2024 House Bill 5556

Appropriations: department of health and human services; appropriations for fiscal year 2024-2025; provide for.

A bill to make appropriations for the department of health and human services for the fiscal year ending September 30, 2025; and to provide for the expenditure of the appropriations.

Introduced in the House

March 12, 2024

Introduced by Reps. Christine Morse (D-40) and Christine Morse (D-40)

Referred to the Committee on Appropriations

May 1, 2024

Reported with substitute H-2

May 8, 2024

Substitute H-2 concurred in by voice vote

Amendment offered by Rep. Donni Steele (R-54)

1. Amend page 177, following line 13, by inserting:

“Sec. 1877. The department must align all pharmacy-related policies with the United States Food and Drug Administration quality and clinical standards.”.

The amendment failed by voice vote

Amendment offered by Rep. Sarah Lightner (R-45)

1. Amend page 36, following line 4, by inserting:

“Sec. 213. The department shall maintain, on a publicly accessible website, information that identifies, tracks, and regularly updates key metrics that are used to monitor and improve the department’s performance.”.

2. Amend page 43, following line 23, by inserting:

“Sec. 233. If the state administrative board, acting under section 3 of 1921 PA 2, MCL 17.3, transfers funds from an amount appropriated under this part or part 1, the legislature may, by a concurrent resolution adopted by a majority of the members elected to and serving in each house, inter-transfer funds within this part or part 1 for the particular department, board, commission, officer, or institution.”.

3. Amend page 44, following line 6, by inserting:

“Sec. 236. (1) From the funds appropriated in part 1, the department shall do the following:

(a) Report any amounts of severance pay for a department director, deputy director, or other high-ranking department official not later than 14 days after a severance agreement with the director or official is signed. The name of the director or official and the amount of severance pay must be included in the report required by this subdivision.

(b) Not later than February 1, report on the total amount of severance pay remitted to former department employees during the previous fiscal year and the total number of former department employees that were remitted severance pay during the previous fiscal year.

(2) Reports required by this section must be submitted to the standard report recipients and to the senate and house appropriations committees.

(3)As used in this section, “severance pay” means compensation that is both payable or paid on the termination of employment and in addition to either wages or benefits earned during the course of employment or generally applicable retirement benefits.”.

The amendment failed by voice vote

Amendment offered by Rep. Ann Bollin (R-49)

1. Amend page 45, following line 15, by inserting:

“Sec. 245. Not later than August 1 of the current fiscal year, the department shall submit a report to the standard report recipients that provides a listing of all current work project accounts and the following information related to each current work project account:

(a) The original work project amount.

(b) A detailed accounting of expenditures to date.

(c) The balance of the work project account.

(d) The intended use of remaining funds in the work project account.

(e) The expected completion date of the work project.”.

The amendment failed by voice vote

Amendment offered by Rep. Doug Wozniak (R-59)

1. Amend page 45, following line 15, by inserting:

“Sec. 246. Appropriations in part 1 from state and federal sources are prohibited from being used to provide services, grants, or programming to individuals who are not citizens of the United States unless the recipient is a qualified alien under 8 USC 1641.”.

The amendment failed by voice vote

Amendment offered by Rep. Greg VanWoerkom (R-88)

1. Amend page 45, following line 15, by inserting:

“Sec. 250. (1) Any funds appropriated in part 1 that are utilized for grants or grant programs are subject to the following conditions:

(a) Grant funds shall only be provided to an entity that has been established or operating in this state or another state for more than 2 years prior to approval or disbursement of the grant.

(b) Grant funds shall only be provided to an entity that has had an office within this state or in the service area covered under any grant for at least 6 months prior to approval or disbursement of the grant.

(c) Prior to the disbursement or awarding of any grant, all grant recipients must provide a spending plan specifying how all grant funds would be used and if any grant funds would be provided to a third party or subrecipient.

(d) Each department or agency responsible for the disbursement or awarding of grant funds must audit the entity’s use of the grant funds for each fiscal year in which the grant is active.

