Bill Text: MI HB5772 | 2015-2016 | 98th Legislature | Introduced
Bill Title: Human services; other; reference to the various department names in the social welfare act; update. Amends title & secs. 1, 1c, 3, 6, 10, 11a, 11b, 12, 13, 14, 14b, 14f, 14g, 14h, 17, 18d, 18e, 19, 20, 24, 25, 32, 35, 36, 37, 38, 41, 43, 43b, 45, 46, 47, 50, 53, 55, 56i, 58, 58b, 58c, 59, 59a, 60, 61, 63a, 66, 66a, 66b, 66e, 66h, 66i, 66j, 67, 68, 68a, 69, 70, 71, 73a, 76, 77, 77a, 80, 83, 84, 85, 86, 90, 100, 105, 105a, 105b, 105c, 105d, 105e, 105f, 106, 106a, 106b, 107, 108, 109, 109c, 109e, 109f, 109g, 109h, 109k, 109l, 111a, 111i, 111k, 111l, 112b, 112c, 112e, 112g, 112i, 112j, 114, 115f, 115o, 115s, 116 & 117c of 1939 PA 280 (MCL 400.1 et seq.); adds sec. 1d & repeals secs. 2, 109i & 109j of 1939 PA 280 (MCL 400.2 et seq.).
Spectrum: Bipartisan Bill
Status: (Introduced - Dead) 2016-09-07 - Referred To Second Reading [HB5772 Detail]
Download: Michigan-2015-HB5772-Introduced.html
HOUSE BILL No. 5772
July 13, 2016, Introduced by Reps. LaFontaine, Kosowski, Darany, Santana, Heise, Cox and Inman and referred to the Committee on Families, Children, and Seniors.
A bill to amend 1939 PA 280, entitled
"The social welfare act,"
by amending the title and sections 1, 1c, 3, 6, 10, 11a, 11b, 12,
13, 14, 14b, 14f, 14g, 14h, 17, 18d, 18e, 19, 20, 24, 25, 32, 35,
36, 37, 38, 41, 43, 43b, 45, 46, 47, 50, 53, 55, 56i, 58, 58b, 58c,
59, 59a, 60, 61, 63a, 66, 66a, 66b, 66e, 66h, 66i, 66j, 67, 68,
68a, 69, 70, 71, 73a, 76, 77, 77a, 80, 83, 84, 85, 86, 90, 100,
105, 105a, 105b, 105c, 105d, 105e, 105f, 106, 106a, 106b, 107, 108,
109, 109c, 109e, 109f, 109g, 109h, 109k, 109l, 111a, 111i, 111k,
111l, 112b, 112c, 112e, 112g, 112i, 112j, 114, 115f, 115o, 115s,
116, and 117c (MCL 400.1, 400.1c, 400.3, 400.6, 400.10, 400.11a,
400.11b, 400.12, 400.13, 400.14, 400.14b, 400.14f, 400.14g,
400.14h, 400.17, 400.18d, 400.18e, 400.19, 400.20, 400.24, 400.25,
400.32, 400.35, 400.36, 400.37, 400.38, 400.41, 400.43, 400.43b,
400.45, 400.46, 400.47, 400.50, 400.53, 400.55, 400.56i, 400.58,
400.58b, 400.58c, 400.59, 400.59a, 400.60, 400.61, 400.63a, 400.66,
400.66a, 400.66b, 400.66e, 400.66h, 400.66i, 400.66j, 400.67,
400.68, 400.68a, 400.69, 400.70, 400.71, 400.73a, 400.76, 400.77,
400.77a, 400.80, 400.83, 400.84, 400.85, 400.86, 400.90, 400.100,
400.105, 400.105a, 400.105b, 400.105c, 400.105d, 400.105e,
400.105f, 400.106, 400.106a, 400.106b, 400.107, 400.108, 400.109,
400.109c, 400.109e, 400.109f, 400.109g, 400.109h, 400.109k,
400.109l, 400.111a, 400.111i, 400.111k, 400.111l, 400.112b,
400.112c, 400.112e, 400.112g, 400.112i, 400.112j, 400.114,
400.115f, 400.115o, 400.115s, 400.116, and 400.117c), the title and
sections 14, 66, and 66i as amended and section 66j as added by
1987 PA 266, sections 1, 6, 17, 32, and 45 as amended and sections
14f, 14g, and 63a as added by 1995 PA 223, sections 3 and 10 as
amended by 1996 PA 483, section 11a as amended by 1990 PA 122,
section 11b as amended by 2012 PA 175, section 14h as added by 2001
PA 280, section 18e as added by 2004 PA 18, section 43b as added by
2002 PA 573, section 55 as amended by 2015 PA 90, section 56i as
added by 1997 PA 162, section 58 as amended by 2006 PA 200, section
60 as amended by 1999 PA 194, section 83 as amended by 1985 PA 161,
sections 105, 105a, 107, 108, and 109c as amended and sections
105c, 105d, 105e, and 105f as added by 2013 PA 107, section 105b as
added by 2007 PA 100, section 106 as amended and section 106b as
added by 2014 PA 452, section 106a as amended by 2014 PA 518,
section 109 as amended by 2012 PA 48, section 109e as added by 1996
PA 124, section 109f as amended by 2005 PA 84, section 109g as
added by 2000 PA 409, section 109h as added by 2004 PA 248, section
109k as added by 2012 PA 375, section 109l as added by 2014 PA 167,
section 111a as amended by 2012 PA 472, section 111i as added by
2000 PA 187, section 111k as added by 2004 PA 55, section 111l as
added by 2006 PA 286, sections 112b, 112c, and 112e as amended by
2006 PA 674, sections 112g, 112i, and 112j as added by 2007 PA 74,
section 115f as amended by 2014 PA 308, section 115o as added and
sections 116 and 117c as amended by 1998 PA 516, and section 115s
as added by 2002 PA 648, and by adding section 1d; and to repeal
acts and parts of acts.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
TITLE
An act to protect the welfare of the people of this state; to
provide general assistance, hospitalization, infirmary, and medical
care to poor or unfortunate persons; to provide for compliance by
this state with the social security act; to provide protection,
welfare and services to aged persons, dependent children, the
blind, and the permanently and totally disabled; to administer
programs and services for the prevention and treatment of
delinquency, dependency, and neglect of children; to create a state
department
of social health and human
services; to prescribe the
powers and duties of the department; to provide for the interstate
and intercounty transfer of dependents; to create county and
district
departments; of social services; to create within certain
county
departments, bureaus, of social aid and certain divisions,
and
offices; thereunder; to prescribe the powers and
duties of the
departments, bureaus, and officers; to provide for appeals in
certain cases; to prescribe the powers and duties of the state
department with respect to county and district departments; to
prescribe certain duties of certain other state departments,
officers, and agencies; to make an appropriation; to prescribe
penalties for the violation of the provisions of this act; and to
repeal certain parts of this act on specific dates.
Sec. 1. (1) A department of state government is created that
shall
be known and designated as the family independence agency,
and
that shall possess department
of health and human services,
which
department possesses the powers granted
and perform performs
the
duties imposed in this act. The family independence agency
department shall consist of a director and the assistants and
employees
appointed or employed in the family independence
agency.department.
(2)
The family independence agency department
is responsible
for the operation and supervision of the institutions and
facilities
established within the family independence
agency.department. The institutions and facilities may be operated
on
a coeducational basis. The family independence agency department
shall make and enforce its own rules, not inconsistent with the law
governing the institutions or facilities under its control,
respecting the conduct of the institutions and facilities,
discipline in the institutions and facilities, the care of
property, and the welfare of the residents.
(3)
The family independence agency shall be, department is, in
all respects, the legal successor to the powers, duties and
responsibilities of the juvenile institute commission.
(4)
A reference in this act to "the state department of social
services",
"the state department", or "department" means the family
independence
agency.
Sec.
1c. (1) A person employed by the department of social
services
at the W.J. Maxey campus in Whitmore lake or any of its
affiliated
facilities, at the Adrian training school in Adrian, the
Arbor
Heights center in Ann Arbor, Camp Nokomis in Prudenville, at
Camp Shawano in Grayling, or a similar facility under the
jurisdiction of the department established or funded by the state
after
the effective date of this section, May 4, 1978, who is
injured during the course of his or her employment as a result of
an assault by a recipient of social services shall receive his or
her full wages by the state department until worker's compensation
benefits begin and then shall receive in addition to worker's
compensation
benefits a supplement from the state department which
that together with the worker's compensation benefits shall equal
but not exceed the weekly net wage of the employee at the time of
the
injury. This supplement shall only apply applies while
the
person is on the state department's payroll and is receiving
worker's
compensation benefits and shall include includes an
employee who is currently receiving worker's compensation due to an
injury covered by this section. Fringe benefits normally received
by an employee shall be in effect during the time the employee
receives the supplement provided by this section from the
department.
(2)
Subsection (1) shall apply applies
whether the employee
was directly assaulted or was assaulted as a result of aiding
another employee in subduing a recipient.
Sec. 1d. As used in this act:
(a) "Administrative procedures act of 1969" means the
administrative procedures act of 1969, 1969 PA 306, MCL 24.201 to
24.328.
(b) "Department" or "state department" means the department of
health and human services.
(c) "Director" means the director of the department.
(d) "Federal poverty guidelines" 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 section 673(2) of subtitle B of title
VI of the omnibus budget reconciliation act of 1981, 42 USC 9902.
(e) "Medicaid" means the program of medical assistance
administered by the state under section 105.
(f) "Public health code" means the public health code, 1978 PA
368, MCL 333.1101 to 333.25211.
(g) "Social security act" means the federal social security
act, 42 USC 301 to 1397mm.
(h) "Title XVI" means title XVI of the social security act, 42
USC 1381 to 1383f.
(i) "Title XVIII" means title XVIII of the social security
act, 42 USC 1395 to 1395kkk-1.
(j) "Title XIX" means title XIX of the social security act, 42
USC 1396 to 1396w-5.
(k) "Title XX" means title XX of the social security act, 42
USC 1397 to 1397m-5.
Sec. 3. (1) The director of the family
independence agency
shall be appointed by the governor with the advice and consent of
the senate, and shall serve at the pleasure of the governor. The
director
shall be the executive officer of the family independence
agency
department and shall be responsible to the governor for
performing his or her duties.
(2)
The director shall receive such a
salary as shall be
appropriated by the legislature, and shall receive actual and
necessary traveling and other expenses incurred in the discharge of
his or her official duties, to be paid in the same manner as
salaries and expenses of other state employees are paid.
(3)
Whenever reference is made in this act to the "bureau of
social
security", or the "state bureau", reference shall be deemed
to
be intended to be made to the family independence agency.
(4)
Whenever reference is made in this act to the "supervisor
of
the state bureau", reference shall be deemed to be made to the
director
of the family independence agency.
(5)
For counties having a population of 600,000 or less and
for
all cities regardless of population, whenever reference is made
in
this act to the "county bureau of social aid", reference shall
be
deemed to be made to the county or city family independence
agency.
Sec.
6. (1) The family independence agency department may
promulgate all rules necessary or desirable for the administration
of programs under this act. Rules shall be promulgated under the
administrative
procedures act of 1969. , Act No. 306 of the Public
Acts
of 1969, being sections 24.201 to 24.328 of the Michigan
Compiled
Laws. Beginning 2 years after the effective date of
subsection
(2), if the Michigan supreme court rules that sections
45
and 46 of Act No. 306 of the Public Acts of 1969, being sections
24.245
and 24.246 of the Michigan Compiled Laws, are
unconstitutional
and a statute requiring legislative review of
administrative
rules is not enacted within 90 days after the
Michigan
supreme court ruling, this subsection does not apply.
(2)
The family independence agency department
may develop
regulations to implement the goals and principles of assistance
programs created under this act, including all standards and
policies related to applicants and recipients that are necessary or
desirable to administer the programs. These regulations are
effective and binding on all those affected by the assistance
programs.
Except for policies described in subsections (3) and (4),
regulations
described in this subsection, setting standards and
policies
necessary or desirable to administer the programs, are
exempt
until the expiration of 12 months after the effective date
of
this subsection from the rule promulgation requirements of the
administrative
procedures act of 1969, Act No. 306 of the Public
Acts
of 1969, being sections 24.201 to 24.328 of the Michigan
Compiled
Laws. Upon the expiration of 12 months after the effective
date
of this subsection, regulations described in this subsection
are
not effective and binding unless processed as emergency rules
under
section 48 of Act No. 306 of the Public Acts of 1969, being
section
24.248 of the Michigan Compiled Laws, or promulgated in
accordance
with Act No. 306 of the Public Acts of 1969.
(3)
The family independence agency department
may develop
policies to establish income and asset limits, types of income and
assets to be considered for eligibility, and payment standards for
assistance programs administered under this act. Policies developed
under this subsection are effective and binding on all those
affected by the assistance programs. Policies described in this
subsection are exempt from the rule promulgation requirements of
Act
No. 306 of the Public Acts the
administrative procedures act of
1969. Not less than 30 days before policies developed under this
subsection are implemented, they shall be submitted to the senate
and house standing committees and appropriation subcommittees with
oversight of human services.
(4)
The family independence agency department
may develop
policies to implement requirements that are mandated by federal
statute or regulations as a condition of receipt of federal funds.
Policies developed under this subsection are effective and binding
on all those affected by the programs. Policies described in this
subsection are exempt from the rule promulgation requirements of
Act
No. 306 of the Public Acts the
administrative procedures act of
1969.
