Bill Text: MI SB0198 | 2013-2014 | 97th Legislature | Engrossed
Bill Title: Appropriations; zero budget; department of community health; provide for fiscal year 2013-2014. Creates appropriation act.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Engrossed - Dead) 2013-06-04 - For Final Disposition Of Budget, See Hb 4328 [SB0198 Detail]
Download: Michigan-2013-SB0198-Engrossed.html
SB-0198, As Passed Senate, May 16, 2013
SUBSTITUTE FOR
SENATE BILL NO. 198
A bill to make appropriations for the department of community
health for the fiscal year ending September 30, 2014; and to
provide for the expenditure of the appropriations.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
PART 1
LINE-ITEM APPROPRIATIONS
Sec. 101. There is appropriated for the department of
community health for the fiscal year ending September 30, 2014,
from the following funds:
DEPARTMENT OF COMMUNITY HEALTH
APPROPRIATION SUMMARY
Full-time equated unclassified positions.......... 6.0
Full-time equated classified positions........ 3,593.6
Average population.............................. 893.0
Senate Bill No. 198 as amended May 16, 2013
GROSS APPROPRIATION.................................... $ <15,365,251,900
Interdepartmental grant revenues:
Total interdepartmental grants and intradepartmental
transfers............................................ 10,056,100
ADJUSTED GROSS APPROPRIATION........................... $ <15,355,195,800
Federal revenues:
Total federal revenues................................. 9,904,596,700
Social security act, temporary assistance for needy
families............................................. 19,545,400
Special revenue funds:
Total local revenues................................... 253,450,100
Total private revenues................................. 106,342,400
Merit award trust fund................................. <<136,934,700>>
Total other state restricted revenues.................. <2,089,583,500>
State general fund/general purpose..................... $ <2,844,743,000>
State general fund/general purpose schedule:
Ongoing state general fund/general
purpose............................ <<2,837,667,900>>
One-time state general fund/general
purpose.................................... 7,075,100
Sec. 102. DEPARTMENTWIDE ADMINISTRATION
Full-time equated unclassified positions.......... 6.0
Full-time equated classified positions.......... 176.7
Director and other unclassified--6.0 FTE positions..... $ 707,000
Departmental administration and management--166.7
FTE positions........................................ 25,069,900
Worker's compensation program.......................... 6,963,000
Senate Bill No. 198 as amended May 16, 2013
Rent and building occupancy............................ 9,791,300
Developmental disabilities council and
projects--10.0 FTE positions......................... 3,024,700
<<Human trafficking intervention services.............. 100>>
GROSS APPROPRIATION.................................... $ <<45,556,000>>
Appropriated from:
Federal revenues:
Total federal revenues................................. 15,196,600
Special revenue funds:
Total private revenues................................. 35,200
Total other state restricted revenues.................. 792,700
State general fund/general purpose..................... $ <<29,531,500>>
Sec. 103. BEHAVIORAL HEALTH PROGRAM ADMINISTRATION
AND SPECIAL PROJECTS
Full-time equated classified positions.......... 103.0
Behavioral health program administration--102.0 FTE
positions............................................ $ 18,059,500
Gambling addiction--1.0 FTE position................... 3,002,800
Protection and advocacy services support............... 194,400
Community residential and support services............. 992,100
Federal and other special projects..................... 3,111,200
Family support subsidy................................. 19,364,900
Housing and support services........................... 11,322,500
GROSS APPROPRIATION.................................... $ 56,047,400
Appropriated from:
Federal revenues:
Total federal revenues................................. 19,926,000
Social security act, temporary assistance for needy
families............................................. 19,545,400
Special revenue funds:
Total private revenues................................. 200,000
Total other state restricted revenues.................. 3,002,800
State general fund/general purpose..................... $ 13,373,200
Sec. 104. BEHAVIORAL HEALTH SERVICES
Full-time equated classified positions............ 9.5
Medicaid mental health services........................ $ 2,187,650,100
Community mental health non-Medicaid services.......... 283,688,700
Medicaid adult benefits waiver......................... 31,989,600
Mental health services for special populations......... 5,842,900
Medicaid substance abuse services...................... 47,696,700
CMHSP, purchase of state services contracts............ 139,391,500
Civil service charges.................................. 1,499,300
Federal mental health block grant--2.5 FTE positions... 15,440,000
State disability assistance program substance abuse
services............................................. 2,018,800
Community substance abuse prevention, education, and
treatment programs................................... 80,093,000
Children's waiver home care program.................... 21,544,900
Nursing home PAS/ARR-OBRA--7.0 FTE positions........... 12,252,100
Children with serious emotional disturbance waiver..... 12,651,000
GROSS APPROPRIATION.................................... $ 2,841,758,600
Appropriated from:
Interdepartmental grant revenues:
Interdepartmental grant from the department of human
services............................................. 6,194,900
Federal revenues:
Total federal revenues................................. 1,619,363,200
Special revenue funds:
Total local revenues................................... 25,228,900
Total other state restricted revenues.................. 22,276,700
State general fund/general purpose..................... $ 1,168,694,900
Sec. 105. STATE PSYCHIATRIC HOSPITALS AND FORENSIC
MENTAL HEALTH SERVICES
Total average population........................ 893.0
Full-time equated classified positions........ 2,130.9
Caro Regional Mental Health Center - psychiatric
hospital - adult--461.3 FTE positions................ $ 56,149,600
Average population.............................. 185.0
Kalamazoo Psychiatric Hospital - adult--466.1 FTE
positions............................................ 63,649,300
Average population.............................. 189.0
Walter P. Reuther Psychiatric Hospital -
adult--420.8 FTE positions........................... 54,587,000
Average population.............................. 234.0
Hawthorn Center - psychiatric hospital - children
and adolescents--226.4 FTE positions................. 28,433,800
Average population............................... 75.0
Center for forensic psychiatry--556.3 FTE positions.... 71,187,800
Average population.............................. 210.0
Revenue recapture...................................... 750,000
IDEA, federal special education........................ 120,000
Special maintenance.................................... 332,500
Purchase of medical services for residents of
hospitals and centers................................ 445,600
Gifts and bequests for patient living and treatment
environment.......................................... 1,000,000
GROSS APPROPRIATION.................................... $ 276,655,600
Appropriated from:
Federal revenues:
Total federal revenues................................. 34,529,300
Special revenue funds:
CMHSP, purchase of state services contracts............ 139,391,500
Other local revenues................................... 19,163,800
Total private revenues................................. 1,000,000
Total other state restricted revenues.................. 16,733,800
State general fund/general purpose..................... $ 65,837,200
Sec. 106. PUBLIC HEALTH ADMINISTRATION
Full-time equated classified positions.......... 102.9
Public health administration--7.3 FTE positions........ $ 1,549,500
Health and wellness initiatives--11.7 FTE positions.... 7,190,200
Minority health grants and contracts--2.5 FTE
positions............................................ 612,700
Vital records and health statistics--81.4 FTE
positions............................................ 9,870,600
GROSS APPROPRIATION.................................... $ 19,223,000
Appropriated from:
Interdepartmental grant revenues:
Interdepartmental grant from the department of human
services............................................. 1,199,200
Federal revenues:
Total federal revenues................................. 4,224,400
Special revenue funds:
Total other state restricted revenues.................. 10,470,700
State general fund/general purpose..................... $ 3,328,700
Sec. 107. HEALTH POLICY
Full-time equated classified positions........... 87.8
Emergency medical services program--23.0 FTE positions. $ 5,181,300
Health policy administration--24.1 FTE positions....... 4,377,600
Health innovation grants............................... 100
Nurse education and research program--3.0 FTE
positions............................................ 769,900
Certificate of need program administration--12.3 FTE
positions............................................ 2,063,700
Rural health services--1.0 FTE position................ 1,531,500
Michigan essential health provider..................... 2,491,300
Primary care services--1.4 FTE positions............... 3,731,300
GROSS APPROPRIATION.................................... $ 20,146,700
Appropriated from:
Interdepartmental grant revenues:
Interdepartmental grant from the department of
licensing and regulatory affairs..................... 2,066,400
Interdepartmental grant from the department of
treasury, Michigan state hospital finance authority.. 114,900
Federal revenues:
Total federal revenues................................. 7,164,000
Special revenue funds:
Total private revenues................................. 255,000
Total other state restricted revenues.................. 5,830,500
State general fund/general purpose..................... $ 4,715,900
Sec. 108. INFECTIOUS DISEASE CONTROL
Full-time equated classified positions........... 49.5
AIDS prevention, testing, and care programs--15.7
FTE positions........................................ $ 69,164,400
Immunization program--12.8 FTE positions............... 14,999,000
Pediatric AIDS prevention and control--1.0 FTE
position............................................. 1,233,100
Sexually transmitted disease control program--20.0
FTE positions........................................ 6,213,800
GROSS APPROPRIATION.................................... $ 91,610,300
Appropriated from:
Federal revenues:
Total federal revenues................................. 42,783,000
Special revenue funds:
Total private revenues................................. 38,278,400
Total other state restricted revenues.................. 7,696,700
State general fund/general purpose..................... $ 2,852,200
Sec. 109. LABORATORY SERVICES
Full-time equated classified positions.......... 100.0
Laboratory services--100.0 FTE positions ... $ 18,167,000
GROSS APPROPRIATION.................................... $ 18,167,000
Appropriated from:
Interdepartmental grant revenues:
Interdepartmental grant from the department of
environmental quality................................ 480,700
Federal revenues:
Total federal revenues................................. 2,271,300
Special revenue funds:
Total other state restricted revenues.................. 8,728,000
State general fund/general purpose..................... $ 6,687,000
Sec. 110. EPIDEMIOLOGY
Full-time equated classified positions.......... 115.1
AIDS surveillance and prevention program............... $ 2,254,100
Bioterrorism preparedness--55.0 FTE positions.......... 35,466,400
Epidemiology administration--41.6 FTE positions........ 12,257,200
Healthy homes program--8.0 FTE positions............... 2,962,500
Newborn screening follow-up and treatment
services--10.5 FTE positions......................... 6,026,100
Tuberculosis control and prevention.................... 867,000
GROSS APPROPRIATION.................................... $ 59,833,300
Appropriated from:
Federal revenues:
Total federal revenues................................. 50,165,300
Special revenue funds:
Total private revenues................................. 238,000
Total other state restricted revenues.................. 7,416,800
State general fund/general purpose..................... $ 2,013,200
Sec. 111. LOCAL HEALTH ADMINISTRATION AND GRANTS
Full-time equated classified positions............ 2.0
Essential local public health services................. $ 37,386,300
Implementation of 1993 PA 133, MCL 333.17015........... 20,000
Local health services--2.0 FTE positions............... 533,300
Medicaid outreach cost reimbursement to local health
departments.......................................... 9,000,000
GROSS APPROPRIATION.................................... $ 46,939,600
Appropriated from:
Federal revenues:
Total federal revenues................................. 9,533,300
Special revenue funds:
Total local revenues................................... 5,150,000
State general fund/general purpose..................... $ 32,256,300
Sec. 112. CHRONIC DISEASE AND INJURY PREVENTION AND
HEALTH PROMOTION
Full-time equated classified positions........... 63.3
Cancer prevention and control program--11.0 FTE
positions............................................ $ 14,987,100
Chronic disease control and health promotion
administration--29.4 FTE positions................... 6,273,100
Diabetes and kidney program--8.0 FTE positions......... 1,885,600
Injury control intervention project.................... 200,100
Smoking prevention program--12.0 FTE positions......... 2,576,800
Violence prevention--2.9 FTE positions................. 2,170,600
GROSS APPROPRIATION.................................... $ 28,093,300
Appropriated from:
Federal revenues:
Total federal revenues................................. 25,000,900
Special revenue funds:
Total private revenues................................. 500,000
Total other state restricted revenues.................. 728,400
State general fund/general purpose..................... $ 1,864,000
Sec. 113. FAMILY, MATERNAL, AND CHILDREN'S HEALTH
SERVICES
Full-time equated classified positions........... 49.6
Childhood lead program--2.5 FTE positions.............. $ 1,243,200
Dental programs--3.0 FTE positions..................... 1,643,900
Dental program for persons with developmental
disabilities......................................... 151,000
Family, maternal, and children's health services
administration--41.6 FTE positions................... 7,245,200
Family planning local agreements....................... 9,085,700
Local MCH services..................................... 7,018,100
Pregnancy prevention program........................... 602,100
Prenatal care outreach and service delivery support.... 9,701,500
Special projects--2.5 FTE positions.................... 9,927,800
Sudden infant death syndrome program................... 321,300
GROSS APPROPRIATION.................................... $ 46,939,800
Appropriated from:
Federal revenues:
Total federal revenues................................. 36,619,400
Special revenue funds:
Total local revenues................................... 75,000
Total private revenues................................. 874,500
State general fund/general purpose..................... $ 9,370,900
