HB-4392,As Passed House,Apr 3, 2003
SUBSTITUTE FOR
HOUSE BILL NO. 4392
A bill to make appropriations for the department of community
health and certain state purposes related to mental health, public
health, and medical services for the fiscal year ending September 30,
2004; to provide for the expenditure of those appropriations; to
create funds; to require and provide for reports; to prescribe the
powers and duties of certain local and state agencies and departments;
and to provide for disposition of fees and other income received by
the various state agencies.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
1 PART 1
2 LINE-ITEM APPROPRIATIONS - FISCAL YEAR 2003-2004
3 Sec. 101. Subject to the conditions set forth in this act, the
4 amounts listed in this part are appropriated for the department of
5 community health for the fiscal year ending September 30, 2004, from
6 the funds indicated in this part. The following is a summary of the
1 appropriations in this part:
2 DEPARTMENT OF COMMUNITY HEALTH
3 Full-time equated unclassified positions........6.0
4 Full-time equated classified positions......4,382.3
5 Average population............................995.0
6 GROSS APPROPRIATION................................. $ 9,078,801,100
7 Interdepartmental grant revenues:
8 Total interdepartmental grants and intradepartmental
9 transfers......................................... $ 69,204,800
10 ADJUSTED GROSS APPROPRIATION........................ $ 9,009,596,300
11 Federal revenues:
12 Total federal revenues.............................. 4,845,868,100
13 Special revenue funds:
14 Total local revenues................................ 806,552,500
15 Total private revenues.............................. 57,844,000
16 Tobacco settlement revenue.......................... 137,468,200
17 Total other state restricted revenues............... 513,494,300
18 State general fund/general purpose.................. $ 2,648,369,200
19 Sec. 102. DEPARTMENTWIDE ADMINISTRATION
20 Full-time equated unclassified positions........6.0
21 Full-time equated classified positions........286.9
22 Director and other unclassified--6.0 FTE positions.. $ 581,500
23 Community health advisory council................... 28,900
24 Departmental administration and management--265.5
25 FTE positions..................................... 23,490,400
26 Certificate of need program administration--10.0 FTE
27 positions......................................... 944,800
1 Worker's compensation program....................... 10,381,100
2 Rent and building occupancy......................... 8,300,100
3 Developmental disabilities council and
4 projects--10.0 FTE positions...................... 2,743,600
5 Rural health services............................... 1,377,900
6 Michigan essential health care provider program..... 1,391,700
7 Primary care services--1.4 FTE positions............ 2,790,100
8 GROSS APPROPRIATION................................. $ 52,030,100
9 Appropriated from:
10 Interdepartmental grant revenues:
11 Interdepartmental grant from the department of
12 treasury, Michigan state hospital finance
13 authority......................................... 101,600
14 Federal revenues:
15 Total federal revenues.............................. 15,706,000
16 Special revenue funds:
17 Total private revenues.............................. 185,900
18 Total other state restricted revenues............... 1,580,000
19 State general fund/general purpose.................. $ 34,456,600
20 Sec. 103. MENTAL HEALTH/SUBSTANCE ABUSE SERVICES
21 ADMINISTRATION AND SPECIAL PROJECTS
22 Full-time equated classified positions.........83.3
23 Mental health/substance abuse program
24 administration--83.3 FTE positions................ $ 9,135,900
25 Consumer involvement program........................ 189,100
26 Gambling addiction.................................. 3,500,000
27 Protection and advocacy services support............ 777,400
1 Mental health initiatives for older persons......... 1,349,200
2 Community residential and support services.......... 3,838,200
3 Highway safety projects............................. 1,837,200
4 Federal and other special projects.................. 1,977,200
5 GROSS APPROPRIATION................................. $ 22,604,200
6 Appropriated from:
7 Federal revenues:
8 Total federal revenues.............................. 6,169,100
9 Special revenue funds:
10 Total private revenues.............................. 190,000
11 Total other state restricted revenues............... 3,682,300
12 State general fund/general purpose.................. $ 12,562,800
13 Sec. 104. COMMUNITY MENTAL HEALTH/SUBSTANCE ABUSE
14 SERVICES PROGRAMS
15 Full-time equated classified positions..........2.5
16 Medicaid mental health services..................... $ 1,350,092,900
17 Community mental health non-Medicaid services....... 328,394,100
18 Medicaid adult benefits waiver...................... 40,000,000
19 Multicultural services.............................. 3,663,800
20 Medicaid substance abuse services................... 27,333,700
21 Respite services.................................... 1,000,000
22 CMHSP, purchase of state services contracts......... 98,412,200
23 Civil service charges............................... 2,065,500
24 Federal mental health block grant--2.5 FTE positions 15,317,400
25 State disability assistance program substance abuse
26 services.......................................... 2,509,800
27 Community substance abuse prevention, education and
1 treatment programs................................ 80,548,400
2 GROSS APPROPRIATION................................. $ 1,949,337,800
3 Appropriated from:
4 Federal revenues:
5 Total federal revenues.............................. 874,767,200
6 Special revenue funds:
7 Total local revenues................................ 26,000,000
8 Total other state restricted revenues............... 3,042,400
9 State general fund/general purpose.................. $ 1,045,528,200
10 Sec. 105. STATE PSYCHIATRIC HOSPITALS, CENTERS
11 FOR PERSONS WITH DEVELOPMENTAL DISABILITIES, AND
12 FORENSIC AND PRISON MENTAL HEALTH SERVICES
13 Total average population......................995.0
14 Full-time equated classified positions......3,060.4
15 Caro regional mental health center-psychiatric
16 hospital-adult--409.2 FTE positions............... $ 36,376,400
17 Average population............................167.0
18 Kalamazoo psychiatric hospital-adult--317.9 FTE
19 positions......................................... 20,568,200
20 Average population............................115.0
21 Walter P. Reuther psychiatric hospital-adult--452.0
22 FTE positions..................................... 38,718,800
23 Average population............................244.0
24 Hawthorn center-psychiatric hospital-children and
25 adolescents--242.6 FTE positions.................. 20,370,500
26 Average population.............................80.0
27 Mount Pleasant center-developmental
1 disabilities--428.1 FTE positions................. 29,107,100
2 Average population............................164.0
3 Center for forensic psychiatry--495.0 FTE positions. 41,785,400
4 Average population............................225.0
5 Forensic mental health services provided to the
6 department of corrections--704.6 FTE positions.... 68,120,600
7 Revenue recapture................................... 750,000
8 IDEA, federal special education..................... 120,000
9 Special maintenance and equipment................... 335,300
10 Purchase of medical services for residents of
11 hospitals and centers............................. 1,358,200
12 Closed site, transition, and related costs--11.0 FTE
13 positions......................................... 1,067,200
14 Severance pay....................................... 216,900
15 Gifts and bequests for patient living and treatment
16 environment....................................... 500,000
17 GROSS APPROPRIATION................................. $ 259,394,600
18 Appropriated from:
19 Interdepartmental grant revenues:
20 Interdepartmental grant from the department of
21 corrections....................................... 68,120,600
22 Federal revenues:
23 Total federal revenues.............................. 28,708,500
24 Special revenue funds:
25 CMHSP, purchase of state services contracts......... 98,412,200
26 Other local revenues................................ 15,228,300
27 Total private revenues.............................. 500,000
1 Total other state restricted revenues............... 7,034,600
2 State general fund/general purpose.................. $ 41,390,400
3 Sec. 106. PUBLIC HEALTH ADMINISTRATION
4 Full-time equated classified positions.........76.3
5 Executive administration--7.0 FTE positions......... $ 1,014,300
6 Minority health grants and contracts................ 650,000
7 Vital records and health statistics--69.3 FTE
8 positions......................................... 6,141,700
9 GROSS APPROPRIATION................................. $ 7,806,000
10 Appropriated from:
11 Interdepartmental grant revenues:
12 Interdepartmental grant from family independence
13 agency............................................ 447,800
14 Federal revenues:
15 Total federal revenues.............................. 2,045,100
16 Special revenue funds:
17 Total other state restricted revenues............... 2,963,400
18 State general fund/general purpose.................. $ 2,349,700
19 Sec. 107. INFECTIOUS DISEASE CONTROL
20 Full-time equated classified positions.........51.3
21 AIDS prevention, testing and care programs--13.0 FTE
22 positions......................................... $ 29,158,600
23 Immunization local agreements....................... 13,990,300
24 Immunization program management and field
25 support--14.0 FTE positions....................... 1,582,100
26 Sexually transmitted disease control local
27 agreements........................................ 3,494,900
1 Sexually transmitted disease control management and
2 field support--24.3 FTE positions................. 3,377,100
3 GROSS APPROPRIATION................................. $ 51,603,000
4 Appropriated from:
5 Federal revenues:
6 Total federal revenues.............................. 37,593,000
7 Special revenue funds:
8 Total private revenues.............................. 1,847,000
9 Total other state restricted revenues............... 7,550,000
10 State general fund/general purpose.................. $ 4,613,000
11 Sec. 108. LABORATORY SERVICES
12 Full-time equated classified positions........115.2
13 Laboratory services--115.2 FTE positions............ $ 12,091,600
14 GROSS APPROPRIATION................................. $ 12,091,600
15 Appropriated from:
16 Interdepartmental grant revenues:
17 Interdepartmental grant from environmental quality.. 392,100
18 Federal revenues:
19 Total federal revenues.............................. 2,040,100
20 Special revenue funds:
21 Total other state restricted revenues............... 3,131,300
22 State general fund/general purpose.................. $ 6,528,100
23 Sec. 109. EPIDEMIOLOGY
24 Full-time equated classified positions.........90.0
25 AIDS surveillance and prevention program............ $ 1,883,100
26 Asthma prevention and control....................... 1,032,300
27 Bioterrorism preparedness--59.5 FTE positions....... 34,157,700
1 Epidemiology administration--30.5 FTE positions..... 5,375,700
2 Tuberculosis control and recalcitrant AIDS program.. 867,000
3 GROSS APPROPRIATION................................. $ 43,315,800
4 Appropriated from:
5 Federal revenues:
6 Total federal revenues.............................. 41,197,400
7 Special revenue funds:
8 Total other state restricted revenues............... 179,000
9 State general fund/general purpose.................. $ 1,939,400
10 Sec. 110. LOCAL HEALTH ADMINISTRATION AND GRANTS
11 Full-time equated classified positions..........3.0
12 Implementation of 1993 PA 133, MCL 333.17015........ $ 100,000
13 Lead abatement program--3.0 FTE positions........... 1,550,200
14 Local health services............................... 220,000
15 Local public health operations...................... 40,618,400
16 Medical services cost reimbursement to local health
17 departments....................................... 1,800,000
18 GROSS APPROPRIATION................................. $ 44,288,600
19 Appropriated from:
20 Federal revenues:
21 Total federal revenues.............................. 3,249,100
22 Special revenue funds:
23 Total other state restricted revenues............... 344,600
24 State general fund/general purpose.................. $ 40,694,900
25 Sec. 111. CHRONIC DISEASE AND INJURY PREVENTION
26 AND HEALTH PROMOTION
27 Full-time equated classified positions.........41.6
1 African-American male health initiative............. $ 106,700
2 AIDS and risk reduction clearinghouse and media
3 campaign.......................................... 1,576,000
4 Alzheimer's information network..................... 440,000
5 Cancer prevention and control program--10.6 FTE
6 positions......................................... 11,043,100
7 Chronic disease prevention.......................... 1,572,400
8 Diabetes and kidney program--8.0 FTE positions...... 2,953,900
9 Health education, promotion, and research
10 programs--11.0 FTE positions...................... 938,800
11 Injury control intervention project................. 714,900
12 Obesity program..................................... 250,000
13 Public health traffic safety coordination........... 350,000
14 Smoking prevention program--12.0 FTE positions...... 4,852,700
15 Tobacco tax collection and enforcement.............. 810,000
16 Violence prevention................................. 1,446,900
17 GROSS APPROPRIATION................................. $ 27,055,400
18 Appropriated from:
19 Federal revenues:
20 Total federal revenues.............................. 15,493,200
21 Special revenue funds:
22 Total other state restricted revenues............... 9,891,800
23 State general fund/general purpose.................. $ 1,670,400
24 Sec. 112. COMMUNITY LIVING, CHILDREN, AND
25 FAMILIES
26 Full-time equated classified positions.........72.0
27 Childhood lead program--5.0 FTE positions........... $ 1,470,700
1 Children's waiver home care program................. 19,549,800
2 Community living, children, and families
3 administration--60.0 FTE positions................ 7,074,100
4 Dental programs..................................... 485,400
5 Dental program for persons with developmental
6 disabilities...................................... 151,000
7 Family planning local agreements.................... 11,318,100
8 Family support subsidy.............................. 15,593,500
9 Housing and support services........................ 5,579,300
10 Local MCH services.................................. 13,050,200
11 Migrant health care................................. 200,000
12 Newborn screening follow-up and treatment services.. 2,428,000
13 Omnibus budget reconciliation act
14 implementation--7.0 FTE positions................. 12,770,500
15 Pediatric AIDS prevention and control............... 1,026,300
16 Pregnancy prevention program........................ 5,846,100
17 Prenatal care outreach and service delivery support. 3,049,300
18 Southwest community partnership..................... 996,700
19 Special projects.................................... 5,274,500
20 Sudden infant death syndrome program................ 321,300
21 GROSS APPROPRIATION................................. $ 106,184,800
22 Appropriated from:
23 Federal revenues:
24 Total federal revenues.............................. 75,804,200
25 Special revenue funds:
26 Total private revenues.............................. 261,100
27 Total other state restricted revenues............... 10,540,000