(5) All rules, regulations, and policies established by the
family
independence agency department
shall be in writing, shall be
provided to the legislature, and shall be made available for
inspection
by to any member of the public at all offices of the
family
independence agency department
during regular business
hours.
(6)
Until the expiration of 12 months after the effective date
of
this subsection, a bipartisan task force of legislators
appointed
in the same manner as members are appointed to standing
committees
of the legislature shall meet regularly with the family
independence
agency to review proposed policies and regulations for
the
family independence program. Meetings of the bipartisan task
force
are subject to the open meetings act, Act No. 267 of the
Public
Acts of 1976, being sections 15.261 to 15.275 of the
Michigan
Compiled Laws.
(6) (7)
Subsection (2) does not apply to
standards and
policies
related to the providers of services which that have
a
written
contractual relationship or are an enrolled medicaid
Medicaid
provider with the family
independence agency.department.
Sec.
10. (1) The family independence agency department is
designated as the state agency to cooperate with the federal
government
in the administration of the social security act. ,
chapter
531, 49 Stat. 620. The family
independence agency
department
may administer the food stamp act of 1977,
Public Law
88-525,
7 U.S.C. 2011 to 2012 and 2013 to 2032, 2008, 7 USC 2011 to
2036c,
and any other law which that the
governor or the legislature
of
the state may designate. The family independence agency
department may cooperate with the proper departments or agencies of
the federal government and with all other departments or agencies
of the state and local governments, and supervise the
administration by local governmental departments or agencies of any
plans established by the state in cooperation with the federal
government under these provisions and the rules promulgated
pursuant
thereto. under these provisions.
The director shall make
reports,
in such the form and containing such the information,
required under the social security act, and shall comply with the
requirements
made to assure ensure the correctness and verification
of the reports.
(2) The director, with the approval of the governor, may
cooperate with the federal government, or any of its agencies or
instrumentalities, in handling the welfare and relief problems and
needs of the people of this state, to the extent authorized by the
laws of this state.
(3) The director may adopt any plan required or desirable to
participate
in the distribution of federal moneys money or the
assistance of the federal government, and may accept on behalf of
the
state any allotment of federal moneys. money. The state
treasurer
may forward state moneys money
to the federal social
security
administration Social
Security Administration for federal
administration of the state supplemental program of the social
security
act in accordance with an agreement pertaining thereto. to
administration of that program. The director may promulgate rules
and the director or his or her designee may enter into any
agreement or agreements with federal, state, or local units of
government or private agencies necessary to enable the state or
such
those units to participate in any plan the director deems
considers desirable for the welfare of the people of this state.
(4)
For the purpose of assuring ensuring
full federal approval
of the activities of the department and local departments with
respect to the operation of a plan, the director may do all things
reasonable and proper to conform with federal requirements
pertaining to methods and standards of administration. In making
rules
with respect thereto, to
that, there shall be included such
methods and standards of administration for the conduct of the work
of
local units, including the necessary supervision thereof, of the
local units, as may be required for the receipt of aid from the
federal government.
Sec. 11a. (1) A person who is employed, licensed, registered,
or certified to provide health care, educational, social welfare,
mental health, or other human services; an employee of an agency
licensed to provide health care, educational, social welfare,
mental health, or other human services; a law enforcement officer;
or an employee of the office of the county medical examiner who
suspects or has reasonable cause to believe that an adult has been
abused, neglected, or exploited shall make immediately, by
telephone
or otherwise, an oral report to the county department of
social
services of the county in which the
abuse, neglect, or
exploitation is suspected of having or believed to have occurred.
After making the oral report, the reporting person may file a
written report with the county department. A person described in
this
subsection who is also required to make a report pursuant to
under
section 21771 of the public health
code, Act No. 368 of the
Public
Acts of 1978, as amended, being section 333.21771 of the
Michigan
Compiled Laws MCL 333.21771, and who makes that report is
not
required to make a duplicate report to the county department of
social
services under this section.
(2) A report made by a physician or other licensed health
professional
pursuant to under subsection (1) shall is not
be
considered
a violation of any legally
recognized privileged
communication or a violation of article 15 of the public health
code,
Act No. 368 of the Public Acts of 1978, being sections
333.16101
to 333.18838 of the Michigan Compiled Laws.MCL 333.16101
to 333.18838.
(3) In addition to those persons required to make an oral
report under subsection (1), any person who suspects that an adult
has been abused, neglected, or exploited may make a report to the
county
department of social services of the county in which the
abuse, neglect, or exploitation is suspected of having occurred.
(4) A report made under this section shall contain the name of
the adult and a description of the abuse, neglect, or exploitation.
If possible, the report shall contain the adult's age and the names
and addresses of the adult's guardian or next of kin, and of the
persons with whom the adult resides, including their relationship
to the adult. The report shall contain other information available
to the reporting person that may establish the cause of the abuse,
neglect, or exploitation and the manner in which the abuse,
neglect, or exploitation occurred or is occurring. The county
department
shall reduce to put in writing the information provided
in
an oral report received pursuant to under this section.
(5) The county department shall report to a police agency any
criminal activity that it believes to be occurring, upon receipt of
the oral report.
(6)
This section shall does not be construed as limiting limit
the responsibilities of the police agency of a local unit of
government
to enforce the laws of this state or as precluding
preclude the police agency from reporting and investigating, as
appropriate, alleged criminal conduct.
Sec. 11b. (1) Within 24 hours after receiving a report made or
information obtained under section 11a, the county department shall
commence an investigation to determine whether the person suspected
of being or believed to be abused, neglected, or exploited is an
adult in need of protective services. A reasonable belief on the
part of the county department that the person is an adult in need
of protective services is a sufficient basis for investigation. If
an investigation pertains to an adult residing in an adult foster
care
facility licensed by the department of human services,
licensing and regulatory affairs, the county department shall
provide the adult foster care licensee with the substance of the
abuse or neglect allegations as soon as practicable after the
beginning of the investigation. The licensee shall have the
opportunity to respond to the allegations, and the response shall
be included in the record.
(2) Upon a request by the county department, local law
enforcement officers shall cooperate with the county department in
an investigation of suspected abuse, neglect, or exploitation.
However,
the The investigation required by this section shall is
not
be in place of an investigation by the appropriate police
agency regarding suspected criminal conduct arising from the
suspected abuse, neglect, or exploitation.
(3) The investigation shall include a determination of the
nature, extent, and cause of the abuse, neglect, or exploitation;
examination of evidence; identification, if possible, of the person
responsible for the abuse, neglect, or exploitation; the names and
conditions of other adults in the place of residence; an evaluation
of the persons responsible for the care of the adult, if
appropriate; the environment of the residence; the relationship of
the adult to the person responsible for the adult's care; an
evaluation as to whether or not the adult would consent to
receiving protective services; and other pertinent data.
(4) The investigation shall include an in-person interview
with the adult. The county department shall conduct the interview
by means of a personal visit with the adult in the adult's dwelling
or in the office of the county department. In attempting to conduct
a personal visit with the adult in the adult's dwelling, if
admission to the dwelling is denied, the county department may seek
to obtain a search warrant as provided in 1966 PA 189, MCL 780.651
to 780.659.
(5) The investigation may include a medical, psychological,
social, vocational, and educational evaluation and review.
(6) In the course of an investigation, the county department
shall determine if the adult is or was abused, neglected, or
exploited. The county department shall make available to the adult
the appropriate and least restrictive protective services, directly
or through the purchase of services from other agencies and
professions, and shall take necessary action to safeguard and
enhance the welfare of the adult, if possible. The county
department also shall collaborate with law enforcement officers,
courts of competent jurisdiction, and appropriate state and
community agencies providing human services, which services are
provided in relation to preventing, identifying, and treating adult
abuse, neglect, or exploitation. If the abuse, neglect, or
exploitation involves substance abuse, the county department shall
collaborate
with the local substance abuse coordinating agency
department-designated community mental health entity as designated
by
the office of substance abuse services in the department of
community
health for a referral for substance
abuse use disorder
services. The county department may petition for a finding of
incapacity and appointment of a guardian or temporary guardian as
provided in section 5303 or 5312 of the estates and protected
individuals code, 1998 PA 386, MCL 700.5303 and 700.5312, and may
petition for the appointment of a conservator as provided in
section 5401 of the estates and protected individuals code, 1998 PA
386, MCL 700.5401, for a vulnerable adult.
(7) Upon completion of an investigation, the county department
shall prepare a written report of the investigation and its
findings. A copy of this written report shall be forwarded to the
state
department of human services upon
the state department's
request. of
the department of human services.
(8) The county department may provide a copy of the written
report to the prosecuting attorney for the county in which the
adult suspected of being or believed to be abused, neglected, or
exploited resides or is found.
(9)
A representative from the department, of human services,
the department of state police, the department of the attorney
general, and the office of services to the aging, and an individual
who is a representative of long-term care providers and is
designated
by the state attorney general, shall meet and develop a
state model protocol for the investigation of vulnerable adult
abuse
cases. This state model protocol shall be developed not more
than
1 year after the effective date of the amendatory act that
added
this subsection. later than
June 19, 2013. A county
prosecuting attorney, in cooperation with the local county
department and local law enforcement agencies, may adopt a local
protocol for the investigation of vulnerable adult abuse cases that
is based on the state model protocol.
Sec.
12. All funds in the hands of held
by the state treasurer
or on deposit to the credit of any of the departments, boards,
commissions, and
offices which that are hereby abolished shall be
transferred to and are hereby appropriated for the state
department, of
social welfare, and shall be disbursed on its order.
Sec.
13. The commission department
is hereby authorized,
subject to the approval of the attorney general, to enter into
reciprocal agreements with corresponding state agencies of other
states, regarding the interstate transportation of indigent
persons, and to arrange with the proper officials in this state for
the acceptance, transfer, and support of persons receiving any form
of public aid or relief in other states in accordance with the
terms
of such a reciprocal agreement. : Provided, That this This
state
shall not, nor shall any county or any county department of
social
welfare, in this state, be
committed to the support of
persons
whom who the commission department determines are
not
entitled to public support under the laws of this state. This
section shall be so interpreted and construed as to effectuate its
general
purpose to make uniform laws of such states as that enact
similar legislation.
Sec. 14. (1) The state department has all of the following
additional powers and duties:
(a) To allocate and distribute to the county and district
departments, of
social services, as provided in section 18, and in
accordance with the rules promulgated by the director, money
appropriated by the legislature, or received from the federal
government for the relief of destitution or unemployment within the
state , or a political subdivision of the state.
(b) To distribute, as provided in this act, subject to federal
rules and regulations, and in accordance with the rules promulgated
by the director, money appropriated by the legislature, or received
from
the federal government for the granting of aid to dependent
children
temporary assistance for
needy families and supplemental
security income; for medical, dental, optometric, nursing,
pharmaceutical, and burial relief; for services furnished by
professions
under the public health code; , Act No. 368 of the
Public
Acts of 1978, as amended, being sections 333.1101 to
333.25211
of the Michigan Compiled Laws; and
for other relief or
welfare services provided by law.
(c)
To operate a day child care program in rural and urban
areas and assist in the development of sound programs and standards
for
day child care by public organizations throughout the state.
If
the
director , commissioner, or those officials responsible for
enforcing a state or local building code determine that a dwelling
unit fails to meet the standards of that code through fault of the
landlord, the department may refuse to pay public assistance grants
authorized under this act for payment of rent on the dwelling unit.
A written notice of the refusal, stating the grounds for the
refusal and listing the defects to be corrected, shall be mailed
immediately to the landlord by certified mail. During the period of
refusal, the landlord may bring an action against the department in
the nature of quo warranto, but may not maintain an action for the
rent or possession of the premises. If the defects have been
corrected or if the department's refusal to pay is determined by a
court of competent jurisdiction to be wrongful, the department
shall pay the rent that is owed, but not more than the amount of
the grants withheld.
(d) (g)
To assist other departments,
agencies, and
institutions
of the federal and state governments, when so
requested, in performing services in conformity with the purposes
of this act. The director shall act as certifying agent for federal
departments or agencies in determining eligibility of applicants
for aid or service rendered by those departments or agencies. The
rules
of the state departments under this subsection shall be are
binding
upon the county departments. of social services.
(e) (h)
To collect and compile statistics,
make special fact-
finding studies, and publish reports in reference to the field of
welfare, including a biennial report as provided in section 17.
(f) (i)
To arbitrate and decide disputed or
contested claims
between 2 or more counties relative to the settlement or domicile
of a person or family given or in need of any form of public aid or
relief, and to determine and declare the county of settlement or
domicile
in any instance when so requested or on the department's
own volition. All decisions and determinations made under this
subdivision
shall be are binding upon the county departments. of
social
services.
(g) (j)
To administer or supervise relief
or welfare functions
vested in the department by law, and to provide for the progressive
codification of the laws governing relief and welfare problems.
(h) (k)
To inspect county infirmaries and
places of detention
for juveniles for the purpose of obtaining facts pertaining to the
usefulness and proper management of the infirmaries and places of
detention, and of promoting proper, efficient, and humane
administration of those infirmaries and places of detention. A
reasonable order of the department fixing minimum standards of
sanitation, fire protection, food, and comfortable lodging may be
enforced, through mandamus or injunction in the circuit court for
the county where the county infirmary or place of detention for the
juveniles is located, through proper proceedings instituted by the
attorney general on behalf of the department. The burden of proof
shall
be is on the department to establish the reasonableness of
the order.