Sec. 114. WOMEN, INFANTS, AND CHILDREN FOOD AND
NUTRITION PROGRAM
Full-time equated classified positions........... 45.0
Women, infants, and children program administration
and special projects--45.0 FTE positions............. $ 17,832,600
Women, infants, and children program local
agreements and food costs............................ 256,285,000
GROSS APPROPRIATION.................................... $ 274,117,600
Appropriated from:
Federal revenues:
Total federal revenues................................. 213,039,700
Special revenue funds:
Total private revenues................................. 61,077,900
State general fund/general purpose..................... $ 0
Sec. 115. CHILDREN'S SPECIAL HEALTH CARE SERVICES
Full-time equated classified positions........... 46.8
Children's special health care services
administration--44.0 FTE positions................... $ 5,506,600
Bequests for care and services--2.8 FTE positions...... 1,524,100
Outreach and advocacy.................................. 5,510,000
Nonemergency medical transportation.................... 1,505,900
Medical care and treatment............................. 97,557,700
GROSS APPROPRIATION.................................... $ 111,604,300
Appropriated from:
Federal revenues:
Total federal revenues................................. 44,039,500
Special revenue funds:
Total private revenues................................. 1,005,900
Total other state restricted revenues.................. 3,854,600
State general fund/general purpose..................... $ 62,704,300
Sec. 116. CRIME VICTIM SERVICES COMMISSION
Full-time equated classified positions........... 13.0
Grants administration services--13.0 FTE positions..... $ 1,899,200
Justice assistance grants.............................. 19,106,100
Crime victim rights services grants.................... 16,570,000
GROSS APPROPRIATION.................................... $ 37,575,300
Appropriated from:
Federal revenues:
Total federal revenues................................. 23,494,800
Special revenue funds:
Total other state restricted revenues.................. 14,080,500
State general fund/general purpose..................... $ 0
Sec. 117. OFFICE OF SERVICES TO THE AGING
Full-time equated classified positions........... 40.0
Office of services to aging administration--40.0 FTE
positions............................................ $ 6,389,200
Community services..................................... 36,614,400
Nutrition services..................................... 36,744,100
Foster grandparent volunteer program................... 2,233,600
Retired and senior volunteer program................... 627,300
Senior companion volunteer program..................... 1,604,400
Employment assistance.................................. 3,500,000
Respite care program................................... 5,868,700
GROSS APPROPRIATION.................................... $ 93,581,700
Appropriated from:
Federal revenues:
Total federal revenues................................. 58,154,600
Special revenue funds:
Total private revenues................................. 677,500
Merit award trust fund................................. 4,068,700
Total other state restricted revenues.................. 1,800,000
State general fund/general purpose..................... $ 28,880,900
Sec. 118. MEDICAL SERVICES ADMINISTRATION
Full-time equated classified positions.......... 458.5
Medical services administration--434.5 FTE positions... $ 68,849,100
Facility inspection contract........................... 132,800
MIChild administration................................. 4,327,800
Electronic health record incentive program--24.0 FTE
positions............................................ 144,193,800
GROSS APPROPRIATION.................................... $ 217,503,500
Appropriated from:
Federal revenues:
Total federal revenues................................. 191,886,000
Special revenue funds:
Total local revenues................................... 105,900
Total private revenues................................. 100,000
Total other state restricted revenues.................. 330,000
State general fund/general purpose..................... $ 25,081,600
Sec. 119. MEDICAL SERVICES
Hospital services and therapy.......................... $ 1,244,519,700
Hospital disproportionate share payments............... 45,000,000
Physician services..................................... 465,599,800
Medicare premium payments.............................. 438,208,000
Pharmaceutical services................................ 269,310,900
Home health services................................... 3,783,700
Hospice services....................................... 102,974,400
Transportation......................................... 23,572,600
Auxiliary medical services............................. 9,517,200
Dental services........................................ 194,890,600
Ambulance services..................................... 10,751,000
Long-term care services................................ 1,756,486,200
Integrated care organizations.......................... 100
Medicaid home- and community-based services waiver..... 299,895,900
Adult home help services............................... 308,323,300
Personal care services................................. 13,327,300
Program of all-inclusive care for the elderly.......... 50,254,300
Autism services........................................ 38,000,000
Health plan services................................... 4,742,683,300
MIChild program........................................ 69,744,400
Plan first family planning waiver...................... 13,628,100
Medicaid adult benefits waiver......................... 105,877,700
Special indigent care payments......................... 95,738,800
Federal Medicare pharmaceutical program................ 196,140,500
Maternal and child health.............................. 20,279,500
Subtotal basic medical services program................ 10,518,507,300
School-based services.................................. 131,502,700
Special Medicaid reimbursement......................... 337,217,600
Subtotal special medical services payments............. 468,720,300
GROSS APPROPRIATION.................................... $ 10,987,227,600
Appropriated from:
Senate Bill No. 198 as amended May 16, 2013
Federal revenues:
Total federal revenues................................. 7,443,249,500
Special revenue funds:
Total local revenues................................... 64,335,000
Total private revenues................................. 2,100,000
Merit award trust fund................................. <<132,866,000>>
Total other state restricted revenues.................. <1,983,875,600>
State general fund/general purpose..................... $ <1,360,801,500>
Sec. 120. INFORMATION TECHNOLOGY
Information technology services and projects........... $ 36,530,900
Michigan Medicaid information system................... 30,201,100
GROSS APPROPRIATION.................................... $ 66,732,000
Appropriated from:
Federal revenues:
Total federal revenues................................. 45,091,700
Special revenue funds:
Total other state restricted revenues.................. 1,965,700
State general fund/general purpose..................... $ 19,674,600
Sec. 121. ONE-TIME BASIS ONLY APPROPRIATIONS
Hospital services and therapy - graduate medical
education............................................ $ 4,314,200
Mental health services for special populations......... 3,000,000
Michigan Medicaid information system................... 18,300,000
Primary care services--island clinics.................. 325,000
Mental health innovation............................... 100
GROSS APPROPRIATION.................................... $ 25,939,300
Appropriated from:
Senate Bill No. 198 as amended May 16, 2013
Federal revenues:
Total federal revenues................................. 18,864,200
State general fund/general purpose..................... $ 7,075,100
PART 2
PROVISIONS CONCERNING APPROPRIATIONS
FOR FISCAL YEAR 2013-2014
GENERAL SECTIONS
Sec. 201. Pursuant to section 30 of article IX of the state
constitution of 1963, total state spending from state resources
under part 1 for fiscal year 2013-2014 is <<$5,071,261,200.00>> and
state spending from state resources to be paid to local units of
government for fiscal year 2013-2014 is $1,235,720,300.00. The
itemized statement below identifies appropriations from which
spending to local units of government will occur:
DEPARTMENT OF COMMUNITY HEALTH
BEHAVIORAL HEALTH PROGRAM ADMINISTRATION
Community residential and support services............. $ 451,500
Housing and support services........................... 77,500
BEHAVIORAL HEALTH SERVICES
State disability assistance program substance abuse
services............................................ $ 2,018,000
Community substance abuse prevention, education, and
treatment programs.................................. 12,769,200
Medicaid mental health services........................ 708,534,800
Community mental health non-Medicaid services.......... 283,688,700
Mental health services for special populations......... 8,842,900
Medicaid adult benefits waiver......................... 10,774,100
Medicaid substance abuse services...................... 16,065,200
Children's waiver home care program.................... 5,871,900
Nursing home PAS/ARR-OBRA.............................. 2,721,700
Health policy
Primary care services.................................. $ 88,900
INFECTIOUS DISEASE CONTROL
AIDS prevention, testing, and care programs............ $ 1,041,100
Sexually transmitted disease control program........... 174,500
LABORATORY SERVICES
Laboratory services.................................... $ 2,800
LOCAL HEALTH ADMINISTRATION AND GRANTS
Implementation of 1993 PA 133, MCL 333.17015........... $ 5,700
Essential local public health services................. 32,236,300
CHRONIC DISEASE AND INJURY PREVENTION AND HEALTH PROMOTION
Cancer prevention and control program.................. $ 94,700
FAMILY, MATERNAL, AND CHILDREN'S HEALTH SERVICES
Prenatal care outreach and service delivery support.... $ 2,100,000
CHILDREN'S SPECIAL HEALTH CARE SERVICES
Medical care and treatment............................. $ 585,300
Outreach and advocacy.................................. 1,250,800
CRIME VICTIM SERVICES COMMISSION
Crime victim rights services grants.................... $ 6,180,200
OFFICE OF SERVICES TO THE AGING
Community services..................................... $ 12,229,300
Nutrition services..................................... 8,783,000
Foster grandparent volunteer program................... 536,400
Retired and senior volunteer program................... 147,300
Senior companion volunteer program..................... 183,400
Respite care program................................... 5,115,000
MEDICAL SERVICES
Dental services........................................ $ 1,364,200
Long-term care services................................ 80,798,400
Transportation......................................... 3,583,000
Medicaid adult benefits waiver......................... 10,481,900
Hospital services and therapy.......................... 2,489,000
Physician services..................................... 14,433,600
TOTAL OF PAYMENTS TO LOCAL UNITS
OF GOVERNMENT.......................................... $ 1,235,720,300
Sec. 202. The appropriations authorized under this act are
subject to the management and budget act, 1984 PA 431, MCL 18.1101
to 18.1594.
Sec. 203. As used in this act:
(a) "AIDS" means acquired immunodeficiency syndrome.
(b) "CMHSP" means a community mental health services program
as that term is defined in section 100a of the mental health code,
1974 PA 258, MCL 330.1100a.
(c) "Current fiscal year" means the fiscal year ending
September 30, 2013.
(d) "Department" means the department of community health.
(e) "Director" means the director of the department.
(f) "DSH" means disproportionate share hospital.
(g) "EPSDT" means early and periodic screening, diagnosis, and
treatment.
(h) "Federal health care reform legislation" means the patient
protection and affordable care act, Public Law 111-148, and the
health care and education reconciliation act of 2010, Public Law
111-152.
(i) "Federal poverty level" means the poverty guidelines
published annually in the federal register by the United States
department of health and human services under its authority to
revise the poverty line under 42 USC 9902.
(j) "FTE" means full-time equated.
(k) "GME" means graduate medical education.
(l) "Health plan" means, at a minimum, an organization that
meets the criteria for delivering the comprehensive package of
services under the department's comprehensive health plan.
(m) "HEDIS" means healthcare effectiveness data and
information set.
(n) "HIV" means human immunodeficiency virus.
(o) "HMO" means health maintenance organization.
(p) "IDEA" means the individuals with disabilities education
act, 20 USC 1400 to 1482.
(q) "MCH" means maternal and child health.
(r) "MIChild" means the program described in section 1670.
(s) "PAS/ARR-OBRA" means the preadmission screening and annual
resident review required under the omnibus budget reconciliation
act of 1987, section 1919(e)(7) of the social security act, and 42
USC 1396r.
(t) "PIHP" means a specialty prepaid inpatient health plan for
Medicaid mental health services, services to individuals with
developmental disabilities, and substance abuse services. Specialty
prepaid inpatient health plans are described in section 232b of the
mental health code, 1974 PA 258, MCL 330.1232b.
(u) "Temporary assistance for needy families" means part A of
title IV of the social security act, 42 USC 601 to 619.
(v) "Title XVIII" and "Medicare" mean title XVIII of the
social security act, 42 USC 1395 to 1395kkk-1.
(w) "Title XIX" and "Medicaid" mean title XIX of the social
security act, 42 USC 1396 to 1396w-5.
(x) "Title XX" means title XX of the social security act, 42
USC 1397 to 1397m-5.
Sec. 206. (1) In addition to the funds appropriated in part 1,
there is appropriated an amount not to exceed $200,000,000.00 for
federal contingency funds. These funds are not available for
expenditure until they have been transferred to another line item
in this act under section 393(2) of the management and budget act,
1984 PA 431, MCL 18.1393.
(2) In addition to the funds appropriated in part 1, there is
appropriated an amount not to exceed $40,000,000.00 for state
restricted contingency funds. These funds are not available for
expenditure until they have been transferred to another line item
in this act under section 393(2) of the management and budget act,
1984 PA 431, MCL 18.1393.
(3) In addition to the funds appropriated in part 1, there is
appropriated an amount not to exceed $20,000,000.00 for local
contingency funds. These funds are not available for expenditure
until they have been transferred to another line item in this act
under section 393(2) of the management and budget act, 1984 PA 431,
MCL 18.1393.
(4) In addition to the funds appropriated in part 1, there is
appropriated an amount not to exceed $20,000,000.00 for private
contingency funds. These funds are not available for expenditure
until they have been transferred to another line item in this act
under section 393(2) of the management and budget act, 1984 PA 431,
MCL 18.1393.
Sec. 208. Unless otherwise specified, the departments shall
use the Internet to fulfill the reporting requirements of this act.
This requirement may include transmission of reports via electronic
mail to the recipients identified for each reporting requirement,
or it may include placement of reports on the Internet or Intranet
site.
