental grant from family independence
agency 137,800
Federal revenues:
Total federal revenue 2,809,800
Special revenue funds:
Total other state restricted revenues 2,036,600
State general fund/general purpose $ 3,200,600
Sec. 107. INFECTIOUS DISEASE CONTROL
Full-time equated classified positions 44.3
AIDS prevention, testing and care programs--9.8 FTE
positions $ 22,218,400
Immunization local agreements 14,190,300
Immunization program management and field
support--7.7 FTE positions 1,698,900
Sexually transmitted disease control local
agreements 2,460,700
Sexually transmitted disease control management and
field support--26.8 FTE positions 2,825,800
GROSS APPROPRIATION $ 43,394,100
Appropriated from:
Federal revenues:
Total federal revenues 29,306,600
Special revenue funds:
Private funds 1,155,000
Total other state restricted revenues 6,937,700
State general fund/general purpose $ 5,994,800
Sec. 108. LABORATORY SERVICES
Full-time equated classified positions 118.2
Laboratory services--118.2 FTE positions $ 12,566,100
Lyme disease 75,000 GROSS APPROPRIATION $ 12,641,100
Appropriated from:
Interdepartmental grant revenues:
Interdepartmental grant from environmental
quality 389,400
Federal revenues:
Total federal revenues 2,028,000
Special revenue funds:
Total other state restricted revenues 3,607,400
State general fund/general purpose $ 6,616,300
Sec. 109. EPIDEMIOLOGY
Full-time equated classified positions 31.5
AIDS surveillance and prevention program--7.0 FTE
positions $ 1,772,800
Epidemiology administration--24.5 FTE positions 5,330,900
Tuberculosis control and recalcitrant AIDS program 498,300
GROSS APPROPRIATION $ 7,602,000
Appropriated from:
Interdepartmental grant revenues:
Interdepartmental grant from the department
of environmental quality 80,600
Federal revenues:
Total federal revenues 4,679,100
Special revenue funds:
Total other state restricted revenues 781,000
State general fund/general purpose $ 2,061,300
Sec. 110. LOCAL HEALTH ADMINISTRATION AND GRANTS
Full-time equated classified positions 3.0
Implementation of 1933 PA 133, MCL 333.17015 $ 100,000
Lead abatement program--3.0 FTE positions 1,835,500
Local health services 462,300
Local public health operations 41,070,200
Medical services cost reimbursement to local
health departments 1,800,000
Special populations health care 620,600
GROSS APPROPRIATION $ 45,888,600
Appropriated from:
Federal revenues:
Total federal revenues 3,791,000
Special revenue funds:
Total other state restricted revenues 243,500
State general fund/general purpose $ 41,854,100
Sec. 111. CHRONIC DISEASE AND INJURY PREVENTION AND HEALTH PROMOTION
Full-time equated classified positions 33.7
AIDS and risk reduction clearinghouse and media
campaign $ 2,001,000
Alzheimer's information network 440,000 Cancer prevention and control program--13.6
FTE positions 12,505,100
Chronic disease prevention 1,967,400
Diabetes program--9.0 FTE positions 4,197,200
Morris J. Hood Wayne State University Diabetes
Outreach 500,000
Early childhood collaborative secondary prevention 1,300,000
Employee wellness program grants (includes $50.00
per diem and expenses for the risk reduction and
AIDS policy commission) 4,259,200
Health education, promotion, and research
programs--2.9 FTE positions 1,318,100
Injury control intervention project 942,800
Physical fitness, nutrition, and health 1,250,000
Public health traffic safety coordination 115,000
School health and education programs 2,182,800
Smoking prevention program--6.2 FTE positions 8,073,800
Violence prevention--2.0 FTE positions 3,235,500
GROSS APPROPRIATION $ 44,287,900
Appropriated from:
Federal revenues:
Total federal funds 12,232,100
Special revenue funds:
Total other state restricted revenues 28,855,800
State general fund/general purpose $ 3,200,000
Sec. 112. COMMUNITY LIVING, CHILDREN, AND FAMILIES
Full-time equated classified positions 88.8
Adolescent health care services $ 2,892,300
Childhood lead program--5.0 FTE positions 1,397,800
Children's waiver home care program 21,713,700
Community living, children and families
administration--73.3 FTE positions 7,658,600
Dental programs 260,400
Dental programs for persons with developmental
disabilities 151,000
Family planning local agreements 8,100,000
Family support subsidy 14,276,700
Housing and support services--1.0 FTE position 4,830,900
Local MCH services 9,049,200
Migrant health care 166,100
Newborn screening follow-up and treatment
services 2,123,400
Omnibus budget reconciliation act
implementation--9.0 FTE positions 12,757,000
Pediatric AIDS prevention and control 985,300
Pregnancy prevention program 7,196,100
Prenatal care outreach and service
delivery support 4,299,300
Southwest community partnership 2,247,300
Special projects--0.5 FTE positions 3,926,600
Sudden infant death syndrome program 321,300
GROSS APPROPRIATION $ 104,353,000 Appropriated from:
Federal revenues:
Total federal revenue 66,978,200
Special revenue funds:
Private funds 261,100
Total other state restricted revenues 9,269,200
State general fund/general purpose $ 27,844,500
Sec. 113. WOMEN, INFANTS, AND CHILDREN FOOD AND NUTRITION PROGRAM
Full-time equated classified positions 42.0
WIC administration and special projects--42.0
FTE positions $ 5,017,100
WIC program 156,882,400
GROSS APPROPRIATION $ 161,899,500
Appropriated from:
Federal revenues:
Total federal revenue 117,452,200
Special revenue funds:
Total private revenue 44,447,300
State general fund/general purpose $ 0
Sec. 114. CHILDREN'S SPECIAL HEALTH CARE SERVICES
Full-time equated classified positions 66.6
Children's special health care services
administration--66.6 FTE positions $ 5,434,400
Amputee program 184,600
Bequests for care and services 1,329,600
Case management services 3,923,500
Conveyor contract 559,100
Medical care and treatment 130,005,400
GROSS APPROPRIATION $ 141,436,600
Appropriated from:
Federal revenues:
Total federal revenue 66,177,100
Special revenue funds:
Private-bequests 900,000
Total other state restricted revenues 4,048,500
State general fund/general purpose $ 70,311,000
Sec. 115. OFFICE OF DRUG CONTROL POLICY
Full-time equated classified positions 17.0
Drug control policy--17.0 FTE positions $ 1,733,700
Anti-drug abuse grants 25,800,000
GROSS APPROPRIATION $ 27,533,700
Appropriated from:
Federal revenues:
Total federal revenue 27,354,100
State general fund/general purpose $ 179,600
Sec. 116. CRIME VICTIM SERVICES COMMISSION
Full-time equated classified positions 9.0
Grants administration services--9.0 FTE positions $ 1,033,800
Justice assistance grants 15,000,000
Crime victim rights services grants 7,955,300
GROSS APPROPRIATION $ 23,989,100
Appropriated from:
Federal revenues:
Total federal revenues: 15,840,200
Special revenue funds:
Total other state restricted revenues 7,641,200
State general fund/general purpose $ 507,700
Sec. 117. OFFICE OF SERVICES TO THE AGING
Full-time equated classified positions 40.5 Commission (per diem $50.00) $ 10,500
Office of services to aging administration--37.5
FTE positions 4,070,300
Long-term care advisor--3.0 FTE positions 3,021,400
Community services 27,907,900
Nutrition services 28,248,000
Senior volunteer services 4,220,800