(i) (l) To
promulgate by rules a recommended schedule of
payment
for care and maintenance, pursuant according to the
administrative
procedures act of 1969, Act No. 306 of the Public
Acts
of 1969, as amended, being sections 24.201 to 24.328 of the
Michigan
Compiled Laws, to be used, as
provided by law, in
determining the amount of payment to be made by patients, their
guardians, or relatives who are liable for the care and maintenance
of
persons entitled to treatment under the mental health code, Act
No.
258 of the Public Acts of 1974, as amended, being sections
330.1001
to 330.2106 of the Michigan Compiled Laws. 1974 PA 258,
MCL 330.1001 to 330.2106. The department in promulgating the
schedule may give consideration to the person's income, the number
of other persons he or she is obligated to support, his or her
estate, medical and other necessary expenses, and other relevant
matters.
(j) (n)
To provide or contract for legal
services for persons
receiving assistance under this act in guardianship and support
proceedings.
(k) (p)
To provide services to adults and
aging persons ,
which
that shall include:
(i) Services for the blind in accordance with the
rehabilitation
act of 1973, 29 U.S.C. USC
701 to 796i.796l.
(ii) Services authorized in title XX of the social security
act,
42 U.S.C. USC 1397 to 1397e.1397h.
(l) (q)
To license and regulate child care
organizations and
programs
as described in Act No. 116 of the Public Acts of 1973, as
amended,
being sections 722.111 to 722.128 of the Michigan Compiled
Laws.1973 PA 116, MCL 722.111 to 722.128.
(2) Other sections of this act notwithstanding, all powers and
duties
of the county social services boards to develop, implement,
and administer a program of general public relief, are transferred
to the state department effective beginning with the first county
fiscal
year following December 1, 1975. However, in In a
county
that
operates a patient care management system pursuant to under
section
66j, the county social services board may change the
eligibility standards and coverages for medical care for persons
eligible for services under a patient care management system
subject to the consent of the county board of commissioners, or, in
a charter county, subject to the consent of the county board of
commissioners and the county executive.
Sec. 14b. The director, and under his or her supervision,
county,
city, and district departments, of
social welfare, may
provide written or oral notice to recipients of public assistance
of the availability of advice and treatment in family planning.
Such
The notice shall include a statement that receipt of
public
assistance is in no way dependent upon a request or nonrequest for
family planning services. No effort shall be made to suggest or
persuade recipients to request or not request family planning
services. The director, and under his or her supervision, county,
city, and
district departments, of social welfare may make
available upon request of recipients of public assistance advice
and treatment in family planning by referral upon request of the
recipient to a licensed medical doctor, licensed osteopathic
physician, public agency, or, on a contractual basis, to a private
agency of the recipient's choice. Necessary drugs and recognized
medical appliances for use in family planning may also be made
available through licensed pharmacists upon prescription issued by
a
licensed physician. Such The
family planning services shall be
made available in accordance with rules and regulations promulgated
by the director under law.
Sec. 14f. Subject to section 5 of article XI of the state
constitution
of 1963, the family independence agency department may
contract with a private individual or agency to administer a
program
created under this act or to perform a duty of the family
independence
agency department under this act.
Sec. 14g. In order to achieve more efficient and effective use
of funds for public assistance, to reduce dependency, or to improve
the living conditions and increase the incomes of individuals
receiving
public assistance, the family independence agency
department may establish and conduct pilot projects in 1 or more
county
or district offices. The family independence agency
department may apply different policies in the pilot programs than
it applies in the rest of the county or district offices, and may
conduct the pilot projects as long as is necessary to provide a
reasonable test of the policy being evaluated. Pilot projects shall
be consistent with principles and goals set forth in this act.
Sec.
14h. (1) The family independence agency department shall
use
an electronic benefit transfer system for food stamp
distribution of supplemental nutrition assistance program benefits.
(2) To the extent that rules or parts of rules promulgated
under this act conflict with the provisions of this section, the
provisions of this section supersede those rules or parts of rules.
(3) The following rules are rescinded:
(a)
R 400.3002 of the Michigan administrative
code.Administrative Code.
(b)
R 400.3003 of the Michigan administrative code.
Administrative Code.
(c)
R 400.3004 of the Michigan administrative code.
Administrative Code.
(d)
R 400.3007 of the Michigan administrative code.
Administrative Code.
(e)
R 400.3008 of the Michigan administrative code.
Administrative Code.
(f)
R 400.3012 of the Michigan administrative code.
Administrative Code.
(g)
R 400.3013 of the Michigan administrative code.
Administrative Code.
(h)
R 400.3125 of the Michigan administrative code.
Administrative Code.
Sec.
17. (1) The family independence agency department shall
establish
program goals consistent with section 57a. and shall
report
these goals to the governor and the legislature within 6
months
after the effective date of this subsection.
(2)
The family independence agency shall prepare and on or
before the fifteenth day of December in each even-numbered year
make a report to the governor, setting forth the operation of the
family
independence agency department
during the preceding fiscal
biennium of the state, reporting on progress toward the goals
established under subsection (1), and containing any findings and
recommendations
of the family independence agency. department. The
report shall also be submitted to the legislature.
Sec.
18d. The county department, of social welfare, upon
authorization of the county board of supervisors, may operate an
emergency receiving facility for the temporary care of homeless,
dependent, or
neglected children for whom such that care is
necessary, pending foster care placement or restoration to their
own
homes or any other plan deemed considered
best for the health,
safety, and
welfare of such the children. The county department
operating an emergency receiving facility shall maintain the
standards of the state department established in respect to places
of
detention for juveniles under section 14. of this act.
Sec. 18e. (1) The family independence agency department shall
establish and administer a state plan for foster care according to
the provisions of part E of title IV of the social security act, 42
USC
670 to 679b. 679c. The state plan shall include programs and
services that promote, implement, and support foster care focus
groups. When developing and annually reviewing the state plans to
carry
out foster care policy and services, the family independence
agency
department shall utilize input from locally-based locally
based foster care focus groups.
(2) Foster care focus groups shall be composed of youth in
foster care or independent living programs, youth previously in
foster care, foster parents or relatives caring for youth in foster
care, and adults previously in foster care or independent living
programs. The majority of the focus group consists of youth in
foster care or independent living programs.
(3) In order to inform the legislature, the executive office,
the judiciary, and the public of the needs and interests of youth
in foster care, foster parents, and relatives caring for youth in
foster care, the foster care focus groups are encouraged to be
established in both of the following:
(a)
Licensed child placing agencies with which the family
independence
agency department contracts for youth foster care
services that have an annual average daily foster care caseload of
150
or more cases or that derives derive
more than 50% of its their
operating
budget from contracts with the family independence agency
department for youth foster care services.
(b)
Counties in which the family independence agency
department has an annual average daily foster care caseload of 150
or more cases.
(4) State and federal funds appropriated to implement state
plans in compliance with part E of title IV of the social security
act,
42 USC 670 to 679b 679c, and state laws may be used to meet
the provisions of this section.
Sec. 19. The powers and duties vested by law in the board of
corrections
and charities and transferred to the state welfare
commission,
in the state welfare department, in
the director of the
state
welfare department, in the state welfare commission and in
the state institute commission as relating to the Michigan
employment institution for the blind at Saginaw or a successor
agency, are hereby transferred to and vested in the state
department. of
social welfare herein created. Immediately on the
taking
effect of this act, the A
reference made in any law of this
state to the departments, boards, commissions, and officers whose
powers
and duties are hereby transferred shall be abolished, and,
whenever
reference thereto is made in any law of the state,
reference
shall be deemed to be intended to be made under this
section
is considered to be a reference to the
state department. of
social
welfare.
Sec. 20. All of the powers and duties prescribed in any law of
this state with respect to any subject matter vested in the state
department
of social welfare shall be are
transferred to and be
vested
in said the department.
Sec. 24. The state department, for programs financed in whole
or
in part with federal funds, may make such rules as are necessary
for
guiding and regulating the county departments. of social
services.
The state department shall prepare
and have printed all
blanks
and books of record used in the county departments, of
social
services, to the end that a uniform
system shall be employed
in all counties. The state department shall establish eligibility
and financial standards for all forms of general public relief and
burial. Differential area standards may be established to
correspond to the characteristics of the community. Recommended
standards for general relief and burial shall annually be submitted
to
the department by the Michigan county social services
association.
County Social Services
Association. A county social
services
board which that is
dissatisfied with general relief and
burial standards established for its county shall, within 30 days
after notification of those standards, be given the opportunity to
meet with the state director to review the determination.
Eligibility and financial standards shall not be affected by a
county decision to supplement individual payments to recipients of
general public relief.
Sec. 25. An applicant for assistance or a third party acting
responsibly in his or her behalf shall deliver his or her
application
in writing to the county department of social services
in the manner and form prescribed by the state department. All
statements in the application shall be over the signature or
witnessed
mark of the applicant or such the
third party and shall
include a declaration under the penalties of perjury that the
application has been examined by or read to the applicant or third
party, and, to the best of the applicant's or third party's
knowledge, that all facts are true in each material point and are
complete. ;
and the The applicant or third party shall empower the
county
department of social services and the state department to
obtain all necessary information concerning the recipient of social
services for whom the application is made and his or her resources
in order to determine the eligibility of the applicant. No
question, inquiry, or recommendation shall relate to the political
opinions or religious affiliations of any person, and no grant or
denial of aid under this act shall be in any manner affected or
influenced
by such those opinions or affiliations.
Sec. 32. (1) Subject to section 14g, a person qualified for
and receiving assistance under this act in any county in this state
who moves or is taken to another county in this state may continue
to receive assistance in the county to which the person has moved
or
is taken, and the county family independence agency department
of the county from which the person has moved shall transfer all
necessary
records relating to the person to the county family
independence
agency department of the county to which the person
has moved.
(2) For purposes of the family independence program and
medical assistance under this act, a resident of this state is a
person who is living in this state voluntarily with the intention
of making his or her home in this state and not for a temporary
purpose and who is not receiving assistance from another state. For
purposes of medical assistance, a resident of this state also
includes a person and the dependents of a person who, at the time
of application, is living in this state, is not receiving
assistance from another state, and entered the state with a job
commitment or seeking employment in this state. For purposes of
determining eligibility to receive assistance under this act,
excluding recipients of supplemental security income under title
XVI
of the social security act, chapter 531, 49 Stat. 620, 42
U.S.C.
USC 1381 to 1382, and 1383 to 1383d 1385, or
state
supplementation under this act, the continued absence of a
recipient from this state, unless the absence is temporary or
intent to return is established as provided by applicable federal
regulations,
shall constitute is abandonment by the recipient of
residence in this state. Any existing rule that has been
promulgated under this act that defines temporary absence for the
purpose of eligibility for family independence program assistance
or medical assistance, or that provides for continuation of
eligibility if the absence is not temporary, is not applicable.
(3) For purposes of medical assistance eligibility the
requirements in subsection (2) apply except as otherwise provided
in federal regulations for the administration of the medical
assistance program under title XIX of the social security act, 42
U.S.C.
USC 1396 to 1396g and 1396i to 1396v.1396w-5.
(4)
The residence of a husband shall not be 1 spouse is not
considered
to be the residence of the wife other
spouse if they are
living
separate and apart. If a husband and wife the spouses are
living separate and apart, each may have a separate residence
dependent upon proof of the fact and not upon legal presumption.
This
subsection shall does not be construed to prohibit a person
from acquiring or retaining a legal residence.
Sec.
35. Notwithstanding section 2(6), records Records
relating to categorical assistance, including medical assistance,
shall
be are confidential and shall are not
be open to inspection
except
as prescribed in section 64. The state department of social
services
may promulgate and enforce rules
for the use of the
records as may be necessary for purposes related to federal, state,
or
local public assistance, pursuant according to Act No. 306
of
the
Public Acts of 1969, as amended.the
administrative procedures
act of 1969.
Sec. 36. When assistance is given to any person under the
provisions
of this act with respect to old age assistance, aid to
dependent
children temporary assistance
for needy families, aid to
the blind, and aid to the permanently and totally disabled, the
county
department of social welfare shall comply with all
requirements of the state department.
Sec. 37. Whenever an application is made for assistance, the
county
department of social welfare shall make a thorough
investigation and report to the state department in the manner
prescribed by it, giving its recommendation of the amount of
assistance,
if any, to be allowed. If the application be is
disallowed, or if the applicant is dissatisfied with the amount of
assistance he or she is receiving, or is to receive, he or she may
demand, in writing, a hearing of his or her case, as provided for
in section 9 or section 65. The applicant or recipient may appeal
to the circuit court of the county in which he or she resides,
which court shall have power to review questions of law involved in
any
final decision or determination of the state department. Said
The
petition shall be filed within 30 days
of the receipt of such
the
decision or determination. The
petitioner shall is not be
required to furnish any bond and costs shall not be taxed against
him or her.
If the court shall decide decides
in favor of the
petitioner, assistance shall be paid from the first day of the
month
following the date of the application therefor or of the date
of the original application for the relief in question.
Sec. 38. Upon receipt of the recommendations of the county
department, of
social services, the state department shall
determine the amount of categorical assistance to be allowed
monthly, if any, and the date for which the first payment shall be
made,
to be payable as the state department shall decide. decides.
If a person has been authorized to receive a payment in respect to
his or her requirements for any month for categorical assistance,
no assistance shall be allowed nor shall eligibility exist for him
or her for that month for any other categorical assistance. The
state department shall cause to be made due record of all
authorizations of assistance with the address of the recipient and
shall
furnish the county department of social services with a copy
thereof.
of the record. Whenever payment of assistance is made,
warrants
shall be drawn upon the appropriation made, therefor, or
other
moneys money available for these forms of assistance, and
delivered to the recipients, or third parties acting responsibly in
their behalf or the providers of goods or services authorized by
the
state department in accordance with such the regulations as may
be
made by the state department.