Sec. 209. Funds appropriated in part 1 shall not be used for
the purchase of foreign goods or services, or both, if
competitively priced and of comparable quality American goods or
services, or both, are available. Preference shall be given to
goods or services, or both, manufactured or provided by Michigan
businesses if they are competitively priced and of comparable
quality. In addition, preference shall be given to goods or
services, or both, that are manufactured or provided by Michigan
businesses owned and operated by veterans if they are competitively
priced and of comparable quality.
Sec. 211. If the revenue collected by the department from fees
and collections exceeds the amount appropriated in part 1, the
revenue may be carried forward with the approval of the state
budget director into the subsequent fiscal year. The revenue
carried forward under this section shall be used as the first
source of funds in the subsequent fiscal year.
Sec. 212. (1) On or before February 1 of the current fiscal
year, the department shall report to the house and senate
appropriations subcommittees on community health, the house and
senate fiscal agencies, and the state budget director on the
detailed name and amounts of federal, restricted, private, and
local sources of revenue that support the appropriations in each of
the line items in part 1.
(2) Upon the release of the next fiscal year executive budget
recommendation, the department shall report to the same parties in
subsection (1) on the amounts and detailed sources of federal,
restricted, private, and local revenue proposed to support the
total funds appropriated in each of the line items in part 1 of the
next fiscal year executive budget proposal.
Sec. 213. The state departments, agencies, and commissions
receiving tobacco tax funds and healthy Michigan funds from part 1
shall report by April 1 of the current fiscal year to the senate
and house appropriations committees, the senate and house fiscal
agencies, and the state budget director on the following:
(a) Detailed spending plan by appropriation line item
including description of programs and a summary of organizations
receiving these funds.
(b) Description of allocations or bid processes including need
or demand indicators used to determine allocations.
(c) Eligibility criteria for program participation and maximum
benefit levels where applicable.
(d) Outcome measures used to evaluate programs, including
measures of the effectiveness of these programs in improving the
health of Michigan residents.
(e) Any other information considered necessary by the house of
representatives or senate appropriations committees or the state
budget director.
Sec. 216. (1) In addition to funds appropriated in part 1 for
all programs and services, there is appropriated for write-offs of
accounts receivable, deferrals, and for prior year obligations in
excess of applicable prior year appropriations, an amount equal to
total write-offs and prior year obligations, but not to exceed
amounts available in prior year revenues.
(2) The department's ability to satisfy appropriation
deductions in part 1 shall not be limited to collections and
accruals pertaining to services provided in the current fiscal
year, but shall also include reimbursements, refunds, adjustments,
and settlements from prior years.
Sec. 218. The department shall include the following in its
annual list of proposed basic health services as required in part
23 of the public health code, 1978 PA 368, MCL 333.2301 to
333.2321:
(a) Immunizations.
(b) Communicable disease control.
(c) Sexually transmitted disease control.
(d) Tuberculosis control.
(e) Prevention of gonorrhea eye infection in newborns.
(f) Screening newborns for the conditions listed in section
5431 of the public health code, 1978 PA 368, MCL 333.5431, or
recommended by the newborn screening quality assurance advisory
committee created under section 5430 of the public health code,
1978 PA 368, MCL 333.5430.
(g) Community health annex of the Michigan emergency
management plan.
(h) Prenatal care.
Sec. 219. (1) The department may contract with the Michigan
public health institute for the design and implementation of
projects and for other public health-related activities prescribed
in section 2611 of the public health code, 1978 PA 368, MCL
333.2611. The department may develop a master agreement with the
institute to carry out these purposes for up to a 3-year period.
The department shall report to the house and senate appropriations
subcommittees on community health, the house and senate fiscal
agencies, and the state budget director on or before January 1 of
the current fiscal year all of the following:
(a) A detailed description of each funded project.
(b) The amount allocated for each project, the appropriation
line item from which the allocation is funded, and the source of
financing for each project.
(c) The expected project duration.
(d) A detailed spending plan for each project, including a
list of all subgrantees and the amount allocated to each
subgrantee.
(2) On or before September 30 of the current fiscal year, the
department shall provide to the same parties listed in subsection
(1) a copy of all reports, studies, and publications produced by
the Michigan public health institute, its subcontractors, or the
department with the funds appropriated in part 1 and allocated to
the Michigan public health institute.
Sec. 223. The department may establish and collect fees for
publications, videos and related materials, conferences, and
workshops. Collected fees shall be used to offset expenditures to
pay for printing and mailing costs of the publications, videos and
related materials, and costs of the workshops and conferences. The
department shall not collect fees under this section that exceed
the cost of the expenditures.
Sec. 264. (1) Upon submission of a Medicaid waiver, a Medicaid
state plan amendment, or a similar proposal to the centers for
Medicare and Medicaid services, the department shall notify the
house and senate appropriations subcommittees on community health
and the house and senate fiscal agencies of the submission.
(2) The department shall provide written or verbal biannual
reports to the senate and house appropriations subcommittees on
community health and the senate and house fiscal agencies
summarizing the status of any new or ongoing discussions with the
centers for Medicare and Medicaid services or the federal
department of health and human services regarding potential or
future Medicaid waiver applications.
(3) The department shall inform the senate and house
appropriations subcommittees on community health and the senate and
house fiscal agencies of any alterations or adjustments made to the
published plan for integrated care for individuals who are dual
Medicare/Medicaid eligibles when the final version of the plan has
been submitted to the federal centers for Medicare and Medicaid
services or the federal department of health and human services.
(4) At least 30 days before implementation of the plan for
integrated care for individuals who are dual Medicare/Medicaid
eligibles, the department shall submit the plan to the legislature
for review.
Sec. 265. The department and agencies receiving appropriations
in part 1 shall receive and retain copies of all reports funded
from appropriations in part 1. Federal and state guidelines for
short-term and long-term retention of records shall be followed.
The department may electronically retain copies of reports unless
otherwise required by federal and state guidelines.
Sec. 266. (1) The departments and agencies receiving
appropriations in part 1 shall prepare a report on out-of-state
travel expenses not later than January 1 of each year. The travel
report shall be a listing of all travel by classified and
unclassified employees outside this state in the immediately
preceding fiscal year that was funded in whole or in part with
funds appropriated in the department's budget. The report shall be
submitted to the house and senate standing committees on
appropriations, the house and senate fiscal agencies, and the state
budget director. The report shall include the following
information:
(a) The dates of each travel occurrence.
(b) The total transportation and related costs of each travel
occurrence, including the proportion funded with state general
fund/general purpose revenues, the proportion funded with state
restricted revenues, the proportion funded with federal revenues,
and the proportion funded with other revenues.
(2) If out-of-state travel is necessary but does not meet 1 or
more of the conditions in subsection (1), the state budget director
may grant an exception to allow the travel. Any exceptions granted
by the state budget director shall be reported on a monthly basis
to the senate and house of representatives standing committees on
appropriations.
Sec. 267. The department shall not take disciplinary action
against an employee for communicating with a member of the
legislature or his or her staff.
Sec. 270. Within 180 days after receipt of the notification
from the attorney general's office of a legal action in which
expenses had been recovered pursuant to section 106(4) of the
social welfare act, 1939 PA 280, MCL 400.106, or any other statute
under which the department has the right to recover expenses, the
department shall submit a written report to the house and senate
appropriations subcommittees on community health, the house and
senate fiscal agencies, and the state budget office which includes,
at a minimum, all of the following:
(a) The total amount recovered from the legal action.
(b) The program or service for which the money was originally
expended.
(c) Details on the disposition of the funds recovered such as
the appropriation or revenue account in which the money was
deposited.
(d) A description of the facts involved in the legal action.
Sec. 276. Funds appropriated in part 1 shall not be used by a
principal executive department, state agency, or authority to hire
a person to provide legal services that are the responsibility of
the attorney general. This prohibition does not apply to legal
services for bonding activities and for those outside services that
the attorney general authorizes.
Sec. 282. (1) The department, through its organizational units
responsible for departmental administration, operation, and
finance, shall establish uniform definitions, standards, and
instructions for the classification, allocation, assignment,
calculation, recording, and reporting of administrative costs by
the following entities:
(a) Coordinating agencies on substance abuse and the Salvation
Army harbor light program that receive payment or reimbursement
from funds appropriated under section 104.
(b) Area agencies on aging and local providers that receive
payment or reimbursement from funds appropriated under section 117.
(2) By May 15 of the current fiscal year, the department shall
provide a written draft of its proposed definitions, standards, and
instructions to the house of representatives and senate
appropriations subcommittees on community health, the house and
senate fiscal agencies, and the state budget director.
Sec. 287. Not later than November 30 of the current fiscal
year, the department shall prepare and transmit a report that
provides for estimates of the total general fund/general purpose
appropriation lapses at the close of the previous fiscal year. This
report shall summarize the projected year-end general fund/general
purpose appropriation lapses by major departmental program or
program areas. The report shall be transmitted to the office of the
state budget, the chairpersons of the senate and house of
representatives standing appropriations committees, and the senate
and house fiscal agencies.
Sec. 292. (1) The department shall maintain a searchable
website accessible by the public at no cost that includes, but is
not limited to, all of the following:
(a) Fiscal year-to-date expenditures by category.
(b) Fiscal year-to-date expenditures by appropriation unit.
(c) Fiscal year-to-date payments to a selected vendor,
including the vendor name, payment date, payment amount, and
payment description.
(d) The number of active department employees by job
classification.
(e) Job specifications and wage rates.
(2) The department may develop and operate its own website to
provide this information or may reference the state's central
transparency website as the source for this information.
Sec. 296. Within 14 days after the release of the executive
budget recommendation, the department shall provide the state
budget director, the senate and house appropriations chairs, the
senate and house appropriations subcommittees on community health,
respectively, and the senate and house fiscal agencies with an
annual report on estimated state restricted fund balances, state
restricted fund projected revenues, and state restricted fund
expenditures for the fiscal years ending September 30, 2013 and
September 30, 2014.
BEHAVIORAL HEALTH SERVICES
Sec. 401. Funds appropriated in part 1 are intended to support
a system of comprehensive community mental health services under
the full authority and responsibility of local CMHSPs or PIHPs. The
department shall ensure that each CMHSP or PIHP provides all of the
following:
(a) A system of single entry and single exit.
(b) A complete array of mental health services that includes,
but is not limited to, all of the following services: residential
and other individualized living arrangements, outpatient services,
acute inpatient services, and long-term, 24-hour inpatient care in
a structured, secure environment.
(c) The coordination of inpatient and outpatient hospital
services through agreements with state-operated psychiatric
hospitals, units, and centers in facilities owned or leased by the
state, and privately-owned hospitals, units, and centers licensed
by the state pursuant to sections 134 through 149b of the mental
health code, 1974 PA 258, MCL 330.1134 to 330.1149b.
(d) Individualized plans of service that are sufficient to
meet the needs of individuals, including those discharged from
psychiatric hospitals or centers, and that ensure the full range of
recipient needs is addressed through the CMHSP's or PIHP's program
or through assistance with locating and obtaining services to meet
these needs.
(e) A system of case management or care management to monitor
and ensure the provision of services consistent with the
individualized plan of services or supports.
(f) A system of continuous quality improvement.
(g) A system to monitor and evaluate the mental health
services provided.
(h) A system that serves at-risk and delinquent youth as
required under the provisions of the mental health code, 1974 PA
258, MCL 330.1001 to 330.2106.
Sec. 402. (1) From funds appropriated in part 1, final
authorizations to CMHSPs or PIHPs shall be made upon the execution
of contracts between the department and CMHSPs or PIHPs. The
contracts shall contain an approved plan and budget as well as
policies and procedures governing the obligations and
responsibilities of both parties to the contracts. Each contract
with a CMHSP or PIHP that the department is authorized to enter
into under this subsection shall include a provision that the
contract is not valid unless the total dollar obligation for all of
the contracts between the department and the CMHSPs or PIHPs
entered into under this subsection for the current fiscal year does
not exceed the amount of money appropriated in part 1 for the
contracts authorized under this subsection.
(2) The department shall immediately report to the senate and
house appropriations subcommittees on community health, the senate
and house fiscal agencies, and the state budget director if either
of the following occurs:
(a) Any new contracts with CMHSPs or PIHPs that would affect
rates or expenditures are enacted.
(b) Any amendments to contracts with CMHSPs or PIHPs that
would affect rates or expenditures are enacted.
(3) The report required by subsection (2) shall include
information about the changes and their effects on rates and
expenditures.
Sec. 403. (1) From the funds appropriated in part 1 for mental
health services for special populations, the department shall
ensure that CMHSPs or PIHPs meet with multicultural service
providers to develop a workable framework for contracting, service
delivery, and reimbursement.
(2) Funds appropriated in part 1 for mental health services
for special populations shall not be utilized for services provided
to illegal immigrants, fugitive felons, and individuals who are not
residents of this state. The department shall maintain contracts
with recipients of multicultural services grants that mandate
grantees establish that recipients of services are legally residing
in the United States. An exception to the contractual provision
shall be allowed to address individuals presenting with emergent
mental health conditions.