Senior citizen centers staffing and equipment 2,140,700
Employment assistance 2,748,000
DAG commodity supplement 7,200,000
Michigan pharmaceutical program 1,500,000
Respite care program 7,100,000
GROSS APPROPRIATION $ 88,167,600
Appropriated from:
Federal revenues:
Total federal revenues 40,954,200
Special revenue funds:
Total private revenue 125,000
Tobacco settlement revenue 8,021,400
Total other state restricted revenues 4,100,000
State general fund/general purpose $ 34,967,000
Sec. 118. MEDICAL SERVICES ADMINISTRATION
Full-time equated classified positions 352.5
Medical services administration--350.7 FTE
positions $ 47,222,200
Data processing contractual services 100
Facility inspection contract-state police 132,800
MIChild administration 3,327,800
Michigan essential health care provider 1,229,100
Palliative and hospice care 700,000
Primary care services--1.8 FTE positions 2,548,200
GROSS APPROPRIATION $ 55,160,200
Appropriated from:
Federal revenues:
Total federal revenues 35,296,300
Special revenue funds:
Private funds 100,000
Total other state restricted revenues 1,463,300
State general fund/general purpose $ 18,300,600
Sec. 119. MEDICAL SERVICES
Hospital disproportionate share payments $ 45,000,000
Medicare premium payments 130,895,000
Pharmaceutical services 279,207,900
Home health services 31,398,500
Transportation 7,825,900
Auxiliary medical services 71,650,000
Long term care services 1,153,380,400
Elder prescription insurance coverage 37,500,700
EPSDT and maternal and infant support services
outreach 8,488,600
MIChild outreach 3,327,800
MIChild program 57,567,100
Personal care services 29,162,900
Maternal and child health 9,234,500
Adult home help 158,781,400
Social services to the physically disabled 1,344,900
Subtotal basic medical services program 2,024,765,600
Wayne county medical program 44,012,800
School based services 142,782,300
State and local medical programs 56,724,200
Special adjustor payments 891,280,400
Subtotal special medical services payments 1,134,799,700
GROSS APPROPRIATION $ 3,159,565,300
Appropriated from:
Federal revenues:
Total federal revenues 1,885,342,300
Special revenue funds:
Local revenues 727,454,200
Private funds 500,000
Tobacco settlement revenue 48,000,000
Total other state restricted 194,194,000
State general fund/general purpose $ 304,074,800
GENERAL SECTIONS
Sec. 201. (1) Pursuant to section 30 of article IX of the state constitution of 1963, total state spending under part 1 for fiscal year 2000-2001 is $2,017,939,900.00 and state appropriations to be paid to local units of government are as follows:
DEPARTMENT OF COMMUNITY HEALTH
Departmental administration and management $ 1,618,000
Pilot projects in prevention for adults and
children 913,200
Community substance abuse prevention, education,
and treatment programs 18,419,700
Medicaid substance abuse services 11,942,500
Medicaid mental health managed care 505,182,000
Community mental health non-Medicaid services 311,801,500
AIDS prevention, testing, and care program 1,466,800
Sexually transmitted disease control local
agreements 452,900
Special populations health care 29,600
Local public health operations 41,070,200
Cancer prevention and control program 397,000
Diabetes program 1,275,000
Employee wellness program grants 1,545,100
School health and education programs 2,000,000
Smoking prevention program 2,880,000
Adolescent health care services 1,358,000
Family planning local agreements 1,230,300
Homelessness formula grant program - state
match 708,800
Local MCH services 246,100
OBRA implementation 2,459,100
Pregnancy prevention program 2,511,800
Prenatal care outreach and service
delivery support 1,250,000
Case management services 1,433,200
Special adjustor payments 1,383,800
Hospital disproportionate share payments 18,000,000
Hospital services and therapy 17,559,300
Physician services 5,305,100
Pharmaceutical services 7,265,000
Home health services 1,195,200
Transportation 184,500
Community services 13,681,400
Nutrition services 12,363,000
Senior volunteer services 3,845,300
Michigan pharmaceutical program 140,000
Respite care program 2,000,000
Crime victim rights services grants 4,585,700
Total $ 999,699,100
(2) If it appears to the principal executive officer of a department or branch that state spending to local units of government will be less than the amount that was projected to be expended for any quarter under subsection (1), the principal executive officer shall immediately give notice of the approximate shortfall to the state budget director, the senate and house of representatives standing committees on appropriations, and the senate and house fiscal agencies.
Sec. 202. The expenditures and funding sources authorized under this bill are subject to the management and budget act, 1984 PA 431, MCL 18.1101 to 18.1594.
Sec. 203. Funds for which the state is acting as the custodian or agent are not subject to annual appropriation.
Sec. 204. As used in this bill:
(a) "AIDS" means acquired immunodeficiency syndrome.
(b) "CMHSP" means a community mental health service program as that term is defined in section 100a of the mental health code, 1974 PA 258, MCL 330.1100a.
(c) "DAG" means the United States department of agriculture.
(d) "Disease management" means a comprehensive system that incorporates the patient, physician, and health plan into 1 system with the common goal of achieving desired outcomes for patients.
(e) "Department" means the Michigan department of community health.
(f) "DSH" means disproportionate share hospital.
(g) "EPIC" means Elder prescription insurance coverage program.
(h) "EPSDT" means early and periodic screening, diagnosis, and treatment
(i) "FTE" means full-time equated.
(j) "GME" means graduate medical education.
(k) "HIV" means human immunodeficiency virus.
(l) "HMO" means health maintenance organization.
(m) "IDEA" means individual disability education act.
(n) "MCH" means maternal and child health.
(o) "MSS/ISS" means maternal and infant support services.
(p) "OBRA" means the omnibus budget reconciliation act of 1987, Public Law 100-203, 101 Stat. 1330.
(q) "Qualified 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.
(r) "Title XVIII" means title XVIII of the social security act, chapter 531, 49 Stat. 620, 42 U.S.C. 1395 to 1395b, 1395b-2, 1395b-6 to 1395b-7, 1395c to 1395i, 1395i-2 to 1395i-5, 1395j to 1395t, 1395u to 1395w, 1395w-2 to 1395w-4, 1395w-21 to 1395w-28, 1395x to 1395yy, and 1395bbb to 1395ggg.
(s) "Title XIX" means title XIX of the social security act, chapter 531, 49 Stat. 620, 42 U.S.C. 1396 to 1396d, 1396f, 1396g-1 to 1396r-6, and 1396r-8 to 1396v.
(t) "WIC" means women, infants, and children supplemental nutrition program.
Sec. 205. (1) Beginning October 1, a hiring freeze is imposed on the state classified civil service. State departments and agencies are prohibited from hiring any new full-time state classified civil service employees and prohibited from filling any vacant state classified civil service positions. This hiring freeze does not apply to internal transfers of classified employees from one position to another within a department or to positions that are funded with 80% or more federal or restricted funds.