Sec. 41. If at any time after approval of a grant of
assistance the recipient, or the spouse of the recipient, becomes
possessed of any property or income of which the county department
of
social welfare has no knowledge, it
shall be the duty of the
recipient
to shall notify said the county department, of
social
welfare
which shall report and make
recommendations to the state
department, which in turn may cancel, suspend, or alter the
certificate of allowance.
Sec. 43. All assistance granted under this act shall be
reconsidered
from time to time, or as frequently as may be required
by
the state department requires.
After further investigation by
the
county department, of social welfare, the amount and manner of
giving assistance may be changed, or the assistance may be
withdrawn if the state department finds that the recipient's
circumstances
have changed sufficiently to warrant such that
action.
It shall be within the power of the The state department
may,
at any time, to
cancel and revoke assistance for cause. , and
it
The state department may, for cause, suspend payments for
assistance
as it may deem considers proper, subject to appeal and
hearing by the recipient as provided for in section 9. The
provisions
of this section shall be are
mandatory only with respect
to
old age assistance, aid to dependent children , temporary
assistance for needy families, aid to the blind, aid to the
permanently and totally disabled, or any other function financed in
whole or in part by federal funds.
Sec. 43b. An office of inspector general is established as a
criminal
justice agency in the family independence agency.
department. The primary duty of the inspector general is to
investigate cases of alleged fraud within the department. The
inspector general shall also perform the following activities:
(a) Investigate fraud, waste, and abuse in the programs
administered
by the family independence agency.department.
(b) Make referrals for prosecution and disposition of
appropriate cases as determined by the inspector general.
(c) Review administrative policies, practices, and procedures.
(d) Make recommendations to improve program integrity and
accountability.
Sec.
45. (1) A county family independence agency department is
created
in each county of this state, which shall possess possesses
the
powers granted and perform performs
the duties imposed in this
act.
The county family independence agency department shall consist
of
a county family independence agency board and the director of
the
county family independence agency, department, together with
assistants and employees as may be necessary to operate the county
department.
family independence agency. As used
in this act,
references
to "county department of social services" or "county
department"
mean the county family independence agency and
references
to "county social services board" and "county board"
mean
the county family independence agency board.
(2)
The powers and duties of the county family independence
agency
board include all of the following:
(a) Supervision of and responsibility for the administration
of the county infirmary and county medical care facility and child
caring institution, except as provided in sections 55(c) and 58.
(b)
Conduct, in conjunction with the family independence
agency,
department, an annual review of social service programs
operating within the county.
(c) Development of policy and supervision of the
administration of social service programs authorized by the county
board of commissioners or financed solely from county funds or
county administered funds.
(d) Development and administration of employment programs and
work training projects complementary to and not in conflict with
state programs.
(e) Review and submit recommendations on contracts involving
programs
administered by the family independence agency department
proposed
to be entered into between the family independence agency
department and public or private agencies within the county,
including proposed purchases of service contracts from applicant
agencies within the county eligible for funding under title XX of
the
social security act, chapter 531, 49 Stat. 620, 42 U.S.C. USC
1397
to 1397f. 1397m-5. A contract shall not be entered into
between
the family independence agency department
and a public or
private agency within the county until the board has been provided
an opportunity for review of the contract. The board shall be
advised
by the family independence agency department within 30 days
after contracts have been signed with an explanation of the
differences between contracts recommended by the board and those
actually entered into.
(f) Act as the agent for the county board of commissioners in
the development of coordinated or consolidated approaches to the
delivery of social services and cooperative service delivery
arrangements
between the family independence agency department and
each public and private social service agency within the county.
(g) Represent the county board of commissioners in all
negotiations
between the county and the family independence
agency.department.
(h)
Make annual policy recommendations to the Michigan county
social
services association County
Social Services Association on
annual departmental appropriations, priorities for utilization of
title XX funds, eligibility standards for general public relief and
burial, employment programs, work training projects, and other
related issues.
(3)
The family independence agency department
shall provide
suitable office accommodations for programs funded in whole or in
part
with state funds. The county family independence agency board
shall review and recommend to the director proposed office sites
within the county. The director shall notify the board before final
site selection with an explanation of the selection of a site other
than that proposed by the board.
(4) The salary and expenses of each member of the county board
shall be fixed by the county board of commissioners according to
the amount of time the member devotes to the performance of
official duties. A member of the county board may not serve as the
director
or an employee of the county family independence agency.
department. The members of the county boards shall be appointed at
the annual October session of commissioners, and members shall
qualify by taking and filing the oath of office with the county
clerk, and shall assume their duties as prescribed by this act not
later than November 1 of the year appointed.
(5) The director, employees, and assistants of the county
family
independence agency department
shall be appointed by the
family
independence agency department
from among persons certified
as qualified by the state civil service commission. The county
family
independence agency board shall
review the qualifications of
and
interview each applicant for the position of county family
independence
agency department director. The county director shall
be appointed from among persons certified as eligible and
recommended
by the family independence agency department and by the
county board. These appointment provisions do not apply under
conditions of reduction in state work force, in which case the
administrative employment preference rules for bumping promulgated
by the Michigan civil service commission apply. The county board
shall advise and make recommendations to the state director
regarding the performance of the county director within 6 months
after the appointment of the county director and annually after
that time. A copy of each evaluation shall be provided to the
county director.
(6) Except as prescribed in sections 35 and 64, a writing
prepared, owned, used, in the possession of, or retained by the
county
family independence agency department
in the performance of
an official function shall be made available to the public in
compliance
with the freedom of information act, Act No. 442 of the
Public
Acts of 1976, being sections 15.231 to 15.246 of the
Michigan
Compiled Laws.1976 PA 442,
MCL 15.231 to 15.246.
Sec. 46. (1) The administration of the powers and duties of
the
county department shall be are
vested in a county social
services
board of 3 members, appointed from
persons residing within
the county and not holding an elective office, for 3-year terms as
follows: 2 members shall be appointed by the county board of
commissioners,
and 1 member by the director of social services.
Members
appointed before October 27, 1965, shall continue in office
until
the expiration of their terms and until successors are
appointed
and qualified. the
department. Each member shall qualify
by taking and filing with the county clerk the constitutional oath
of office, and shall hold office until the appointment and
qualification of a successor. Vacancies in the membership of the
board shall be filled for the expiration of the unexpired term, in
the same manner as provided for appointment of the original
members.
(2)
The business which that the county social services board
may perform shall be conducted at a public meeting of the county
social
services board held in compliance
with Act No. 267 of the
Public
Acts of 1976. the open
meetings act, 1976 PA 267, MCL 15.261
to 15.275. Public notice of the time, date, and place of the
meeting
shall be given in the manner required by Act No. 267 of the
Public
Acts of 1976. the open
meetings act, 1976 PA 267, MCL 15.261
to 15.275. A majority of the board constitutes a quorum for the
transaction of business. The board shall meet on the call of the
chairperson, or on a written request to the chairperson signed by 2
members of the board, or at times and places as prescribed by the
rules of the board. The board shall hold not less than 12 meetings
each fiscal year with an interval of not more than 5 weeks between
2 meetings.
(3) At the first meeting following the appointment of a new
member to the board, the members shall choose 1 member as
chairperson, who shall continue to act as chairperson of the board
until the selection of a successor.
(4)
If a member of the county social services board, upon
receiving notification, fails to attend 3 consecutive regularly
scheduled meetings of the board, the county board of commissioners
after
notification from the county social services board of the
failure of a member to attend without reasonable cause such as
illness or other circumstances beyond the member's control shall by
formal vote excuse the member or declare the office vacant. The
vacancy shall be filled for the remainder of the unexpired term in
the same manner as the original appointment was made.
(5) Members of the board shall be reimbursed for necessary
travel
and other expenses, and shall be paid such an amount
as
shall
be fixed by the board of commissioners
or board of county
auditors.
(6) Except as prescribed in sections 35 and 64, a writing
prepared, owned, used, in the possession of, or retained by the
county
social services board in the performance of an official
function shall be made available to the public in compliance with
Act
No. 442 of the Public Acts of 1976.the
freedom of information
act, 1976 PA 442, MCL 15.231 to 15.246.
Sec. 47. (1) Two or more counties may organize a district
department
of social welfare and medical relief by a majority vote
of the members elect of the county board of commissioners of each
county. The administration of the powers and duties of the
department
shall be vested in a district social welfare board and
medical
advisory council. The district social welfare board and
medical advisory council shall consist of members appointed from
persons who are residents within the district, for 3-year terms as
follows:
1 member shall be appointed by the state social welfare
commission
county department and the county board of commissioners
of each county included in the district shall each appoint 2
members.
Of the members first appointed the member appointed by the
state
social welfare commission shall be appointed for a term of 1
year;
1 member appointed by the county board of commissioners of
each
county shall be appointed for the term of 2 years, and 1
member
for the term of 3 years. A
reference in this act to a county
department
of social services or to a county social services board
,
shall be deemed to apply applies
to a district department of
social
welfare or a district social
welfare board, where a district
has been created as provided in this section. A member of a
district board shall not hold an elective office. The members of
the
district social welfare board shall choose a chairperson as
provided in section 46.
(2)
The business which that a district social welfare board
may perform shall be conducted at a public meeting of the board
held
in compliance with Act No. 267 of the Public Acts of 1976. the
open meetings act, 1976 PA 267, MCL 15.261 to 15.275. Public notice
of the time, date, and place of the meeting shall be given in the
manner
required by Act No. 267 of the Public Acts of 1976.the open
meetings act, 1976 PA 267, MCL 15.261 to 15.275.
(3) Except as prescribed in sections 35 and 64, a writing
prepared, owned, used, in the possession of, or retained by a
district
department of social welfare or a district social welfare
board in the performance of an official function shall be made
available
to the public in compliance with Act No. 442 of the
Public
Acts of 1976.the freedom of
information act, 1976 PA 442,
MCL 15.231 to 15.246.
Sec. 50. Any county employee or officer who transports,
brings, or causes to be transported or brought, any other person
receiving general relief, hospitalization, or infirmary care, or in
need of general relief, hospitalization, or infirmary care from any
county
or from any city operating a separate department of social
welfare
under this act into any other
county or city operating a
separate
department without legal authority and there leave leaves
the person there receiving general relief or in need of general
relief;
or who induces such a person by threat or other means to
remove to another county or city operating a separate department,
with the intent to make the county or city to which the removal is
made chargeable with the support of the person receiving or in need
of public assistance, is guilty of a misdemeanor.
Sec.
53. Said A board shall cooperate with the state
department
of social welfare in handling the welfare and relief
problems
and needs of the people of its county, and to such end may
adopt any plan or plans required or desirable in order to
participate
in the distribution of federal or state moneys, money,
or in order to receive the assistance of the federal or state
governments. The board may adopt any rules and regulations or do
any
act in order to enable participation of the county in any such
a plan or plans.
Sec. 55. The county department shall administer a public
welfare program, as follows:
(a) To grant general assistance, including medical care and
care in the county medical care facility, but not including
hospitalization and infirmary care except for care in the county
medical care facility or a county infirmary existing on January 1,
1981, to any person domiciled in the county who has a legal
settlement in this state. General assistance may also be granted to
a person who has a legal settlement in this state but no domicile
in the county, and a recoupment may be made when appropriate in the
manner provided in cases of emergency hospitalization under this
act. In a temporary emergency, general assistance may be given to
indigents without a settlement in this state as the county
department considers necessary, including, if other funds are not
available for the purpose, all necessary expenses in transporting
an indigent to his or her domicile in this state, or in another
state or nation, when information reasonably tends to show that the
person has a home available in his or her place of domicile in this
state or a legal residence in another state or nation. A legal
settlement in this state is acquired by an emancipated person who
has lived continuously in this state for 1 year with the intent to
make it his or her home and who, during the 1-year period has not
received public assistance, other than assistance received during
and as a direct result of a civil defense emergency, or support
from relatives. Time spent in a public institution shall not be
counted in determining settlement. A legal settlement shall be lost
by remaining away from this state for an uninterrupted period of 1
year except that absence from this state for labor or other special
or temporary purpose shall not occasion loss of settlement.
(b) To administer categorical assistance including medical
care.
(c) To supervise and be responsible for the operation of the
county infirmary and county medical care facility. In a county
having a population of 1,000,000 or more that maintains a county
infirmary or county hospital or a joint infirmary and hospital
providing for mental patients, the institution and the admissions
to the institution are subject to the control of a board to be
known as the board of county institutions. The board shall consist
of 5 members appointed by the county board of commissioners, except
that in a county having a board of county auditors, 3 members of
the board of county institutions shall be appointed by the county
board of commissioners and 2 members shall be appointed by the
board of county auditors. Each member of the board shall hold
office for a term and receive compensation as the county board of
commissioners provides by ordinance. In relation to the
administration of the institutions, the board has and succeeds to
all powers and duties formerly vested by law, general, local, or
special, in the superintendents of the poor in the county and the
board of county institutions as constituted on April 13, 1943. The
board of county institutions of the county may also maintain
outpatient facilities for the treatment of needy persons suffering
from
mental disorders. illness.
The board also has the same powers
as
are given to the county board in section 78.
(d) To furnish in all cases, insofar as practicable, care and
treatment that will tend to restore needy persons to a condition of
financial and social independence.
(e) To require that each applicant shall furnish proof
satisfactory to the county board that the applicant is entitled to
the aid, assistance, or benefit sought.
(f) To investigate, in respect to each application for any
form of public aid or assistance, the circumstances of the
applicant, both at the time of application and periodically during
the receipt of aid or assistance.