(3) The department shall require an annual report from the
independent organizations that receive mental health services for
special populations funding. The annual report, due January 1 of
the current fiscal year, shall include specific information on
services and programs provided, the client base to which the
services and programs were provided, information on any wraparound
services provided, and the expenditures for those services. The
department shall provide the annual reports to the senate and house
appropriations subcommittees on community health and the senate and
house fiscal agencies.
Sec. 404. (1) Not later than May 31 of the current fiscal
year, the department shall provide a report on the community mental
health services programs to the members of the house and senate
appropriations subcommittees on community health, the house and
senate fiscal agencies, and the state budget director that includes
the information required by this section.
(2) The report shall contain information for each CMHSP or
PIHP and a statewide summary, each of which shall include at least
the following information:
(a) A demographic description of service recipients which,
minimally, shall include reimbursement eligibility, client
population, age, ethnicity, housing arrangements, and diagnosis.
(b) Per capita expenditures by client population group.
(c) Financial information that, minimally, includes a
description of funding authorized; expenditures by client group and
fund source; and cost information by service category, including
administration. Service category includes all department-approved
services.
(d) Data describing service outcomes that includes, but is not
limited to, an evaluation of consumer satisfaction, consumer
choice, and quality of life concerns including, but not limited to,
housing and employment.
(e) Information about access to community mental health
services programs that includes, but is not limited to, the
following:
(i) The number of people receiving requested services.
(ii) The number of people who requested services but did not
receive services.
(f) The number of second opinions requested under the code and
the determination of any appeals.
(g) An analysis of information provided by CMHSPs in response
to the needs assessment requirements of the mental health code,
1974 PA 258, MCL 330.1001 to 330.2106, including information about
the number of individuals in the service delivery system who have
requested and are clinically appropriate for different services.
(h) Lapses and carryforwards during the immediately preceding
fiscal year for CMHSPs or PIHPs.
(i) Information about contracts for mental health services
entered into by CMHSPs or PIHPs with providers, including, but not
limited to, all of the following:
(i) The amount of the contract, organized by type of service
provided.
(ii) Payment rates, organized by the type of service provided.
(iii) Administrative costs for services provided to CMHSPs or
PIHPs.
(j) Information on the community mental health Medicaid
managed care program, including, but not limited to, both of the
following:
(i) Expenditures by each CMHSP or PIHP organized by Medicaid
eligibility group, including per eligible individual expenditure
averages.
(ii) Performance indicator information required to be submitted
to the department in the contracts with CMHSPs or PIHPs.
(k) An estimate of the number of direct care workers in local
residential settings and paraprofessional and other nonprofessional
direct care workers in settings where skill building, community
living supports and training, and personal care services are
provided by CMHSPs or PIHPs as of September 30 of the prior fiscal
year employed directly or through contracts with provider
organizations.
(3) The department shall include data reporting requirements
listed in subsection (2) in the annual contract with each
individual CMHSP or PIHP.
(4) The department shall take all reasonable actions to ensure
that the data required are complete and consistent among all CMHSPs
or PIHPs.
Sec. 406. (1) The funds appropriated in part 1 for the state
disability assistance substance abuse services program shall be
used to support per diem room and board payments in substance abuse
residential facilities. Eligibility of clients for the state
disability assistance substance abuse services program shall
include needy persons 18 years of age or older, or emancipated
minors, who reside in a substance abuse treatment center.
(2) The department shall reimburse all licensed substance
abuse programs eligible to participate in the program at a rate
equivalent to that paid by the department of human services to
adult foster care providers. Programs accredited by department-
approved accrediting organizations shall be reimbursed at the
personal care rate, while all other eligible programs shall be
reimbursed at the domiciliary care rate.
Sec. 407. (1) The amount appropriated in part 1 for substance
abuse prevention, education, and treatment grants shall be expended
to coordinate care and services provided to individuals with severe
and persistent mental illness and substance abuse diagnoses.
(2) The department shall approve managing entity fee schedules
for providing substance abuse services and charge participants in
accordance with their ability to pay.
(3) The managing entity shall continue current efforts to
collaborate on the delivery of services to those clients with
mental illness and substance abuse diagnoses with the goal of
providing services in an administratively efficient manner.
Sec. 408. (1) By April 1 of the current fiscal year, the
department shall collect data in order to analyze trends in
substance abuse prevention, treatment, and recovery programs and
determining effectiveness relative to positive outcomes of invested
dollars.
(2) The department shall take all reasonable actions to ensure
that the required data reported are complete and consistent across
the state.
Sec. 410. The department shall assure that substance abuse
treatment is provided to applicants and recipients of public
assistance through the department of human services who are
required to obtain substance abuse treatment as a condition of
eligibility for public assistance.
Sec. 411. (1) The department shall ensure that each contract
with a CMHSP or PIHP requires the CMHSP or PIHP to implement
programs to encourage diversion of individuals with serious mental
illness, serious emotional disturbance, or developmental disability
from possible jail incarceration when appropriate.
(2) Each CMHSP or PIHP shall have jail diversion services and
shall work toward establishing working relationships with
representative staff of local law enforcement agencies, including
county prosecutors' offices, county sheriffs' offices, county
jails, municipal police agencies, municipal detention facilities,
and the courts. Written interagency agreements describing what
services each participating agency is prepared to commit to the
local jail diversion effort and the procedures to be used by local
law enforcement agencies to access mental health jail diversion
services are strongly encouraged.
Sec. 412. The department shall contract directly with the
Salvation Army harbor light program to provide non-Medicaid
substance abuse services.
Sec. 418. On or before the tenth of each month, the department
shall report to the senate and house appropriations subcommittees
on community health, the senate and house fiscal agencies, and the
state budget director on the amount of funding paid to PIHPs to
support the Medicaid managed mental health care program in the
preceding month. The information shall include the total paid to
each PIHP, per capita rate paid for each eligibility group for each
PIHP, and number of cases in each eligibility group for each PIHP,
and year-to-date summary of eligibles and expenditures for the
Medicaid managed mental health care program.
Sec. 424. Each PIHP that contracts with the department to
provide services to the Medicaid population shall adhere to the
following timely claims processing and payment procedure for claims
submitted by health professionals and facilities:
(a) A "clean claim" as described in section 111i of the social
welfare act, 1939 PA 280, MCL 400.111i, shall be paid within 45
days after receipt of the claim by the PIHP. A clean claim that is
not paid within this time frame shall bear simple interest at a
rate of 12% per annum.
(b) A PIHP shall state in writing to the health professional
or facility any defect in the claim within 30 days after receipt of
the claim.
(c) A health professional and a health facility have 30 days
after receipt of a notice that a claim or a portion of a claim is
defective within which to correct the defect. The PIHP shall pay
the claim within 30 days after the defect is corrected.
Sec. 428. Each PIHP shall provide, from internal resources,
local funds to be used as a bona fide part of the state match
required under the Medicaid program in order to increase capitation
rates for PIHPs. These funds shall not include either state funds
received by a CMHSP for services provided to non-Medicaid
recipients or the state matching portion of the Medicaid capitation
payments made to a PIHP.
Sec. 435. A county required under the provisions of the mental
health code, 1974 PA 258, MCL 330.1001 to 330.2106, to provide
matching funds to a CMHSP for mental health services rendered to
residents in its jurisdiction shall pay the matching funds in equal
installments on not less than a quarterly basis throughout the
fiscal year, with the first payment being made by October 1 of the
current fiscal year.
Sec. 474. The department shall ensure that each contract with
a CMHSP or PIHP requires the CMHSP or PIHP to provide each
recipient and his or her family with information regarding the
different types of guardianship and the alternatives to
guardianship. A CMHSP or PIHP shall not, in any manner, attempt to
reduce or restrict the ability of a recipient or his or her family
from seeking to obtain any form of legal guardianship without just
cause.
Sec. 490. (1) The department shall develop a plan to maximize
uniformity and consistency in the standards required of providers
contracting directly with PIHPs and CMHSPs. The standards shall
include, but are not limited to, contract language, training
requirements for direct support staff, performance indicators,
financial and program audits, and billing procedures.
(2) The department shall provide a status report to the senate
and house appropriations subcommittees on community health, the
senate and house fiscal agencies, and the state budget director on
implementation of the plan by July 1 of the current fiscal year.
Sec. 491. The department shall explore changes in program
policy in the habilitation supports waiver for persons with
developmental disabilities that would permit the movement of a slot
that has become available to a county that has demonstrated a
greater need for the services.
Sec. 492. If a CMHSP has entered into an agreement with a
county or county sheriff to provide mental health services to the
inmates of the county jail, the department shall not prohibit the
use of state general fund/general purpose dollars by CMHSPs to
provide mental health services to inmates of a county jail.
Sec. 494. (1) In order to avoid duplication of efforts, the
department shall utilize applicable national accreditation review
criteria to determine compliance with corresponding state
requirements for CMHSPs, PIHPs, or subcontracting provider agencies
that have been reviewed and accredited by a national accrediting
entity for behavioral health care services.
(2) Upon a coordinated submission by the CMHSPs, PIHPs, or
subcontracting provider agencies, a listing of program requirements
that are part of the state program review criteria but are not
reviewed by an applicable national accrediting entity, the
department shall review the listing and provide a recommendation to
the house and senate appropriations subcommittees on community
health, the house and senate fiscal agencies, and the state budget
office as to whether or not state program review should continue.
The CMHSPs, PIHPs, or subcontracting agencies may request the
department to convene a workgroup to fulfill this section.
(3) The department shall continue to comply with state and
federal law and shall not initiate an action that negatively
impacts beneficiary safety.
(4) As used in this section, "national accrediting entity"
means the joint commission on accreditation of healthcare
organizations, the commission on accreditation of rehabilitation
facilities, the council of accreditation, or other appropriate
entity, as approved by the department.
(5) By July 1 of the current fiscal year, the department shall
provide a progress report to the house and senate appropriations
subcommittees on community health, the house and senate fiscal
agencies, and the state budget office on implementation of this
section.
Sec. 496. CMHSPs and PIHPs are permitted to offset state
funding reductions by limiting the administrative component of
their contracts with providers and case management to a maximum of
9%.
Sec. 497. The population data used in determining the
distribution of substance abuse block grant funds shall be from the
most recent federal census.
Sec. 499. The department shall continue efforts to use mental
health funding to address the mental health needs of deaf and hard-
of-hearing persons. The department shall report to the senate and
house appropriations subcommittees on community health on the
results of this process by March 1 of the current fiscal year.
Sec. 501. From the funds appropriated in part 1 for mental
health services for special populations, the department shall
allocate $100.00 to establish a pilot project in several CMHSPs to
provide post-traumatic stress disorder services to current or
former service members.
Sec. 502. The department shall work to develop an outreach
program on fetal alcohol syndrome services. The department shall
report to the senate and house subcommittees on community health by
April 1 of the current fiscal year on efforts to prevent and combat
fetal alcohol syndrome as well as deficiencies in efforts to reduce
the incidence of fetal alcohol syndrome.
Sec. 503. (1) The department shall formally consult with
CMHSPs from across this state when developing policies and
procedures that will impact PIHPs or CMHSPs. The department shall
consult with all of the following under this subsection:
(a) Representatives of CMHSPs designated by the Michigan
association of community mental health boards or by the boards of
directors of the PIHPs.
(b) Two or more CMHSP representatives from each multi-
community mental health PIHP region.
(c) Representatives of PIHPs.
(2) The department and representatives identified in
subsection (1) shall address a range of issues, including, but not
limited to, the following:
(a) Clinical initiatives.
(b) Finance.
(c) Information services.
(d) Quality improvement.
(e) Compliance issues.
(f) Changes in state reporting requirements.
(g) Changes in funding or state payment mechanics.
(h) Changes or amendments being considered for the Medicaid as
well as non-Medicaid contracts.
(i) Changes or additions to special projects for or changes to
Senate Bill No. 198 as amended May 16, 2013
the Medicaid benefit or service array.
Sec. 504. The department shall work to seek more statewide
uniformity in capitation payments made to the PIHPs.
<<Sec. 504. (1) The department shall create a workgroup to
make recommendations to achieve more uniformity in capitation
payments made to the PIHPs.
(2) The workgroup shall include but not be limited to
representatives of the department, PIHPs, and CMHSPs.
(3) The department shall provide the workgroup's
recommendations to the senate and house appropriations
subcommittees on community health, the senate and house fiscal
agencies, and the state budget director by March 1 of the current
fiscal year.>>
STATE PSYCHIATRIC HOSPITALS AND FORENSIC MENTAL HEALTH SERVICES
Sec. 601. The department shall continue a revenue recapture
project to generate additional revenues from third parties related
to cases that have been closed or are inactive. A portion of
revenues collected through project efforts may be used for
departmental costs and contractual fees associated with these
retroactive collections and to improve ongoing departmental
reimbursement management functions.