1 State general fund/general purpose.................. $ 19,579,500
2 Sec. 113. WOMEN, INFANTS, AND CHILDREN FOOD AND
3 NUTRITION PROGRAMS
4 Full-time equated classified positions.........41.0
5 Women, infants, and children program administration
6 and special projects--41.0 FTE positions.......... $ 5,600,100
7 Women, infants, and children program local
8 agreements and food costs......................... 181,392,100
9 GROSS APPROPRIATION................................. $ 186,992,200
10 Appropriated from:
11 Federal revenues:
12 Total federal revenues.............................. 136,644,900
13 Special revenue funds:
14 Total private revenues.............................. 50,347,300
15 State general fund/general purpose.................. $ 0
16 Sec. 114. CHILDREN'S SPECIAL HEALTH CARE SERVICES
17 Full-time equated classified positions.........66.6
18 Children's special health care services
19 administration--66.6 FTE positions................ $ 4,478,800
20 Amputee program..................................... 184,600
21 Bequests for care and services...................... 1,829,600
22 Case management services............................ 3,773,500
23 Conveyor contract................................... 513,500
24 Medical care and treatment.......................... 156,247,200
25 GROSS APPROPRIATION................................. $ 167,027,200
26 Appropriated from:
27 Federal revenues:
1 Total federal revenues.............................. 79,815,600
2 Special revenue funds:
3 Total private revenues.............................. 1,000,000
4 Total other state restricted revenues............... 650,000
5 State general fund/general purpose.................. $ 85,561,600
6 Sec. 115. OFFICE OF DRUG CONTROL POLICY
7 Full-time equated classified positions.........17.0
8 Drug control policy--17.0 FTE positions............. $ 1,973,400
9 Anti-drug abuse grants.............................. 26,859,200
10 IDG to judiciary for drug treatment courts.......... 1,800,000
11 GROSS APPROPRIATION................................. $ 30,632,600
12 Appropriated from:
13 Federal revenues:
14 Total federal revenues.............................. 30,246,600
15 State general fund/general purpose.................. $ 386,000
16 Sec. 116. CRIME VICTIM SERVICES COMMISSION
17 Full-time equated classified positions..........9.0
18 Grants administration services--9.0 FTE positions... $ 1,080,500
19 Justice assistance grants........................... 13,000,000
20 Crime victim rights services grants................. 8,265,300
21 GROSS APPROPRIATION................................. $ 22,345,800
22 Appropriated from:
23 Federal revenues:
24 Total federal revenues.............................. 13,946,900
25 Special revenue funds:
26 Total other state restricted revenues............... 7,984,400
27 State general fund/general purpose.................. $ 414,500
1 Sec. 117. OFFICE OF SERVICES TO THE AGING
2 Full-time equated classified positions.........32.5
3 Commission (per diem $50.00)........................ $ 10,500
4 Office of services to aging administration--32.5 FTE
5 positions......................................... 4,167,800
6 Community services.................................. 35,286,100
7 Nutrition services.................................. 38,191,200
8 Senior volunteer services........................... 5,645,900
9 Senior citizen centers staffing and equipment....... 1,068,700
10 Employment assistance............................... 2,818,300
11 Respite care program................................ 7,100,000
12 GROSS APPROPRIATION................................. $ 94,288,500
13 Appropriated from:
14 Federal revenues:
15 Total federal revenues.............................. 52,094,300
16 Special revenue funds:
17 Tobacco settlement revenue.......................... 5,000,000
18 Total other state restricted revenues............... 2,267,000
19 State general fund/general purpose.................. $ 34,927,200
20 Sec. 118. MEDICAL SERVICES ADMINISTRATION
21 Full-time equated classified positions........333.7
22 Medical services administration--333.7 FTE positions $ 39,319,900
23 Facility inspection contract - state police......... 132,800
24 MIChild administration.............................. 4,327,800
25 GROSS APPROPRIATION................................. $ 43,780,500
26 Appropriated from:
27 Federal revenues:
1 Total federal revenues.............................. 29,512,300
2 Special revenue funds:
3 State general fund/general purpose.................. $ 14,268,200
4 Sec. 119. MEDICAL SERVICES
5 Hospital services and therapy....................... $ 833,077,400
6 Hospital disproportionate share payments............ 45,000,000
7 Physician services.................................. 205,468,700
8 Medicare premium payments........................... 166,046,600
9 Pharmaceutical services............................. 477,438,800
10 Home health services................................ 28,887,900
11 Transportation...................................... 8,918,200
12 Auxiliary medical services.......................... 75,478,000
13 Ambulance services.................................. 5,000,000
14 Long-term care services............................. 1,490,390,400
15 Elder prescription insurance coverage............... 68,011,800
16 Health plan services................................ 1,437,028,400
17 MIChild program..................................... 36,875,600
18 Medicaid adult benefits waiver...................... 178,707,600
19 Maternal and child health........................... 9,234,500
20 Social services to the physically disabled.......... 1,344,900
21 Subtotal basic medical services program............. 5,066,908,800
22 School-based services............................... 69,159,500
23 Special adjustor payments........................... 791,338,100
24 Subtotal special medical services payments.......... 860,497,600
25 GROSS APPROPRIATION................................. $ 5,927,406,400
26 Appropriated from:
27 Federal revenues:
1 Total federal revenues.............................. 3,383,530,400
2 Special revenue funds:
3 Total local revenues................................ 666,912,000
4 Total private revenues.............................. 3,512,700
5 Tobacco settlement revenue.......................... 132,468,200
6 Total other state restricted revenues............... 450,859,700
7 State general fund/general purpose.................. $ 1,290,123,400
8 Sec. 120. INFORMATION TECHNOLOGY
9 Information technology services and projects........ $ 30,616,000
10 GROSS APPROPRIATION................................. $ 30,616,000
11 Appropriated from:
12 Interdepartmental grant revenues:
13 Interdepartmental grant from the department of
14 corrections....................................... 142,700
15 Federal revenues:
16 Total federal revenues.............................. 17,304,200
17 Special revenue funds:
18 Total other state restricted revenues............... 1,793,800
19 State general fund/general purpose.................. $ 11,375,300
20 PART 2
21 PROVISIONS CONCERNING APPROPRIATIONS FOR FISCAL YEAR 2003-2004
22 GENERAL SECTIONS
23 Sec. 201. Pursuant to section 30 of article IX of the state
24 constitution of 1963, total state spending from state resources under
25 part 1 for fiscal year 2003-2004 is $3,299,331,600.00 and state
1 spending from state resources to be paid to units of local government
2 for fiscal year 2003-2004 is $1,060,415,000.00. The itemized
3 statement below identifies appropriations from which spending to units
4 of local government will occur:
5 DEPARTMENT OF COMMUNITY HEALTH
6 DEPARTMENTWIDE ADMINISTRATION
7 Departmental administration and management........ $ 11,657,700
8 Rural health services............................. 35,000
9 MENTAL HEALTH/SUBSTANCE ABUSE SERVICES ADMINISTRATION
10 AND SPECIAL PROJECTS
11 Mental health initiatives for older persons....... 1,049,200
12 COMMUNITY MENTAL HEALTH/SUBSTANCE ABUSE SERVICES
13 PROGRAMS
14 State disability assistance program substance
15 abuse services.................................... 2,509,800
16 Community substance abuse prevention, education,
17 and treatment programs............................ 19,133,500
18 Medicaid mental health services................... 595,525,800
19 Community mental health non-Medicaid services..... 326,811,700
20 Multicultural services............................ 3,663,800
21 Medicaid substance abuse services................. 12,056,900
22 Respite services.................................. 1,000,000
23 INFECTIOUS DISEASE CONTROL
24 AIDS prevention, testing and care programs.......... 1,466,800
25 Immunization local agreements....................... 2,973,900
26 Sexually transmitted disease control local
27 agreements........................................ 406,100
1 LOCAL HEALTH ADMINISTRATION AND GRANTS
2 Local public health operations...................... 40,618,400
3 CHRONIC DISEASE AND INJURY PREVENTION AND HEALTH
4 PROMOTION
5 Smoking prevention program.......................... 1,898,400
6 COMMUNITY LIVING, CHILDREN, AND FAMILIES
7 Childhood lead program.............................. 85,000
8 Family planning local agreements.................... 1,142,200
9 Local MCH services.................................. 246,100
10 Omnibus budget reconciliation act implementation.... 2,030,800
11 Prenatal care outreach and service delivery support. 610,000
12 CHILDREN'S SPECIAL HEALTH CARE SERVICES
13 Case management services............................ 3,169,900
14 MEDICAL SERVICES
15 Transportation...................................... 1,175,300
16 OFFICE OF SERVICES TO THE AGING
17 Community services.................................. 12,530,300
18 Nutrition services.................................. 12,439,500
19 Senior volunteer services........................... 517,500
20 CRIME VICTIM SERVICES COMMISSION
21 Crime victim rights services grants................. 5,661,300
22 TOTAL OF PAYMENTS TO LOCAL UNITS
23 OF GOVERNMENT..................................... $ 1,060,415,000
24 Sec. 202. (1) The appropriations authorized under this act are
25 subject to the management and budget act, 1984 PA 431, MCL 18.1101 to
26 18.1594.
27 (2) Funds for which the state is acting as the custodian or agent
1 are not subject to annual appropriation.
2 Sec. 203. As used in this act:
3 (a) "AIDS" means acquired immunodeficiency syndrome.
4 (b) "CMHSP" means a community mental health services program as
5 that term is defined in section 100a of the mental health code, 1974
6 PA 258, MCL 330.1100a.
7 (c) "Disease management" means a comprehensive system that
8 incorporates the patient, physician, and health plan into 1 system with
9 the common goal of achieving desired outcomes for patients.
10 (d) "Department" means the Michigan department of community health.
11 (e) "DSH" means disproportionate share hospital.
12 (f) "EPIC" means elder prescription insurance coverage program.
13 (g) "EPSDT" means early and periodic screening, diagnosis, and
14 treatment.
15 (h) "FTE" means full-time equated.
16 (i) "GME" means graduate medical education.
17 (j) "Health plan" means, at a minimum, an organization that meets
18 the criteria for delivering the comprehensive package of services under
19 the department's comprehensive health plan.
20 (k) "HMO" means health maintenance organization.
21 (l) "IDEA" means individual disability education act.
22 (m) "IDG" means interdepartmental grant.
23 (n) "MCH" means maternal and child health.
24 (o) "MiChild" means the program described in section 1670.
25 (p) "MSS/ISS" means maternal and infant support services.
26 (q) "Specialty prepaid health plan" means a program described in
27 section 232b of the mental health code, 1974 PA 258, MCL 330.1232b.
1 (r) "Title XVIII" means title XVIII of the social security act,
2 chapter 531, 49 Stat. 620, 42 U.S.C. 1395 to 1395b, 1395b-2, 1395b-6 to
3 1395b-7, 1395c to 1395i, 1395i-2 to 1395i-5, 1395j to 1395t, 1395u to
4 1395w, 1395w-2 to 1395w-4, 1395w-21 to 1395w-28, 1395x to 1395yy, and
5 1395bbb to 1395ggg.
6 (s) "Title XIX" means title XIX of the social security act, chapter
7 531, 49 Stat. 620, 42 U.S.C. 1396 to 1396r-6 and 1396r-8 to 1396v.
8 (t) "Title XX" means title XX of the social security act, chapter
9 531, 49 Stat. 620, 49 U.S.C. 1397 to 1397f.
10 (u) "WIC" means women, infants, and children supplemental nutrition
11 program.
12 Sec. 204. The department of civil service shall bill departments
13 and agencies at the end of the first fiscal quarter for the 1% charge
14 authorized by section 5 of article XI of the state constitution of
15 1963. Payments shall be made for the total amount of the billing by
16 the end of the second fiscal quarter.
17 Sec. 205. (1) A hiring freeze is imposed on the state classified
18 civil service. State departments and agencies are prohibited from
19 hiring any new state classified civil service employees and prohibited
20 from filling any vacant state classified civil service positions.
21 This hiring freeze does not apply to internal transfers of classified
22 employees from 1 position to another within a department.
23 (2) The state budget director shall grant exceptions to this
24 hiring freeze when the state budget director believes that the hiring
25 freeze will result in rendering a state department or agency unable to
26 deliver basic services, cause loss of revenue to the state, result in
27 the inability of the state to receive federal funds, or would
1 necessitate additional expenditures that exceed any savings from
2 maintaining the vacancy. The state budget director shall report
3 quarterly to the chairpersons of the senate and house of
4 representatives standing committees on appropriations the number of
5 exceptions to the hiring freeze approved during the previous quarter
6 and the reasons to justify the exception.
7 Sec. 206. (1) In addition to the funds appropriated in part 1,
8 there is appropriated an amount not to exceed $100,000,000.00 for
9 federal contingency funds. These funds are not available for
10 expenditure until they have been transferred to another line item in
11 this act under section 393(2) of the management and budget act, 1984
12 PA 431, MCL 18.1393.
13 (2) In addition to the funds appropriated in part 1, there is
14 appropriated an amount not to exceed $20,000,000.00 for
15 state-restricted contingency funds. These funds are not available for
16 expenditure until they have been transferred to another line item in
17 this act under section 393(2) of the management and budget act, 1984
18 PA 431, MCL 18.1393.
19 (3) In addition to the funds appropriated in part 1, there is
20 appropriated an amount not to exceed $20,000,000.00 for local
21 contingency funds. These funds are not available for expenditure
22 until they have been transferred to another line item in this act
23 under section 393(2) of the management and budget act, 1984 PA 431,
24 MCL 18.1393.
25 (4) In addition to the funds appropriated in part 1, there is
26 appropriated an amount not to exceed $10,000,000.00 for private
27 contingency funds. These funds are not available for expenditure
1 until they have been transferred to another line item in this act
2 under section 393(2) of the management and budget act, 1984 PA 431,
3 MCL 18.1393.
4 Sec. 207. Sixty days before beginning any effort to privatize
5 services, the department shall submit a complete project plan to the
6 appropriate senate and house of representatives appropriations
7 subcommittees and the senate and house fiscal agencies. The plan
8 shall include the criteria under which the privatization initiative
9 will be evaluated. The evaluation shall be completed and submitted to
10 the appropriate senate and house of representatives appropriations
11 subcommittees and the senate and house fiscal agencies within 30
12 months.