(g) To maintain adequate social and financial records
pertaining to each recipient of aid or assistance and so far as is
practicable engage in the prevention of social disabilities.
(h) Except as otherwise provided in this subdivision, to
investigate, when requested by the probate court or the family
division of circuit court, matters pertaining to dependent,
neglected, and delinquent children and wayward minors under the
court's jurisdiction, to provide supervision and foster care as
provided by court order, and to furnish the court, on request,
investigational service in respect to the hospitalization of
children under the program of services for children and youth with
special health care needs established under part 58 of the public
health
code, 1978 PA 368, MCL 333.5801 to 333.5879, which services
shall include the follow-up investigation and continuing
observations. If the county is a county juvenile agency as defined
in section 2 of the county juvenile agency act, 1998 PA 518, MCL
45.622, the county department's obligations under this subdivision
are limited to public wards within the county's jurisdiction under
the youth rehabilitation services act, 1974 PA 150, MCL 803.301 to
803.309, and county juvenile agency services as defined in section
117a.
(i) To assist other departments, agencies, and institutions of
the federal, state, and county governments, when requested, in
performing services in conformity with the purposes of this act.
(j) To assist in the development of sound programs and
standards of child welfare, and promote programs and policies
looking toward the prevention of dependency, neglect, and
delinquency and other conditions affecting adversely the welfare of
families and children.
(k) To create within the county department a division of
medical care. The county board may appoint a properly qualified and
licensed doctor of medicine as the head of the division and an
advisory committee. The advisory committee shall consist of 1
doctor of medicine, nominated by the county medical society; 1
dentist, nominated by the district dental society; and 1
pharmacist, nominated by the district pharmaceutical association,
to assist in formulating policies of medical care and auditing and
reviewing bills. "Medical care" as used in this act means medical
care rendered under the supervision of a licensed physician in an
organized
out-patient outpatient department of a hospital licensed
by
the department of community health under article 17 of the
public
health code, 1978 PA 368, MCL 333.20101 to 333.22260, or
home and office attendance by a physician, osteopathic physician
and surgeon, or podiatrist licensed or otherwise authorized to
engage
in practice under article 15 of the public health code, 1978
PA
368, MCL 333.16101 to 333.18838;
and when prescribed by the
physician, osteopathic physician and surgeon, or podiatrist,
diagnostic services requiring the use of equipment not available in
his or her offices, if the services do not require overnight care,
dental service, optometric service, bedside nursing service in the
home, or pharmaceutical service. The private physician-patient
relationship shall be maintained. The normal relationships between
the recipients of dental, optometric, nursing, and pharmaceutical
services, and the services furnished by a physician, osteopathic
physician and surgeon, podiatrist, or a chiropractor licensed or
otherwise authorized to engage in practice under article 15 of the
public
health code, 1978 PA 368, MCL 333.16101 to 333.18838, and
the persons furnishing these services shall be maintained. This
section does not affect the office of a city physician or city
pharmacist established under a city charter, a county health
officer, or the medical superintendent of a county hospital. This
section permits the use of a case management system, a patient care
management system, or other alternative system for providing
medical care.
(l) To cause to be suitably buried the body of a deceased
indigent person who has a domicile in the county, when requested by
the person's relative or friend, or of a stranger, when requested
by a public official following an inquest.
(m) To administer additional welfare functions as are vested
in the department, including hospitalization.
(n) To act as an agent for the state department in matters
requested by the state department under the rules of the state
department.
(o) To provide temporary general assistance for each family
found ineligible for family independence program assistance by
reason of unsuitable family home as provided in section 56.
Sec.
56i. (1) The family independence agency department shall
establish and enforce standards and procedures to do all of the
following:
(a) Screen and identify individuals who are receiving
assistance under section 57b who have a history of domestic
violence, while maintaining the confidentiality of that
information.
(b) Refer those individuals identified under subdivision (a)
to counseling and supportive services.
(c) In accordance with a determination of good cause, waive
certain program requirements of the family independence program
established in section 57a in cases where compliance with those
requirements would make it more difficult for individuals receiving
assistance to escape domestic violence or would unfairly penalize
individuals who are or have been victimized by domestic violence or
individuals who are at risk of further domestic violence.
(2)
The family independence agency department
shall include in
the state plan required for federal temporary assistance for needy
families block grants a certification by the governor that the
state has established and is enforcing the standards and procedures
described in subsection (1).
(3)
The family independence agency department
shall collect
and compile data regarding administration of the waiver authorized
under subsection (1)(c), including information regarding
individuals screened and identified under subsection (1)(a) and
information regarding individuals actually granted a waiver. The
family
independence agency department
shall annually report to the
legislature on the information collected and compiled under this
subsection.
Sec. 58. (1) A county board may, with the approval of the
county board of commissioners, supervise and be responsible for the
operation of a county medical care facility in, auxiliary to, or
independent of the county infirmary. If a county has a board of
county institutions, a county medical care facility shall be
supervised and operated by the board of county institutions, and
all
references in this section to the county board means, mean, for
that county, the board of county institutions. The county board in
a county that has established a county medical care facility may
collect from any available source for the cost of care given in the
facility, and the collections shall be deposited in the social
welfare fund created under section 73a. The facility shall provide
a program of planned and continuing medical treatment and nursing
care under the general direction and supervision of a licensed
physician
employed full full-time or part-time who shall be known
as the medical director.
(2) Medical treatment and nursing care provided in a county
medical care facility shall consist of services given to persons
suffering from prolonged illness, defect, infirmity, or senility,
or recovering from injury or illness. The services provided shall
include some or all of the procedures commonly employed, such as
physical examination, diagnosis, minor surgical treatment,
administration of medicines, providing special diets, giving
bedside care, and carrying out any required treatment prescribed by
a licensed physician that are within the ability of the facility to
provide.
(3) Services provided in a county medical care facility shall
be consistent with the needs of the type of patient admitted and
cared for, professionally supervised and planned, and provided on a
continuing basis. A person shall not be admitted or retained for
care if he or she requires special medical or surgical treatment or
treatment for a psychosis, tuberculosis, or contagious disease,
except that the facility may contain a supervised psychiatric ward
for the temporary detention of mentally ill patients if the ward
has
been inspected and approved by the department of community
health
and certified by the department of
community health to the
county board, and if no other facility for temporary detention of
mentally ill patients exists in the county. A county department may
provide for the support of poor persons who may be feeble-minded or
mentally ill at some other place or places and in a manner that
best promotes the interests of the county and the comfort and
recovery
of such those persons, at the expense of the county.
(4) A county board, in seeking approval to establish, extend,
and operate a county medical care facility in an existing building,
shall apply in writing to the department. The county board shall
include with the application a proposed plan with specifications,
including standards of operation, for the examination and
recommendations of the department.
(5) A county board of commissioners may determine to erect a
county infirmary or county medical care facilities for the
reception and care of the poor and unfortunate of the county. The
county medical care facilities may be on different sites than the
county infirmary. On filing the determination with the county
clerk, the county board of commissioners may direct the county
board to purchase 1 or more tracts of land, not exceeding 320
acres, and to erect on the land 1 or more suitable buildings for
the county infirmary or county medical care facilities. Before any
county infirmary or county medical care facility is erected or any
existing buildings are remodeled, added to, or substantially
altered under this section, before plans for the county infirmary
or county medical care facilities are finally accepted, and before
any contract is entered into for construction, the plans shall be
submitted to the department for examination and approval. The
determination reached shall be certified to the county clerk and
presented to the county board of commissioners at the next regular
meeting of the county board of commissioners. A county infirmary or
county medical care facility shall not be constructed unless the
plans have been certified under this subsection. A contract for the
erection of a county infirmary or county medical care facility is
not valid or binding unless the plans referred to in the contract
and actually followed in the construction have been approved. Money
shall not be paid from county funds for construction until the
plans have been approved and the determination filed.
(6) The department shall review the proposals and plans of a
county board submitted in connection with an application for the
establishment, extension, and operation of a county medical care
facility or county infirmary and shall consult with and give advice
to the county department as to plans, procedures, and programs
required for the proper establishment, extension, and operation of
the county medical care facility or county infirmary.
(7) The department shall approve the county medical care
facilities by proper notice to the county department. After
approval, the department shall inspect the facility as frequently
as it considers necessary, but at least once each year. A county
department shall comply with any reasonable order issued by the
department. The county department may appeal an order in writing,
within 30 days of receiving the order, to the director of the
department.
(8) Any reasonable order of the department for the
establishment, extension, operation, or closing of a county
infirmary or county medical care facility may be enforced by
mandamus or injunction in the circuit court for the county where
the facility is located in proceedings instituted by the attorney
general on behalf of the department.
(9) A county medical care facility shall not be opened for
operation until it has been inspected and approved in writing to
the department by the bureau of fire services created in section 1b
of
the fire protection prevention
code, 1941 PA 207, MCL 29.1b, and
the
department. of community health. The county department
shall
comply with any reasonable directive issued by the bureau of fire
services
or the department of community health with regard to the
fire safety and sanitation of the county infirmary or county
medical care facility. A directive may be enforced by the
department in the same manner as are orders of the department.
After receiving the approval of the department, the county
department shall represent the facility to the public as the county
medical care facility and shall make reasonable and continuing
effort to divorce the facility from an association in the public
mind with the words "poor house" or "poor farm".
Sec. 58b. The state department in accordance with its rules
and regulations may pay for medical care that a recipient of aid to
the
blind, aid to disabled, aid to dependent children, temporary
assistance for needy families, or old age assistance, receives in
the county medical care facility. Other persons admitted to care in
the facility shall be charged for the cost of their care to the
extent of their financial ability as determined by the county
department
and such their financial ability shall does not
preclude
their
eligibility for such care. Prior consideration shall be given
to any person who comes within the definition of a "poor person"
set
forth in section 1 of chapter 1 of Act No. 146 of the Public
Acts
of 1925, as amended, being section 401.1 of the Compiled Laws
of
1948. 1925 PA 146, MCL 401.1.
No poor persons as so person as
defined in section 1 of chapter 1 of 1925 PA 146, MCL 401.1, shall
be refused admittance to a county medical care facility if there
are
then within such a county medical care facility persons who are
not senile and who are paying the total cost of their care.
Any
county department which shall accept that accepts state
financial aid for capital expenditures related to the
establishment, extension or improvement of its facilities shall
accept for care any patient eligible for admission as provided in
section 58a, and having a domicile in the county and any patient
for whom care is requested by the state department because of being
found in the county without either a known domicile in the state or
a place of residence outside the state to which he or she may be
returned.
Direct state financial aid to meet part of the cost of capital
expenditures for the establishment, extension, or improvement of a
county medical care facility may be provided from the general funds
of
the state or from such federal funds as may be made available in
the
following manner: The county social welfare board with the
approval of the county board of supervisors will make an
application to the state department as otherwise provided in
section 58 but shall make in addition, a showing of need, in the
same manner as provided in section 18, that it is unable to meet
all of the capital expenses of a county medical care facility. The
state department shall determine the percentage of the total
capital
cost of the facility which that
the county will be unable
to meet and shall request from the legislature an appropriation
from
the general fund of the state or such federal funds as may be
made available for this purpose to meet this amount. Requests of
the
legislature from the state department for such these
appropriations shall be separate items for each medical care
facility. The amount of state aid actually granted the county by
the
state department shall not exceed (1) the amount appropriated
by the legislature in respect to the amount of the item in the
budget,
or (2) the percentage of state aid required as previously
determined by the state department, whichever is the lesser.
To defray the cost of construction in the establishment or
extension of the medical care facility, the board of supervisors
may raise in any 1 year a sum not exceeding .1 mill of each dollar
of
assessed valuation of the county, such the tax to shall be
regarded as a special tax collected in the same manner as other
county
charges, and moneys money received therefrom from that tax
shall be transmitted to the treasurer of the county, who shall
deposit same in a special fund to be used solely for the purposes
for which the tax is spread. Money expended for construction in the
establishment or extension of the facility shall be paid out by the
county
treasurer on the order of the county social welfare board.
Sec. 58c. Notwithstanding any other provision of this act,
patients suffering from contagious diseases may be admitted to any
county medical care facility where the facility is constructed or
operated
with the approval of the state department of social
welfare
and is able to provide an isolated
area for such care
approved
by the state health commissioner.director.
Sec. 59. All applications for aid, relief, or assistance
provided
under this act shall be made to the county department of
social
welfare in such the manner
and upon such the forms as may be
prescribed by the state department. When any person applies for or
requires public aid as a poor person under this act other than
hospitalization or those forms of aid financed in whole or in part
by federal funds, the county department shall ascertain the legal
settlement and domicile of the person. The county department shall
ascertain the settlement and domicile of other persons when
requested
by the county health department or by the state health
commissioner.
director. Except as otherwise provided in this act,
general relief granted to persons with a legal settlement in this
state may be charged to the county of domicile. The sending of
notices, billings, and appeals in respect to charges to the county
of
domicile , shall
be made in accordance with regulations of the
commission.
department. Wherever in this act a chargeback or return
to the county or city of "settlement" or "legal settlement" is
authorized, a chargeback or return to the county or city of
"domicile"
shall be deemed considered
to be intended. Hospitals,
jails, nursing homes, convalescent homes, homes for the aged, and
prisons are not places of domicile. General relief and
hospitalization granted to persons who, while receiving assistance
under this act, move into a county to receive care in a home for
the aged, convalescent home, or other institution shall be a charge
against the county of their domicile just prior to the move
regardless of other provisions of this act and even though domicile
in the home for the aged or other institutions is intended.