(2) The state budget director shall grant exceptions to this hiring freeze when the state budget director believes that the hiring freeze will result in rendering a state department or agency unable to deliver basic services. The state budget director shall report by the 30th of each month to the chairpersons of the senate and house of representatives standing committees on appropriations the number of exceptions to the hiring freeze approved during the previous month and the reasons to justify the exception.
Sec. 206. 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. 207. (1) From the amounts appropriated in part 1, no greater than the following amounts are supported with federal maternal and child health block grant, preventive health and health services block grant, substance abuse block grant, healthy Michigan fund, and Michigan health initiative funds:
(a) Maternal and child health block grant $ 20,977,000
(b) Preventive health and health services
block grant 6,347,100
(c) Substance abuse block grant 61,371,200
(d) Healthy Michigan funds 42,714,100
(e) Michigan health initiative 9,900,800
(2) On or before February 1, 2001, the department shall report to the house and senate appropriations subcommittees on community health, the house and senate fiscal agencies, and the state budget director on the detailed name and amounts of federal, restricted, private, and local sources of revenue that support the appropriations in each of the line items in part 1 of this bill.
(3) Upon the release of the fiscal year 2001-2002 executive budget recommendation, the department shall report to the same parties in subsection (2) 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 fiscal year 2001-2002 executive budget proposal.
(4) The department shall provide to the same parties in subsection (2) all revenue source detail for consolidated revenue line item detail upon request to the department.
Sec. 208. The state departments, agencies, and commissions receiving tobacco tax funds from part 1 shall report by November 1, 2000 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.
(b) Allocations from funds appropriated under these sections.
(c) Description of allocations or bid processes including need or demand indicators used to determine allocations.
(d) Eligibility criteria for program participation and maximum benefit levels where applicable.
(e) Outcome measures to be used to evaluate programs.
(f) Any other information deemed necessary by the house or senate appropriations committees or the state budget director.
Sec. 209. The use of state restricted tobacco tax revenue received for the purpose of tobacco prevention, education, and reduction efforts and deposited in the healthy Michigan fund shall not be used for lobbying as defined in 1978 PA472, MCL 4.411 to 4.431.
Sec. 210. The department of civil service shall bill departments and agencies at the end of the first fiscal quarter for the 1% charge authorized by section 5 of article XI of the state constitution of 1963. Payments shall be made for the total amount of the billing by the end of the second fiscal quarter.
Sec. 211. (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 fiscal year 2000-2001, but shall also include reimbursements, refunds, adjustments, and settlements from prior years.
Sec. 212. 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 the CMHSPs to support the Medicaid managed mental health care program in that month. The information shall include the total paid to each CMHSP, per capita rate paid for each eligibility group for each CMHSP, and number of cases in each eligibility group for each CMHSP.
Sec. 213. (1) In addition to the funds appropriated in part 1, there is appropriated an amount not to exceed $100,000,000.00 for federal contingency funds. These funds are not available for expenditure until they have been transferred to another line item in this bill pursuant to 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 $50,000,000.00 for state restricted contingency funds. These funds are not available for expenditure until they have been transferred to another line item in this bill pursuant to 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 $50,000,000.00 for local contingency funds. These funds are not available for expenditure until they have been transferred to another line item in this bill pursuant to section 393(2) of the management and budget act, 1984 PA 431, MCL 18.1393.
(4) In addition to the funds appropriated in part 1, there is appropriated an amount not to exceed $10,000,000.00 for private contingency funds. These funds are not available for expenditure until they have been transferred to another line item in this bill pursuant to section 393(2) of the management and budget act, 1984 PA 431, MCL 18.1393.
Sec. 214. Basic health services for the purpose of part 23 of the public health code, 1978 PA 368, MCL 333.2301 to 333.2321, are: immunizations, communicable disease control, sexually transmitted disease control, tuberculosis control, prevention of gonorrhea eye infection in newborns, screening newborns for the 7 conditions listed in section 5431(1)(a) through (g) of the public health code, 1978 PA 368, MCL 333.5431, community health annex of the Michigan emergency management plan, and prenatal care.
Sec. 215. (1) The department may contract with the Michigan public health institute for the design and implementation of projects and for other public health related activities prescribed in section 2611 of the public health code, 1978 PA 368, MCL 333.2611. The department may develop a master agreement with the institute to carry out these purposes for up to a 3-year period. The department shall report to the house and senate appropriations subcommittees on community health, the house and senate fiscal agencies, and the state budget director on or before November 1, 2000 and May 1, 2001 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) If a report required under subsection (1) is not received by the house and senate appropriations subcommittees on community health, the house and senate fiscal agencies, and the state budget director on or before the date specified for that report, the disbursement of funds to the Michigan public health institute under this section shall stop. The disbursement of those funds shall recommence when the overdue report is received.
Sec. 216. All contracts with the Michigan public health institute funded with appropriations in part 1 shall include a requirement that the Michigan public health institute submit to financial and performance audits by the state auditor general of projects funded with state appropriations.
Sec. 217. Sixty days before beginning any effort to privatize, the department shall submit a complete project plan to the appropriate subcommittees of the senate and house of representatives standing committees on appropriations and the senate and house fiscal agencies. The plan shall include the criteria under which the privatization initiative will be evaluated. The evaluation shall be completed and submitted to the appropriate subcommittees of the senate and house of representatives standing committees on appropriations and the senate and house fiscal agencies within 30 months.
Sec. 218. The department of community health may establish and collect fees for publications, videos and related materials, conferences, and workshops. Collected fees shall be used to offset expenditures to pay for printing and mailing costs of the publications, videos and related materials, and costs of the workshops and conferences. The costs shall not exceed fees collected.
Sec. 219. The department shall continue to pilot the use of the Internet to fulfill the reporting requirements in this bill. This 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 on the Intranet. The appropriations subcommittee shall be notified in writing of the Internet/Intranet site of any such report.
DEPARTMENTWIDE ADMINISTRATON
Sec. 301. From funds appropriated for worker's compensation, the department may make payments in lieu of worker's compensation payments for wage/salary and related fringe benefits for employees who return to work under limited duty assignments.
Sec. 302. Funds appropriated in part 1 for the community health advisory council may be used for member per diems of $50.00 and other council expenditures.
COMMUNITY MENTAL HEALTH/SUBSTANCE ABUSE SERVICES PROGRAMS
Sec. 401. (1) From funds appropriated in part 1, final authorizations to CMHSPs shall be made upon the execution of contracts between the department and CMHSPs. 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 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 entered into under this subsection for fiscal year 2000-2001 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 that would affect rates or expenditures are enacted.
(b) Any amendments to contracts with CMHSPs 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. 402. From the funds appropriated in part 1 for multicultural services, the department shall ensure that CMHSPs continue contracts with multicultural services providers.
Sec. 403. (1) Not later than May 31 of each fiscal year, the department shall provide a report on the community mental health services programs to the members of the house and senate appropriations subcommittees on community health, the house and senate fiscal agencies, and the state budget director which shall include information required by this section.
(2) The report shall contain information for each community mental health services board 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 which, minimally, shall include a description of funding authorized; expenditures by client group and fund source; and cost information by service category, including administration. Service category shall include all department approved services.
(d) Data describing service outcomes which shall include, but not be limited to, an evaluation of consumer satisfaction, consumer choice, and quality of life concerns including, but not limited to, housing and employment.