13 Sec. 208. Unless otherwise specified, the department shall use
14 the Internet to fulfill the reporting requirements of this act. This
15 requirement may include transmission of reports via electronic mail to
16 the recipients identified for each reporting requirement or it may
17 include placement of reports on the Internet or Intranet site.
18 Sec. 209. (1) Funds appropriated in part 1 shall not be used for
19 the purchase of foreign goods or services, or both, if competitively
20 priced and comparable quality American goods or services, or both, are
21 available.
22 (2) Funds appropriated in part 1 shall not be used for the
23 purchase of out-of-state goods or services, or both, if competitively
24 priced and comparable quality Michigan goods or services, or both, are
25 available.
26 Sec. 210. (1) The director shall take all reasonable steps to
27 ensure businesses in deprived and depressed communities compete for
1 and perform contracts to provide services or supplies, or both. The
2 director shall strongly encourage firms with which the department
3 contracts to subcontract with certified businesses in depressed and
4 deprived communities for services, supplies, or both.
5 (2) The director shall take all reasonable steps to ensure equal
6 opportunity for all who compete for and perform contracts to provide
7 services or supplies, or both, for the department. The director shall
8 strongly encourage firms with which the department contracts to
9 provide equal opportunity for subcontractors to provide services or
10 supplies, or both.
11 Sec. 211. If the revenue collected by the department from fees
12 and collections exceeds the amount appropriated in part 1, the revenue
13 may be carried forward with the approval of the state budget director
14 into the subsequent fiscal year. The revenue carried forward under
15 this section shall be used as the first source of funds in the
16 subsequent fiscal year.
17 Sec. 212. (1) From the amounts appropriated in part 1, no
18 greater than the following amounts are supported with federal maternal
19 and child health block grant, preventive health and health services
20 block grant, substance abuse block grant, healthy Michigan fund, and
21 Michigan health initiative funds:
22 (a) Maternal and child health block grant........... $ 21,714,000
23 (b) Preventive health and health services block
24 grant............................................. 4,982,500
25 (c) Substance abuse block grant..................... 60,095,600
26 (d) Healthy Michigan fund........................... 56,617,100
27 (e) Michigan health initiative...................... 9,060,200
1 (2) On or before February 1, 2004, the department shall report to
2 the house of representatives and senate appropriations subcommittees
3 on community health, the house and senate fiscal agencies, and the
4 state budget director on the detailed name and amounts of federal,
5 restricted, private, and local sources of revenue that support the
6 appropriations in each of the line items in part 1 of this act.
7 (3) Upon the release of the fiscal year 2004-2005 executive budget
8 recommendation, the department shall report to the same parties in
9 subsection (2) on the amounts and detailed sources of federal,
10 restricted, private, and local revenue proposed to support the total
11 funds appropriated in each of the line items in part 1 of the fiscal
12 year 2004-2005 executive budget proposal.
13 (4) The department shall provide to the same parties in subsection
14 (2) all revenue source detail for consolidated revenue line item
15 detail upon request to the department.
16 Sec. 213. The state departments, agencies, and commissions
17 receiving tobacco tax funds from part 1 shall report by January 1,
18 2004, to the senate and house of representatives appropriations
19 committees, the senate and house fiscal agencies, and the state budget
20 director on the following:
21 (a) Detailed spending plan by appropriation line item including
22 description of programs.
23 (b) Description of allocations or bid processes including need or
24 demand indicators used to determine allocations.
25 (c) Eligibility criteria for program participation and maximum
26 benefit levels where applicable.
27 (d) Outcome measures to be used to evaluate programs.
1 (e) Any other information considered necessary by the house of
2 representatives or senate appropriations committees or the state
3 budget director.
4 Sec. 214. The use of state-restricted tobacco tax revenue
5 received for the purpose of tobacco prevention, education, and
6 reduction efforts and deposited in the healthy Michigan fund shall not
7 be used for lobbying as defined in 1978 PA 472, MCL 4.411 to 4.431.
8 Sec. 216. (1) In addition to funds appropriated in part 1 for
9 all programs and services, there is appropriated for write-offs of
10 accounts receivable, deferrals, and for prior year obligations in
11 excess of applicable prior year appropriations, an amount equal to
12 total write-offs and prior year obligations, but not to exceed amounts
13 available in prior year revenues.
14 (2) The department's ability to satisfy appropriation deductions
15 in part 1 shall not be limited to collections and accruals pertaining
16 to services provided in fiscal year 2003-2004, but shall also include
17 reimbursements, refunds, adjustments, and settlements from prior
18 years.
19 (3) The department shall report by March 15, 2004 to the house of
20 representatives and senate appropriations subcommittees on community
21 health on all reimbursements, refunds, adjustments, and settlements
22 from prior years.
23 Sec. 218. Basic health services for the purpose of part 23 of
24 the public health code, 1978 PA 368, MCL 333.2301 to 333.2321, are:
25 immunizations, communicable disease control, sexually transmitted
26 disease control, tuberculosis control, prevention of gonorrhea eye
27 infection in newborns, screening newborns for the 7 conditions listed
1 in section 5431(1)(a) through (g) of the public health code, 1978
2 PA 368, MCL 333.5431, community health annex of the Michigan emergency
3 management plan, and prenatal care.
4 Sec. 219. (1) The department may contract with the Michigan
5 public health institute for the design and implementation of projects
6 and for other public health related activities prescribed in section
7 2611 of the public health code, 1978 PA 368, MCL 333.2611. The
8 department may develop a master agreement with the institute to carry
9 out these purposes for up to a 3-year period. The department shall
10 report to the house of representatives and senate appropriations
11 subcommittees on community health, the house and senate fiscal
12 agencies, and the state budget director on or before November 1, 2003
13 and May 1, 2004 all of the following:
14 (a) A detailed description of each funded project.
15 (b) The amount allocated for each project, the appropriation line
16 item from which the allocation is funded, and the source of financing
17 for each project.
18 (c) The expected project duration.
19 (d) A detailed spending plan for each project, including a list of
20 all subgrantees and the amount allocated to each subgrantee.
21 (2) If a report required under subsection (1) is not received by
22 the house of representatives and senate appropriations subcommittees
23 on community health, the house and senate fiscal agencies, and the
24 state budget director on or before the date specified for that report,
25 the disbursement of funds to the Michigan public health institute
26 under this section shall stop. The disbursement of those funds shall
27 recommence when the overdue report is received.
1 (3) On or before September 30, 2004, the department shall provide
2 to the same parties listed in subsection (1) a copy of all reports,
3 studies, and publications produced by the Michigan public health
4 institute, its subcontractors, or the department with the funds
5 appropriated in part 1 and allocated to the Michigan public health
6 institute.
7 Sec. 220. All contracts with the Michigan public health
8 institute funded with appropriations in part 1 shall include a
9 requirement that the Michigan public health institute submit to
10 financial and performance audits by the state auditor general of
11 projects funded with state appropriations.
12 Sec. 223. The department of community health may establish and
13 collect fees for publications, videos and related materials,
14 conferences, and workshops. Collected fees shall be used to offset
15 expenditures to pay for printing and mailing costs of the
16 publications, videos and related materials, and costs of the workshops
17 and conferences. The costs shall not exceed fees collected.
18 Sec. 259. From the funds appropriated in part 1 for information
19 technology, the department shall pay user fees to the department of
20 information technology for technology-related services and projects.
21 Such user fees shall be subject to provisions of an interagency
22 agreement between the departments and agencies and the department of
23 information technology.
24 Sec. 260. Amounts appropriated in part 1 for information
25 technology may be designated as work projects and carried forward to
26 support department of community health projects under the direction of
27 the department of information technology. Funds designated in this
1 manner are not available for expenditure until approved as work
2 projects under section 451a of the management and budget act, 1984
3 PA 431, MCL 18.1451a.
4 Sec. 262. (1) The department shall provide the members of the
5 house of representatives and senate appropriations subcommittees on
6 community health and the house and senate fiscal agencies with a
7 written explanation for all legislative transfers upon submission of
8 the request for legislative transfer by the department of management
9 and budget. The explanation should include reasons for not fully
10 expending appropriated funds which shall include references to
11 boilerplate language expressing intent for program implementation, if
12 applicable, and transfers requested for work projects.
13 (2) The department shall provide an annual report of lapses by
14 line item for this appropriation act.
15 Sec. 264. Upon submission of a Medicaid waiver, a Medicaid state
16 plan amendment, or a similar proposal to the centers for Medicare and
17 Medicaid services, the department shall notify the house of
18 representatives and senate appropriations subcommittees on community
19 health and the house and senate fiscal agencies of the submission.
20 Sec. 265. The departments and agencies receiving appropriations
21 in part 1 shall receive and retain copies of all reports funded from
22 appropriations in part 1. Federal and state guidelines for short-term
23 and long-term retention of records shall be followed.
24 DEPARTMENTWIDE ADMINISTRATION
25 Sec. 301. From funds appropriated for worker's compensation, the
26 department may make payments in lieu of worker's compensation payments
1 for wage and salary and related fringe benefits for employees who
2 return to work under limited duty assignments.
3 Sec. 303. The department is prohibited from requiring
4 first-party payment from individuals or families with a taxable income
5 of $10,000.00 or less for mental health services for determinations
6 made in accordance with section 818 of the mental health code, 1974
7 PA 258, MCL 330.1818.
8 Sec. 304. The funds appropriated in part 1 for the Michigan
9 essential health care provider program may also provide loan repayment
10 for dentists that fit the criteria established by part 27 of the
11 public health code, 1978 PA 368, MCL 333.2701 to 333.2727.
12 Sec. 305. The department is directed to continue support of
13 multicultural agencies that provide primary care services from the
14 funds appropriated in part 1.
15 Sec. 307. From the funds appropriated in part 1 for primary care
16 services, an amount not to exceed $2,790,100.00 is appropriated to
17 enhance the service capacity of the federally qualified health centers
18 and other health centers which are similar to federally qualified
19 health centers.
20 Sec. 313. By November 1, 2003, the department shall report to
21 the house of representatives and senate appropriations subcommittees
22 on community health, the house and senate fiscal agencies, and the
23 state budget director on activities undertaken by the department to
24 address compulsive gambling.
25 MENTAL HEALTH/SUBSTANCE ABUSE SERVICES ADMINISTRATION
26 AND SPECIAL PROJECTS
1 Sec. 350. The department may enter into a contract with the
2 protection and advocacy service, authorized under section 931 of the
3 mental health code, 1974 PA 258, MCL 330.1931, or a similar
4 organization to provide legal services for purposes of gaining and
5 maintaining occupancy in a community living arrangement which is under
6 lease or contract with the department or a community mental health
7 services program to provide services to persons with mental illness or
8 developmental disability.
9 COMMUNITY MENTAL HEALTH/SUBSTANCE ABUSE SERVICES
10 PROGRAMS
11 Sec. 401. Funds appropriated in part 1 are intended to support a
12 system of comprehensive community mental health services under the
13 full authority and responsibility of local CMHSPs or specialty prepaid
14 health plans. The department shall ensure that each CMHSP or
15 specialty prepaid health plan provides all of the following:
16 (a) A system of single entry and single exit.
17 (b) A complete array of mental health services which shall
18 include, but shall not be limited to, all of the following services:
19 residential and other individualized living arrangements, outpatient
20 services, acute inpatient services, and long-term, 24-hour inpatient
21 care in a structured, secure environment.
22 (c) The coordination of inpatient and outpatient hospital services
23 through agreements with state-operated psychiatric hospitals, units,
24 and centers in facilities owned or leased by the state, and
25 privately-owned hospitals, units, and centers licensed by the state
26 pursuant to sections 134 through 149b of the mental health code, 1974
1 PA 258, MCL 330.1134 to 330.1149b.
2 (d) Individualized plans of service that are sufficient to meet
3 the needs of individuals, including those discharged from psychiatric
4 hospitals or centers, and that ensure the full range of recipient
5 needs is addressed through the CMHSP's or specialty prepaid health
6 plan's program or through assistance with locating and obtaining
7 services to meet these needs.
8 (e) A system of case management to monitor and ensure the
9 provision of services consistent with the individualized plan of
10 services or supports.
11 (f) A system of continuous quality improvement.
12 (g) A system to monitor and evaluate the mental health services
13 provided.
14 (h) A system that serves at-risk and delinquent youth as required
15 under the provisions of the mental health code, 1974 PA 258,
16 MCL 330.1001 to 330.2106.
17 Sec. 402. (1) From funds appropriated in part 1, final
18 authorizations to CMHSPs or specialty prepaid health plans shall be
19 made upon the execution of contracts between the department and CMHSPs
20 or specialty prepaid health plans. The contracts shall contain an
21 approved plan and budget as well as policies and procedures governing
22 the obligations and responsibilities of both parties to the
23 contracts. Each contract with a CMHSP or specialty prepaid health
24 plan that the department is authorized to enter into under this
25 subsection shall include a provision that the contract is not valid
26 unless the total dollar obligation for all of the contracts between
27 the department and the CMHSPs or specialty prepaid health plans
1 entered into under this subsection for fiscal year 2003-2004 does not
2 exceed the amount of money appropriated in part 1 for the contracts
3 authorized under this subsection.
4 (2) The department shall immediately report to the senate and
5 house of representatives appropriations subcommittees on community
6 health, the senate and house fiscal agencies, and the state budget
7 director if either of the following occurs:
8 (a) Any new contracts with CMHSPs or specialty prepaid health
9 plans that would affect rates or expenditures are enacted.
10 (b) Any amendments to contracts with CMHSPs or specialty prepaid
11 health plans that would affect rates or expenditures are enacted.
12 (3) The report required by subsection (2) shall include
13 information about the changes and their effects on rates and
14 expenditures.
15 Sec. 403. From the funds appropriated in part 1 for
16 multicultural services, the department shall ensure that CMHSPs or
17 specialty prepaid health plans continue contracts with multicultural
18 services providers.