(e) Grant recipients and their immediate family members are prohibited from being employed by the executive branch or legislative branch of this state. In addition, grant recipients are prohibited from serving on any state board that has direct or indirect responsibility for the approval or auditing of grant funds disbursed by any department or agency.

(f) Full and complete audits of grant funds issued by a department or agency of this state, without redaction unless required by law, must be posted to a department or agency website in a conspicuous place for public review.

(2) On a quarterly basis, the department shall submit a report to the standard reporting recipients on legislatively-sponsored grant funds that includes, but is not limited to, all of the following:

(a) The status of each grant.

(b) The amount distributed to each grant.

(c) The remaining amount to be distributed to each grant.”.

The amendment failed by voice vote

Amendment offered by Rep. Thomas Kuhn (R-57)

1. Amend page 152, following line 20, by inserting:

“(2) When seeking federal authority to implement a transitional Medicaid benefit for incarcerated individuals, the department must make all efforts to ensure the department receives federal approval to make the transitional Medicaid benefit for incarcerated individuals available to county jails by not later than the second year of the waiver demonstration.” and renumbering remaining subsections accordingly.

The amendment failed by voice vote

Amendment offered by Rep. Donni Steele (R-54)

1. Amend page 98, following line 3, by inserting:

“Sec. 710. The department shall provide, to the standard report recipients, notification of completion of any inspection or investigation and resolution of any current Michigan Occupational Safety and Health Administration (MIOSHA) complaints against Shawono Center not later than 7 days after closure or resolution of complaints.”.

The amendment failed by voice vote

Amendment offered by Rep. Bradley Slagh (R-85)

1. Amend page 8, line 12, after “1.0” by striking out “57,500,000” and inserting “50,000,000” and adjusting the subtotals, totals, and section 201 accordingly.

The amendment failed by voice vote

Amendment offered by Rep. Donni Steele (R-54)

1. Amend page 111, following line 15, by inserting:

“(h) The department must work with the opioid advisory commission established in 2022 PA 84, MCL 4.1851, the align the remaining funds allocated in subsection (1) with the funding and programmatic recommendations of the opioid advisory commission.”.

The amendment failed by voice vote

Amendment offered by Rep. Phil Green (R-67)

1. Amend page 8, line 1, after “$” by striking out “38,813,500” and inserting “8,813,500”.

2. Amend page 8, line 22, after “families” by striking out “132,538,100” and inserting “114,106,200” and adjusting the subtotals, totals, and section 201 accordingly.

The amendment failed by voice vote

Amendment offered by Rep. Ann Bollin (R-49)

1. Amend page 23, by striking out all of line 10 and adjusting the subtotals, totals, and section 201 accordingly.

2. Amend page 189, line 4, by striking out all of section 1950.

The amendment failed by voice vote

Amendment offered by Rep. Thomas Kuhn (R-57)

1. Amend page 24, by striking out all of line 16, and adjusting the subtotals, totals, and section 201 accordingly.

2. Amend page 204, line 11, by striking out all of section 2008.

The amendment failed by voice vote

Amendment offered by Rep. Phil Green (R-67)

1. Amend page 93, following line 28, by inserting:

“(f) The number of cases sanctioned because of the school truancy policy.”.

The amendment failed by voice vote

Amendment offered by Rep. Jamie Thompson (R-28)

1. Amend page 129, following line 19, by inserting:

“(s) The number of complaints received by the department from patients, parents, and guardians along with the number of those complaints that were determined to be substantiated at the center for forensic psychiatry and each state-operated hospital or center.”.

The amendment failed by voice vote

Amendment offered by Rep. Donni Steele (R-54)

1. Amend page 167, line 4, after “plans.” by inserting “If the evaluation results of this section show costs trending higher than anticipated in the current fiscal year rate setting process, the department must adjust rates accordingly by not later than July 30 of the current fiscal year.”.