(e) Information about access to community mental health services programs which shall include, but not be limited to:
(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 community mental health service programs in response to the needs assessment requirements of the mental health code.
(h) An estimate of the number of FTEs employed by CMHSPs or contracted directly by the CMHSPs as of September 30, 2000 and an estimate of the number of FTEs employed through contracts with provider organizations as of September 30, 2000.
(i) Lapses and carryforwards during fiscal year 1999-2000 for CMHSPs.
(j) Contracts for mental health services entered into by CMHSPs with providers, including amounts and rates, organized by type of service provided.
(k) Information on the community mental health Medicaid managed care program, including, but not limited to:
(i) Expenditures by each CMHSP 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.
(3) The department shall include data reporting requirements listed in subsection (2) in the annual contract with each individual CMHSP.
(4) The department shall take all reasonable actions to ensure that the data required are complete and consistent among all CMHSPs.
Sec. 404. (1) The funds appropriated in part 1 for the state disability assistance substance abuse services program shall be used to support per diem room and board payments in substance abuse residential facilities. Eligibility of clients for the state disability assistance substance abuse services program shall include needy persons 18 years of age or older, or emancipated minors, who reside in a substance abuse treatment center.
(2) The department shall reimburse all licensed substance abuse programs eligible to participate in the program at a rate equivalent to that paid by the family independence agency to adult foster care providers. Programs accredited by department-approved accrediting organizations shall be reimbursed at the personal care rate, while all other eligible programs shall be reimbursed at the domiciliary care rate. Sec. 405. (1) The amount appropriated in part 1 for substance abuse prevention, education, and treatment grants shall be expended for contracting with coordinating agencies or designated service providers. It is the intent of the legislature that the coordinating agencies or designated service providers work with the CMHSPs to coordinate the care and services provided to individuals with both mental illness and substance abuse diagnoses.
(2) The department shall establish a fee schedule for providing substance abuse services and charge participants in accordance with their ability to pay.
Sec. 406. (1) By April 15, 2001, the department shall report the following data from fiscal year 1999-00 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 and by subcontractor shall be reported.
(b) Expenditures per state client, with data on the distribution of expenditures reported using a histogram approach.
(c) Number of services provided by central diagnosis and referral agency, by subcontractor, and by service type. Additionally, data on length of stay, referral source, and participation in other state programs.
(d) Collections from other first- or third-party payers, private donations, or other state or local programs, by coordinating agency, by subcontractor, by population served, and by service type.
(2) The department shall take all reasonable actions to ensure that the required data reported are complete and consistent among all coordinating agencies.
Sec. 407. The funding in part 1 for substance abuse services shall be distributed in a manner so as to provide priority to service providers which furnish child care services to clients with children.
Sec. 408. The department shall assure that substance abuse treatment is provided to applicants and recipients of public assistance through the family independence agency who are required to obtain substance abuse treatment as a condition of eligibility for public assistance.
Sec. 409. (1) The department shall ensure that each contract with a CMHSP shall require the CMHSP to implement programs to encourage diversions of persons with serious mental illness, serious emotional disturbance, or developmental disability from possible jail incarceration when appropriate.
(2) Each CMHSP shall have jail diversion services and shall work toward establishing working relationships with representative staff of local law enforcement agencies. Such agencies include the 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. 410. The department is authorized to implement a plan for competitive procurement of managed medicaid mental health, developmental disabilities, and substance abuse services, as well as non-medicaid services, based upon an approved plan by the health care financing administration.
STATE PSYCHIATRIC HOSPITALS, CENTERS FOR PERSONS WITH DEVELOPMENTAL
DISABILITIES, AND FORENSIC AND PRISON MENTAL HEALTH SERVICES
Sec. 501. (1) In funding of staff in the financial support division, reimbursement, and billing and collection sections, priority shall be given to obtaining third-party payments for services. Collection from individual recipients of services and their families shall be handled in a sensitive and nonharassing manner.
(2) The department shall continue a revenue recapture project to generate additional revenues from third parties related to cases which have been closed or are inactive. Revenues collected through project efforts are appropriated to the department for departmental costs and contractual fees associated with these retroactive collections and to improve ongoing departmental reimbursement management functions so that the need for retroactive collections will be reduced or eliminated.
Sec. 502. Unexpended and unencumbered amounts and accompanying expenditure authorizations up to $2,000,000.00 remaining on September 30, 2001 from pay telephone revenues and the amounts appropriated in part 1 for gifts and bequests for patient living and treatment environments shall be carried forward for 1 fiscal year. The purpose of gifts and bequests for patient living and treatment environments is to use additional private funds to provide specific enhancements for individuals residing at state-operated facilities. Use of the gifts and bequests shall be consistent with the stipulation of the donor. The expected completion date for the use of gifts and bequests donations is within 3 years unless otherwise stipulated by the donor. Sec. 503. The funds appropriated in part 1 for forensic mental health services provided to the department of corrections are in accordance with the interdepartmental plan developed in cooperation with the department of corrections. The department is authorized to receive and expend funds from the department of corrections in addition to the appropriations in part 1 to fulfill the obligations outlined in the interdepartmental agreements. Sec. 504. (1) The CMHSPs shall provide semiannual reports to the department on the following information:
(a) The number of days of care purchased from state hospitals and centers.
(b) The number of days of care purchased from private hospitals in lieu of purchasing days of care from state hospitals and centers.
(c) The number and type of alternative placements to state hospitals and centers other than private hospitals.
(d) Waiting lists for placements in state hospitals and centers.
(2) The department shall semiannually report the information in subsection (1) to the house and senate appropriations subcommittees on community health, the house and senate fiscal agencies, and the state budget director. Sec. 505. (1) The department shall not implement any closures or consolidations of state hospitals, centers, or agencies until CMHSPs have programs and services in place for those persons currently in those facilities and a plan for service provision for those persons who would have been admitted to those facilities.
(2) All closures or consolidations are dependent upon adequate department-approved CMHSP plans which include a discharge and aftercare plan for each person currently in the facility. A discharge and aftercare plan shall address the person's housing needs. A homeless shelter or similar temporary shelter arrangements are inadequate to meet the person's housing needs.
(3) Four months after the certification of closure required in section 19(6) of 1943 PA 240, MCL 38.19, the department shall provide a closure plan to the house and senate appropriations subcommittees.
(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 responsible for providing services for persons previously served by the operations.
PUBLIC HEALTH ADMINISTRATION
Sec. 601. Of the amount appropriated in part 1 from revenues from fees and collections, not more than $250,000.00 received from the sale of vital records death data shall be used for improvements in the vital records and health statistics program.
INFECTIOUS DISEASE CONTROL
Sec. 701. State funds appropriated in any other account in part 1 may be used to supplant not more than $350,000.00 in federal funds projected for immunization, if the federal funds are unavailable. The department shall inform the senate and house appropriations subcommittees on community health, the senate and house fiscal agencies, and the state budget director of the specific line items reduced pursuant to this section.
Sec. 702. In the expenditure of funds appropriated in part 1 for AIDS programs, the department and its subcontractors shall ensure that adolescents receive priority for prevention, education, and outreach services.
Sec. 703. The department shall continue the AIDS drug assistance program maintaining the prior year eligibility criteria and drug formulary. This section is not intended to prohibit the department from providing assistance for improved AIDS treatment medications.