Temporary relief granted to persons with no settlement in this
state shall be at the expense of the county where found. In the
case of persons illegally brought or induced to come into the
county, necessary relief shall be a charge against the county where
they were living when transported or induced to move.
Sec.
59a. The county or city department, of social welfare, as
part of its general relief program, may provide funds and necessary
attendants for the return of a person to his or her place of
residence as authorized in section 55, or to a new place of
residence
under the conditions of sections section 59 or 59f. State
or county funds shall not be used for the return of a person to
another nation who may be deported under federal law.
If
the probable place of legal settlement is in Michigan this
state and the probable place of domicile is in some other county of
this state, the county department where application for aid was
made, within 60 calendar days following the application, shall give
notice and necessary information in writing to the county
department of the county of probable domicile on forms prescribed
for that purpose by the state department. If it appears that
domicile may lie in any 1 of 2 or more counties, notices shall be
sent
to all such of those counties. If the notice is not given to
the county of probable domicile within 60 days following the
application for aid, the county granting relief to the applicant
shall have no claim whatsoever, irrespective of any other
provisions of this act, for reimbursement for the relief granted
the applicant prior to 60 calendar days preceding the date the
notice is given to the county of probable domicile.
Sec. 60. (1) Any person who by means of willful false
statement or representation, by impersonation or other fraudulent
device, or by using an access device obtains or attempts to obtain,
or
aids or abets any person to obtain or attempt to obtain ,
(a)
assistance
or relief to which the person is not entitled ; or (b) a
larger amount of assistance or relief than that to which the person
is justly entitled; or any officer or employee of a county, city,
or
district family independence agency department who authorizes or
recommends relief to persons known to the officer or employee to be
ineligible or to have fraudulently created their eligibility; or
any person who knowingly buys or aids or abets in buying or in
disposal of the property of a person receiving assistance or relief
without the consent of the director or supervisor of the state
department, shall,
if the amount involved shall be is of the value
of
$500.00 or less, be deemed is
guilty of a misdemeanor and,
shall,
if the amount involved shall be is of
the value of more than
$500.00,
be deemed is guilty of a felony, and upon conviction shall
be punished as provided by the laws of this state. The amount
involved as used in this subsection shall be defined as the
difference between the lawful amount of assistance or aid and the
amount of assistance or aid actually received. If anyone receives
assistance or relief through means enumerated in this section, in
which
prosecution is deemed considered
unnecessary, the state
department or county departments may take the necessary steps to
recover from the recipient the amount involved, plus interest at 5%
per annum. On conviction of the violation of the provisions of this
section of any officer or employee of any county, city, or district
department, of
social welfare, the officer or employee shall be
removed or dismissed from office. For the purpose of this
subsection,
"access device" means that term as it is defined in
section 300a of the Michigan penal code, 1931 PA 328, MCL 750.300a.
(2) There is imposed upon every person receiving relief under
this act either upon the person's own application or by the
person's inclusion, to his or her knowledge, in the application of
another the continuing obligation to supply to the department
issuing the relief: (a) the complete circumstances in regard to the
person's income from employment or from any other source or the
existence of income, if known to the person, of other persons
receiving relief through the same application; (b) information
regarding each and every offer of employment for the person or, if
known to him or her, of the other persons receiving relief through
the same application; (c) information concerning changes in the
person's circumstances or those of other persons receiving relief
through
the same application which that
would decrease the need for
relief; and (d) the circumstances or whereabouts, known to the
person, of relatives legally responsible for the person's support
or for the support of other persons receiving relief through the
same application if changes in those circumstances or whereabouts
could affect the amount of assistance available from those
relatives or affect their legal liability to furnish support. Any
person
who shall neglect or refuse neglects
or refuses to submit to
the department issuing relief the information required by this
section, if the amount of relief granted as a result of the neglect
or refusal is less than $500.00, is guilty of a misdemeanor, and if
the amount of relief granted as a result of the neglect or refusal
is $500.00 or more, is guilty of a felony, and upon conviction
shall be punished as provided by the laws of this state.
Sec. 61. (1) Except as provided in subsections (2) and (3), a
person who violates this act for which a penalty is not
specifically provided is guilty of a misdemeanor and, upon
conviction, shall be sentenced as provided in the laws of this
state. If a person receiving aid, relief, or assistance is
convicted of an offense under this act, or of another crime or
offense and punished by imprisonment for 1 month or longer, the
county board may direct that payments for aid, relief, or
assistance under this act shall cease and shall not be made during
the period of that person's imprisonment.
(2)
A member of the Michigan social welfare commission, a
county
social services board , or the
parole and review board who
intentionally
violates section 2(3), 46(2)
, or 121(2), shall be is
subject
to the penalties prescribed in Act No. 267 of the Public
Acts
of 1976.the open meetings
act, 1976 PA 267, MCL 15.261 to
15.275.
(3)
If the Michigan social welfare commission, a county
department, of
social services, a county social services board, a
district
department, of social welfare, a district
social welfare
board, or the parole and review board arbitrarily and capriciously
violates
section 2(6), 45(6), 46(6), or 64(3), the commission,
department , or board shall be is subject
to the penalties
prescribed
in Act No. 442 of the Public Acts of 1976.the freedom of
information act, 1976 PA 442, MCL 15.231 to 15.246.
Sec.
63a. The family independence agency department shall not
award contracts to specific organizations that have not been
competitively bid unless the award is permissible under state
contracting procedures.
Sec.
66. As to those forms of relief which that are in no part
financed by state or federal funds, the decision of the county or
district
department of social services as to the denial, granting,
form,
and amount of that relief shall be is final, except as
provided in section 66i. In a county that establishes a patient
care management system under section 66j, the decision of the
county as to the denial, granting, form, and amount of medical care
shall
be is final. This section does not prevent the state
department
from making investigations, collecting statistics, and
otherwise gaining information concerning the administration of
welfare in any county or district as the state department considers
advisable.
Sec.
66a. The county social welfare boards shall make
provision
for hospitalization which that
is necessary and not more
advantageously provided to the recipient under other law or
provided under other sections of this act for every person found in
their respective counties under rules of financial eligibility
established by the boards and shall be reimbursed 100% by the state
for the monthly net cost of the hospitalization for nonresidents of
the state. The county department, in its discretion, may direct
that the patient be conveyed to the university hospital at Ann
Arbor or any other hospital for hospitalization. As used in this
act, "hospitalization" means medical, surgical, or obstetrical care
in the university hospital or in a hospital licensed under article
17
of Act No. 368 of the Public Acts of 1978, as amended, being
sections
333.20101 to 333.22190 of the Michigan Compiled Laws, the
public health code, MCL 333.20101 to 333.22260, together with
necessary drugs, x-rays, physical therapy, prosthesis,
transportation, and nursing care incidental to the medical,
surgical,
or obstetrical care. , but shall Hospitalization does not
include medical care as defined in section 55. Before a patient
shall
be is admitted, except in an emergency, to any hospital other
than the university hospital, a definite agreement, statement, or
schedule of charges, expenses, and fees to be received by the
hospital and physicians or surgeons performing necessary services
under this act shall be filed with the county department of the
county in which the hospital is located and approved by the county
department, except as provided for in section 66i. The hospital
shall, at the conclusion of the treatment, make a report of the
treatment and an itemized statement of the expenses of the
treatment
to the county department which that
issued the order, but
charges for special nurses shall not be made without the consent of
the
county social welfare director. The expenses for sending the
patient home or to other institutions after being discharged from
the hospital may be paid by the hospital and charged in the regular
bill for maintenance unless different instructions have been
received
from the county department which that issued the order for
admission.
Sec.
66b. The county social welfare board shall require the
county department to act promptly on all applications for
hospitalization and shall provide for retroactive authorizations
for
emergency care in accordance with rules which that the
board
shall
establish including one a
rule defining "emergency".
When the
person hospitalized in an emergency is found to be eligible for
hospitalization
at public expense under section 66a of this act and
is found to be a transient in the county with a domicile elsewhere
in the state, the county in which his or her domicile is located
shall
be is responsible for the cost of hospitalization to the
county
department which that has authorized the care. When a
patient is taken without authorization in an emergency across a
county line to a hospital in a county other than the county of
domicile of the patient, the county department in which the
emergency
occurred shall be is responsible, in accordance with its
own rules governing emergency care, to the hospital for the expense
of the emergency care subject to reimbursement by the county of
domicile as provided by this section. The state department shall
provide rules governing intercounty payments and shall arbitrate
and
decide disputes arising thereunder.under those rules.
Sec. 66e. The admitting officer of the university hospital,
upon receiving a patient with an authorization issued by a county
department
of social services under this act, may provide a bed in
the
hospital and designate the clinic of the hospital to which such
the
person shall be is assigned
for treatment. The physician or
surgeon in charge of the patient shall proceed with proper care to
perform
such the operation and bestow such treatment upon the
patient
as in his or her judgment shall be is necessary.
No
compensation shall be charged or received by the admitting officer,
or by the medical faculty or by the physician, surgeon, or nurses
of
the university hospital, who shall treat treats and
care cares
for the patients, other than the salaries received by them provided
by
the board of regents of the university. If any such patient has
medical or surgical insurance coverage, the university hospital may
then charge for the service of its medical and surgical staff in
amounts
not to exceed the amounts available from such insurance
coverage. The superintendent shall make and file with the county
board
of social services an affidavit containing so as far
as
possible an itemized statement of all expenses of hospitalization
incurred
at said the hospital in care of patients admitted under
this
act in accordance with the usual rates therefor fixed by the
regents of the university. He or she shall also make reports at
suitable
intervals to the county department which that issued the
order, stating the condition of the patient and the expense
incurred.
No county shall be is liable for expenses incurred after
the expiration date of the order of the county department unless a
new order is obtained.
Sec.
66h. Nothing in this act shall be construed as empowering
empowers any physician or surgeon, or any officer or representative
of
the state or county departments, of social welfare, in carrying
out the provisions of this act, to compel any person, either child
or adult, to undergo a surgical operation, or to accept any form of
medical
treatment contrary to the wishes of said the person. If the
person for whom surgical or medical treatment is recommended is not
of sound mind, or is not in a condition to make decisions for
himself or herself, the written consent of such that person's
nearest relative, or legally appointed guardian, or person standing
in
loco parentis, shall be secured before such medical or surgical
treatment is given. This provision is not intended to prevent
temporary first aid from being given in case of an accident or
sudden acute illness where the consent of those concerned cannot be
immediately obtained.
Sec. 66i. (1) Except as provided in subsection (4), the state
department, on behalf of a county, shall reimburse the hospital in
accordance with established hospital reimbursement principles under
title
XIX of the social security act. , 42 U.S.C. 1396 to 1396d,
1396f
to 1396s. However, if If state law provides for a different
level of reimbursement, the state, on behalf of the county, shall
reimburse the hospital at that level of reimbursement.
Reimbursement will be based on eligibility information provided to
the state department by the county department.
(2) Except as provided in subsection (4), a county department
of
social services shall reimburse the
state an amount equal to the
sum of the following:
(a) The total amount the state department approves for payment
under subsection (1) to a hospital owned by that county.
(b) The total amount the state department approves for payment
to all other hospitals, on behalf of the county, less either
$100.00 per day of hospital care or an amount per day established
by state law for the county, whichever is higher.
(3) Subsection (2)(b) does not require a county department to
reimburse the state under that subdivision when the amount of
payments made to the hospitals described in subsection (2)(b), on
behalf of the county, is less than either $100.00 per day of
hospital care or an amount established by state law for the county,
whichever is higher. In addition, subsection (2) does not require
the county department to reimburse the state for the cost of the
hospitalization for nonresidents of this state.
(4) If the total payments to hospitals by the state department
for hospitalization of persons determined by the county department
of a county to be eligible for hospitalization under section 66a
were less than $2,000,000.00 during the county's full fiscal year
immediately
before October 1, 1982, the county department of social
services
of that county may elect to
reimburse hospitals directly
in accordance with reimbursement principles established by the
county
department. A county department which that elects to
reimburse hospitals directly shall notify the state department
before the beginning of the county's fiscal year in which the
election is to become effective. If the county's fiscal year in
which the election is to become effective begins in 1983 or a
subsequent year, the notice to the state department shall be made
at least 60 days before the beginning of the county's fiscal year.
(5)
The rules of financial eligibility established pursuant to
under section 66a in a county on whose behalf the state makes
payments to hospitals under subsection (1) shall not be made less
restrictive than the rules in effect in the county during the
county department's fiscal year ending in 1979.
Sec. 66j. (1) As an alternative to sections 55(k), 66a, and
66i, a county other than a county described in subsection (2) may
establish a patient care management system as described in this
section
and sections 66k to 66p.66n.
(2) If a county intending to establish a patient care
management
system is one a county in which the total payments to
hospitals in the county for the county's resident county
hospitalization program was less than $10,000,000.00 during the
county's
full fiscal year immediately preceding the effective date
of
this section, December 28,
1987, the county shall apply to the
state department for certification of its proposed patient care
management system, and the state department shall approve or
disapprove the application based upon minimum standards that are
established by the state department for county patient care
management
systems and are based upon on
this section and sections
66k to 66n. The department shall submit recommended procedures to
the appropriate standing committees of the legislature for approval
in order to allow other counties to adopt a patient care management
system
pursuant to under this act. Such procedures shall be
submitted
by January 1, 1989. If a county's
original application
for certification of a patient care management system is approved
under this section, the county shall apply to the state department
in each subsequent year for recertification of its patient care
management system according to the standards established under this
subsection. The application for recertification shall be submitted
not later than April 1 of each year, and shall be considered
automatically approved by the state department unless denied by the
state department, based upon the standards established under this
section, within 30 days after being received by the state
department. An approval or disapproval of a patient care management
system by the state department may be reversed by the legislature
by subsequent appropriations legislation or other legislation. An
original application for certification or an application for
recertification shall be in a form as prescribed by the department.