The amendment failed by voice vote

Amendment offered by Rep. Ann Bollin (R-49)

1. Amend page 24, striking out all of line 6.

2. Amend page 24, following line 16, by inserting.

“Weatherization assistance - IIJA

5,000,000”

and adjusting the subtotals, totals, and section 201 accordingly.

3. Amend page 201, line, 24, by striking out all of section 1992.

4. Amend page 204, following line 16, by inserting:

“Sec. 2010. (1) From the funds appropriated in part 1 for weatherization assistance – IIJA, the department shall allocate $5,000,000.00 in general fund/general purpose revenue to reduce energy costs for low-income families.

(2) The unexpended funds appropriated in part 1 for weatherization assistance - IIJA are designated as a work project appropriation. Unencumbered or unallotted funds shall not lapse at the end of the fiscal year and shall be available for expenditures under this section until the project has been completed. 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 is to reduce energy costs for low-income families, particularly for the elderly, people with disabilities, and children, while ensuring their health and safety.

(b) The project will be accomplished by utilizing state employees or contracts.

(c) The total estimated cost of the project is $5,000,000.00.

(d) The tentative completion date is September 30, 2029.”.

The amendment failed by voice vote

Amendment offered by Rep. Donni Steele (R-54)

1. Amend page 24, following line 15, by inserting:

“Vital data technology platform

1,000,000”

and adjusting the subtotals, totals, and section 201 accordingly.

2. Amend page 204, following line 16, by inserting:

“Sec. 2008. From the funds appropriated in part 1 for vital data technology platform, the department shall allocate $1,000,000.00 to create a real-time unified medical and behavioral health record platform that can be shared with medical and behavioral health stakeholders across the state, including, but not limited to CMHSPs, Medicaid health plans, providers, and a public and private nonprofit collaboration that is designated as this state’s statewide health information exchange by cooperative agreement.” And renumbering remaining sections accordingly.

The amendment failed by voice vote

Amendment offered by Rep. Gina Johnsen (R-78)

1. Amend page 23, by striking all of line 12 and adjusting the subtotals, totals, and section 201 accordingly.

2. Amend page 191, line 1, by striking out all of section 1954.

The amendment failed by voice vote

Amendment offered by Rep. Cameron Cavitt (R-106)

1. Amend page 23, by striking out all of line 11 and adjusting the subtotals, totals, and section 201 accordingly.

2. Amend page 189, line 23, by striking out all of section 1952.

The amendment failed by voice vote

Amendment offered by Rep. Ken Borton (R-105)

1. Amend page 20, line 28, after “services” by striking out “2,406,027,000” and inserting “2,392,027,000” and adjusting the subtotals, totals, and section 201 accordingly.

2. Amend page 159, line 25, by striking out all of section 1645.

The amendment failed by voice vote

Amendment offered by Rep. Doug Wozniak (R-59)

1. Amend page 8, line 3, after “program” by striking out “80,877,500” and inserting “52,522,100”.

2. Amend page 8, line 22, after “families” by striking out “132,538,100” and inserting “104,182,700” and adjusting the subtotals, totals, and section 201 accordingly.

3. Amend page 93, line 25, after the second “of” by inserting “the 48-month and 60-month”.

4. Amend page 93, following line 28, by inserting:

“(f) The number of cases sanctioned because of the school truancy policy.”.

The amendment failed by voice vote

Amendment offered by Rep. Brad Paquette (R-37)

1. Amend page 19, line 14, after “$” by striking out “60,706,900” and inserting “65,706,800” and adjusting the subtotals, totals, and section 201 accordingly.

2. Amend page 150, following line 21, by inserting:

“Sec. 1422. From the funds appropriated in part 1 for community services, the department shall allocate an additional $5,000,000.00 to support area agencies on aging for the continued development of caregiver resource centers, caregiver educational opportunities, and supports with a focus on health equity.”