Sec. 602. The purpose of gifts and bequests for patient living
and treatment environments is to use additional private funds to
provide specific enhancements for individuals residing at state-
operated facilities. Use of the gifts and bequests shall be
consistent with the stipulation of the donor. The expected
completion date for the use of gifts and bequests donations is
within 3 years unless otherwise stipulated by the donor.
Sec. 605. (1) The department shall not implement any closures
or consolidations of state hospitals, centers, or agencies until
CMHSPs or PIHPs have programs and services in place for those
individuals currently in those facilities and a plan for service
provision for those individuals who would have been admitted to
those facilities.
(2) All closures or consolidations are dependent upon adequate
department-approved CMHSP and PIHP plans that include a discharge
and aftercare plan for each individual currently in the facility. A
discharge and aftercare plan shall address the individual's housing
needs. A homeless shelter or similar temporary shelter arrangements
are inadequate to meet the individual's housing needs.
(3) Four months after the certification of closure required in
section 19(6) of the state employees' retirement act, 1943 PA 240,
MCL 38.19, the department shall provide a closure plan to the house
and senate appropriations subcommittees on community health and the
state budget director.
(4) Upon the closure of state-run operations and after
transitional costs have been paid, the remaining balances of funds
appropriated for that operation shall be transferred to CMHSPs or
PIHPs responsible for providing services for individuals previously
served by the operations.
Sec. 606. The department may collect revenue for patient
reimbursement from first- and third-party payers, including
Medicaid and local county CMHSP payers, to cover the cost of
placement in state hospitals and centers. The department is
authorized to adjust financing sources for patient reimbursement
based on actual revenues earned. If the revenue collected exceeds
current year expenditures, the revenue may be carried forward with
approval of the state budget director. The revenue carried forward
shall be used as a first source of funds in the subsequent year.
Sec. 608. Effective October 1, 2012, the department, in
consultation with the department of technology, management, and
budget, may maintain a bid process to identify 1 or more private
contractors to provide food service and custodial services for the
administrative areas at any state hospital identified by the
department as capable of generating savings through the outsourcing
of such services.
PUBLIC HEALTH ADMINISTRATION
Sec. 650. By October 1 of the current fiscal year, the
department shall provide to the senate and house appropriations
subcommittees on community health a report that includes detailed
information regarding the current process by which fish consumption
advisories are created and revised. The department shall include
all of the following information in the report:
(a) The triggers to begin the process for developing the fish
consumption advisories, such as evidence of human disease, fish
residue data, and biomonitoring data.
(b) The process for developing and modifying a fish
consumption advisory, including the data inputs used, the rationale
behind the selection of particular fish for collection, whether the
process has been independently reviewed and validated by a
scientific panel or benchmarked in any way, and the reasons for the
lack of any independent review, validation, or benchmarking.
(c) The type of data specific to a particular body of water
that would be needed to modify a current fish consumption advisory,
including the data quality criteria that are used to determine if
data are suitable for use in the assessment and exclusions to
bodies of data and the justifications for such exclusions.
(d) Information on the ways stakeholder input is incorporated
into the fish consumption advisory process prior to an advisory
being issued.
(e) Information on how advisory analyses are documented,
including how uncertainty analyses are conducted and reported, with
information as to whether these evaluations are publicly available
and, if not available, an explanation of why any such evaluations
are not publicly available.
Sec. 651. The department shall work with the Michigan health
endowment fund corporation established pursuant to section 653 of
the nonprofit health care corporation reform act, 1980 PA 350, MCL
550.1653, to explore ways to expand health and wellness programs,
in particular efforts to serve those with diabetes and kidney
disease.
Sec. 652. From the funds appropriated in part 1 for health and
wellness programs, $100.00 shall be allocated to support the
exemplary physical fitness curriculum.
Sec. 653. From the funds appropriated in part 1 for health and
wellness programs, $100.00 shall be allocated to support efforts to
combat Alzheimer's disease.
Sec. 655. From the funds appropriated in part 1 for health and
wellness programs, $100.00 shall be allocated to support a center
for integrative medicine project in Kent County.
HEALTH POLICY
Sec. 704. The department shall continue to contract with
grantees supported through the appropriation in part 1 for the
emergency medical services program to ensure that a sufficient
number of qualified emergency medical services personnel exist to
serve rural areas of the state.
Sec. 709. (1) The funds appropriated in part 1 for the
Michigan essential health care provider program may also provide
loan repayment for dentists that fit the criteria established by
part 27 of the public health code, 1978 PA 368, MCL 333.2701 to
333.2727.
(2) From the funds appropriated in part 1 for the Michigan
essential health provider program, the department may reduce the
local and private share of the loan repayment costs to 25% for
primary care physicians, particularly obstetricians and
gynecologists working in underserved areas.
Sec. 712. From the funds appropriated in part 1 for primary
care services, $250,000.00 shall be allocated to free health
clinics operating in the state. The department shall distribute the
funds equally to each free health clinic. For the purpose of this
appropriation, "free health clinics" means nonprofit organizations
that use volunteer health professionals to provide care to
uninsured individuals.
Sec. 713. The department shall continue support of
multicultural agencies that provide primary care services from the
funds appropriated in part 1.
Sec. 715. The department shall evaluate options for
incentivizing students attending medical schools in this state to
meet their primary care residency requirements in this state and
ultimately, for some period of time, to remain in this state and
serve as primary care physicians.
Sec. 716. (1) The department is encouraged to create and
implement a pilot program limited to counties with a population of
less than 100,000 to incentivize students attending medical schools
in Michigan through a loan repayment program or other approaches
for committing to provide medical services in rural counties with a
medically underserved population. The program shall be limited to
those students or individuals performing primary care or specialty
services as identified by the department.
(2) By no later than September 30 of the current fiscal year,
the department shall prepare a report and submit it to the senate
and house appropriations subcommittees on community health, the
senate and house fiscal agencies, and the state budget director.
The department shall evaluate the effectiveness of the pilot
program, identify potential changes to improve the program, and
make recommendations for statewide implementation in its report
under this subsection.
INFECTIOUS DISEASE CONTROL
Sec. 804. The department, in conjunction with efforts to
implement the Michigan prisoner reentry initiative, shall cooperate
with the department of corrections to share data and information as
they relate to prisoners being released who are HIV positive or
positive for the hepatitis C antibody.
EPIDEMIOLOGY
Sec. 851. (1) From the funds appropriated in part 1 for the
healthy homes program, $100.00 shall be allocated to expand lead
abatement efforts.
(2) The department shall coordinate its lead abatement efforts
with the Michigan public service commission, specifically on the
issue of window replacement.
LOCAL HEALTH ADMINISTRATION AND GRANTS
Sec. 901. The amount appropriated in part 1 for implementation
of the 1993 additions of or amendments to sections 9161, 16221,
16226, 17014, 17015, and 17515 of the public health code, 1978 PA
368, MCL 333.9161, 333.16221, 333.16226, 333.17014, 333.17015, and
333.17515, shall be used to reimburse local health departments for
costs incurred related to implementation of section 17015(18) of
the public health code, 1978 PA 368, MCL 333.17015.
Sec. 902. If a county that has participated in a district
health department or an associated arrangement with other local
health departments takes action to cease to participate in such an
arrangement after October 1 of the current fiscal year, the
department shall have the authority to assess a penalty from the
local health department's operational accounts in an amount equal
to no more than 6.25% of the local health department's essential
local public health services funding. This penalty shall only be
assessed to the local county that requests the dissolution of the
health department.
Sec. 904. (1) Funds appropriated in part 1 for essential local
public health services shall be prospectively allocated to local
health departments to support immunizations, infectious disease
control, sexually transmitted disease control and prevention,
hearing screening, vision services, food protection, public water
supply, private groundwater supply, and on-site sewage management.
Food protection shall be provided in consultation with the
department of agriculture and rural development. Public water
supply, private groundwater supply, and on-site sewage management
shall be provided in consultation with the department of
environmental quality.
(2) Local public health departments shall be held to
contractual standards for the services in subsection (1).
(3) Distributions in subsection (1) shall be made only to
counties that maintain local spending in the current fiscal year of
at least the amount expended in fiscal year 1992-1993 for the
services described in subsection (1).
Sec. 905. From the funds appropriated in part 1 for essential
local public health services, the department shall increase funding
to local public health departments by $200.00.
CHRONIC DISEASE AND INJURY PREVENTION AND HEALTH PROMOTION
Sec. 1005. From the funds appropriated in part 1 for the
injury control intervention project, $100.00 shall be allocated to
provide services to those with traumatic brain injuries.
FAMILY, MATERNAL, AND CHILDREN'S HEALTH SERVICES
Sec. 1103. By January 3 of the current fiscal year the
department shall annually issue to the legislature, and to the
public on the Internet, a report providing estimated public funds
administered by the department for family planning, sexually
transmitted infection prevention and treatment, and pregnancies and
births, as well as demographics collected by the department as
voluntarily self-reported by individuals utilizing those services.
The department shall provide the actual expenditures by marital
status or, where actual expenditures are not available, shall
provide estimated expenditures by marital status. The department
may utilize the Plan First application (Form MSA 1582), MIChild,
and Healthy Kids application (DCH 0373) or Assistance Application
(DHS 1171) or any other official application for public assistance
for medical coverage to determine the actual or estimated public
expenditures based on marital status.
Sec. 1104. (1) Before April 1 of the current fiscal year, the
department shall submit a report to the house and senate fiscal
agencies and the state budget director on planned allocations from
the amounts appropriated in part 1 for local MCH services, prenatal
care outreach and service delivery support, family planning local
agreements, and pregnancy prevention programs. Using applicable
federal definitions, the report shall include information on all of
the following:
(a) Funding allocations.
(b) Actual number of women, children, and adolescents served
and amounts expended for each group for the immediately preceding
fiscal year.
(c) A breakdown of the expenditure of these funds between
urban and rural communities.
(2) The department shall ensure that the distribution of funds
through the programs described in subsection (1) takes into account
the needs of rural communities.
(3) For the purposes of this section, "rural" means a county,
city, village, or township with a population of 30,000 or less,
including those entities if located within a metropolitan
statistical area.
Sec. 1106. Each family planning program receiving federal
title X family planning funds under 42 USC 300 to 300a-8 shall be
in compliance with all performance and quality assurance indicators
that the office of family planning within the United States
department of health and human services specifies in the family
planning annual report. An agency not in compliance with the
indicators shall not receive supplemental or reallocated funds.
Sec. 1108. The funds appropriated in part 1 for pregnancy
prevention programs shall not be used to provide abortion
counseling, referrals, or services.
Sec. 1109. (1) From the amounts appropriated in part 1 for
dental programs, funds shall be allocated to the Michigan dental
association for the administration of a volunteer dental program
that provides dental services to the uninsured.
(2) Not later than December 1 of the current fiscal year, the
department shall report to the senate and house appropriations
subcommittees on community health and the senate and house standing
committees on health policy the number of individual patients
treated, number of procedures performed, and approximate total
market value of those procedures from the immediately preceding
fiscal year.
Sec. 1119. From the funds appropriated in part 1 for family
planning local agreements or pregnancy prevention programs, no
state funds shall be used to encourage or support abortion
services.
Sec. 1135. (1) If funds become available, provision of the
school health education curriculum, such as the Michigan model for
health or another comprehensive school health education curriculum,
shall be in accordance with the health education goals established
by the Michigan model steering committee. The steering committee
shall be composed of a representative from each of the following
offices and departments:
(a) The department of education.
(b) The department of community health.
(c) The health administration in the department of community
health.
(d) The behavioral health and developmental disabilities
administration in the department of community health.
(e) The department of human services.
(f) The department of state police.
(2) Upon written or oral request, a pupil not less than 18
years of age or a parent or legal guardian of a pupil less than 18
years of age, within a reasonable period of time after the request
is made, shall be informed of the content of a course in the health
education curriculum and may examine textbooks and other classroom
materials that are provided to the pupil or materials that are
presented to the pupil in the classroom. This subsection does not
require a school board to permit pupil or parental examination of
test questions and answers, scoring keys, or other examination
instruments or data used to administer an academic examination.
Sec. 1136. From the funds appropriated in part 1 for prenatal
care outreach and service delivery support, $1,000,000.00 shall be
allocated for a real alternatives 1 pregnancy and parenting support
services program as a pilot project. The department shall establish
a fee-for-service contract with 1 or more qualified agencies to
provide free counseling, support, and referral services to eligible
women during pregnancy through 12 months after birth. As
appropriate, the goals for client outcomes shall include an
increase of counseling support, childbirth choice, and adoption
knowledge and an improvement in parenting skills and knowledge of
reproductive health. The department shall provide for counselor
training, client educational material, program marketing, and
annual provider site monitoring.