19 Sec. 404. (1) Not later than May 31 of each fiscal year, the
20 department shall provide a report on the community mental health
21 services programs to the members of the house of representatives and
22 senate appropriations subcommittees on community health, the house and
23 senate fiscal agencies, and the state budget director that includes
24 the information required by this section.
25 (2) The report shall contain information for each CMHSP or
26 specialty prepaid health plan and a statewide summary, each of which
27 shall include at least the following information:
1 (a) A demographic description of service recipients which,
2 minimally, shall include reimbursement eligibility, client population,
3 age, ethnicity, housing arrangements, and diagnosis.
4 (b) When the encounter data is available, a breakdown of clients
5 served, by diagnosis. As used in this subdivision, "diagnosis" means
6 a recipient's primary diagnosis, stated as a specifically named mental
7 illness, emotional disorder, or developmental disability corresponding
8 to terminology employed in the latest edition of the American
9 psychiatric association's diagnostic and statistical manual.
10 (c) Per capita expenditures by client population group.
11 (d) Financial information which, minimally, shall include a
12 description of funding authorized; expenditures by client group and
13 fund source; and cost information by service category, including
14 administration. Service category shall include all department
15 approved services.
16 (e) Data describing service outcomes which shall include, but not
17 be limited to, an evaluation of consumer satisfaction, consumer
18 choice, and quality of life concerns including, but not limited to,
19 housing and employment.
20 (f) Information about access to community mental health services
21 programs which shall include, but not be limited to, the following:
22 (i) The number of people receiving requested services.
23 (ii) The number of people who requested services but did not
24 receive services.
25 (iii) The number of people requesting services who are on waiting
26 lists for services.
27 (iv) The average length of time that people remained on waiting
1 lists for services.
2 (g) The number of second opinions requested under the code and the
3 determination of any appeals.
4 (h) An analysis of information provided by community mental health
5 service programs in response to the needs assessment requirements of
6 the mental health code, including information about the number of
7 persons in the service delivery system who have requested and are
8 clinically appropriate for different services.
9 (i) An estimate of the number of FTEs employed by the CMHSPs or
10 specialty prepaid health plans or contracted with directly by the
11 CMHSPs or specialty prepaid health plans as of September 30, 2003 and
12 an estimate of the number of FTEs employed through contracts with
13 provider organizations as of September 30, 2003.
14 (j) Lapses and carryforwards during fiscal year 2002-2003 for
15 CMHSPs or specialty prepaid health plans.
16 (k) Contracts for mental health services entered into by CMHSPs or
17 specialty prepaid health plans with providers, including amount and
18 rates, organized by type of service provided.
19 (l) Information on the community mental health Medicaid managed
20 care program, including, but not limited to, both of the following:
21 (i) Expenditures by each CMHSP or specialty prepaid health plan
22 organized by Medicaid eligibility group, including per eligible
23 individual expenditure averages.
24 (ii) Performance indicator information required to be submitted to
25 the department in the contracts with CMHSPs or specialty prepaid
26 health plans.
27 (3) The department shall include data reporting requirements
1 listed in subsection (2) in the annual contract with each individual
2 CMHSP or specialty prepaid health plan.
3 (4) The department shall take all reasonable actions to ensure
4 that the data required are complete and consistent among all CMHSPs or
5 specialty prepaid health plans.
6 Sec. 406. (1) The funds appropriated in part 1 for the state
7 disability assistance substance abuse services program shall be used
8 to support per diem room and board payments in substance abuse
9 residential facilities. Eligibility of clients for the state
10 disability assistance substance abuse services program shall include
11 needy persons 18 years of age or older, or emancipated minors, who
12 reside in a substance abuse treatment center.
13 (2) The department shall reimburse all licensed substance abuse
14 programs eligible to participate in the program at a rate equivalent
15 to that paid by the family independence agency to adult foster care
16 providers. Programs accredited by department-approved accrediting
17 organizations shall be reimbursed at the personal care rate, while all
18 other eligible programs shall be reimbursed at the domiciliary care
19 rate.
20 Sec. 407. (1) The amount appropriated in part 1 for substance
21 abuse prevention, education, and treatment grants shall be expended
22 for contracting with coordinating agencies or designated service
23 providers. It is the intent of the legislature that the coordinating
24 agencies and designated service providers work with the CMHSPs or
25 specialty prepaid health plans to coordinate the care and services
26 provided to individuals with both mental illness and substance abuse
27 diagnoses.
1 (2) The department shall establish a fee schedule for providing
2 substance abuse services and charge participants in accordance with
3 their ability to pay. Any changes in the fee schedule shall be
4 developed by the department with input from substance abuse
5 coordinating agencies.
6 Sec. 408. (1) By April 15, 2004, the department shall report the
7 following data from fiscal year 2002-2003 on substance abuse
8 prevention, education, and treatment programs to the senate and house
9 of representatives appropriations subcommittees on community health,
10 the senate and house fiscal agencies, and the state budget office:
11 (a) Expenditures stratified by coordinating agency, by central
12 diagnosis and referral agency, by fund source, by subcontractor, by
13 population served, and by service type. Additionally, data on
14 administrative expenditures by coordinating agency and by
15 subcontractor shall be reported.
16 (b) Expenditures per state client, with data on the distribution
17 of expenditures reported using a histogram approach.
18 (c) Number of services provided by central diagnosis and referral
19 agency, by subcontractor, and by service type. Additionally, data on
20 length of stay, referral source, and participation in other state
21 programs.
22 (d) Collections from other first- or third-party payers, private
23 donations, or other state or local programs, by coordinating agency,
24 by subcontractor, by population served, and by service type.
25 (2) The department shall take all reasonable actions to ensure
26 that the required data reported are complete and consistent among all
27 coordinating agencies.
1 Sec. 409. The funding in part 1 for substance abuse services
2 shall be distributed in a manner that provides priority to service
3 providers that furnish child care services to clients with children.
4 Sec. 410. The department shall assure that substance abuse
5 treatment is provided to applicants and recipients of public
6 assistance through the family independence agency who are required to
7 obtain substance abuse treatment as a condition of eligibility for
8 public assistance.
9 Sec. 411. (1) The department shall ensure that each contract
10 with a CMHSP or specialty prepaid health plan requires the CMHSP or
11 specialty prepaid health plan to implement programs to encourage
12 diversion of persons with serious mental illness, serious emotional
13 disturbance, or developmental disability from possible jail
14 incarceration when appropriate.
15 (2) Each CMHSP or specialty prepaid health plan shall have jail
16 diversion services and shall work toward establishing working
17 relationships with representative staff of local law enforcement
18 agencies, including county prosecutors' offices, county sheriffs'
19 offices, county jails, municipal police agencies, municipal detention
20 facilities, and the courts. Written interagency agreements describing
21 what services each participating agency is prepared to commit to the
22 local jail diversion effort and the procedures to be used by local law
23 enforcement agencies to access mental health jail diversion services
24 are strongly encouraged.
25 Sec. 412. The department shall contract directly with the
26 Salvation Army harbor light program to provide non-Medicaid substance
27 abuse services at not less than the amount contracted for in fiscal
1 year 2002-2003.
2 Sec. 414. Medicaid substance abuse treatment services shall be
3 managed by selected CMHSPs or specialty prepaid health plans pursuant
4 to the centers for Medicare and Medicaid services' approval of
5 Michigan's 1915(b) waiver request to implement a managed care plan for
6 specialized substance abuse services. The selected CMHSPs or
7 specialty prepaid health plans shall receive a capitated payment on a
8 per eligible per month basis to assure provision of medically
9 necessary substance abuse services to all beneficiaries who require
10 those services. The selected CMHSPs or specialty prepaid health plans
11 shall be responsible for the reimbursement of claims for specialized
12 substance abuse services. The CMHSPs or specialty prepaid health
13 plans that are not coordinating agencies may continue to contract with
14 a coordinating agency. Any alternative arrangement must be based on
15 client service needs and have prior approval from the department.
16 Sec. 418. On or before the tenth of each month, the department
17 shall report to the senate and house of representatives appropriations
18 subcommittees on community health, the senate and house fiscal
19 agencies, and the state budget director on the amount of funding paid
20 to the CMHSPs or specialty prepaid health plans to support the
21 Medicaid managed mental health care program in that month. The
22 information shall include the total paid to each CMHSP or specialty
23 prepaid health plan, per capita rate paid for each eligibility group
24 for each CMHSP or specialty prepaid health plan, and number of cases
25 in each eligibility group for each CMHSP or specialty prepaid health
26 plan, and year-to-date summary of eligibles and expenditures for the
27 Medicaid managed mental health care program.
1 Sec. 423. The department shall work cooperatively with the
2 family independence agency and the departments of corrections,
3 education, state police, and military and veterans affairs to
4 coordinate and improve the delivery of substance abuse prevention,
5 education, and treatment programs within existing appropriations. The
6 department shall report by March 15, 2004 on the outcomes of this
7 cooperative effort to the house of representatives and senate
8 appropriations subcommittees on community health, the house and senate
9 fiscal agencies, and the state budget director.
10 Sec. 424. Each community mental health services program or
11 specialty prepaid health plan that contracts with the department to
12 provide services to the Medicaid population shall adhere to the
13 following timely claims processing and payment procedure for claims
14 submitted by health professionals and facilities:
15 (a) A "clean claim" as described in section 111i of the social
16 welfare act, 1939 PA 280, MCL 400.111i, must be paid within 45 days
17 after receipt of the claim by the community mental health services
18 program or specialty prepaid health plan. A clean claim that is not
19 paid within this time frame shall bear simple interest at a rate of
20 12% per annum.
21 (b) A community mental health services program or specialty
22 prepaid health plan must state in writing to the health professional
23 or facility any defect in the claim within 30 days after receipt of
24 the claim.
25 (c) A health professional and a health facility have 30 days after
26 receipt of a notice that a claim or a portion of a claim is defective
27 within which to correct the defect. The community mental health
1 services program or specialty prepaid health plan shall pay the claim
2 within 30 days after the defect is corrected.
3 Sec. 425. By April 1, 2004, the department, in conjunction with
4 the department of corrections, shall report the following data from
5 fiscal year 2002-2003 on mental health and substance abuse services to
6 the house of representatives and senate appropriations subcommittees
7 on community health and corrections, the house and senate fiscal
8 agencies, and the state budget office:
9 (a) The number of prisoners receiving substance abuse services
10 which shall include a description and breakdown on the type of
11 substance abuse services provided to prisoners.
12 (b) The number of prisoners receiving mental health services which
13 shall include a description and breakdown on the type of mental health
14 services provided to prisoners.
15 (c) Data indicating if prisoners receiving mental health services
16 were previously hospitalized in a state psychiatric hospital for
17 persons with mental illness.
18 Sec. 428. (1) Each CMHSP and affiliation of CMHSPs shall
19 provide, from internal resources, local funds to be used as a bona
20 fide part of the state match required under the Medicaid program in
21 order to increase capitation rates for CMHSPs and affiliations of
22 CMHSPs. These funds shall not include either state funds received by
23 a CMHSP for services provided to non-Medicaid recipients or the state
24 matching portion of the Medicaid capitation payments made to a CMHSP
25 or an affiliation of CMHSPs.
26 (2) The distribution of the aforementioned increases in the
27 capitation payment rates, if any, shall be based on a formula
1 developed by a committee established by the department, including
2 representatives from CMHSPs or affiliations of CMHSPs and department
3 staff.
4 Sec. 435. A county required under the provisions of the mental
5 health code, 1974 PA 258, MCL 330.1001 to 330.2106, to provide
6 matching funds to a CMHSP for mental health services rendered to
7 residents in its jurisdiction shall pay the matching funds in equal
8 installments on not less than a quarterly basis throughout the fiscal
9 year, with the first payment being made by October 1, 2003.
10 Sec. 439. (1) It is the intent of the legislature that the
11 department, in conjunction with CMHSPs, support pilot projects that
12 facilitate the movement of adults with mental illness from state
13 psychiatric hospitals to community residential settings.
14 (2) The purpose of the pilot projects is to encourage the
15 placement of persons with mental illness in community residential
16 settings who may require any of the following:
17 (a) A secured and supervised living environment.
18 (b) Assistance in taking prescribed medications.
19 (c) Intensive case management services.
20 (d) Assertive community treatment team services.
21 (e) Alcohol or substance abuse treatment and counseling.
22 (f) Individual or group therapy.
23 (g) Day or partial day programming activities.
24 (h) Vocational, educational, or self-help training or activities.
25 (i) Other services prescribed to treat a person's mental illness
26 to prevent the need for hospitalization.
27 (3) The pilot projects described in this section shall be
1 completely voluntary.
2 (4) The department shall provide semiannual reports to the house
3 of representatives and senate appropriations subcommittees on
4 community health, the state budget office, and the house and senate
5 fiscal agencies as to any activities undertaken by the department and
6 CMHSPs to pilot projects under this section.
7 Sec. 442. (1) It is the intent of the legislature that the
8 $40,000,000.00 in funding transferred from the community mental health
9 non-Medicaid services line to support the Medicaid adult benefits
10 waiver program be used to provide state match for increases in federal
11 funding for primary care and specialty services provided to Medicaid
12 adult benefits waiver enrollees and for economic increases for the
13 Medicaid specialty services and supports program.
14 (2) The department shall assure that persons eligible for mental
15 health services under the priority population sections of the mental
16 health code, 1974 PA 258, MCL 330.1001 to 330.2106, will receive
17 mandated services under this plan.
18 (3) Capitation payments to CMHSPs or specialty prepaid health
19 plans for persons who become enrolled in the Medicaid adult benefits
20 waiver program shall be made using the same rate methodology as
21 payments for the current Medicaid beneficiaries.
22 (4) If enrollment in the Medicaid adult benefits waiver program
23 does not achieve expectations and the funding appropriated for the
24 Medicaid adult benefits waiver program for specialty services is not
25 expended, the general fund balance shall be transferred back to the
26 community mental health non-Medicaid services line. The department
27 shall report quarterly to the senate and house of representatives
1 appropriation subcommittees on community health a summary of eligible
2 expenditures for the Medicaid adult benefits waiver program by CMHSPs
3 or specialty prepaid health plans.