LOCAL HEALTH ADMINISTRTION AND GRANTS
Sec. 801. The amount appropriated in part 1 for implementation of the 1993 amendments to sections 9161, 16221, 16226, 17014, 17015, and 17515 of the public health code, 1978 PA 368, MCL 333.9161, 333.16221, 333.16226, 333.17014, 333.17015, and 333.17515, shall reimburse local health departments for costs incurred related to implementation of section 17015(15) of the public health code, 1978 PA 368, MCL 333.17015.
Sec. 802. If a county which 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, 2000, the department shall have the authority to assess a penalty from the local health department's administrative accounts in an amount equal to no more than 3% of the local health department's local public health operations funding. This penalty shall only be assessed to the local county that requests the dissolution of the health department.
Sec. 803. (1) Funds appropriated in part 1 for local public health operations shall be prospectively allocated to local health departments to support immunizations, infectious disease control, sexually transmitted disease control and prevention, 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. Public water supply, private groundwater supply, and on-site sewage management shall be provided under contract with the Michigan department of environmental quality.
(2) Local public health departments will be held to contractual standards for the services in subsection (1), including the local public health accreditation program.
(3) Distributions in subsection (1) shall be made only to counties that maintain local spending in fiscal year 2000-2001 of at least the amount expended in fiscal year 1992-93 for the services described in subsection (1).
CHRONIC DISEASE AND INJURY PREVENTION AND HEALTH PROMOTION
Sec. 901. (1) The amount appropriated in part 1 for school health and education programs shall be allocated in 2000-2001 to provide grants to or contract with certain districts and intermediate districts for the provision of a school health education curriculum. Provision of the curriculum, such as the Michigan model or another comprehensive school health education curriculum, shall be in accordance with the health education goals established by the Michigan model for the comprehensive school health education state steering committee. The state steering committee shall be comprised of a representative from each of the following offices and departments:
(a) The department of education.
(b) The department of community health.
(c) The public health agency in the department of community health.
(d) The office of substance abuse services in the department of community health.
(e) The family independence agency.
(f) The department of state police.
(2) Upon written or oral request, a pupil not less than 18 years of age or a parent or legal guardian of a pupil less than 18 years of age, within a reasonable period of time after the request is made, shall be informed of the content of a course in the health education curriculum and may examine textbooks and other classroom materials that are provided to the pupil or materials that are presented to the pupil in the classroom. This subsection does not require a school board to permit pupil or parental examination of test questions and answers, scoring keys, or other examination instruments or data used to administer an academic examination.
Sec. 902. From the funds appropriated in part 1 for physical fitness, nutrition, and health, up to $1,000,000.00 may be allocated to the Michigan physical fitness and sports foundation. The allocation to the Michigan physical fitness and sports foundation is contingent upon the foundation providing at least a 20% cash match.
Sec. 903. In spending the funds appropriated in part 1 for the smoking prevention program, priority shall be given to prevention and smoking cessation programs for pregnant women, women with young children, and adolescents.
Sec. 904. From the funds appropriated in part 1 for the diabetes program, a portion of the funds may be allocated to the national kidney foundation of Michigan for kidney disease prevention programming including early identification and education programs and kidney disease prevention demonstration projects.
Sec. 905. From the funds appropriated in part 1 for the diabetes program, $320,000.00 shall be allocated for improving the health of African-American men in Michigan. The funds shall be used for screening and patient self-care activities for diabetes, hypertension, stroke, and glaucoma and other eye diseases.
COMMUNITY LIVING, CHILDREN, AND FAMILIES
Sec. 1001. (1) Agencies receiving funds appropriated from part 1 for adolescent health care services shall:
(a) Require each adolescent health clinic funded by the agency to report to the department on an annual basis all of the following information:
(i) Funding sources of the adolescent health clinic.
(ii) Demographic information of populations served including sex, age, and race. Reporting and presentation of demographic data by age shall include the range of ages of 0-17 years and the range of ages of 18-23 years.
(iii) Utilization data that reflects the number of visits and repeat visits and types of services provided per visit.
(iv) Types and number of referrals to other health care agencies.
(b) As a condition of the contract, a contract shall include the establishment of a local advisory committee before the planning phase of an adolescent health clinic intended to provide services within that school district. The advisory committee shall be comprised of not less than 50% residents of the local school district, and shall not be comprised of more than 50% health care providers. A person who is employed by the sponsoring agency shall not have voting privileges as a member of the advisory committee.
(c) Not allow an adolescent health clinic funded by the agency, as part of the services offered, to provide abortion counseling or services or make referrals for abortion services.
(d) Require each adolescent health clinic funded by the agency to have a written policy on parental consent, developed by the local advisory committee and submitted to the local school board for approval if the services are provided in a public school building where instruction is provided in grades kindergarten through 12.
(2) A local advisory committee established under subsection (1)(b), in cooperation with the sponsoring agency, shall submit written recommendations regarding the implementation and types of services rendered by an adolescent health clinic to the local school board for approval of adolescent health services rendered in a public school building where instruction is provided in grades kindergarten through 12.
(3) The department shall submit a report to the members of the senate and house appropriations subcommittees on community health and the senate and house fiscal agencies based on the information provided under subsection (1)(a). The report is due 90 days after the end of the calendar year.
Sec. 1002. (1) Federal abstinence money expended in part 1 for the purpose of promoting abstinence education shall provide abstinence education to teenagers most likely to engage in high risk behavior as their primary focus, and may include programs that include 9- to 17-year-olds. Programs funded must meet all of the following guidelines:
(a) Teaches the gains to be realized by abstaining from sexual activity.
(b) Teaches abstinence from sexual activity outside of marriage as the expected standard for all school age children.
(c) Teaches that abstinence is the only certain way to avoid out-of-wedlock pregnancy, sexually transmitted diseases, and other health problems.
(d) Teaches that a monogamous relationship in the context of marriage is the expected standard of human sexual activity.
(e) Teaches that sexual activity outside of marriage is likely to have harmful effects.
(f) Teaches that bearing children out of wedlock is likely to have harmful consequences.
(g) Teaches young people how to avoid sexual advances and how alcohol and drug use increases vulnerability to sexual advances.
(h) Teaches the importance of attaining self-sufficiency before engaging in sexual activity.
(2) Programs and organizations that meet the guidelines of subsection (1) and criteria of subsection (2) shall have the option of receiving all or part of their funds directly from the department of community health.
Sec. 1003. Of the amount appropriated in part 1 for prenatal care outreach and service delivery support, not more than 10% shall be expended for local administration, data processing, and evaluation.
Sec. 1004. The funds appropriated in part 1 for pregnancy prevention programs shall not be used to provide abortion counseling, referrals, or services.
Sec. 1005. 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 would provide dental services to the uninsured in an amount that is no less than the amount allocated to that program in fiscal year 1996-97.
Sec. 1006. Agencies that currently receive pregnancy prevention funds and either receive or are eligible for other family planning funds shall have the option of receiving all of their family planning funds directly from the department of community health and be designated as delegate agencies.
Sec. 1007. From the funds appropriated for prenatal care outreach and service delivery support, the department shall allocate at least $1,000,000.00 to communities with high infant mortality rates.