Sec. 1137. From the funds appropriated in part 1 for prenatal
care outreach and service delivery support, not less than
$600,000.00 shall be allocated for evidence-based programs to
reduce infant mortality. The funds shall be used for enhanced
support and education to nursing teams and for client recruitment
in areas designated as underserved for obstetrical and
gynecological services. The funds shall also be used for strategic
planning to expand and sustain the program and for marketing and
communications of the program to raise awareness, engage
stakeholders, and recruit nurses.
Sec. 1138. The department shall allocate funds appropriated in
section 113 of part 1 for family, maternal, and children's health
services pursuant to section 1 of 2002 PA 360, MCL 333.1091.
Sec. 1139. From the funds appropriated in part 1 for dental
programs, $100.00 shall be allocated to support an expansion of
dental clinic services.
Sec. 1140. From the funds appropriated in part 1 for special
projects, the department shall make the following allocations:
(a) $1,000,000.00 to the Eastern Michigan University autism
center.
(b) $500,000.00 to the Central Michigan University central
assessment lending library.
(c) $500,000.00 to the Oakland University center for autism
research, education, and support.
(d) $500,000.00 to the Western Michigan University autism
center of excellence.
CHILDREN'S SPECIAL HEALTH CARE SERVICES
Sec. 1202. The department may do 1 or more of the following:
(a) Provide special formula for eligible clients with
specified metabolic and allergic disorders.
(b) Provide medical care and treatment to eligible patients
with cystic fibrosis who are 21 years of age or older.
(c) Provide medical care and treatment to eligible patients
with hereditary coagulation defects, commonly known as hemophilia,
who are 21 years of age or older.
(d) Provide human growth hormone to eligible patients.
Sec. 1204. By October 1 of the current fiscal year, the
department shall report to the senate and house appropriations
committees on community health and the senate and house fiscal
agencies on its plan for enrolling Medicaid-eligible children's
special health care services recipients in the Medicaid health
plans. The report shall include information on which Medicaid
health plans are participating, the methods used to assure
continuity of care and continuity of ongoing relationships with
providers, and projected savings from the implementation of the
proposal.
Sec. 1205. From the funds appropriated in part 1 for medical
care and treatment, the department is authorized to spend up to
$500,000.00 for the continued development and expansion of
telemedicine capacity to allow families with children in the
children's special health care services program to access specialty
providers more readily and in a more timely manner.
CRIME VICTIM SERVICES COMMISSION
Sec. 1302. From the funds appropriated in part 1 for justice
assistance grants, up to $200,000.00 shall be allocated for
expansion of forensic nurse examiner programs to facilitate
training for improved evidence collection for the prosecution of
sexual assault. The funds shall be used for program coordination
and training.
OFFICE OF SERVICES TO THE AGING
Sec. 1403. (1) By February 1 of the current fiscal year, the
office of services to the aging shall require each region to report
to the office of services to the aging and to the legislature home-
delivered meals waiting lists based upon standard criteria.
Determining criteria shall include all of the following:
(a) The recipient's degree of frailty.
(b) The recipient's inability to prepare his or her own meals
safely.
(c) Whether the recipient has another care provider available.
(d) Any other qualifications normally necessary for the
recipient to receive home-delivered meals.
(2) Data required in subsection (1) shall be recorded only for
individuals who have applied for participation in the home-
delivered meals program and who are initially determined as likely
to be eligible for home-delivered meals.
Sec. 1417. The department shall provide to the senate and
house appropriations subcommittees on community health, senate and
house fiscal agencies, and state budget director a report by March
30 of the current fiscal year that contains all of the following:
(a) The total allocation of state resources made to each area
agency on aging by individual program and administration.
(b) Detail expenditure by each area agency on aging by
individual program and administration including both state-funded
resources and locally-funded resources.
Sec. 1420. If funds become available, the department shall
create a pilot project to establish an aging care management
services program with services provided solely by nurses. This
pilot project shall be established in a county with a population
greater than 150,000 but less than 250,000.
Sec. 1421. From the funds appropriated in part 1 for community
services, $1,100,000.00 shall be allocated to area agencies on
aging for locally determined needs.
MEDICAL SERVICES ADMINISTRATION
Sec. 1501. The unexpended funds appropriated in part 1 for the
electronic health records incentive program are considered work
project appropriations, and any unencumbered or unallotted funds
are carried forward into the following fiscal year. The following
is in compliance with section 451a(1) of the management and budget
act, 1984 PA 431, MCL 18.1451a:
(a) The purpose of the project to be carried forward is to
implement the Medicaid electronic health record program that
provides financial incentive payments to Medicaid health care
providers to encourage the adoption and meaningful use of
electronic health records to improve quality, increase efficiency,
and promote safety.
(b) The projects will be accomplished according to the
approved federal advanced planning document.
(c) The estimated cost of this project phase is identified in
the appropriation line item.
(d) The tentative completion date for the work project is
September 30, 2018.
Sec. 1502. From the funds appropriated in part 1 for the
medical services administration, the department shall spend
$300,000.00 plus any associated federal match to develop an all
payer claims database.
MEDICAL SERVICES
Sec. 1601. The cost of remedial services incurred by residents
of licensed adult foster care homes and licensed homes for the aged
shall be used in determining financial eligibility for the
medically needy. Remedial services include basic self-care and
rehabilitation training for a resident.
Sec. 1603. (1) The department may establish a program for
individuals to purchase medical coverage at a rate determined by
the department.
(2) The department may receive and expend premiums for the
buy-in of medical coverage in addition to the amounts appropriated
in part 1.
(3) The premiums described in this section shall be classified
as private funds.
(4) The department shall modify program policies to permit
individuals eligible for the transitional medical assistance plus
program, as structured in fiscal year 2009-2010, to access medical
assistance coverage through a 100% cost share.
Sec. 1605. The protected income level for Medicaid coverage
determined pursuant to section 106(1)(b)(iii) of the social welfare
act, 1939 PA 280, MCL 400.106, shall be 100% of the related public
assistance standard.
Sec. 1606. For the purpose of guardian and conservator
charges, the department of community health may deduct up to $60.00
per month as an allowable expense against a recipient's income when
determining medical services eligibility and patient pay amounts.
Sec. 1607. (1) An applicant for Medicaid, whose qualifying
condition is pregnancy, shall immediately be presumed to be
eligible for Medicaid coverage unless the preponderance of evidence
in her application indicates otherwise. The applicant who is
qualified as described in this subsection shall be allowed to
select or remain with the Medicaid participating obstetrician of
her choice.
(2) An applicant qualified as described in subsection (1)
shall be given a letter of authorization to receive Medicaid
covered services related to her pregnancy. All qualifying
applicants shall be entitled to receive all medically necessary
obstetrical and prenatal care without preauthorization from a
health plan. All claims submitted for payment for obstetrical and
prenatal care shall be paid at the Medicaid fee-for-service rate in
the event a contract does not exist between the Medicaid
participating obstetrical or prenatal care provider and the managed
care plan. The applicant shall receive a listing of Medicaid
physicians and managed care plans in the immediate vicinity of the
applicant's residence.
(3) In the event that an applicant, presumed to be eligible
pursuant to subsection (1), is subsequently found to be ineligible,
a Medicaid physician or managed care plan that has been providing
pregnancy services to an applicant under this section is entitled
to reimbursement for those services until such time as they are
notified by the department that the applicant was found to be
ineligible for Medicaid.
(4) If the preponderance of evidence in an application
indicates that the applicant is not eligible for Medicaid, the
department shall refer that applicant to the nearest public health
clinic or similar entity as a potential source for receiving
pregnancy-related services.
(5) The department shall develop an enrollment process for
pregnant women covered under this section that facilitates the
selection of a managed care plan at the time of application.
(6) The department shall mandate enrollment of women, whose
qualifying condition is pregnancy, into Medicaid managed care
plans.
(7) The department shall encourage physicians to provide
women, whose qualifying condition for Medicaid is pregnancy, with a
referral to a Medicaid participating dentist at the first
pregnancy-related appointment.
Sec. 1611. (1) For care provided to medical services
recipients with other third-party sources of payment, medical
services reimbursement shall not exceed, in combination with such
other resources, including Medicare, those amounts established for
medical services-only patients. The medical services payment rate
shall be accepted as payment in full. Other than an approved
medical services co-payment, no portion of a provider's charge
shall be billed to the recipient or any person acting on behalf of
the recipient. Nothing in this section shall be considered to
affect the level of payment from a third-party source other than
the medical services program. The department shall require a
nonenrolled provider to accept medical services payments as payment
in full.
(2) Notwithstanding subsection (1), medical services
reimbursement for hospital services provided to dual
Medicare/medical services recipients with Medicare part B coverage
only shall equal, when combined with payments for Medicare and
other third-party resources, if any, those amounts established for
medical services-only patients, including capital payments.
Sec. 1620. (1) For fee-for-service recipients who do not
reside in nursing homes, the pharmaceutical dispensing fee shall be
$2.75 or the pharmacy's usual or customary cash charge, whichever
is less. For nursing home residents, the pharmaceutical dispensing
fee shall be $3.00 or the pharmacy's usual or customary cash
charge, whichever is less.
(2) The department shall require a prescription co-payment for
Medicaid recipients of $1.00 for a generic drug and $3.00 for a
brand-name drug, except as prohibited by federal or state law or
regulation.
Sec. 1627. (1) The department shall use procedures and rebate
amounts specified under section 1927 of title XIX, 42 USC 1396r-8,
to secure quarterly rebates from pharmaceutical manufacturers for
outpatient drugs dispensed to participants in MIChild, maternal
outpatient medical services program, and children's special health
care services.
(2) For products distributed by pharmaceutical manufacturers
not providing quarterly rebates as listed in subsection (1), the
department may require preauthorization.
Sec. 1629. The department shall utilize maximum allowable cost
pricing for generic drugs that is based on wholesaler pricing to
providers that is available from at least 2 wholesalers who deliver
in the state of Michigan.
Sec. 1630. (1) Medicaid coverage for adult dental and
podiatric services shall continue at not less than the level in
effect on October 1, 2002, except that reasonable utilization
limitations may be adopted in order to prevent excess utilization.
(2) Medicaid coverage for adult chiropractic and vision
services shall continue at not less than the level in effect on
October 1, 2002, except that reasonable utilization limitations may
be adopted in order to prevent excess utilization.
Sec. 1631. (1) The department shall require co-payments on
dental, podiatric, and vision services provided to Medicaid
recipients, except as prohibited by federal or state law or
regulation.
(2) Except as otherwise prohibited by federal or state law or
regulations, the department shall require Medicaid recipients to
pay the following co-payments:
(a) Two dollars for a physician office visit.
(b) Three dollars for a hospital emergency room visit.
(c) Fifty dollars for the first day of an inpatient hospital
stay.
(d) One dollar for an outpatient hospital visit.
Sec. 1641. An institutional provider that is required to
submit a cost report under the medical services program shall
submit cost reports completed in full within 5 months after the end
of its fiscal year.
Sec. 1657. (1) Reimbursement for medical services to screen
and stabilize a Medicaid recipient, including stabilization of a
psychiatric crisis, in a hospital emergency room shall not be made
contingent on obtaining prior authorization from the recipient's
HMO. If the recipient is discharged from the emergency room, the
hospital shall notify the recipient's HMO within 24 hours of the
diagnosis and treatment received.
(2) If the treating hospital determines that the recipient
will require further medical service or hospitalization beyond the
point of stabilization, that hospital shall receive authorization
from the recipient's HMO prior to admitting the recipient.
(3) Subsections (1) and (2) do not require an alteration to an
existing agreement between an HMO and its contracting hospitals and
do not require an HMO to reimburse for services that are not
considered to be medically necessary.
Sec. 1659. The following sections of this act are the only
ones that shall apply to the following Medicaid managed care
programs, including the comprehensive plan, MIChoice long-term care
plan, and the mental health, substance abuse, and developmentally
disabled services program: 404, 411, 418, 428, 474, 494, 1607,
1657, 1662, 1689, 1699, 1740, 1756, 1764, 1815, 1816, 1820, 1835,
1850, 1863, 1880, 1881, and 1882.
Sec. 1662. (1) The department shall assure that an external
quality review of each contracting HMO is performed that results in
an analysis and evaluation of aggregated information on quality,
timeliness, and access to health care services that the HMO or its
contractors furnish to Medicaid beneficiaries.
(2) The department shall require Medicaid HMOs to provide
EPSDT utilization data through the encounter data system, and HEDIS
well child health measures in accordance with the national
committee for quality assurance prescribed methodology.
(3) The department shall provide a copy of the analysis of the
Medicaid HMO annual audited HEDIS reports and the annual external
quality review report to the senate and house of representatives
appropriations subcommittees on community health, the senate and
house fiscal agencies, and the state budget director, within 30
days of the department's receipt of the final reports from the
contractors.