The amendment failed by voice vote

Amendment offered by Rep. Luke Meerman (R-89)

1. Amend page 23, following line 19, by inserting:

“Kinship care

313,300”

and adjusting the subtotals, totals, and section 201 accordingly.

2. Amend page 194, following line 12, by inserting:

“Sec. 1967. From the funds appropriated in part 1 for kinship care, the department shall allocate $313,300.00 to establish a family finding pilot program in a county with a population between 175,000 and 176,000 according to the most recent federal decennial census with the objective of locating and engaging family members of foster children for the purposes of adoption. Funding shall be used for program staffing costs.”.

The amendment failed by voice vote

Amendment offered by Rep. Luke Meerman (R-89)

1. Amend page 5, line 22, after “FTEs” by striking out “218.2” and inserting “219.2”.

2. Amend page 5, line 22, after “218.2” by striking out “28,681,400” and inserting “28,781,400” and adjusting the subtotals, totals, and section 201 accordingly.

3. Amend page 76, line 13, after “allocate” by striking out “$200,000.00” and inserting “$300,000.00”.

4. Amend page 76, line 15, after “council” by inserting “and 1.0 full-time staff person”.

The amendment failed by voice vote

Amendment offered by Rep. Luke Meerman (R-89)

1. Amend page 150, following line 23, by inserting:

“Sec. 1502. (1) Michigan Medicaid shall contract with a third-party entity to apply a medication risk reduction model 2-year pilot program using 2 voluntary members from the Michigan Medicaid managed care health plans. The model pilot program must be provided under the Medicaid program for the purpose of identifying and reducing simultaneous, multi-drug medication-related risk and adverse drug events, enhancing compliance and quality of care, and improving health-related outcomes while reducing total cost of care in a measurable and reportable manner.

(2) In carrying out this purpose, the model pilot program, at a minimum, shall leverage both retrospective and ongoing Medicaid prescription drug and medical claims data, using technology that has the capability of providing a simultaneous multi-drug analysis using pharmacokinetic and pharmacodynamic sciences, and assessing cumulative effects of taking multiple prescription medications, including over-the-counter medications, herbals, and supplements to illuminate simultaneous, multi-drug interactions.

(3) The model pilot program must be administered using health plan-employed pharmacists, and vendor call centers, pursuant to vendor requirements that are certified to deliver medication safety reviews using simultaneous, multi-drug interaction analysis tools and has previous experience in saving medical costs through proven results. The model pilot program must be constructed as a value-based contract, so that this state shares savings realized with the Michigan Medicaid managed care health plans, by which the vendor has proven experience in conducting a retrospective, pre-post, cohort study that evaluated the outcomes of beneficiaries in cohorts: one that received medication safety reviews and a comparable group that did not.

(4) By September 30 of the current fiscal year, the department shall evaluate the vendor’s return on investment and program-related state savings. The evaluation conducted pursuant to this section shall be reported to the standard report recipients upon its completion.”.

The amendment failed by voice vote

Amendment offered by Rep. Cameron Cavitt (R-106)

1. Amend page 24, by striking out all of lines 11 and 12 and adjusting the subtotals, totals, and section 201 accordingly.

2. Amend page 203, line 5, by striking out all of section 2000.

The amendment failed by voice vote

Amendment offered by Rep. Thomas Kuhn (R-57)

1. Amend page 11, following line 7, by inserting:

“Narcotics awareness program

5,000,000”

and adjusting the subtotals, totals, and section 110 accordingly.

2. Amend page 23, by striking out all of line 25, and adjusting the subtotals, totals, and section 201 accordingly.

3. Amend page 106, following line 21, by inserting:

“Sec. 906. (1) From the funds appropriated in part 1 for narcotics awareness program, the department shall allocate $5,000,000.00 to a nonprofit organization organized under the laws of this state that is exempt from federal income tax under section 501(c)(3) of the internal revenue code of 1986, 26 USC 501, and with a headquarters in a charter township with a population between 100,000 and 105,000 in a county with a population between 700,000 and 1,000,000, according to the most recent federal decennial census. To be eligible to receive funding, the nonprofit organization must have a state mission to offer community-based, compassionate, best-practice/evidence-based services to those suffering from addiction, as well as to their loved ones, and to erase the stigma of addiction and instill compassion and hope.