Sec. 1008. From the funds appropriated in part 1 for special projects, the department shall allocate no less than $200,000.00 to provide education and outreach to targeted populations on the dangers of drug use during pregnancy and fetal alcohol syndrome and further develop its infant support services to target families with infants with fetal alcohol syndrome or suffering from drug addiction.
CHILDREN'S SPECIAL HEALTH CARE SERVICES
Sec. 1101. Funds appropriated in part 1 for medical care and treatment of children with special health care needs shall be paid according to reimbursement policies determined by the Michigan medical services program. Exceptions to these policies may be taken with the prior approval of the state budget director.
Sec. 1102. 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 genetic diagnostic and counseling services for eligible families.
(d) Provide medical care and treatment to eligible patients with hereditary coagulation defects, commonly known as hemophilia, who are 21 years of age or older.
OFFICE OF DRUG CONTROL POLICY
Sec. 1201. From the amount appropriated in part 1 to the office of drug control policy, anti-drug abuse grants, $200,000.00 shall be transferred to the department of education to fund the office for safe schools.
CRIME VICTIM SERVICES COMMISSION
Sec. 1301. The per diem amount authorized for the crime victim services commission is $100.00.
OFFICE OF SERVICES TO THE AGING
Sec. 1401. The appropriation in part 1 to the office of services to the aging, for community and nutrition services and home services, shall be restricted to eligible individuals at least 60 years of age who fail to qualify for home care services under title XVIII, XIX, or XX of the social security act, chapter 531, 49 Stat. 620.
Sec. 1402. Money appropriated in part 1 for the Michigan pharmaceutical program shall be used to purchase generic medicine when available and medically practicable.
Sec. 1403. The office of services to the aging shall require each region to report to the office of services to the aging home delivered meals waiting lists based upon standard criteria. Determining criteria shall include all of the following:
(a) The recipient's degree of frailty.
(b) The recipient's inability to prepare his or her own meals safely.
(c) Whether the recipient has another care provider available.
(d) Any other qualifications normally necessary for the recipient to receive home delivered meals.
Sec. 1404. The office of services to the aging may receive and expend fees for the provision of day care, care management, and respite care. The office of services to the aging shall base the fees on a sliding scale taking into consideration the client income. The office of services to the aging shall use the fees to expand services.
Sec. 1405. The office of services to the aging may receive and expend Medicaid funds for care management services.
MEDICAL SERVICES ADMINISTRATION
Sec. 1501. 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.
MEDICAL SERVICES
Sec. 1601. (1) For care provided to medical services recipients with other third-party sources of payment, medical services reimbursement shall not exceed, in combination with such other resources, including Medicare, those amounts established for medical services-only patients. The medical services payment rate shall be accepted as payment in full. Other than an approved medical services copayment, no portion of a provider's charge shall be billed to the recipient or any person acting on behalf of the recipient. Nothing in this section shall be deemed 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. 1602. 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. The department shall require copayments on dental, podiatric, chiropractic, vision, pharmaceutical, and hearing aid services provided to Medicaid recipients, except as prohibited by federal or state law or regulation.
Sec. 1604. (1) From the funds appropriated in part 1 for the indigent medical care program, the department shall establish a program which provides for the basic health care needs of indigent persons as delineated in the following subsections.
(2) Eligibility for this program is limited to the following:
(a) Persons currently receiving cash grants under either the family independence program or state disability assistance programs who are not eligible for any other public or private health care coverage.
(b) Any other resident of this state who currently meets the income and asset requirements for the state disability assistance program and is not eligible for any other public or private health care coverage.
(3) All potentially eligible persons, except those defined in subsection (2)(a), who shall be automatically enrolled, may apply for enrollment in this program at local family independence agency offices or other designated sites.
(4) The program shall provide for the following minimum level of services for enrolled individuals:
(a) Physician services provided in private, clinic, or outpatient office settings.
(b) Diagnostic laboratory and x-ray services.
(c) Pharmaceutical services.
(5) Notwithstanding subsection (2)(b), the state may continue to provide nursing facility coverage, including medically necessary ancillary services, to individuals categorized as permanently residing under color of law and who meet either of the following requirements:
(a) The individuals were medically eligible and residing in such a facility as of August 22, 1996 and qualify for emergency medical services.
(b) The individuals were Medicaid eligible as of August 22, 1996, and admitted to a nursing facility before a new eligibility determination was conducted by the family independence agency.
Sec. 1605. The department may require medical services recipients residing in counties offering managed care options to choose the particular managed care plan in which they wish to be enrolled. Persons not expressing a preference may be assigned to a managed care provider.
Sec. 1606. (1) The department of community health is authorized to pursue reimbursement for eligible services provided in Michigan schools from the federal Medicaid program. The department and the state budget director are authorized to negotiate and enter into agreements, together with the department of education, with local and intermediate school districts regarding the sharing of federal Medicaid services funds received for these services. The department is authorized to receive and disburse funds to participating school districts pursuant to such agreements and state and federal law.
(2) From the funds appropriated in part 1 for medical services school 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. 1607. The special medical services payments appropriation in part 1 may be increased if the department submits a medical services state plan amendment pertaining to this line item at a level higher than the appropriation. The department is authorized to appropriately adjust financing sources in accordance with the increased appropriation.
Sec. 1608. (1) The department shall implement enforcement actions as specified in the nursing facility enforcement provisions of section 1919 of title XIX of the social security act, chapter 531, 49 Stat. 620, 42 U.S.C. 1396r.
(2) The department is authorized to receive and spend penalty money received as the result of noncompliance with medical services certification regulations. Penalty money, characterized as private funds, received by the department shall increase authorizations and allotments in the long-term care accounts.
(3) Any unexpended penalty money, at the end of the year, shall carry forward to the following year.
Sec. 1609. (1) From the funds appropriated in part 1, the department, subject to the requirements and limitations in this section, shall establish a funding pool of up to $44,012,800.00 for the purpose of enhancing the aggregate payment for medical services hospital services.
(2) For counties with populations in excess of 2,000,000 persons, the department shall distribute $44,012,800.00 to hospitals if $15,026,700.00 is received by the state from such a county, which meets the criteria of an allowable state matching share as determined by applicable federal laws and regulations. If the state receives a lesser sum of an allowable state matching share from such a county, the amount distributed shall be reduced accordingly.
(3) The department may establish county-based, indigent health care programs that are at least equal in eligibility and coverage to the fiscal year 1996 state medical program.
(4) The department is authorized to establish similar programs in additional counties if the expenditures for the programs do not increase state general fund/general purpose costs and local funds are provided.
(5) If a locally administered indigent health care program replaces the state medical program authorized by section 1604 for a given county on or before October 1, 1998, the state general fund/general purpose dollars allocated for that county under this section shall not be less than the general fund/general purpose expenditures for the state medical program in that county in the previous fiscal year.
Sec. 1610. 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. 1611. (1) The department may establish a program for persons to purchase medical coverage at a rate determined by the department.
(2) The department may receive and expend premiums for the buy-in of medical coverage in addition to the amounts appropriated in part 1.
(3) The premiums described in this section shall be classified as private funds.
Sec. 1612. Implementation and contracting for managed care by Medicaid plans to the department are subject to the following conditions:
(a) Continuity of care is assured by allowing enrollees to continue receiving required medically necessary services from their current providers for a period not to exceed 1 year if enrollees meet the managed care medical exception criteria.