(3) Under a patient care management system, a county shall
establish sufficient rates of reimbursement and appropriate length
of stay for inpatient treatments for hospitals and other health
care providers and shall contract with hospitals and other health
care providers for medical care of persons determined to be
eligible by the county. The county shall enter into sufficient
contracts
to assure ensure that persons determined to be eligible
by the county have access to hospital services, physician services,
and other medical services considered appropriate by the county
board. of
social services.
(4) A county that establishes a patient care management system
annually
shall annually submit
a report to the state department
containing information on the number of patients served, the
services rendered for those patients, the amount of funds spent for
those services, and the terms of the contracts entered into
pursuant
to under subsection (3). The report shall be submitted not
later than 90 days after the end of the county's fiscal year. A
county's expenditures for the operation and administration of a
patient care management system are subject to audit by the state.
(5) A county that establishes a patient care management system
shall create a system to provide the data specified in subsection
(4) and to keep track of records of admissions, diagnoses,
treatments, and payment records for individuals eligible under the
patient care management system.
Sec. 67. If any application for aid financed in whole or in
part
by federal funds is not acted upon by the county department of
social
welfare within a reasonable time
after the filing of the
application, or is denied or revoked, in whole or in part, the
applicant may appeal to the state department in the manner and form
prescribed by the state department and an opportunity for a fair
hearing
shall be granted by said the
department as provided in
section 9. The state department may also, upon its own motion,
review
any decision of a county department, of social welfare, and
may
consider any such application upon which a decision has not
been
made by the county department of social welfare within a
reasonable
time. The state department may make such an additional
investigation
as it may deem considers necessary, and shall make
such
a decision as to the granting of aid financed in whole
or in
part
by federal funds and the amount thereof to be granted to the
applicant as in its opinion is justified and in conformity with the
laws
of this state. In such those
cases, the decisions of the state
department
shall be are binding upon the county department of
social
welfare involved and shall be
complied with by such the
county department.
Sec. 68. The county board shall apply to the state department
of
social welfare at such a time,
on such the forms, and in such
the
manner, as the state department shall
prescribe prescribes for
the
allocation and distribution under section 18 of this act of
state
or federal moneys money available for the several forms of
public
aid and relief, and with respect to such the application
shall be governed by the requirements and rules and regulations of
the state department.
Sec. 68a. The county department furnishing general relief,
including medical care, hospitalization, or infirmary care, to any
poor person at the expense of another county in this state, shall
present
to the department of social welfare of the county liable
for the aid and infirmary care, from time to time as the case might
be, a sworn, itemized statement of the expense, which shall be
allowed
and paid by the department of social welfare of the county
that
is liable, therefor, within 60
days after being presented. No
item of the itemized statement of expense shall be a proper and
collectible
charge against the county which that
has been
determined
to be or has agreed to be liable therefor unless
submitted within 180 days from the end of the month during which
services covered by the item were rendered. In the case of an item,
the exact amount of which the county department furnishing care is
unable
to determine during the 180 days 180-day period or prior
thereto,
to that, notice of the existence of such an item of
undetermined amount shall be given to the county liable during the
180
days, whereupon after which the county
furnishing care shall
have
has an additional 180 days in which to include the
amount of
the item in an itemized statement.
Sec.
69. The county social welfare board shall prepare and
submit to the county board of supervisors, at the annual meeting of
said
the county board of supervisors or at such other another time
as
the said county board of supervisors shall request, an estimate
of the funds necessary to carry out the provisions of this act,
including funds needed for the several institutions under the
jurisdiction
of the county social welfare board. The county social
welfare
board shall also render an account
of all moneys money
received and expended by them. In the case of a district
department, of
social welfare the district social welfare board
shall
submit such an estimate to the county
board of supervisors of
each
county forming a part of such the
district.
Sec. 70. The county board of supervisors shall, within its
discretion,
make such appropriations as are necessary to maintain
the
various welfare human services within the county, as provided
in this act, and to defray the cost of administration of these
services.
In the case of a district department, of social welfare
the county board of supervisors of each county forming a part of
said
the district shall appropriate funds necessary to care
for the
welfare
human services of such that county,
and the administrative
expenses of the district department shall be defrayed by all of the
counties
in said the district in the proportion that the population
of each county, according to the last federal census, bears to the
population of the entire district.
Sec. 71. Except in respect to a city maintaining a separate
department
of social welfare under section 48, of this act, the
distinction between township, city, and county poor is abolished.
Sec. 73a. (1) The county treasurer is designated as the
custodian
of all moneys money provided for the use of the county
department. of
social services. The treasurer shall create and
maintain
a social welfare fund. The following moneys, money,
exclusive
of funds which that must be deposited in the child care
fund, shall be deposited in the social welfare fund:
(a)
All moneys funds raised by the county for the use of the
county
department. of social services.
(b)
All funds made available to the county department of
social
services by the state and federal
governments.
(c) All refunds and collections arising out of reimbursements
to
the county department. of social services.
(d) All funds made available to the county department from any
other
source. whatsoever.
(2) Money in the social welfare fund shall remain separate and
apart from all other funds of the county and shall not be
transferred to or commingled with other funds of the county. The
fund shall be used exclusively for carrying out the purposes
authorized by this act.
(3) The state department shall prescribe, with respect to the
social
welfare fund, such subaccounts and expenditure
classifications
as the state department deems considers
suitable,
to comply with requirements to secure federal funds, to facilitate
uniform reporting, and for other purposes. The state department may
promulgate rules, plans, procedures, and controls with respect to
accounting, disbursements, and any other kind of element of
financial transactions in connection with the social welfare fund.
The county board of commissioners may establish further financial
practices not inconsistent with the above. The state department
shall prescribe the manner and extent to which the county
department shall keep on file vouchers or other authorizations to
show the items and reasons for which money is disbursed.
Sec.
76. (1) This act shall does
not be construed to relieve
the liability for support by relatives under the provisions of
chapter
1 of Act No. 146 of the Public Acts of 1925, as amended,
being
sections 401.1 to 401.21 of the Compiled Laws of 1948, I of
1925
PA 146, MCL 401.1 to 401.9, but shall
be construed as
superseding
supersedes the definition of settlement contained in
section
1 of chapter 1. I of 1925
PA 146, MCL 401.1. The terms of
chapter
1 I of 1925 PA 146, MCL
401.1 to 401.9, with respect to
liability for support by relatives may be invoked in connection
with any form of public aid or relief administered under this act.
(2)
The social welfare county board of the county of legal
settlement of a recipient of any form of aid granted under this
act,
or a social welfare county
board granting aid, may maintain an
action in the circuit court for the county the board represents, or
the circuit court for the county in which the defendant resides or
is found: (a) Against the county, township, or city neglecting or
refusing to allow and pay a bill owing under this act and presented
more than 90 days prior to the commencement of the action; or (b)
Against a recipient of emergency hospitalization or his or her
relatives who are neglecting or refusing to acknowledge
responsibility for reimbursement of the county for the costs of the
emergency hospitalization; or (c) Against a recipient of
hospitalization or his or her relatives legally liable for his or
her support to enforce its agreement with the recipient or
relatives for reimbursement of the county for hospitalization
expenses.
(3)
The prosecuting attorney shall represent the county social
welfare
board in such actions,
service, or process of courts of
like
jurisdiction in any county in this state, and such service and
return
thereof of service in accordance with law shall give gives
the court in which the action is commenced full jurisdiction to
hear and determine the cause. If any legally responsible relative
of a poor person receiving or having received any form of public
welfare support in this state lives or can be found in some other
state
which that has enacted a uniform reciprocal enforcement of
support
law, suitable action may be initiated in Michigan this
state by the prosecuting attorney against the legally responsible
relative
under the provisions of Act No. 8 of the Public Acts of
1952,
as amended, being sections 780.151 to 780.172 of the Compiled
Laws
of 1948.the revised uniform
reciprocal enforcement of support
act, 1952 PA 8, MCL 780.151 to 780.183.
Sec.
77. The county department of social welfare is hereby
authorized and empowered to collect and receive funds to reimburse
the county for expenditures made on behalf of recipients of any
form of aid or relief, or hospital care provided at county expense,
from
such recipients, their relatives legally responsible under the
laws
of this state for the support of such those recipients, or
from the estates of recipients, in accordance with the laws of this
state,
and the rules and regulations of the state department, of
social
welfare, which funds, reimbursed
for direct relief, shall be
disbursed to carry out the provisions of this act. Agreements for
the
reimbursement of the county department of social welfare for
relief granted to persons or families in their own homes may be
required in the cases of applicants whose need for relief is based
in
whole or in part on inability to obtain funds, moneys, moneys
which
money, money that may be received, income, or
assets
unavailable
at the time of application for or grant of relief, :
Provided,
however, That if earnings from wages or salaries not due
or
owing at the time of application for or grant of relief shall
are
not be included in reimbursement
agreements. Reimbursements for
any form of hospital care provided at county expense shall be
collected
and paid over by the department of social welfare to the
county
treasurer for deposit to the fund from which such the
expenditure
was made, : Provided, That if no county department of
social
welfare nor or any other agency of county government shall
collect
or receive collects or
receives reimbursements for
hospitalization or other treatment for tuberculosis, whether there
is
an agreement to reimburse the county or not, unless such the
reimbursement has been ordered by the state commissioner of health
or is found acceptable by him or her as a voluntary reimbursement
as
provided in section 3a of Act No. 314 of the Public Acts of
1927,
as added, being section 329.403a of the Compiled Laws of
1948,
former 1927 PA 314, MCL 329.403a,
and no county department of
social
welfare shall collect or receive collects
or receives
reimbursements for hospitalization or other treatment for any other
communicable
disease or diseases. Nothing in this This section
shall
be construed to does not affect the civil service status, if
any, of county employees now engaged in collecting reimbursements
for the county for any form of aid, relief, or hospital care, under
the
supervision of any other county department. All such of these
employees, and all collection records and files in the county on
cases
investigated by the department of social welfare prior to the
effective
date hereof, before September
23, 1949, shall be
transferred to and be under the supervision, control, and
jurisdiction
of the county board of social welfare in such that
county.
If a county has acknowledged liability or has reimbursed
another county for the cost of any form of aid, relief, or hospital
care
provided at county expense, the county so that was reimbursed
shall credit or remit, as the case may be, to the paying county,
within
60 days, any additional collections thereon after that from
any
other source. It shall be the duty of each Each county
department
of social welfare to shall
continue to collect according
to
its best judgment and ability, if so requested by the county
which
that has acknowledged or paid for any form of aid, relief, or
hospital care provided at county expense.
Sec.
77a. Under such the rules and regulations as that the
state
department of social welfare shall promulgate, promulgates,
inconsequential earnings shall not affect the determination of any
amount of assistance to be paid by the state for old age assistance
,
aid to dependent children or
temporary assistance for needy
families or matched by the state in connection with the granting of
welfare relief.
Sec.
80. It shall be the duty of the The
county social welfare
board
to shall report to the state department monthly, and in
such
a
form as that the
state department shall furnish and prescribe,
furnishes and prescribes, the activities of the county department.
The
board shall also make such other and additional reports as
shall
be required by the state
department.
Sec. 83. (1) The director of the state department of
social
services
or the director of any county
department of social
services
may demand and receive from any
financial institution, the
Michigan
department of treasury, the
Michigan employment security
commission or a successor entity, employer, or former employer
doing business in this state, information with respect to the
transactions
with any such financial institution, dates of
employment, number of hours worked, and rate of pay of an applicant
for or recipient of any form of aid or relief under this act. The
officers and employees of the institution or employer shall furnish
the information on the written demand of the director. A demand
directed to a financial institution or an employer shall be in the
form of a subpoena issued by the director under section 8 when the
identification of applicants and recipients to the financial
institution or employer is by means of computer tape or other data
process media. The financial institution or employer shall furnish
the information within 15 days after the demand or subpoena is
received by the financial institution or employer.
(2) As used in this section, "financial institution" means a
state bank, a national banking association, a state or federal
savings and loan association, a federal savings bank, or a state or
federal credit union.
(3) The director of the state department shall cooperate with
the Michigan employment security commission in the development of a
computer
data matching system by which records of the department of
social
services concerning applicants for,
and recipients of,
assistance under this act shall be compared with claimant and wage
information requested on at least a quarterly basis from, and
furnished
by, the Michigan employment security commission pursuant
to
or a successor entity under sections 11 and 13 of the Michigan
employment
security act, Act No. 1 of the Public Acts of the Extra
Session
of 1936, being sections 421.11 and 421.13 of the Michigan
Compiled
Laws. 1936 (Ex Sess) PA 1,
MCL 421.11 and 421.13. The
computer data matching system shall be used only to determine or
verify eligibility of an individual for aid or assistance
administered under this act or the amount or type of assistance for
which the individual is eligible; to investigate or prosecute
instances of alleged fraud; or to establish and collect child
support obligations or locate individuals owing child support
obligations.
(4)
The information obtained under subsection (3) shall be
considered
is confidential and shall not be disclosed by officers
or
employees of the department of social services to any person or
agency
except as provided in section 11(b)(2) of Act No. 1 of the
Public
Acts of the Extra Session of 1936.the
Michigan employment
security act, 1936 (Ex Sess) PA 1, MCL 421.11.