4 (5) The department shall allow each CMHSP or specialty prepaid
5 health plan to retain 50% of the unspent general fund/general purpose
6 portion of funds allocated to the CMHSP or specialty prepaid health
7 plan for services to be provided under the Medicaid specialty services
8 and supports program.
9 Sec. 450. The department shall establish a work group comprised
10 of CMHSPs or specialty prepaid health plans and departmental staff to
11 recommend strategies to streamline audit requirements for CMHSPs or
12 specialty prepaid health plans. The department shall report on the
13 recommendations of the work group by March 31, 2004 to the house of
14 representatives and senate appropriations subcommittees on community
15 health, the house fiscal agency, the senate fiscal agency, and the
16 state budget director.
17 STATE PSYCHIATRIC HOSPITALS, CENTERS FOR PERSONS WITH
18 DEVELOPMENTAL DISABILITIES, AND FORENSIC AND PRISON
19 MENTAL HEALTH SERVICES
20 Sec. 601. (1) In funding of staff in the financial support
21 division, reimbursement, and billing and collection sections, priority
22 shall be given to obtaining third-party payments for services.
23 Collection from individual recipients of services and their families
24 shall be handled in a sensitive and nonharassing manner.
25 (2) The department shall continue a revenue recapture project to
26 generate additional revenues from third parties related to cases that
27 have been closed or are inactive. Revenues collected through project
1 efforts are appropriated to the department for departmental costs and
2 contractual fees associated with these retroactive collections and to
3 improve ongoing departmental reimbursement management functions.
4 Sec. 602. Unexpended and unencumbered amounts and accompanying
5 expenditure authorizations up to $500,000.00 remaining on September
6 30, 2004 from pay telephone revenues and the amounts appropriated in
7 part 1 for gifts and bequests for patient living and treatment
8 environments shall be carried forward for 1 fiscal year. The purpose
9 of gifts and bequests for patient living and treatment environments is
10 to use additional private funds to provide specific enhancements for
11 individuals residing at state-operated facilities. Use of the gifts
12 and bequests shall be consistent with the stipulation of the donor.
13 The expected completion date for the use of gifts and bequests
14 donations is within 3 years unless otherwise stipulated by the donor.
15 Sec. 603. The funds appropriated in part 1 for forensic mental
16 health services provided to the department of corrections are in
17 accordance with the interdepartmental plan developed in cooperation
18 with the department of corrections. The department is authorized to
19 receive and expend funds from the department of corrections in
20 addition to the appropriations in part 1 to fulfill the obligations
21 outlined in the interdepartmental agreements.
22 Sec. 604. (1) The CMHSPs or specialty prepaid health plans shall
23 provide semiannual reports to the department on the following
24 information:
25 (a) The number of days of care purchased from state hospitals and
26 centers.
27 (b) The number of days of care purchased from private hospitals in
1 lieu of purchasing days of care from state hospitals and centers.
2 (c) The number and type of alternative placements to state
3 hospitals and centers other than private hospitals.
4 (d) Waiting lists for placements in state hospitals and centers.
5 (2) The department shall semiannually report the information in
6 subsection (1) to the house of representatives and senate
7 appropriations subcommittees on community health, the house and senate
8 fiscal agencies, and the state budget director.
9 Sec. 605. (1) The department shall not implement any closures or
10 consolidations of state hospitals, centers, or agencies until CMHSPs
11 or specialty prepaid health plans have programs and services in place
12 for those persons currently in those facilities and a plan for service
13 provision for those persons who would have been admitted to those
14 facilities.
15 (2) All closures or consolidations are dependent upon adequate
16 department-approved CMHSP plans that include a discharge and aftercare
17 plan for each person currently in the facility. A discharge and
18 aftercare plan shall address the person's housing needs. A homeless
19 shelter or similar temporary shelter arrangements are inadequate to
20 meet the person's housing needs.
21 (3) Four months after the certification of closure required in
22 section 19(6) of the state employees' retirement act, 1943 PA 240,
23 MCL 38.19, the department shall provide a closure plan to the house of
24 representatives and senate appropriations subcommittees on community
25 health.
26 (4) Upon the closure of state-run operations and after
27 transitional costs have been paid, the remaining balances of funds
1 appropriated for that operation shall be transferred to CMHSPs or
2 specialty prepaid health plans responsible for providing services for
3 persons previously served by the operations.
4 Sec. 606. The department may collect revenue for patient
5 reimbursement from first- and third-party payers, including Medicaid,
6 to cover the cost of placement in state hospitals and centers. The
7 department is authorized to adjust financing sources for patient
8 reimbursement based on actual revenues earned. If the revenue
9 collected exceeds current year expenditures, the revenue may be
10 carried forward with approval of the state budget director. The
11 revenue carried forward shall be used as a first source of funds in
12 the subsequent year.
13 INFECTIOUS DISEASE CONTROL
14 Sec. 801. In the expenditure of funds appropriated in part 1 for
15 AIDS programs, the department and its subcontractors shall ensure that
16 adolescents receive priority for prevention, education, and outreach
17 services.
18 Sec. 802. In developing and implementing AIDS provider education
19 activities, the department may provide funding to the Michigan state
20 medical society to serve as lead agency to convene a consortium of
21 health care providers, to design needed educational efforts, to fund
22 other statewide provider groups, and to assure implementation of these
23 efforts, in accordance with a plan approved by the department.
24 Sec. 803. The department shall continue the AIDS drug assistance
25 program maintaining the prior year eligibility criteria and drug
26 formulary. This section is not intended to prohibit the department
1 from providing assistance for improved AIDS treatment medications.
2 EPIDEMIOLOGY
3 Sec. 851. From the funds appropriated in part 1 for asthma
4 prevention and control, $190,800.00 of state funds shall be allocated
5 for an asthma intervention program, including surveillance,
6 community-based programs, and awareness and education. The department
7 shall seek federal funds as they are made available for asthma
8 programs.
9 Sec. 853. From the funds appropriated in part 1 for bioterrorism
10 preparedness, $1,000,000.00 shall be allocated for bioterrorism
11 preparedness and response services to a multispecies laboratory and
12 necropsy facility located in this state that is certified by the
13 United States department of agriculture animal, plant, health
14 inspection service, with a biosafety level 2/3 certification.
15 LOCAL HEALTH ADMINISTRATION AND GRANTS
16 Sec. 901. The amount appropriated in part 1 for implementation
17 of the 1993 amendments to sections 9161, 16221, 16226, 17014, 17015,
18 and 17515 of the public health code, 1978 PA 368, MCL 333.9161,
19 333.16221, 333.16226, 333.17014, 333.17015, and 333.17515, shall
20 reimburse local health departments for costs incurred related to
21 implementation of section 17015(15) of the public health code, 1978
22 PA 368, MCL 333.17015.
23 Sec. 902. If a county that has participated in a district health
24 department or an associated arrangement with other local health
25 departments takes action to cease to participate in such an
26 arrangement after October 1, 2003, the department shall have the
1 authority to assess a penalty from the local health department's
2 operational accounts in an amount equal to no more than 5% of the
3 local health department's local public health operations funding.
4 This penalty shall only be assessed to the local county that requests
5 the dissolution of the health department.
6 Sec. 903. The department shall provide a report annually to the
7 house of representatives and senate appropriations subcommittees on
8 community health, the senate and house fiscal agencies, and the state
9 budget director on the expenditures and activities undertaken by the
10 lead abatement program. The report shall include, but is not limited
11 to, a funding allocation schedule, expenditures by category of
12 expenditure and by subcontractor, revenues received, description of
13 program elements, and description of program accomplishments and
14 progress.
15 Sec. 904. (1) Funds appropriated in part 1 for local public
16 health operations shall be prospectively allocated to local health
17 departments to support immunizations, infectious disease control,
18 sexually transmitted disease control and prevention, hearing
19 screening, vision services, food protection, public water supply,
20 private groundwater supply, and on-site sewage management. Food
21 protection shall be provided in consultation with the Michigan
22 department of agriculture. Public water supply, private groundwater
23 supply, and on-site sewage management shall be provided in
24 consultation with the Michigan department of environmental quality.
25 (2) Local public health departments will be held to contractual
26 standards for the services in subsection (1).
27 (3) Distributions in subsection (1) shall be made only to counties
1 that maintain local spending in fiscal year 2003-2004 of at least the
2 amount expended in fiscal year 1992-1993 for the services described in
3 subsection (1).
4 (4) By April 1, 2004, the department shall make available upon
5 request a report to the senate or house of representatives
6 appropriations subcommittee on community health, the senate or house
7 fiscal agency, or the state budget director on the planned allocation
8 of the funds appropriated for local public health operations.
9 CHRONIC DISEASE AND INJURY PREVENTION AND HEALTH
10 PROMOTION
11 Sec. 1001. From the state funds appropriated in part 1, the
12 department shall allocate funds to promote awareness, education, and
13 early detection of breast, cervical, prostate, and colorectal cancer,
14 and provide for other health promotion media activities.
15 Sec. 1002. (1) Provision of the school health education
16 curriculum, such as the Michigan model or another comprehensive school
17 health education curriculum, shall be in accordance with the health
18 education goals established by the Michigan model for the
19 comprehensive school health education state steering committee. The
20 state steering committee shall be comprised of a representative from
21 each of the following offices and departments:
22 (a) The department of education.
23 (b) The department of community health.
24 (c) The health administration in the department of community
25 health.
26 (d) The bureau of mental health and substance abuse services in
1 the department of community health.
2 (e) The family independence agency.
3 (f) The department of state police.
4 (2) Upon written or oral request, a pupil not less than 18 years
5 of age or a parent or legal guardian of a pupil less than 18 years of
6 age, within a reasonable period of time after the request is made,
7 shall be informed of the content of a course in the health education
8 curriculum and may examine textbooks and other classroom materials
9 that are provided to the pupil or materials that are presented to the
10 pupil in the classroom. This subsection does not require a school
11 board to permit pupil or parental examination of test questions and
12 answers, scoring keys, or other examination instruments or data used
13 to administer an academic examination.
14 Sec. 1003. Funds appropriated in part 1 for the Alzheimer's
15 information network shall be used to provide information and referral
16 services through regional networks for persons with Alzheimer's
17 disease or related disorders, their families, and health care
18 providers.
19 Sec. 1006. In spending the funds appropriated in part 1 for the
20 smoking prevention program, priority shall be given to prevention and
21 smoking cessation programs for pregnant women, women with young
22 children, and adolescents.
23 Sec. 1007. (1) The funds appropriated in part 1 for violence
24 prevention shall be used for, but not be limited to, the following:
25 (a) Programs aimed at the prevention of spouse, partner, or child
26 abuse and rape.
27 (b) Programs aimed at the prevention of workplace violence.
1 (2) In awarding grants from the amounts appropriated in part 1 for
2 violence prevention, the department shall give equal consideration to
3 public and private nonprofit applicants.
4 (3) From the funds appropriated in part 1 for violence prevention,
5 the department may include local school districts as recipients of the
6 funds for family violence prevention programs.
7 Sec. 1009. From the funds appropriated in part 1 for the
8 diabetes and kidney program, a portion of the funds may be allocated
9 to the National Kidney Foundation of Michigan for kidney disease
10 prevention programming including early identification and education
11 programs and kidney disease prevention demonstration projects.
12 Sec. 1019. From the funds appropriated in part 1 for chronic
13 disease prevention, $50,000.00 shall be allocated for stroke
14 prevention, education, and outreach. The objectives of the program
15 shall include education to assist persons in identifying risk factors,
16 and education to assist persons in the early identification of the
17 occurrence of a stroke in order to minimize stroke damage.
18 Sec. 1020. From the funds appropriated in part 1 for chronic
19 disease prevention, $55,000.00 shall be allocated for a childhood and
20 adult arthritis program.
21 Sec. 1028. Contingent on the availability of state restricted
22 healthy Michigan fund money or federal preventive health and health
23 services block grant fund money, funds shall be appropriated for the
24 African-American male health initiative.
25 Sec. 1029. Contingent on the availability of state restricted
26 healthy Michigan fund money or federal preventive health and health
27 services block grant fund money, funds shall be appropriated for the
1 Morris Hood Wayne State University diabetes outreach program.
2 COMMUNITY LIVING, CHILDREN, AND FAMILIES
3 Sec. 1101. The department shall review the basis for the
4 distribution of funds to local health departments and other public and
5 private agencies for the women, infants, and children food supplement
6 program; family planning; and prenatal care outreach and service
7 delivery support program and indicate the basis upon which any
8 projected underexpenditures by local public and private agencies shall
9 be reallocated to other local agencies that demonstrate need.
10 Sec. 1104. Before April 1, 2004, the department shall submit a
11 report to the house and senate fiscal agencies and the state budget
12 director on planned allocations from the amounts appropriated in part
13 1 for local MCH services, prenatal care outreach and service delivery
14 support, family planning local agreements, and pregnancy prevention
15 programs. Using applicable federal definitions, the report shall
16 include information on all of the following:
17 (a) Funding allocations.
18 (b) Actual number of women, children, and/or adolescents served
19 and amounts expended for each group for the fiscal year 2002-2003.
20 Sec. 1105. For all programs for which an appropriation is made
21 in part 1, the department shall contract with those local agencies
22 best able to serve clients. Factors to be used by the department in
23 evaluating agencies under this section shall include ability to serve
24 high-risk population groups; ability to serve low-income clients,
25 where applicable; availability of, and access to, service sites;
26 management efficiency; and ability to meet federal standards, when
1 applicable.
2 Sec. 1106. Each family planning program receiving federal title
3 X family planning funds shall be in compliance with all performance
4 and quality assurance indicators that the United States bureau of
5 community health services specifies in the family planning annual
6 report. An agency not in compliance with the indicators shall not
7 receive supplemental or reallocated funds.