(b) The department shall require contracted health plans to submit data determined necessary for the evaluation on a timely basis.
(c) A health plans advisory council is functioning which meets all applicable federal and state requirements for a medical care advisory committee. The council shall review at least quarterly the implementation of the department's managed care plans.
(d) Mandatory enrollment is prohibited until there are at least 2 qualified health plans with the capacity to adequately serve each geographic area affected. Exceptions may be considered in areas where at least 85% of all area providers are in 1 plan.
(e) Enrollment of recipients of children's special health care services in qualified health plans shall be voluntary during fiscal year 2000 - 2001.
(f) The department shall develop a case adjustment to its rate methodology that considers the costs of persons with HIV/AIDS, end stage renal disease, organ transplants, epilepsy, and other high-cost disease or conditions and shall implement the case adjustment when it is proven to be actuarially and fiscally sound. Implementation of the case adjustment must be budget neutral.
Sec. 1613. (1) Medicaid qualified health plans shall establish an ongoing internal quality assurance program for health care services provided to Medicaid recipients which includes:
(a) An emphasis on health outcomes.
(b) Establishment of written protocols for utilization review based on current standards of medical practice.
(c) Review by physicians and other health care professionals of the process followed in the provision of such health care services.
(d) Evaluation of the continuity and coordination of care that enrollees receive.
(e) Mechanisms to detect overutilization and underutilization of services.
(f) Actions to improve quality and assess the effectiveness of such action through systematic follow-up.
(g) Provision of information on quality and outcome measures to facilitate enrollee comparison and choice of health coverage options.
(h) Ongoing evaluation of the plans' effectiveness.
(i) Consumer involvement in the development of the quality assurance program and consideration of enrollee complaints and satisfaction survey results.
(2) Medicaid qualified health plans shall apply for accreditation by an appropriate external independent accrediting organization requiring standards recognized by the department once those plans have met the application requirements. The state shall accept accreditation of a plan by an approved accrediting organization as proof that the plan meets some or all of the state's requirements, if the state determines that the accrediting organization's standards meet or exceed the state's requirements.
(3) Medicaid qualified health plans shall report encounter data, including data on inpatient and outpatient hospital care, physician visits, pharmaceutical services, and other services specified by the department.
(4) Medicaid qualified health plans shall assure that all covered services are available and accessible to enrollees with reasonable promptness and in a manner which assures continuity. Medically necessary services shall be available and accessible 24 hours a day and 7 days a week. Health plans shall continue to develop procedures for determining medical necessity which may include a prior authorization process.
(5) Medicaid qualified health plans shall provide for reimbursement of plan covered services delivered other than through the plan's providers if medically necessary and approved by the plan, immediately required, and which could not be reasonably obtained through the plan's providers on a timely basis. Such services shall be deemed approved if the plan does not respond to a request for authorization within 24 hours of the request. Reimbursement shall not exceed the Medicaid fee-for-service payment for such services.
(6) Medicaid qualified health plans shall provide access to appropriate providers, including qualified specialists for all medically necessary services.
(7) Medicaid qualified health plans shall provide the department with a demonstration of the plan's capacity to adequately serve the plan's expected enrollment of Medicaid enrollees.
(8) Medicaid qualified health plans shall provide assurances to the department that it will not deny enrollment to, expel, or refuse to reenroll any individual because of the individual's health status or need for services, and that it will notify all eligible persons of such assurances at the time of enrollment.
(9) Medicaid qualified health plans shall provide procedures for hearing and resolving grievances between the plan and members enrolled in the plan on a timely basis.
(10) Medicaid qualified health plans shall meet other standards and requirements contained in state laws, administrative rules, and policies promulgated by the department.
(11) Medicaid qualified health plans shall develop written plans for providing nonemergency medical transportation services funded through supplemental payments made to the plans by the department, and shall include information about transportation in their member handbook.
Sec. 1614. (1) The department may require a 12-month lock-in to the qualified health plan selected by the recipient during the initial and subsequent open enrollment periods, but allow for good cause exceptions during the lock-in period.
(2) Medicaid recipients shall be allowed to change health plans for any reason within the initial 90 days of enrollment.
Sec. 1615. (1) The department shall provide an expedited complaint review procedure for Medicaid eligible persons enrolled in qualified health plans for situations where failure to receive any health care service would result in significant harm to the enrollee.
(2) The department shall provide for a toll-free telephone number for Medicaid recipients enrolled in managed care to assist with resolving problems and complaints. If warranted, the department shall immediately disenroll persons from managed care and approve fee-for-service coverage.
(3) Quarterly reports summarizing the problems and complaints reported and their resolution shall be provided to the house and senate appropriations subcommittees on community health, the house and senate fiscal agencies, and the department's health plans advisory council.
Sec. 1616. The department may make separate payments directly to qualifying hospitals serving a disproportionate share of indigent patients, and to hospitals providing graduate medical education training programs. If direct payment for GME and DSH is made to qualifying hospitals for services to Medicaid clients, hospitals will not include GME costs or DSH payments in their contracts with HMOs.
Sec. 1617. The mother of an unborn child shall be eligible for medical services benefits for herself and her child if all other eligibility factors are met. To be eligible for these benefits, the applicant shall provide medical evidence of her pregnancy. If she is unable to provide the documentation, payment for the examination may be at state expense. The department of community health shall undertake such measures as may be necessary to ensure that necessary prenatal care is provided to medical services eligible recipients.
Sec. 1618. (1) The protected income level for Medicaid coverage determined pursuant to section 106(1)(b)(iii) of the social welfare act, 1939 PA 280, MCL 400.106, shall be 100% of the related public assistance standard.
Sec. 1619. 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. 1620. The department shall promote activities that preserve the dignity and rights of terminally ill and chronically ill individuals. Priority shall be given to programs, such as hospice, that focus on individual dignity and quality of care provided persons with terminal illness and programs serving persons with chronic illnesses that reduce the rate of suicide through the advancement of the knowledge and use of improved, appropriate pain management for these persons; and initiatives that train health care practitioners and faculty in managing pain, providing palliative care and suicide prevention.
Sec. 1621. The following sections are the only ones which shall apply to the following Medicaid managed care programs, including the comprehensive plan, children's special health care services plan, MI Choice long-term care plan, and the mental health, substance abuse, and developmentally disabled services program: 213, 401, 403, 410, 1605, 1612, 1613, 1614, 1615, 1616, 1627, 1628, and 1629.
Sec. 1622. (1) The appropriation in part 1 for the MIChild program is to be used to provide comprehensive health care to all children under age 19 who reside in families with income at or below 200% of the federal poverty level, who are uninsured and have not had coverage by other comprehensive health insurance within 6 months of making application for MIChild benefits, and who are residents of this state. The department shall develop detailed eligibility criteria through the medical services administration public concurrence process, consistent with the provisions of this act. Health care coverage for children in families below 150% of the federal poverty level shall be provided through expanded eligibility under the state's Medicaid program. Health coverage for children in families between 150% and 200% of the federal poverty level shall be provided through a state-based private health care program.
(2) The department shall enter into a contract to obtain MIChild services from any health maintenance organization, 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.