(2) The unexpended funds appropriated in part 1 for narcotics awareness program are designated as a work project appropriation. Unencumbered or unallotted funds shall not lapse at the end of the fiscal year and shall be available for expenditure under this section until the project has been completed. The following are in compliance with section 451a of the management and budget act, 1984 PA 431, MCL 18.1451a:

(a) The purpose of the work project is to offer community-based, compassionate, best-practice/evidence-based services to those suffering from addiction, as well as to their loved ones, and to erase the stigma of addiction and instill compassion and hope.

(b) The work project will be accomplished by a nonprofit organization that is exempt from federal income tax under section 501(c)(3) of the internal revenue code of 1986, 26 USC 501.

(c) The estimated cost of the work project is $5,000,000.00.

(d) The tentative completion date is September 30, 2029.”.

4. Amend page 196, line 21, by striking out all of section 1976.

The amendment failed by voice vote

Amendment offered by Rep. Jaime Greene (R-65)

1. Amend page 20, line 26, after “therapy” by striking out “616,810,800” and inserting “603,110,800”.

2. Amend page 21, line 17, after “revenues” by striking out “15,811,314,700” and inserting “15,802,391,900” and adjusting the subtotals, totals, and section 201 accordingly.

The amendment failed by voice vote

Amendment offered by Rep. Christine Morse (D-40)

1. Amend page 169, following line 14, by inserting:

“Sec. 1805. The department shall modify Medicaid policy in the Medicaid Manual, Nursing Facility Chapter, Certification, Survey and Enforcement Appendix, Section 2.3 and submit a Medicaid state plan amendment to CMS to seek approval to allow the department to approve or deny any application seeking Medicaid bed certification and provider enrollment for dual certification of Medicare-only beds. The modified Medicaid policy must replace the current certification criteria. The modified Medicaid policy must provide that the department grant Medicaid bed certification if the application meets all of the following:

(a) A verification from the state survey agency that the beds listed in the applications are Medicare-certified.

(b) The state survey agency finds that the facility named in the application is in substantial compliance with federal regulations at the time of application.

(c) If there is an accepted submitted plan of correction for any survey activity occurring following the date of the application submission, the facility named in the application will be deemed to have satisfactory survey performance.”.

The amendment passed by voice vote

Amendment offered by Rep. Nate Shannon (D-58)

1. Amend page 23, following line 12, by inserting:

“Firefighter health care

3,500,000”

and adjusting the subtotals, totals, and section 201 accordingly.

2. Amend page 191, following line 8, by inserting:

“Sec. 1955. From the funds appropriated in part 1 for firefighter health care, the department shall allocate $3,500,000.00 for health screenings for firefighters. To be eligible for funding under this section, the entity must only request funding for a health screening of a firefighter that is employed and compensated on a full-time basis and the entity is 1 the following:

(a) A fire department of an airport operated by a county, public airport authority, or state university or college.

(b) A fire department of a city, township, or village.

(c) A public fire authority.”.

The amendment passed by voice vote

Amendment offered by Rep. Reggie Miller (D-31)

1. Amend page 23, line 14, after “health” by striking out “2,500,000” and inserting “5,000,000” and adjusting the subtotals, totals, and section 201 accordingly.

2. Amend page 191, line 11, after “allocate” by striking out “$2,500,000.00” and inserting “$5,000,000.00”.

3. Amend page 192, line 11, after “is” by striking out “$2,500,000.00” and inserting “$5,000,000.00”.

The amendment passed by voice vote

Passed in the House 56 to 50 (details)

Motion to give immediate effect by Rep. Jimmie Wilson (D-32)

The motion prevailed by voice vote