Sec. 1670. (1) The appropriation in part 1 for the MIChild
program is to be used to provide comprehensive health care to all
children under age 19 who reside in families with income at or
below 200% of the federal poverty level, who are uninsured and have
not had coverage by other comprehensive health insurance within 6
months of making application for MIChild benefits, and who are
residents of this state. The department shall develop detailed
eligibility criteria through the medical services administration
public concurrence process, consistent with the provisions of this
act. Health coverage for children in families between 150% and 200%
of the federal poverty level shall be provided through a state-
based private health care program.
(2) The department may provide up to 1 year of continuous
eligibility to children eligible for the MIChild program unless the
family fails to pay the monthly premium, a child reaches age 19, or
the status of the children's family changes and its members no
longer meet the eligibility criteria as specified in the federally
approved MIChild state plan.
(3) Children whose category of eligibility changes between the
Medicaid and MIChild programs shall be assured of keeping their
current health care providers through the current prescribed course
of treatment for up to 1 year, subject to periodic reviews by the
department if the beneficiary has a serious medical condition and
is undergoing active treatment for that condition.
(4) To be eligible for the MIChild program, a child must be
residing in a family with an adjusted gross income of less than or
equal to 200% of the federal poverty level. The department's
verification policy shall be used to determine eligibility.
(5) The department shall enter into a contract to obtain
MIChild services from any HMO, dental care corporation, or any
other entity that offers to provide the managed health care
benefits for MIChild services at the MIChild capitated rate. As
used in this subsection:
(a) "Dental care corporation", "health care corporation",
"insurer", and "prudent purchaser agreement" mean those terms as
defined in section 2 of the prudent purchaser act, 1984 PA 233, MCL
550.52.
(b) "Entity" means a health care corporation or insurer
operating in accordance with a prudent purchaser agreement.
(6) The department may enter into contracts to obtain certain
MIChild services from community mental health service programs.
(7) The department may make payments on behalf of children
enrolled in the MIChild program from the line-item appropriation
associated with the program as described in the MIChild state plan
approved by the United States department of health and human
services, or from other medical services.
(8) The department shall assure that an external quality
review of each MIChild contractor, as described in subsection (5),
is performed, which analyzes and evaluates the aggregated
information on quality, timeliness, and access to health care
services that the contractor furnished to MIChild beneficiaries.
(9) The department shall develop an automatic enrollment
algorithm that is based on quality and performance factors.
(10) MIChild services shall include treatment for autism
spectrum disorders as defined in the federally approved state plan.
Sec. 1673. The department may establish premiums for MIChild
eligible individuals in families with income above 150% of the
federal poverty level. The monthly premiums shall not be less than
$10.00 or exceed $15.00 for a family.
Sec. 1682. (1) The department shall implement enforcement
actions as specified in the nursing facility enforcement provisions
of section 1919 of title XIX, 42 USC 1396r.
(2) In addition to the appropriations in part 1, the
department is authorized to receive and spend penalty money
received as the result of noncompliance with medical services
certification regulations. Penalty money, characterized as private
funds, received by the department shall increase authorizations and
allotments in the long-term care accounts.
(3) The department is authorized to provide civil monetary
penalty funds to the disability network/Michigan to be distributed
to the 15 centers for independent living for the purpose of
assisting individuals with disabilities who reside in nursing homes
to return to their own homes.
(4) The department is authorized to use civil monetary penalty
funds to conduct a survey evaluating consumer satisfaction and the
quality of care at nursing homes. Factors can include, but are not
limited to, the level of satisfaction of nursing home residents,
their families, and employees. The department may use an
independent contractor to conduct the survey.
(5) Any unexpended penalty money, at the end of the year,
shall carry forward to the following year.
Sec. 1684. The department shall submit a report by September
30 of the current fiscal year to the house and senate
appropriations subcommittees on community health, the house and
senate fiscal agencies, and the state budget director that will
identify by waiver agent, Medicaid home- and community-based
services waiver costs by administration, case management, and
direct services.
Sec. 1689. (1) Within 60 days of the end of each fiscal year,
the department shall provide a report to the senate and house
appropriations subcommittees on community health and the senate and
house fiscal agencies that details existing and future allocations
for the home- and community-based services waiver program by
regions as well as the associated expenditures. The report shall
include information regarding the net cost savings from moving
individuals from a nursing home to the home- and community-based
services waiver program, the number of individuals transitioned
from nursing homes to the home- and community-based services waiver
program, the number of individuals on waiting lists by region for
the program, and the amount of funds transferred during the fiscal
year. The report shall also include the number of Medicaid
individuals served and the number of days of care for the home- and
community-based services waiver program and in nursing homes.
(2) The department shall develop a system to collect and
analyze information regarding individuals on the home- and
community-based services waiver program waiting list to identify
the community supports they receive, including, but not limited to,
adult home help, food assistance, and housing assistance services
and to determine the extent to which these community supports help
individuals remain in their home and avoid entry into a nursing
home. The department shall provide a progress report on
implementation to the senate and house appropriations subcommittees
on community health and the senate and house fiscal agencies by
June 1 of the current fiscal year.
Sec. 1692. (1) The department is authorized to pursue
reimbursement for eligible services provided in Michigan schools
from the federal Medicaid program. The department and the state
budget director are authorized to negotiate and enter into
agreements, together with the department of education, with local
and intermediate school districts regarding the sharing of federal
Medicaid services funds received for these services. The department
is authorized to receive and disburse funds to participating school
districts pursuant to such agreements and state and federal law.
(2) From the funds appropriated in part 1 for medical services
school-based services payments, the department is authorized to do
all of the following:
(a) Finance activities within the medical services
administration related to this project.
(b) Reimburse participating school districts pursuant to the
fund-sharing ratios negotiated in the state-local agreements
authorized in subsection (1).
(c) Offset general fund costs associated with the medical
services program.
(3) The department is authorized to increase the appropriation
of federal money in part 1 for medical services school-based
services payments such that reimbursements to participating school
districts can be made as described in subsection (1).
Sec. 1693. The special Medicaid reimbursement appropriation in
part 1 may be increased if the department submits a medical
services state plan amendment pertaining to this line item at a
level higher than the appropriation. The department is authorized
to appropriately adjust financing sources in accordance with the
increased appropriation.
Sec. 1694. (1) The department shall distribute $1,122,300.00
for poison control services to an academic health care system that
includes a children's hospital that has a high indigent care
volume.
(2) By March 1 of the current fiscal year, the department
shall report to the senate and house appropriations subcommittees
on community health and the senate and house fiscal agencies on the
adequacy of the payment described in subsection (1).
Sec. 1699. (1) The department may make separate payments in
the amount of $45,000,000.00 directly to qualifying hospitals
serving a disproportionate share of indigent patients and to
hospitals providing GME training programs. If direct payment for
GME and DSH is made to qualifying hospitals for services to
Medicaid clients, hospitals shall not include GME costs or DSH
payments in their contracts with HMOs.
(2) The department shall allocate $45,000,000.00 in DSH
funding using the distribution methodology used in fiscal year
2003-2004.
(3) By September 30 of the current fiscal year, the department
shall report to the senate and house appropriations subcommittees
on community health and the senate and house fiscal agencies on the
new distribution of funding to each eligible hospital from the GME
and DSH pools.
Sec. 1724. The department shall allow licensed pharmacies to
purchase injectable drugs for the treatment of respiratory
syncytial virus for shipment to physicians' offices to be
administered to specific patients. If the affected patients are
Medicaid eligible, the department shall reimburse pharmacies for
the dispensing of the injectable drugs and reimburse physicians for
the administration of the injectable drugs.
Sec. 1740. From the funds appropriated in part 1 for health
plan services, the department shall assure that all GME funds
continue to be promptly distributed to qualifying hospitals using
the methodology developed in consultation with the graduate medical
education advisory group during fiscal year 2006-2007.
Sec. 1741. The department shall continue to provide nursing
homes the opportunity to receive interim payments upon their
request. The department may disapprove requests or discontinue
interim payments that result in financial risk to this state. The
department shall make reasonable efforts to ensure that the interim
payments are as similar in amount to expected cost-settled
payments.
Sec. 1756. The department's plan for beneficiary monitoring
within each Medicaid health plan shall attempt to make rate
adjustments consistent with provider rate adjustments authorized
under the Medicaid fee-for-service program.
Sec. 1757. The department shall direct the department of human
services to obtain proof from all Medicaid recipients that they are
legal United States citizens or otherwise legally residing in this
country and that they are residents of this state before approving
Medicaid eligibility.
Sec. 1764. The department shall annually certify rates paid to
Medicaid health plans and specialty prepaid inpatient health plans
as being actuarially sound in accordance with federal requirements
and shall provide a copy of the rate certification and approval
immediately to the house and senate appropriations subcommittees on
community health and the house and senate fiscal agencies. The
department shall consider, in the case of Medicaid policy bulletins
affecting Medicaid health plans issued after the federal approval
of rates, including an economic analysis of the impact of the
approved rates on the Medicaid health plans.
Sec. 1770. In conjunction with the consultation requirements
of the social welfare act, 1939 PA 280, MCL 400.1 to 400.119b, and
except as otherwise provided in this section, the department shall
attempt to make the effective date for a proposed Medicaid policy
bulletin or adjustment to the Medicaid provider manual on October
1, January 1, April 1, or July 1 after the end of the consultation
period. The department may provide an effective date for a proposed
Medicaid policy bulletin or adjustment to the Medicaid provider
manual other than provided for in this section if necessary to be
in compliance with federal or state law, regulations, or rules or
with an executive order of the governor.
Sec. 1775. If the state's application for a waiver to
implement managed care for dual Medicare/Medicaid eligibles is
approved by the federal government, the department shall provide
quarterly reports to the senate and house appropriations
subcommittees on community health and the senate and house fiscal
agencies on progress in implementing the waiver.
Sec. 1777. From the funds appropriated in part 1 for long-term
care services, the department shall permit, in accordance with
applicable federal and state law, nursing homes to use dining
assistants to feed eligible residents if legislation to permit the
use of dining assistants is enacted into law. The department shall
not be responsible for costs associated with training dining
assistants.
Sec. 1793. The department shall consider the development of a
pilot project that focuses on the prevention of preventable
hospitalizations from nursing homes.
Sec. 1804. The department, in cooperation with the department
of human services and the department of military and veterans
affairs, shall work with the federal public assistance reporting
information system to identify Medicaid recipients who are veterans
and who may be eligible for federal veterans health care benefits
or other benefits.
Sec. 1815. From the funds appropriated in part 1 for health
plan services, the department shall not implement a capitation
withhold as part of the overall capitation rate schedule that
exceeds the 0.19% withhold administered during fiscal year 2008-
2009.
Sec. 1816. The department shall work with the Michigan
association of health plans to develop and implement strategies for
the use of information technology services for claims payment,
claims status, and related functions.
Sec. 1820. (1) In order to avoid duplication of efforts, the
department shall utilize applicable national accreditation review
criteria to determine compliance with corresponding state
requirements for Medicaid health plans that have been reviewed and
accredited by a national accrediting entity for health care
services.
(2) Upon submission by Medicaid health plans of a listing of
program requirements that are part of the state program review
criteria but are not reviewed by an applicable national accrediting
entity, the department shall review the listing and provide a
recommendation to the house and senate appropriations subcommittees
on community health, the house and senate fiscal agencies, and the
state budget office as to whether or not state program review
should continue. The Medicaid health plans may request the
department to convene a workgroup to fulfill this section.
(3) The department shall continue to comply with state and
federal law and shall not initiate an action that negatively
impacts beneficiary safety.
(4) As used in this section, "national accrediting entity"
means the national committee for quality assurance, the utilization
review accreditation committee, or other appropriate entity, as
approved by the department.
(5) By July 1 of the current fiscal year, the department shall
provide a progress report to the house and senate appropriations
subcommittees on community health, the house and senate fiscal
agencies, and the state budget office on implementation of this
section.
Sec. 1822. The department, the department's contracted
Medicaid pharmacy benefit manager, and all Medicaid health plans
shall implement coverage for a mental health prescription drug
within 30 days of that drug's approval by the department's pharmacy
and therapeutics committee.
Sec. 1832. (1) The department shall continue efforts to
standardize billing formats, referral forms, electronic
credentialing, primary source verification, electronic billing and
attachments, claims status, eligibility verification, and reporting
of accepted and rejected encounter records received in the
department data warehouse.
(2) The department shall convene a workgroup on
standardization for the Medicaid program. The workgroup shall
include representatives from medical provider organizations,
Medicaid HMOs, the Michigan association of health plans, and the
department. The department shall report to the legislature on the
findings of the workgroup by April 1 of the current fiscal year.
(3) The department shall provide a report by April 1 of the
current fiscal year to the senate and house appropriations
subcommittees on community health and the senate and house fiscal
agencies detailing the percentage of claims for Medicaid
reimbursement provided to the department that were initially
rejected in the first quarter of fiscal year 2013-2014 and the
percentage of Medicaid health plan encounters rejected during the
same period.