8 Sec. 1106a. (1) Federal abstinence money expended in part 1 for
9 the purpose of promoting abstinence education shall provide abstinence
10 education to teenagers most likely to engage in high-risk behavior as
11 their primary focus, and may include programs that include 9- to
12 17-year-olds. Programs funded must meet all of the following
13 guidelines:
14 (a) Teaches the gains to be realized by abstaining from sexual
15 activity.
16 (b) Teaches abstinence from sexual activity outside of marriage as
17 the expected standard for all school-age children.
18 (c) Teaches that abstinence is the only certain way to avoid
19 out-of-wedlock pregnancy, sexually transmitted diseases, and other
20 health problems.
21 (d) Teaches that a monogamous relationship in the context of
22 marriage is the expected standard of human sexual activity.
23 (e) Teaches that sexual activity outside of marriage is likely to
24 have harmful effects.
25 (f) Teaches that bearing children out of wedlock is likely to have
26 harmful consequences.
27 (g) Teaches young people how to avoid sexual advances and how
1 alcohol and drug use increases vulnerability to sexual advances.
2 (h) Teaches the importance of attaining self-sufficiency before
3 engaging in sexual activity.
4 (2) Coalitions, organizations, and programs that do not provide
5 contraceptives to minors and demonstrate efforts to include parental
6 involvement as a means of reducing the risk of teens becoming pregnant
7 shall be given priority in the allocations of funds.
8 (3) Programs and organizations that meet the guidelines of
9 subsection (1) and criteria of subsection (2) shall have the option of
10 receiving all or part of their funds directly from the department of
11 community health.
12 Sec. 1107. Of the amount appropriated in part 1 for prenatal
13 care outreach and service delivery support, not more than 10% shall be
14 expended for local administration, data processing, and evaluation.
15 Sec. 1108. The funds appropriated in part 1 for pregnancy
16 prevention programs shall not be used to provide abortion counseling,
17 referrals, or services.
18 Sec. 1109. (1) From the amounts appropriated in part 1 for
19 dental programs, funds shall be allocated to the Michigan dental
20 association for the administration of a volunteer dental program that
21 would provide dental services to the uninsured in an amount that is no
22 less than the amount allocated to that program in fiscal year
23 1996-1997.
24 (2) Not later than December 1 of the current fiscal year, the
25 department shall make available upon request a report to the senate or
26 house of representatives appropriations subcommittee on community
27 health or the senate or house of representatives standing committee on
1 health policy the number of individual patients treated, number of
2 procedures performed, and approximate total market value of those
3 procedures through September 30, 2003.
4 Sec. 1110. Agencies that currently receive pregnancy prevention
5 funds and either receive or are eligible for other family planning
6 funds shall have the option of receiving all of their family planning
7 funds directly from the department of community health and be
8 designated as delegate agencies.
9 Sec. 1111. The department shall allocate no less than 87% of the
10 funds appropriated in part 1 for family planning local agreements and
11 the pregnancy prevention program for the direct provision of family
12 planning/pregnancy prevention services.
13 Sec. 1112. From the funds appropriated for prenatal care
14 outreach and service delivery support, the department shall allocate
15 at least $1,000,000.00 to communities with high infant mortality
16 rates.
17 Sec. 1128. The department shall make every effort to maximize
18 the receipt of federal Medicaid funds to support the activities of the
19 migrant health care line item.
20 Sec. 1129. The department shall provide a report annually to the
21 house of representatives and senate appropriations subcommittees on
22 community health, the house and senate fiscal agencies, and the state
23 budget director on the number of children with elevated blood lead
24 levels from information available to the department. The report shall
25 provide the information by county, shall include the level of blood
26 lead reported, and shall indicate the sources of the information.
27 Sec. 1133. The department shall release infant mortality rate
1 data to all local public health departments no later than 48 hours
2 prior to releasing infant mortality rate data to the public.
3 WOMEN, INFANTS, AND CHILDREN FOOD AND NUTRITION PROGRAM
4 Sec. 1151. The department may work with local participating
5 agencies to define local annual contributions for the farmer's market
6 nutrition program, project FRESH, to enable the department to request
7 federal matching funds by April 1, 2004 based on local commitment of
8 funds.
9 CHILDREN'S SPECIAL HEALTH CARE SERVICES
10 Sec. 1201. Funds appropriated in part 1 for medical care and
11 treatment of children with special health care needs shall be paid
12 according to reimbursement policies determined by the Michigan medical
13 services program. Exceptions to these policies may be taken with the
14 prior approval of the state budget director.
15 Sec. 1202. The department may do 1 or more of the following:
16 (a) Provide special formula for eligible clients with specified
17 metabolic and allergic disorders.
18 (b) Provide medical care and treatment to eligible patients with
19 cystic fibrosis who are 21 years of age or older.
20 (c) Provide genetic diagnostic and counseling services for
21 eligible families.
22 (d) Provide medical care and treatment to eligible patients with
23 hereditary coagulation defects, commonly known as hemophilia, who are
24 21 years of age or older.
25 Sec. 1203. All children who are determined medically eligible
26 for the children's special health care services program shall be
1 referred to the appropriate locally-based services program in their
2 community.
3 OFFICE OF DRUG CONTROL POLICY
4 Sec. 1250. In addition to the $1,800,000.00 in Byrne formula
5 grant program funding the department provides to local drug treatment
6 courts, the department shall provide $1,800,000.00 in Byrne formula
7 grant program funding to the judiciary by interdepartmental grant.
8 CRIME VICTIM SERVICES COMMISSION
9 Sec. 1302. From the funds appropriated in part 1 for justice
10 assistance grants, up to $50,000.00 shall be allocated for expansion
11 of forensic nurse examiner programs to facilitate training for
12 improved evidence collection for the prosecution of sexual assault.
13 The funds shall be used for program coordination, training, and
14 counseling. Unexpended funds shall be carried forward.
15 Sec. 1304. The department shall work with the department of
16 state police, the Michigan hospital association, the Michigan state
17 medical society, and the Michigan nurses association to ensure that
18 the recommendations included in the "Standard Recommended Procedures
19 for the Emergency Treatment of Sexual Assault Victims" are followed in
20 the collection of evidence.
21 OFFICE OF SERVICES TO THE AGING
22 Sec. 1401. The appropriation in part 1 to the office of services
23 to the aging, for community and nutrition services and home services,
24 shall be restricted to eligible individuals at least 60 years of age
25 who fail to qualify for home care services under title XVIII, XIX, or
1 XX.
2 Sec. 1403. The office of services to the aging shall require
3 each region to report to the office of services to the aging home
4 delivered meals waiting lists based upon standard criteria.
5 Determining criteria shall include all of the following:
6 (a) The recipient's degree of frailty.
7 (b) The recipient's inability to prepare his or her own meals
8 safely.
9 (c) Whether the recipient has another care provider available.
10 (d) Any other qualifications normally necessary for the recipient
11 to receive home delivered meals.
12 Sec. 1404. The area agencies and local providers may receive and
13 expend fees for the provision of day care, care management, respite
14 care, and certain eligible home and community-based services. The
15 fees shall be based on a sliding scale, taking client income into
16 consideration. The fees shall be used to expand services.
17 Sec. 1406. The appropriation of $5,000,000.00 of tobacco
18 settlement funds to the office of services to the aging for the
19 respite care program shall be allocated in accordance with a long-term
20 care plan developed by the long-term care working group established in
21 section 1657 of 1998 PA 336 upon implementation of the plan. The use
22 of the funds shall be for direct respite care or adult respite care
23 center services. Not more than 10% of the amount allocated under this
24 section shall be expended for administration and administrative
25 purposes.
26 Sec. 1408. The office of services to the aging shall provide
27 that funds appropriated under this act shall be awarded on a local
1 level in accordance with locally determined needs.
2 Sec. 1413. The legislature affirms the commitment to
3 locally-based services. The legislature supports the role of local
4 county board of commissioners in the approval of area agency on aging
5 plans. The legislature supports choice and the right of local
6 counties to change membership in the area agencies on aging if the
7 change is to an area agency on aging that is contiguous to that
8 county. The legislature supports the office of services to the aging
9 working with others to provide training to commissions to better
10 understand and advocate for aging issues. It is the intent of the
11 legislature to prohibit area agencies on aging from providing direct
12 services, including home and community-based waiver services, unless
13 they receive a waiver from the department. The legislature's intent
14 in this section is conditioned on compliance with federal and state
15 laws, rules, and policies.
16 Sec. 1416. The legislature affirms the commitment to provide
17 in-home services, resources, and assistance for the frail elderly who
18 are not being served by the Medicaid home and community services
19 waiver program.
20 MEDICAL SERVICES ADMINISTRATION
21 Sec. 1505. The department shall work with the department of
22 career development to explore options available under the ticket to
23 work and work incentives improvement act of 1999, Public Law 106-170,
24 113 Stat. 1860. The department shall provide a report on the options
25 to extend health care coverage for working disabled persons under
26 federal law by October 1, 2003.
1 MEDICAL SERVICES
2 Sec. 1601. The cost of remedial services incurred by residents
3 of licensed adult foster care homes and licensed homes for the aged
4 shall be used in determining financial eligibility for the medically
5 needy. Remedial services include basic self-care and rehabilitation
6 training for a resident.
7 Sec. 1602. Medical services shall be provided to elderly and
8 disabled persons with incomes less than or equal to 100% of the
9 official poverty line, pursuant to the state's option to elect such
10 coverage set out at section 1902(a)(10)(A)(ii) and (m) of title XIX,
11 42 U.S.C. 1396a.
12 Sec. 1603. (1) The department may establish a program for
13 persons to purchase medical coverage at a rate determined by the
14 department.
15 (2) The department may receive and expend premiums for the buy-in
16 of medical coverage in addition to the amounts appropriated in part
17 1.
18 (3) The premiums described in this section shall be classified as
19 private funds.
20 Sec. 1605. (1) The protected income level for Medicaid coverage
21 determined pursuant to section 106(1)(b)(iii) of the social welfare
22 act, 1939 PA 280, MCL 400.106, shall be 100% of the related public
23 assistance standard.
24 (2) The department shall notify the senate and house of
25 representatives appropriations subcommittees on community health and
26 the state budget director of any proposed revisions to the protected
1 income level for Medicaid coverage related to the public assistance
2 standard 90 days prior to implementation.
3 Sec. 1606. For the purpose of guardian and conservator charges,
4 the department of community health may deduct up to $60.00 per month
5 as an allowable expense against a recipient's income when determining
6 medical services eligibility and patient pay amounts.
7 Sec. 1607. (1) An applicant for Medicaid, whose qualifying
8 condition is pregnancy, shall immediately be presumed to be eligible
9 for Medicaid coverage unless the preponderance of evidence in her
10 application indicates otherwise. The applicant who is qualified as
11 described in this subsection shall be allowed to select or remain with
12 the Medicaid participating obstetrician of her choice.
13 (2) An applicant qualified as described in subsection (1) shall be
14 given a letter of authorization to receive Medicaid covered services
15 related to her pregnancy. All qualifying applicants shall be entitled
16 to receive all medically necessary obstetrical and prenatal care
17 without preauthorization from a health plan. All claims submitted for
18 payment for obstetrical and prenatal care shall be paid at the
19 Medicaid fee-for-service rate in the event a contract does not exist
20 between the Medicaid participation obstetrical or prenatal care
21 provider and the managed care plan. The applicant shall receive a
22 listing of Medicaid physicians and managed care plans in the immediate
23 vicinity of the applicant's residence.
24 (3) In the event that an applicant, presumed to be eligible
25 pursuant to subsection (1), is subsequently found to be ineligible, a
26 Medicaid physician or managed care plan that has been providing
27 pregnancy services to an applicant under this section is entitled to
1 reimbursement for those services until such time as they are notified
2 by the department that the applicant was found to be ineligible for
3 Medicaid.
4 (4) If the preponderance of evidence in an application indicates
5 that the applicant is not eligible for Medicaid, the department shall
6 refer that applicant to the nearest public health clinic or similar
7 entity as a potential source for receiving pregnancy-related
8 services.
9 Sec. 1608. The department shall update by October 1, 2003 and
10 distribute by November 1, 2003 to health care providers the pamphlet
11 identifying patient rights and responsibilities described in
12 section 20201 of the public health code, 1978 PA 368, MCL 333.20201.
13 Sec. 1610. The department of community health shall provide an
14 administrative procedure for the review of cost report grievances by
15 medical services providers with regard to reimbursement under the
16 medical services program. Settlements of properly submitted cost
17 reports shall be paid not later than 9 months from receipt of the
18 final report.
19 Sec. 1611. (1) For care provided to medical services recipients
20 with other third-party sources of payment, medical services
21 reimbursement shall not exceed, in combination with such other
22 resources, including Medicare, those amounts established for medical
23 services-only patients. The medical services payment rate shall be
24 accepted as payment in full. Other than an approved medical services
25 copayment, no portion of a provider's charge shall be billed to the
26 recipient or any person acting on behalf of the recipient. Nothing in
27 this section shall be considered to affect the level of payment from a
1 third-party source other than the medical services program. The
2 department shall require a nonenrolled provider to accept medical
3 services payments as payment in full.
4 (2) Notwithstanding subsection (1), medical services reimbursement
5 for hospital services provided to dual Medicare/medical services
6 recipients with Medicare Part B coverage only shall equal, when
7 combined with payments for Medicare and other third-party resources,
8 if any, those amounts established for medical services-only patients,
9 including capital payments.
10 Sec. 1615. Unless prohibited by federal or state law or
11 regulation, the department shall require enrolled Medicaid providers
12 to submit their billings for services electronically by April 1, 2004
13 and have a program that provides a mechanism for Medicaid providers to
14 submit their billings for services over the Internet.
15 Sec. 1620. (1) For fee-for-service recipients, the
16 pharmaceutical dispensing fee shall be $3.77 or the pharmacy's usual
17 or customary cash charge, whichever is less.
18 (2) If carved-out of the capitation rate for managed care
19 recipients, the pharmaceutical dispensing fee shall be $3.77 or the
20 pharmacy's usual or customary cash charge or the usual charge allowed
21 by the recipient's Medicaid HMO, whichever is less.