(3) The department may enter into contracts to obtain certain MIChild services from community mental health service programs.
(4) The department may make payments on behalf of children enrolled in the MIChild program from the line-item appropriation associated with the program as described in the MIChild state plan approved by the United States department of health and human services, or from other medical services line-item appropriations providing for specific health care services.
Sec. 1623. The department may establish premiums for MIChild eligible persons in families with income above 150% of the federal poverty level. The monthly premiums shall not exceed $5.00 for a family.
Sec. 1624. The department shall not require copayments under the MIChild program.
Sec. 1625. 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.
Sec. 1626. All nursing home rates, class I and class III, must have their respective fiscal year rate set 30 days prior to the beginning of their rate year. Rates may take into account the most recent cost report prepared and certified by the preparer, provider corporate owner or representative as being true and accurate, and filed 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. 1627. (1) Reimbursement for medical services to screen and stabilize a Medicaid recipient in a hospital emergency room shall not be made contingent on obtaining prior authorization from the recipient's qualified health plan. If the recipient is discharged from the emergency room, the hospital shall notify the recipient's qualified health plan within 24 hours of the diagnosis and treatment received.
(2) If the treating hospital determines that the recipient will require further medical service or hospitalization beyond the point of stabilization, that hospital must receive authorization from the recipient's qualified health plan prior to admitting the recipient.
(3) Subsections (1) and (2) shall not be construed as a requirement to alter an existing agreement between a qualified health plan and their contracting hospitals nor as a requirement that a qualified health plan must reimburse for services that are not deemed to be medically necessary.
Sec. 1628. (1) It is the intent of the legislature that a uniform Medicaid billing form be developed by the department in consultation with affected Medicaid providers. Every 2 months, the department shall provide reports to members of the senate and house appropriations subcommittees on community health and the senate and house fiscal agencies on the progress of this initiative.
(2) Until such time as a uniform billing form is developed and implemented, the following shall apply to Medicaid qualified health plans:
(a) If a billing form is received by a qualified health plan with a noncorrectable error, the qualified health plan shall return the form within 10 business days to the billing provider with plain language instructions as to what items need to be corrected.
(b) If a qualified health plan fails to provide reimbursement for 90% of its clean claims within 30 days, the qualified health plans shall be subject to an interest charge based on the value of the unpaid claims. Interest shall be paid at the rate specified in section 3902(a) of title 31 of the United States Code, 31 U.S.C. 3902. As used in this subdivision, "clean claim" means a claim that has no defect or impropriety, including lack of required substantiating documentation for noncontracting providers and suppliers, or particular circumstances requiring special treatment that prevents timely payment from being made on the claim.
(c) If a qualified health plan has followed the procedure specified in subdivision (a), the required time for reimbursement does not begin until a corrected billing form has been received.
(d) A Medicaid provider that submits a duplicate of a claim that has been denied or returned with notice that it is incomplete or incorrect shall be subject to a service charge for each duplicate claim, in an amount determined by the department, if the duplicate claim is submitted without completion, correction, or further information that addresses the denial or return.
(3) The department shall hold regular Medicaid billing seminars targeted to both qualified health plans and Medicaid providers. The number and locations of these seminars should be sufficient to provide reasonable access to qualified health plans and Medicaid providers throughout the state. The department shall provide quarterly reports to the members of the senate and house appropriations subcommittees on community health and the senate and house fiscal agencies on the number of seminars, their content and location, and the number of persons attending these seminars.
Sec. 1629. (1) The department shall do or demonstrate that it has accomplished all of the following concerning the provision of early and periodic screening, diagnosis, and treatment (EPSDT) and maternal and infant support services (MSS/ISS):
(a) Explore the feasibility of developing a uniform encounter form for EPSDT services, MSS/ISS referral, and MSS/ISS screening and services.
(b) Require each qualified health plan to evaluate 100% of pregnant Medicaid enrollees for possible MSS/ISS screening referral during the initial pregnancy services visit, using uniform screening and referral criteria.
(c) Require each qualified health plan to notify the department and the appropriate local health department of all MSS/ISS screening referrals, and require all MSS/ISS screening and service providers to notify the department and the appropriate local health department of Medicaid clients who fail to keep MSS/ISS appointments.
(d) Prohibit qualified health plans from requiring prior authorization for their contracted providers for any EPSDT screening and diagnostic service, for MSS/ISS screening referral, or for up to 3 MSS/ISS service visits.
(e) Coordinate the provision of MSS/ISS services with the women, infants, and children supplemental nutrition (WIC) program, state supported substance abuse, smoking prevention, and violence prevention programs, the family independence agency, and any other state or local program with a focus on preventing adverse birth outcomes and child abuse and neglect.
(2) The department shall require the external quality review contractor to conduct a statistically significant sampling of the health records of Medicaid eligible clients of all qualified health plans for the following information:
(a) The number of Medicaid enrollees under age 19.
(b) The number of Medicaid enrollees receiving at least 1 EPSDT service.
(c) The number and type of EPSDT services rendered.
(d) The immunization status of each EPSDT eligible enrollee who is seen by a plan provider.
(e) The number of enrollees receiving blood lead screening.
(f) The number of referrals to local health departments for blood lead screening, immunization, or objective hearing and vision screening services.
(g) The number of pregnant Medicaid enrollees.
(h) The number of referrals for MSS/ISS assessment.
(i) The number of MSS/ISS assessments performed.
(j) The number and description of MSS/ISS visits or services delivered.
(k) The number of prenatal visits per pregnant enrollee.
(3) The department shall compile and report the information required in subsection (2) to the senate and house appropriations subcommittees on community health, the senate and house fiscal agencies, and the state budget director no later than February 1, 2001.
Sec. 1630. (1) Effective January 1, 2001, an elder prescription insurance coverage program will be established, referred to in this section as the EPIC program. The guiding principles of this program are all of the following:
(a) To enhance access to prescription medications for low income elderly residents of this state.
(b) To make that access meaningful by reducing the cost to senior citizens to obtain prescription medications.
(c) To assist the elderly in understanding how prescription medications can be beneficial in treating diseases, illnesses, and conditions that are more prevalent in the aged.
(d) To provide the means by which those persons who prescribe and dispense prescription medications for the elderly are better able to recognize those prescription situations in which combinations of new and/or existing drugs, or other factors, could result in adverse drug interaction in an elderly person.
(e) The program developed pursuant to this section is not an entitlement and benefits are limited to the level supported by the funding explicitly appropriated in this or subsequent acts.
(2) In furthering these guiding principles, the operational parameters of the EPIC program shall include at least all of the following:
(a) Limiting eligibility to Michigan residents who are over the age of 64, who have household incomes at or below 200% of the federal poverty level, and who are not eligible for Medicaid.
(b) Establishing variable premium rates based on a percentage of household income, which rate shall be not more than 5% of household income if household income is 200% of the federal poverty level and shall be zero if household income is 100% or less of the federal poverty level.
(c) A mechanism, such as limiting the number of policies sold, to ensure that expenditures do not exceed available revenue.
(3) The EPIC program shall not be implemented until after an automated pharmacy claims adjudication and prospective drug utilization review system is operational.
(4) The EPIC program shall not be implemented until section 273 of the income tax act of 1967, 1967 PA 281, M.C.L. 206.273, is repealed.