Sec. 1835. The department shall develop and implement
processes to report rejected and accepted encounters to Medicaid
health plans. Medicaid health plans shall be permitted to report
additional medical records obtained during the medical record
audits to the encounter warehouse consistent with Medicare
guidelines. The department shall further enhance encounter data
reporting processes and program rules that make each health plan's
encounter data as complete as possible, provide a fair measure of
acuity for each health plan's enrolled population for risk
adjustment purposes, and minimize health plan administrative
expenses.
Sec. 1837. The department shall explore utilization of
telemedicine and telepsychiatry as strategies to increase access to
services for Medicaid recipients in medically underserved areas.
Sec. 1842. (1) Subject to the availability of funds, the
department shall adjust the hospital outpatient Medicaid
reimbursement rate for qualifying hospitals as provided in this
section. The Medicaid reimbursement rate for qualifying hospitals
shall be adjusted to provide each qualifying hospital with its
actual cost of delivering outpatient services to Medicaid
recipients.
(2) As used in this section, "qualifying hospital" means a
hospital that has not more than 50 staffed beds and is either
located outside a metropolitan statistical area or in a
metropolitan statistical area but within a city, village, or
township with a population of not more than 12,000 according to the
official 2000 federal decennial census and within a county with a
population of not more than 165,000 according to the official 2000
federal decennial census.
Sec. 1846. (1) The department shall conduct research on the
effectiveness of graduate medical education funding.
(2) The research shall do all of the following:
(a) Identify physician shortages by practice and geographic
area.
(b) Consider efforts by other states to use graduate medical
education funding to address shortages.
(c) Consider policy changes to the graduate medical education
program to reduce practitioner shortages.
(3) The department shall report the results of the research to
the senate and house appropriations subcommittees on community
health, the senate and house fiscal agencies, and the state budget
director by April 1 of the current fiscal year.
Sec. 1847. The department shall meet with the Michigan
association of ambulance services to discuss the possible structure
of an ambulance quality assurance assessment program.
Sec. 1850. The department may allow Medicaid health plans to
assist with the redetermination process through outreach activities
to ensure continuation of Medicaid eligibility and enrollment in
managed care. This may include mailings, telephone contact, or
face-to-face contact with beneficiaries enrolled in the individual
Medicaid health plan. Health plans may offer assistance in
completing paperwork for beneficiaries enrolled in their plan.
Sec. 1854. The department shall work with a provider of kidney
dialysis services and renal care as authorized under section 2703
of the patient protection and affordable care act, Public Law 111-
148, to develop a chronic condition health home program for
Medicaid enrollees identified with chronic kidney disease and who
are beginning dialysis. When initiated, the department shall
develop metrics that evaluate program effectiveness and submit a
report by June 1 of the current fiscal year to the senate and house
appropriations subcommittees on community health. Metrics shall
include cost savings and clinical outcomes.
Sec. 1855. From the funds appropriated in part 1 for health
plan services, the department shall implement a revenue-neutral
financially risk-averse Medicaid patient logistics optimization
solution for the support of emergency room redirection for
nonemergent patients. Such alternatives may be coordinated with the
Medicaid health plans and the Michigan association of health plans.
Sec. 1857. It is the intent of the legislature that the
department not reduce Medicaid reimbursement for wheelchairs.
Sec. 1858. Medicaid services shall include treatment for
autism spectrum disorders as defined in the federally approved
Medicaid state plan. Such alternatives may be coordinated with the
Medicaid health plans and the Michigan association of health plans.
Sec. 1861. Nonemergency medical transportation services
offered to Medicaid recipients may be competitively bid and may
take into consideration a minimum of 2 bids by qualified vendors, 1
of which must be a public transportation agency where such agencies
offer service. For the purpose of this section, "qualified vendor"
means a transportation provider that either meets or exceeds the
quality and safety standards of public transportation agencies,
including, but not limited to, ongoing training requirements for
motor vehicle operators including training on passenger safety,
passenger assistance, and assistive devices, including wheelchair
lifts, tie-down equipment, and child safety seats. In addition, a
qualified vendor shall be able to document that all drivers have
complied with all state licensing regulations and that they have
passed a criminal background check and successfully passed a drug
screening test.
Sec. 1862. From the funds appropriated in part 1, the
department shall continue the 20% reimbursement rate increase for
Medicaid obstetrical services.
Sec. 1863. For the purposes of the next rebidding of contracts
with Medicaid health plans, the department shall study the
possibility of excluding health plans that score in the lowest
quartile on quality indicators from eligibility to bid.
Sec. 1865. Upon federal approval of the department's proposal
for integrated care for individuals who are dual Medicare/Medicaid
eligibles, the department shall provide the senate and house
appropriations subcommittees on community health and the senate and
house fiscal agencies its plan and organizational chart for
administering and providing oversight of this proposal. The plan
shall include information on how the department intends to organize
staff in an integrated manner to ensure that key components of the
proposal are implemented effectively.
Sec. 1866. (1) From the funds appropriated in part 1 for
hospital services and therapy, $12,000,000.00 in general
fund/general purpose revenue and any associated federal match shall
be awarded to hospitals that meet criteria established by the
department for services to low-income rural residents.
(2) No hospital or hospital system shall receive more than
5.0% of the total funding referenced in subsection (1).
(3) The department shall report to the senate and house
appropriations subcommittees on community health and the senate and
house fiscal agencies on the distribution of funds referenced in
subsection (1) by April 1 of the current fiscal year.
Sec. 1867. (1) In addition to the appropriations in part 1,
the department may receive and spend revenue from the Michigan-
Illinois alliance Medicaid management information systems project
with the approval of the state budget director. Upon approval, the
state budget director shall authorize the allotment of these funds
and, if appropriate, identify and unallot any associated general
fund appropriations that can be reduced due to revenues received
from this initiative.
(2) The department shall prepare a quarterly report to the
senate and house community health appropriations subcommittees, the
senate and house fiscal agencies, and the state budget director
identifying any revenue received and spent under the authority in
this section.
Sec. 1869. From the funds appropriated in part 1 for health
plan services, $100.00 shall be allocated to support a school-based
clinic in Kalamazoo County.
Sec. 1870. (1) The department shall work in collaboration with
medical school-affiliated faculty practice physician groups that
are capable of developing freestanding residency programs to create
a Michigan graduate medical education consortium. The consortium
shall develop accredited physician-based primary care graduate
medical education programs to enhance the training of primary care
physicians in Michigan. The consortium shall provide an actionable
plan to the legislature no later than March 31 of the current
fiscal year.
(2) The department shall explore seeking a federal waiver to
implement a program similar to the Utah Medicare graduate medical
education demonstration project.
Sec. 1871. The department shall work with the board of
pharmacy to develop and publish a list of tamper-resistant
formulated controlled substances, including schedules II and III,
for which information has been submitted by the manufacturer of
such a product. Inclusion of a drug on the registry shall not
require that a drug bear a labeling claim with respect to reduction
of tampering, abuse, or abuse potential at the time of listing.
Such a listing may also include a determination by the department
as to which listed controlled substance incorporating tamper-
resistant formulation technology may provide substantially similar
tamper-resistant properties, based solely upon studies submitted by
the drug manufacturer. The department shall distribute this
registry once a year to all pharmacies authorized to dispense
controlled substances and to all dispensing prescribers authorized
to dispense controlled substances.
Sec. 1872. The department shall consider creating a pilot
program to prevent or reduce the costs associated with lower
extremity diabetic care, ulcerations, and amputations. If such a
pilot program is created, the department shall work with the
Michigan podiatric medical association to improve the quality of
lower extremity diabetic care.
Sec. 1873. The department shall establish a workgroup to
discuss new ways to distribute hospital funding through the
Michigan access to care initiative, the hospital rate adjustor
payments, and the quality assurance assessment program. The
department shall report to the senate and house subcommittees on
community health on the findings of the workgroup by April 1 of the
current fiscal year.
Sec. 1874. The department shall explore ways to work with
private providers to develop fraud management solutions to reduce
fraud, waste, and abuse in this state's Medicaid program.
Sec. 1875. The department may seek to expand home- and
community-based services and seek enhanced match funding pursuant
to federal law.
Sec. 1876. From the funds appropriated in part 1 for personal
care services, $100.00 shall be allocated to increase the personal
care services payment rate.
Sec. 1877. The department shall explore requesting a federal
waiver to implement alternative design and funding models for the
Medicaid program.
Sec. 1878. In any project negotiated with the federal
government for integrated health care of individuals dually
enrolled in Medicaid and Medicare, the department shall seek to
assure the existence of an ombudsman program that is not associated
with any project service manager or provider. For activities to be
undertaken by the ombudsman program, the department shall include,
but is not limited to, assisting beneficiaries with navigating
complaint and dispute resolution mechanisms, identifying problems
in the project's complaint and dispute resolution mechanisms, and
reporting to the executive and legislative branches on any such
problems and potential solutions for them.
Sec. 1879. In any program of integrated service for persons
dually enrolled in Medicaid and Medicare that the department
negotiates with the federal government, the department shall seek
to use the Medicare Part D benefit for prescription drug coverage,
and shall seek not to institute any deviations from existing
federal law, rules, and policies pertaining to the Medicare Part D
benefit.
Sec. 1880. The department shall establish the contract
performance standards for Medicaid health plans reasonably in
advance of the application of those standards. The determination of
performance shall be based on recognized concepts such as 1-year
continuous enrollment and the HEDIS audited data.
Sec. 1881. The department shall create a default eligibility
and enrollment determination for newborns so that newborns are
assigned to the same Medicaid health plan as the mother at the time
of birth.
Sec. 1882. For the purposes of Medicaid third-party
collections by Medicaid health plans, each contracting Medicaid
health plan is considered an agent of the department in order to
access other carrier data that are otherwise provided to the
department.
Sec. 1883. For the purposes of more effectively managing
inpatient care for Medicaid health plans and Medicaid fee-for-
service, the department shall consider developing an appropriate
policy and rate for observation stays.
Sec. 1884. (1) By April 1 of the current fiscal year, the
department shall establish and implement a bid process to identify
a Michigan vendor to provide benefit administration for durable
medical equipment, prosthetics, orthotics, and supplies for those
Medicaid clients enrolled in fee-for-service Medicaid. Any current
contracts with the state covering Medicaid and Medicare programs
are exempt from this process. The vendor shall be a licensed third
party administrator in good standing, with experience in the
administration of durable medical equipment, prosthetics,
orthotics, and supplies benefits, and shall at a minimum provide
utilization management, claims and benefit administration, and
provider network management.
(2) The department shall not award a contract for the services
described in subsection (1) unless the contract will lead to at
least a 10% savings in durable medical equipment, prosthetics,
orthotics, and supplies costs.
Sec. 1885. (1) The department shall implement a study to
examine a statistically significant sample of Medicaid claims
information to help estimate the impact of gestational diabetes and
reduce the impact of the condition on the Medicaid program. The
study shall include all of the following elements:
(a) An estimate of the average cost of a case of gestational
diabetes in comparison to the cost of a noncomplicated pregnancy
and the cost of pregnancy for a woman with diabetes.
(b) An estimate of the percentage and number of pregnant women
screened for gestational diabetes per established medical criteria.
(c) An estimate of the percentage and number of pregnant women
diagnosed with gestational diabetes in the Medicaid program each
year.
(2) The department shall submit a report to the senate and
house appropriations subcommittees on community health by September
30 of the current fiscal year. The report shall include all of the
following information:
(a) The information gathered in the study described in
subsection (1).
(b) Steps taken and proposed to increase the screening rate
for gestational diabetes within Medicaid, to reduce the number of
Medicaid-eligible women with undiagnosed gestational diabetes
giving birth, to increase the number of pregnant women with
gestational diabetes receiving appropriate medical care, and to
improve the health of unborn and newborn children of women
diagnosed with gestational diabetes.
Sec. 1886. The department shall conduct a workgroup in
conjunction with the department of human services to determine how
the state can maximize Medicaid claims for community-based and
outpatient treatment services to foster care children and
adjudicated youths who are placed in community-based treatment
programs. The department shall report to the senate and house and
appropriations subcommittees on community health, the senate and
house fiscal agencies, the senate and house policy offices, and the
state budget office by March 1 of the current fiscal year on the
findings of the workgroup.
PART 2A
PROVISIONS CONCERNING ANTICIPATED APPROPRIATIONS
FOR FISCAL YEAR 2014-2015
GENERAL SECTIONS
Sec. 2001. It is the intent of the legislature to provide
appropriations for the fiscal year ending on September 30, 2015 for
the line items listed in part 1. The fiscal year 2014-2015
appropriations are anticipated to be the same as those for fiscal
year 2013-2014, except that the line items will be adjusted for
changes in caseload and related costs, federal fund match rates,
economic factors, and available revenue. These adjustments will be
determined after the January 2014 consensus revenue estimating
conference.
Sec. 2002. It is the intent of the legislature that the
department identify the amounts for normal retirement costs and
legacy retirement costs for the fiscal year ending on September 30,
2015 for the line items listed in part 1.