22 (3) The department shall require a prescription copayment for
23 Medicaid recipients except as prohibited by federal or state law or
24 regulation.
25 Sec. 1621. (1) The department may implement prospective drug
26 utilization review and disease management systems. The prospective
27 drug utilization review and disease management systems authorized by
1 this subsection shall have physician oversight, shall focus on
2 patient, physician, and pharmacist education, and shall be developed
3 in consultation with the national pharmaceutical council, Michigan
4 state medical society, Michigan association of osteopathic physicians,
5 Michigan pharmacists' association, Michigan health and hospital
6 association, and Michigan nurses' association.
7 (2) This section does not authorize or allow therapeutic
8 substitution.
9 Sec. 1622. The department shall implement a pharmaceutical best
10 practice initiative. All of the following apply to that initiative:
11 (a) A physician that calls the department's agent for prior
12 authorization of drugs that are not on the department's preferred drug
13 list shall be informed of the option to speak to the agent's physician
14 on duty concerning the prior authorization request if the agent's
15 pharmacist denies the prior authorization request. If immediate
16 contact with the agent's physician on duty is requested, but cannot be
17 arranged, the physician placing the call shall be immediately informed
18 of the right to request a 72-hour supply of the nonauthorized drug.
19 (b) The department's prior authorization and appeal process shall
20 be available on the department's website. The department shall also
21 continue to implement a program that allows providers to file prior
22 authorization and appeal requests electronically.
23 (c) The department shall provide authorization for prescribed
24 drugs that are not on its preferred drug list if the prescribing
25 physician verifies that the drugs are necessary for the continued
26 stabilization of the patient's medical condition following documented
27 previous failures on earlier prescription regimens. Documentation of
1 previous failures may be provided by telephone, facsimile, or
2 electronic transmission.
3 (d) Meetings of the department's pharmacy and therapeutics
4 committee shall be open to the public with advance notice of the
5 meeting date, time, place, and agenda posted on the department's
6 website 14 days in advance of each meeting date. By January 31 of
7 each year, the department shall publish the committee's regular
8 meeting schedule for the year on the department's website. The
9 pharmacy and therapeutics committee meetings shall be subject to the
10 requirements of the open meetings act, 1976 PA 267, MCL 15.261 to
11 15.275. The committee shall provide an opportunity for interested
12 parties to comment at each meeting following written notice to the
13 committee's chairperson of the intent to provide comment.
14 (e) The pharmacy and therapeutics committee shall make
15 recommendations for the inclusion of medications on the preferred drug
16 list based on sound clinical evidence found in labeling, drug
17 compendia, and peer-reviewed literature pertaining to use of the drug
18 in the relevant population. The committee shall develop a method to
19 receive notification and clinical information about new drugs. The
20 department shall post this process and the necessary forms on the
21 department's website.
22 (f) The department shall assure compliance with the published
23 Medicaid bulletin implementing the Michigan pharmaceutical best
24 practices initiative program. The department shall also include this
25 information on its website.
26 (g) The department shall by March 15, 2004 provide to the members
27 of the house and senate subcommittees on community health a report on
1 the impact of the pharmaceutical best practice initiative on the
2 Medicaid community. The report shall include, but not be limited to,
3 the number of appeals used in the prior authorization process and any
4 reports of patients who are hospitalized because of authorization
5 denial.
6 (h) By May 15, 2004, the department shall provide a report to the
7 members of the house and senate appropriations subcommittees on
8 community health and the house and senate fiscal agencies identifying
9 the prescribed drugs that are grandfathered in as preferred drugs and
10 available without prior authorization and the population groups to
11 which they apply. The report shall assess strategies to improve the
12 drug prior authorization process.
13 Sec. 1623. (1) The department shall continue the Medicaid policy
14 that allows for the dispensing of a 100-day supply for maintenance
15 drugs.
16 (2) The department shall notify all HMOs, physicians, pharmacies,
17 and other medical providers that are enrolled in the Medicaid program
18 that Medicaid policy allows for the dispensing of a 100-day supply for
19 maintenance drugs.
20 (3) The notice in subsection (2) shall also clarify that a
21 pharmacy shall fill a prescription written for maintenance drugs in
22 the quantity specified by the physician, but not more than the maximum
23 allowed under Medicaid, unless subsequent consultation with the
24 prescribing physician indicates otherwise.
25 Sec. 1629. The department shall utilize maximum allowable cost
26 pricing for generic drugs that is based on wholesaler pricing to
27 providers that is available from at least 2 wholesalers who deliver in
1 the state of Michigan with their own fleet of delivery vehicles.
2 Sec. 1630. Medicaid hearing aid services, podiatric services,
3 and chiropractic services shall continue at not less than the level in
4 effect on October 1, 2002, except that reasonable utilization
5 limitations may be adopted in order to prevent excess utilization.
6 The department shall not impose utilization restrictions on
7 chiropractic services unless a recipient has exceeded 18 office visits
8 within 1 year.
9 Sec. 1631. The department shall require copayments on dental,
10 podiatric, chiropractic, vision, and hearing aid services provided to
11 Medicaid recipients, except as prohibited by federal or state law or
12 regulation.
13 Sec. 1633. From the funds appropriated in part 1 for auxiliary
14 medical services, the department shall expand the healthy kids dental
15 program statewide if funds become available specifically for expansion
16 of the program.
17 Sec. 1634. From the funds appropriated in part 1 for ambulance
18 services, the department shall continue the 5% increase in payment
19 rates for ambulance services implemented in fiscal year 2000-2001.
20 Sec. 1641. An institutional provider that is required to submit
21 a cost report under the medical services program shall submit cost
22 reports completed in full within 5 months after the end of its fiscal
23 year.
24 Sec. 1643. Of the funds appropriated in part 1 for graduate
25 medical education in the hospital services and therapy line item
26 appropriation, $7,270,200.00 shall be allocated for the psychiatric
27 residency training program that establishes and maintains
1 collaborative relations with the schools of medicine at Michigan State
2 University and Wayne State University if the necessary Medicaid
3 matching funds are provided by the universities as allowable state
4 match.
5 Sec. 1647. From the funds appropriated in part 1 for hospital
6 services, the department shall allocate for graduate medical education
7 not less than the level of rates and payments in effect on April 1,
8 2003.
9 Sec. 1648. The department shall maintain an automated toll-free
10 phone line to enable medical providers to verify the eligibility
11 status of Medicaid recipients. There shall be no charge to providers
12 for the use of the toll-free phone line.
13 Sec. 1649. From the funds appropriated in part 1 for medical
14 services, the department shall continue breast and cervical cancer
15 treatment coverage for women up to 250% of the federal poverty level,
16 who are under age 65, and who are not otherwise covered by insurance.
17 This coverage shall be provided to women who have been screened
18 through the centers for disease control breast and cervical cancer
19 early detection program, and are found to have breast or cervical
20 cancer, pursuant to the breast and cervical cancer prevention and
21 treatment act of 2000, Public Law 106-354, 114 Stat. 1381.
22 Sec. 1650. (1) The department may require medical services
23 recipients residing in counties offering managed care options to
24 choose the particular managed care plan in which they wish to be
25 enrolled. Persons not expressing a preference may be assigned to a
26 managed care provider.
27 (2) Persons to be assigned a managed care provider shall be
1 informed in writing of the criteria for exceptions to capitated
2 managed care enrollment, their right to change HMOs for any reason
3 within the initial 90 days of enrollment, the toll-free telephone
4 number for problems and complaints, and information regarding
5 grievance and appeals rights.
6 (3) The criteria for medical exceptions to HMO enrollment shall be
7 based on submitted documentation that indicates a recipient has a
8 serious medical condition, and is undergoing active treatment for that
9 condition with a physician who does not participate in 1 of the HMOs.
10 If the person meets the criteria established by this subsection, the
11 department shall grant an exception to mandatory enrollment at least
12 through the current prescribed course of treatment, subject to
13 periodic review of continued eligibility.
14 Sec. 1651. (1) Medical services patients who are enrolled in
15 HMOs have the choice to elect hospice services or other services for
16 the terminally ill that are offered by the HMOs. If the patient
17 elects hospice services, those services shall be provided in
18 accordance with part 214 of the public health code, 1978 PA 368,
19 MCL 333.21401 to 333.21420.
20 (2) The department shall not amend the medical services hospice
21 manual in a manner that would allow hospice services to be provided
22 without making available all comprehensive hospice services described
23 in 42 C.F.R. part 418.
24 Sec. 1653. Implementation and contracting for managed care by
25 the department through HMOs are subject to the following conditions:
26 (a) Continuity of care is assured by allowing enrollees to
27 continue receiving required medically necessary services from their
1 current providers for a period not to exceed 1 year if enrollees meet
2 the managed care medical exception criteria.
3 (b) The department shall require contracted HMOs to submit data
4 determined necessary for evaluation on a timely basis.
5 (c) A health plans advisory council is functioning that meets all
6 applicable federal and state requirements for a medical care advisory
7 committee. The council shall review at least quarterly the
8 implementation of the department's managed care plans.
9 (d) Mandatory enrollment of Medicaid beneficiaries living in
10 counties defined as rural by the federal government, which is any
11 nonurban standard metropolitan statistical area, is allowed if there
12 is only 1 HMO serving the Medicaid population, as long as each
13 Medicaid beneficiary is assured of having a choice of at least 2
14 physicians by the HMO.
15 (e) Enrollment of recipients of children's special health care
16 services in HMOs shall be voluntary during fiscal year 2003-2004.
17 (f) The department shall develop a case adjustment to its rate
18 methodology that considers the costs of persons with HIV/AIDS, end
19 stage renal disease, organ transplants, epilepsy, and other high-cost
20 diseases or conditions and shall implement the case adjustment when it
21 is proven to be actuarially and fiscally sound. Implementation of the
22 case adjustment must be budget neutral.
23 Sec. 1655. (1) The department may require a 12-month lock-in to
24 the HMO selected by the recipient during the initial and subsequent
25 open enrollment periods, but allow for good cause exceptions during
26 the lock-in period.
27 (2) Medicaid recipients shall be allowed to change HMOs for any
1 reason within the initial 90 days of enrollment.
2 Sec. 1656. (1) The department shall provide an expedited
3 complaint review procedure for Medicaid eligible persons enrolled in
4 HMOs for situations in which failure to receive any health care
5 service would result in significant harm to the enrollee.
6 (2) The department shall provide for a toll-free telephone number
7 for Medicaid recipients enrolled in managed care to assist with
8 resolving problems and complaints. If warranted, the department shall
9 immediately disenroll persons from managed care and approve
10 fee-for-service coverage.
11 (3) Annual reports summarizing the problems and complaints
12 reported and their resolution shall be provided to the house of
13 representatives and senate appropriations subcommittees on community
14 health, the house and senate fiscal agencies, the state budget office,
15 and the department's health plans advisory council.
16 Sec. 1657. (1) Reimbursement for medical services to screen and
17 stabilize a Medicaid recipient, including stabilization of a
18 psychiatric crisis, in a hospital emergency room shall not be made
19 contingent on obtaining prior authorization from the recipient's HMO.
20 If the recipient is discharged from the emergency room, the hospital
21 shall notify the recipient's HMO within 24 hours of the diagnosis and
22 treatment received.
23 (2) If the treating hospital determines that the recipient will
24 require further medical service or hospitalization beyond the point of
25 stabilization, that hospital must receive authorization from the
26 recipient's HMO prior to admitting the recipient.
27 (3) Subsections (1) and (2) shall not be construed as a
1 requirement to alter an existing agreement between an HMO and their
2 contracting hospitals nor as a requirement that an HMO must reimburse
3 for services that are not considered to be medically necessary.
4 (4) Prior to contracting with an HMO for managed care services
5 that did not have a contract with the department before October 1,
6 2002, the department shall receive assurances from the office of
7 financial and insurance services that the HMO meets the net worth and
8 financial solvency requirements contained in chapter 35 of the
9 insurance code, 1956 PA 218, MCL 500.3501 to 500.3580.
10 Sec. 1658. (1) It is the intent of the legislature that HMOs
11 shall have contracts with hospitals within a reasonable distance from
12 their enrollees. If a hospital does not contract with the HMO, in its
13 service area, that hospital shall enter into a hospital access
14 agreement as specified in the MSA bulletin Hospital 01-19.
15 (2) A hospital access agreement specified in subsection (1) shall
16 be considered an affiliated provider contract pursuant to the
17 requirements contained in chapter 35 of the insurance code of 1956,
18 1956 PA 218, MCL 500.3501 to 500.3580.
19 Sec. 1659. The following sections are the only ones that shall
20 apply to the following Medicaid managed care programs, including the
21 comprehensive plan, children's special health care services plan,
22 MIChoice long-term care plan, and the mental health, substance abuse,
23 and developmentally disabled services program: 402, 404, 414, 418,
24 424, 428, 442, 1650, 1651, 1653, 1655, 1656, 1657, 1658, 1660, 1661,
25 1662, and 1699.
26 Sec. 1660. (1) The department shall assure that all Medicaid
27 children have timely access to EPSDT services as required by federal
1 law. Medicaid HMOs shall provide EPSDT services to their child
2 members in accordance with Medicaid EPSDT policy.
3 (2) The primary responsibility of assuring a child's hearing and
4 vision screening is with the child's primary care provider. The
5 primary care provider shall provide age appropriate screening or
6 arrange for these tests through referrals to local health
7 departments. Local health departments shall provide preschool hearing
8 and vision screening services and accept referrals for these tests
9 from physicians or from Head Start programs in order to assure all
10 preschool children have appropriate access to hearing and vision
11 screening. Local health departments shall be reimbursed for the cost
12 of providing these tests for Medicaid eligible children by the
13 Medicaid program.
14 (3) The department shall require Medicaid HMOs to provide EPSDT
15 utilization data through the encounter data system, and health
16 employer data and information set well child health measures in
17 accordance with the National Committee on Quality Assurance prescribed
18 methodology.
19 (4) The department shall require HMOs to be responsible for well
20 child visits and maternal and infant support services as described in
21 Medicaid policy. These responsibilities shall be specified in the
22 information distributed by the HMOs to their members.
23 (5) The department shall provide, on an annual basis, budget
24 neutral incentives to Medicaid HMOs and local health departments to
25 improve performance on measures related to the care of children and
26 pregnant women.
27 Sec. 1661. (1) The department shall assure that all Medicaid
1 eligible children and pregnant women have timely access to MSS/ISS
2 services. Medicaid HMOs shall assure that maternal support service
3 screening is available to their pregnant members and that those women
4 found to meet the maternal support service high-risk criteria are
5 offered maternal support services. Local health departments shall
6 assure that maternal support service screening is available for
7 Medicaid pregnant women not enrolled in an HMO and that those women
8 found to meet the maternal support service high-risk criteria are
9 offered maternal support services or are referred to a certified
10 maternal support service provider.
11 (2) The department shall prohibit HMOs from requiring prior
12 authorization of their contracted providers for any EPSDT screening
13 and diagnosis service, for any MSS/ISS screening referral, or for up
14 to 3 MSS/ISS service visits.
15 (3) The department shall assure the coordination of MSS/ISS
16 services with the WIC program, state-supported substance abuse,
17 smoking prevention, and violence prevention programs, the family
18 independence agency, and any other state or local program with a focus
19 on preventing adverse birth outcomes and child abuse and neglect.
20 Sec. 1662. (1) The department shall require the external quality
21 review contractor to conduct a review of all EPSDT components provided
22 to children from a statistically valid sample of health plan medical
23 records.
24 (2) The department shall provide a copy of the analysis of the
25 Medicaid HMO annual audited health employer data and information set
26 reports and the annual external quality review report to the senate
27 and house of representatives appropriations subcommittees on community
1 health, the senate and house fiscal agencies, and the state budget
2 director, within 30 days of the department's receipt of the final
3 reports from the contractors.
4 (3) The department shall work with the Michigan association of
5 health plans and the Michigan association for local public health to
6 improve service delivery and coordination in the MSS/ISS and EPSDT
7 programs.
8 (4) The department shall provide training and technical assistance
9 workshops on EPSDT and MSS/ISS for Medicaid health plans, local health
10 departments, and MSS/ISS contractors.
11 Sec. 1670. (1) The appropriation in part 1 for the MIChild
12 program is to be used to provide comprehensive health care to all
13 children under age 19 who reside in families with income at or below
14 200% of the federal poverty level, who are uninsured and have not had
15 coverage by other comprehensive health insurance within 6 months of
16 making application for MIChild benefits, and who are residents of this
17 state. The department shall develop detailed eligibility criteria
18 through the medical services administration public concurrence
19 process, consistent with the provisions of this act. Health care
20 coverage for children in families below 150% of the federal poverty
21 level shall be provided through expanded eligibility under the state's
22 Medicaid program. Health coverage for children in families between
23 150% and 200% of the federal poverty level shall be provided through a
24 state-based private health care program.
25 (2) The department shall enter into a contract to obtain MIChild
26 services from any HMO, dental care corporation, or any other entity
27 that offers to provide the managed health care benefits for MIChild
1 services at the MIChild capitated rate. As used in this subsection:
2 (a) "Dental care corporation", "health care corporation",
3 "insurer", and "prudent purchaser agreement" mean those terms as
4 defined in section 2 of the prudent purchaser act, 1984 PA 233,
5 MCL 550.52.
6 (b) "Entity" means a health care corporation or insurer operating
7 in accordance with a prudent purchaser agreement.
8 (3) The department may enter into contracts to obtain certain
9 MIChild services from community mental health service programs.
10 (4) The department may make payments on behalf of children
11 enrolled in the MIChild program from the line-item appropriation
12 associated with the program as described in the MIChild state plan
13 approved by the United States department of health and human services,
14 or from other medical services line-item appropriations providing for
15 specific health care services.
16 Sec. 1671. From the funds appropriated in part 1, the department
17 shall continue a comprehensive approach to the marketing and outreach
18 of the MIChild program. The marketing and outreach required under
19 this section shall be coordinated with current outreach, information
20 dissemination, and marketing efforts and activities conducted by the
21 department.
22 Sec. 1672. The department may provide up to 1 year of continuous
23 eligibility to children eligible for the MIChild program unless the
24 family fails to pay the monthly premium, a child reaches age 19, or
25 the status of the children's family changes and its members no longer
26 meet the eligibility criteria as specified in the federally approved
27 MIChild state plan.
1 Sec. 1673. The department may establish premiums for MIChild
2 eligible persons in families with income above 150% of the federal
3 poverty level. The monthly premiums shall not exceed $5.00 for a
4 family.
5 Sec. 1674. The department shall not require copayments under the
6 MIChild program.
7 Sec. 1675. Children whose category of eligibility changes
8 between the Medicaid and MIChild programs shall be assured of keeping
9 their current health care providers through the current prescribed
10 course of treatment for up to 1 year, subject to periodic reviews by
11 the department if the beneficiary has a serious medical condition and
12 is undergoing active treatment for that condition.
13 Sec. 1676. To be eligible for the MIChild program, a child must
14 be residing in a family with an adjusted gross income of less than or
15 equal to 200% of the federal poverty level. The department's
16 verification policy shall be used to determine eligibility.
17 Sec. 1677. The MIChild program shall provide all benefits
18 available under the state employee insurance plan that are delivered
19 through contracted providers and consistent with federal law,
20 including, but not limited to, the following medically necessary
21 services:
22 (a) Inpatient mental health services, other than substance abuse
23 treatment services, including services furnished in a state-operated
24 mental hospital and residential or other 24-hour therapeutically
25 planned structured services.
26 (b) Outpatient mental health services, other than substance abuse
27 services, including services furnished in a state-operated mental
1 hospital and community-based services.
2 (c) Durable medical equipment and prosthetic and orthotic
3 devices.
4 (d) Dental services as outlined in the approved MIChild state
5 plan.
6 (e) Substance abuse treatment services that may include inpatient,
7 outpatient, and residential substance abuse treatment services.
8 (f) Care management services for mental health diagnoses.
9 (g) Physical therapy, occupational therapy, and services for
10 individuals with speech, hearing, and language disorders.
11 (h) Emergency ambulance services.
12 Sec. 1681. From the funds appropriated in part 1 for home and
13 community-based services, the department and local waiver agents shall
14 encourage the use of family members, friends, and neighbors of home
15 and community-based services participants, where appropriate, to
16 provide homemaker services, meal preparation, transportation, chore
17 services, and other nonmedical covered services to participants in the
18 Medicaid home and community-based services program. This section
19 shall not be construed as allowing for the payment of family members,
20 friends, or neighbors for these services unless explicitly provided
21 for in federal or state law.
22 Sec. 1682. (1) The department shall implement enforcement
23 actions as specified in the nursing facility enforcement provisions of
24 section 1919 of title XIX, 42 U.S.C. 1396r.
25 (2) The department is authorized to receive and spend penalty
26 money received as the result of noncompliance with medical services
27 certification regulations. Penalty money, characterized as private
1 funds, received by the department shall increase authorizations and
2 allotments in the long-term care accounts.
3 (3) Any unexpended penalty money, at the end of the year, shall
4 carry forward to the following year.
5 Sec. 1683. The department shall promote activities that preserve
6 the dignity and rights of terminally ill and chronically ill
7 individuals. Priority shall be given to programs, such as hospice,
8 that focus on individual dignity and quality of care provided persons
9 with terminal illness and programs serving persons with chronic
10 illnesses that reduce the rate of suicide through the advancement of
11 the knowledge and use of improved, appropriate pain management for
12 these persons; and initiatives that train health care practitioners
13 and faculty in managing pain, providing palliative care, and suicide
14 prevention.
15 Sec. 1685. All nursing home rates, class I and class III, must
16 have their respective fiscal year rate set 30 days prior to the
17 beginning of their rate year. Rates may take into account the most
18 recent cost report prepared and certified by the preparer, provider
19 corporate owner or representative as being true and accurate, and
20 filed timely, within 5 months of the fiscal year end in accordance
21 with Medicaid policy. If the audited version of the last report is
22 available, it shall be used. Any rate factors based on the filed cost
23 report may be retroactively adjusted upon completion of the audit of
24 that cost report.
25 Sec. 1688. The department shall not impose a limit on per unit
26 reimbursements to service providers that provide personal care or
27 other services under the Medicaid home and community-based waiver
1 program for the elderly and disabled. The department's per day per
2 client reimbursement cap calculated in the aggregate for all services
3 provided under the Medicaid home and community-based waiver is not a
4 violation of this section.
5 Sec. 1689. (1) Priority in enrolling additional persons in the
6 Medicaid home and community-based services program shall be given to
7 those who are currently residing in nursing homes or who are eligible
8 to be admitted to a nursing home if they are not provided home and
9 community-based services. The department shall implement screening
10 and assessment procedures to assure that no additional Medicaid
11 eligible persons are admitted to nursing homes who would be more
12 appropriately served by the Medicaid home and community-based services
13 program. In each case where the program is successful in removing an
14 individual from a nursing home, or prevents an individual from
15 entering a nursing home who currently meets explicit medical criteria
16 for admission to a nursing home, the department shall transfer the
17 estimated amount of cost savings from the long-term care services line
18 item to the home and community-based waiver program line item. The
19 department shall make these transfers on a quarterly basis.
20 (2) Within 30 days of the end of each fiscal quarter, the
21 department shall provide a report to the senate and house
22 appropriations subcommittees on community health and the senate and
23 house fiscal agencies that details existing and future allocations for
24 the home and community-based waiver program by regions as well as the
25 associated expenditures.
26 Sec. 1692. (1) The department of community health is authorized
27 to pursue reimbursement for eligible services provided in Michigan
1 schools from the federal Medicaid program. The department and the
2 state budget director are authorized to negotiate and enter into
3 agreements, together with the department of education, with local and
4 intermediate school districts regarding the sharing of federal
5 Medicaid services funds received for these services. The department
6 is authorized to receive and disburse funds to participating school
7 districts pursuant to such agreements and state and federal law.
8 (2) From the funds appropriated in part 1 for medical services
9 school services payments, the department is authorized to do all of
10 the following:
11 (a) Finance activities within the medical services administration
12 related to this project.
13 (b) Reimburse participating school districts pursuant to the fund
14 sharing ratios negotiated in the state-local agreements authorized in
15 subsection (1).
16 (c) Offset general fund costs associated with the medical services
17 program.
18 Sec. 1693. The special adjustor payments appropriation in part 1
19 may be increased if the department submits a medical services state
20 plan amendment pertaining to this line item at a level higher than the
21 appropriation. The department is authorized to appropriately adjust
22 financing sources in accordance with the increased appropriation.
23 Sec. 1694. The department of community health shall distribute
24 $695,000.00 to children's hospitals that have a high indigent care
25 volume. The amount to be distributed to any given hospital shall be
26 based on a formula determined by the department of community health.
27 Sec. 1697. (1) As may be allowed by federal law or regulation,
1 the department may use funds provided by a local or intermediate
2 school district, which have been obtained from a qualifying health
3 system, as the state match required for receiving federal Medicaid or
4 children health insurance program funds. Any such funds received
5 shall be used only to support new school-based or school-linked health
6 services.
7 (2) A qualifying health system is defined as any health care
8 entity licensed to provide health care services in the state of
9 Michigan, that has entered into a contractual relationship with a
10 local or intermediate school district to provide or manage
11 school-based or school-linked health services.
12 Sec. 1699. The department may make separate payments directly to
13 qualifying hospitals serving a disproportionate share of indigent
14 patients, and to hospitals providing graduate medical education
15 training programs. If direct payment for GME and DSH is made to
16 qualifying hospitals for services to Medicaid clients, hospitals will
17 not include GME costs or DSH payments in their contracts with HMOs.
18 Sec. 1710. Any proposed changes by the department to the
19 MIChoice home and community-based services waiver program screening
20 process shall be provided to the members of the house and senate
21 appropriations subcommittees on community health prior to
22 implementation of the proposed changes.
23 Sec. 1711. (1) The department shall maintain the 2-tier
24 reimbursement methodology for Medicaid emergency physicians
25 professional services that was in effect on September 30, 2002,
26 subject to the following conditions:
27 (a) Payments by case and in the aggregate shall not exceed 80% of
1 Medicare payment rates.
2 (b) Total expenditures for these services shall not exceed the
3 level of total payments made during fiscal year 2001-2002, after
4 adjusting for Medicare copayments and deductibles and for changes in
5 utilization.
6 (2) To ensure that total expenditures stay within the spending
7 constraints of subsection (1)(b), the department shall develop a
8 utilization adjustor for the basic 2-tier payment methodology. The
9 adjustor shall be based on a good faith estimate by the department as
10 to what the expected utilization of emergency room services will be
11 during fiscal year 2003-2004, given changes in the number and category
12 of Medicaid recipients. If expenditure and utilization data indicate
13 that the amount and/or type of emergency physician professional
14 services are exceeding the department's estimate, the utilization
15 adjustor shall be applied to the 2-tier reimbursement methodology in
16 such a manner as to reduce aggregate expenditures to the fiscal year
17 2001-2002 adjusted expenditure target.
18 (3) If federal law, regulation, or judicial ruling finds that this
19 2-tier reimbursement methodology is not health insurance portability
20 and accountability act (HIPAA) compliant prior to the end of fiscal
21 year 2003-2004, the department shall immediately provide the
22 chairpersons of the senate and house appropriations subcommittee on
23 community health and their respective fiscal agencies, with the
24 proposed modifications necessary to bring this methodology into
25 compliance.
26 (4) The proposal specified in subsection (3) should be as
27 consistent as possible with the intent of the methodology specified in
1 this section and must be provided to the subcommittee chairpersons and
2 respective fiscal agencies no less than 30 days before the effective
3 date of the proposal.