Sec. 84. In respect to matters in which a district department
of
social welfare differs from a
county department, of social
welfare,
the state department shall have has the
power to
promulgate rules and regulations relating to organization,
operation, and
procedure affecting such a
district or city
department,
which rules and regulations shall be are binding upon
all persons and authorities concerned.
Sec. 85. The powers and duties now vested by law in the county
superintendents of the poor, except as otherwise provided in
subdivision
(c) of section 55 of this act, section
55(c), are
hereby
transferred to and vested in the
several county departments.
of
social welfare herein created. Whenever A reference is made to
the
above offices in any law of the state, or whenever a reference
is
made to the supervisor of any
township or ward, or to the
director of poor of any city, with respect to the powers and duties
transferred
to the county department, of social welfare, reference
shall
be deemed to be intended to be made is a reference to the
said
county board. of
social welfare.
Sec. 86. All of the powers and duties prescribed in any law of
this state incidental of the transfer of the powers and duties
herein
provided for shall be in this section are transferred to and
be
vested in the several county
departments. of social welfare.
Sec.
90. No member of the state commission or of any county
social
welfare board and no executive
official or employe employee
of
the state or any county welfare department shall participate in
any form of political activity other than may be appropriate to the
exercise of the individual's rights, duties, and privileges or use
his
or her official position for any political purpose. Any employe
employee
of any department violating this
provision shall be is
subject
to discharge or such other disciplinary action as may be
provided by the rules and regulations of the state department.
Sec. 100. Persons who were employees of a city or county
department
of social welfare immediately prior to the effective
date
of this amendatory act, before
October 27, 1965, who (1) were
members of a city or county retirement system and (2) become
members
of the state employees' retirement system, shall be are
entitled
to benefits provided by Act No. 88 of the Public Acts of
1961,
as amended, entitled "An act to provide for the preservation
and
continuity of retirement system service credits for public
employees
who transfer their employment between units of
government",
the reciprocal retirement
act, 1961 PA 88, MCL 38.1101
to 38.1106, notwithstanding that the city or county might not have
adopted
the said Act No. 88. reciprocal
retirement act, 1961 PA 88,
MCL 38.1101 to 38.1106. Whenever the service requirements for
benefits
to be paid under Act No. 240 of the Public Acts of 1943,
as
amended, the state employees'
retirement act, 1943 PA 240, MCL
38.1
to 38.69, to the said persons
who become members of the state
employees' retirement system are lower than the service
requirements
in the said Act No. 88, reciprocal
retirement act,
1961
PA 88, MCL 38.1101 to 38.1106, the provisions
of the said Act
No.
240 shall state employees'
retirement act, 1943 PA 240, MCL
38.1
to 38.69, apply with respect to the said
those persons.
Sec. 105. (1) The department of community health shall
establish a program for medical assistance for the medically
indigent
under title XIX. The director of the department of
community
health shall administer the program
established by the
department
of community health and shall be is responsible for
determining eligibility under this act. Except as otherwise
provided in this act, the director may delegate the authority to
perform a function necessary or appropriate for the proper
administration of the program.
(2)
As used in this section and sections 106 to 112: , "peer
(a) "Peer review advisory committee" means an entity
comprising professionals and experts who are selected by the
director and nominated by an organization or association or
organizations or associations representing a class of providers.
(b) (3)
As used in sections 106 to 112, "professionally
"Professionally accepted standards" means those standards developed
by peer review advisory committees and professionals and experts
with whom the director is required to consult.
(c) (4)
As used in this section and sections 106 to 112,
"provider"
"Provider means an individual, sole proprietorship,
partnership, association, corporation, institution, agency, or
other legal entity, who has entered into an agreement of enrollment
specified by the director under section 111b(4).
Sec.
105a. (1) The department of community health shall
develop written information that sets forth the eligibility
requirements for participation in the program of medical assistance
administered under this act. The written information shall be
updated not less than every 2 years.
(2)
The department of community health shall provide copies of
the written information described in subsection (1) to all of the
following persons, agencies, and health facilities:
(a)
A person applying to the department of community health
for participation in the program of medical assistance administered
under this act who is considering institutionalization for the
person or person's family member in a nursing home or home for the
aged.
(b) Each nursing home in the state.
(c) Each hospital in the state.
(d) Each adult foster care facility in the state.
(e) Each area agency on aging.
(f) The office of services to the aging.
(g) Local health departments.
(h) Community mental health boards.
(i)
Medicaid and medicare Medicare
certified home health
agencies.
(j) County medical care facilities.
(k)
Appropriate department of community health personnel.
(l) Any other person, agency, or health facility determined to
be
appropriate by the department. of community health.
Sec.
105b. (1) The department of community health shall create
incentives for individual medical assistance recipients who
practice specified positive health behaviors. The incentives
described in this subsection may include, but are not limited to,
expanded benefits and incentives relating to premiums, co-pays, or
benefits. The positive health behaviors described in this
subsection may include, but are not limited to, participation in
health risk assessments and health screenings, compliance with
medical treatment, attendance at scheduled medical appointments,
participation in smoking cessation treatment, exercise, prenatal
visits, immunizations, and attendance at recommended educational
health programs.
(2)
The department of community health shall create pay-for-
performance
incentives for contracted medicaid Medicaid health
maintenance
organizations. The medicaid Medicaid
health maintenance
organization contracts shall include incentives for meeting health
outcome targets for chronic disease states, increasing the number
of medical assistance recipients who practice positive health
behaviors, and meeting patient compliance targets established by
the
department. of community health. Priority shall be given
to
strategies that prevent and manage the 10 most prevalent and costly
ailments affecting medical assistance recipients.
(3)
The department of community health shall establish a
preferred product and service formulary program for durable medical
equipment.
The department of community health shall work with the
centers
Centers for medicare Medicare and medicaid
services
Medicaid
Services to determine if a joint
partnership with medicare
Medicare is possible in establishing the program described in this
subsection as a means of achieving savings and efficiencies for
both
the medicaid Medicaid and medicare Medicare programs. The
preferred product and service formulary program for durable medical
equipment
shall require participation from the department of
community
health and shall permit the
contracted medicaid Medicaid
health maintenance organizations and provider organizations to
participate.
(4)
The department of community health shall seek financial
support for electronic health records, including, but not limited
to, personal health records, e-prescribing, web-based medical
records, and other health information technology initiatives using
medicaid
Medicaid funds.
(5)
The department of community health shall include in any
federal waiver request that is submitted with the intent to secure
federal
matching funds to cover the medically uninsured nonmedicaid
non-Medicaid population in the state language to allow the
department
of community health to establish, at a minimum, the
programs required under subsections (1) and (2).
(6)
The department of community health shall not implement
incentives under this section that conflict with federal statute or
regulation.
Sec.
105c. The director of the department of community health
shall submit a recommendation to the senate majority leader, the
speaker of the house, and the state budget office on how to most
effectively
determine medicaid Medicaid
eligibility and enrollment
for
all applicants by January 1, 2015. The department of community
health
may delegate this function to
another state agency, perform
the function directly, or contract with a private or nonprofit
entity, consistent with state law.
Sec.
105d. (1) The department of community health shall seek a
waiver
from the United States department Department of health
Health
and human services Human Services to do, without
jeopardizing federal match dollars or otherwise incurring federal
financial penalties, and upon approval of the waiver shall do, all
of the following:
(a) Enroll individuals eligible under section
1396a(a)(10)(A)(i)(VIII) of title XIX who meet the citizenship
provisions of 42 CFR 435.406 and who are otherwise eligible for the
medical assistance program under this act into a contracted health
plan that provides for an account into which money from any source,
including, but not limited to, the enrollee, the enrollee's
employer, and private or public entities on the enrollee's behalf,
can be deposited to pay for incurred health expenses, including,
but not limited to, co-pays. The account shall be administered by
the
department of community health and can be delegated to a
contracted health plan or a third party administrator, as
considered
necessary. The department of community health shall not
begin enrollment of individuals eligible under this subdivision
until January 1, 2014 or until the waiver requested in this
subsection
is approved by the United States department Department
of
health Health and human services, Human Services, whichever is
later.
(b) Ensure that contracted health plans track all enrollee co-
pays incurred for the first 6 months that an individual is enrolled
in the program described in subdivision (a) and calculate the
average monthly co-pay experience for the enrollee. The average co-
pay amount shall be adjusted at least annually to reflect changes
in
the enrollee's co-pay experience. The department of community
health
shall ensure that each enrollee
receives quarterly
statements for his or her account that include expenditures from
the account, account balance, and the cost-sharing amount due for
the
following 3 months. The enrollee shall be is required to remit
each month the average co-pay amount calculated by the contracted
health
plan into the enrollee's account. The department of
community
health shall pursue a range of
consequences for enrollees
who consistently fail to meet their cost-sharing requirements,
including, but not limited to, using the MIChild program as a
template and closer oversight by health plans in access to
providers.
The department of community health shall report its plan
of action for enrollees who consistently fail to meet their cost-
sharing requirements to the legislature by June 1, 2014.
(c) Give enrollees described in subdivision (a) a choice in
choosing among contracted health plans.
(d) Ensure that all enrollees described in subdivision (a)
have access to a primary care practitioner who is licensed,
registered, or otherwise authorized to engage in his or her health
care profession in this state and to preventive services. The
department
of community health shall require that all new enrollees
be assigned and have scheduled an initial appointment with their
primary care practitioner within 60 days of initial enrollment. The
department
of community health shall monitor and track contracted
health plans for compliance in this area and consider that
compliance
in any health plan incentive programs. The department of
community
health shall ensure that the
contracted health plans have
procedures to ensure that the privacy of the enrollees' personal
information is protected in accordance with the health insurance
portability and accountability act of 1996, Public Law 104-191.
(e) Require enrollees described in subdivision (a) with annual
incomes between 100% and 133% of the federal poverty guidelines to
contribute not more than 5% of income annually for cost-sharing
requirements. Cost-sharing includes co-pays and required
contributions made into the accounts authorized under subdivision
(a). Contributions required in this subdivision do not apply for
the first 6 months an individual described in subdivision (a) is
enrolled. Required contributions to an account used to pay for
incurred health expenses shall be 2% of income annually.
Notwithstanding this minimum, required contributions may be reduced
by the contracting health plan. The reductions may occur only if
healthy behaviors are being addressed as attested to by the
contracted health plan based on uniform standards developed by the
department
of community health in consultation with the contracted
health plans. The uniform standards shall include healthy behaviors
that must include, but are not limited to, completing a department
of
community health approved annual
health risk assessment to
identify unhealthy characteristics, including alcohol use,
substance use disorders, tobacco use, obesity, and immunization
status. Co-pays can be reduced if healthy behaviors are met, but
not until annual accumulated co-pays reach 2% of income except co-
pays for specific services may be waived by the contracted health
plan if the desired outcome is to promote greater access to
services that prevent the progression of and complications related
to chronic diseases. If the enrollee described in subdivision (a)
becomes ineligible for medical assistance under the program
described in this section, the remaining balance in the account
described in subdivision (a) shall be returned to that enrollee in
the form of a voucher for the sole purpose of purchasing and paying
for private insurance.
(f) By July 1, 2014, design and implement a co-pay structure
that encourages use of high-value services, while discouraging low-
value services such as nonurgent emergency department use.
(g) During the enrollment process, inform enrollees described
in subdivision (a) about advance directives and require the
enrollees
to complete a department of community health-approved
department-approved advance directive on a form that includes an
option to decline. The advance directives received from enrollees
as provided in this subdivision shall be transmitted to the peace
of mind registry organization to be placed on the peace of mind
registry.
(h) By April 1, 2015, develop incentives for enrollees and
providers
who assist the department of community health in
detecting fraud and abuse in the medical assistance program. The
department
of community health shall provide an annual report that
includes the type of fraud detected, the amount saved, and the
outcome of the investigation to the legislature.
(i) Allow for services provided by telemedicine from a
practitioner who is licensed, registered, or otherwise authorized
under
section 16171 of the public health code, 1978 PA 368, MCL
333.16171, to engage in his or her health care profession in the
state where the patient is located.
(2) For services rendered to an uninsured individual, a
hospital that participates in the medical assistance program under
this
act shall accept 115% of medicare Medicare rates as payments
in full from an uninsured individual with an annual income level up
to 250% of the federal poverty guidelines. This subsection applies
whether or not either or both of the waivers requested under this
section are approved, the patient protection and affordable care
act is repealed, or the state terminates or opts out of the program
established under this section.
(3) Not more than 7 calendar days after receiving each of the
official waiver-related written correspondence from the United
States
department Department of health Health and human services
Human Services to implement the provisions of this section, the
department
of community health shall submit a written copy of the
approved waiver provisions to the legislature for review.
(4)
By September 30, 2015, the department of community health
shall develop and implement a plan to enroll all existing fee-for-
service enrollees into contracted health plans if allowable by law,
if the medical assistance program is the primary payer and if that
enrollment is cost-effective. This includes all newly eligible
enrollees
as described in subsection (1)(a). The department of
community
health shall include contracted
health plans as the
mandatory
delivery system in its waiver request. The department of
community
health also shall pursue any and
all necessary waivers to
enroll
persons eligible for both medicaid Medicaid and medicare
Medicare into the 4 integrated care demonstration regions beginning
July
1, 2014. By September 30, 2015, the department of community
health shall identify all remaining populations eligible
for
managed care, develop plans for their integration into managed
care, and provide recommendations for a performance bonus incentive
plan mechanism for long-term care managed care providers that are
consistent with other managed care performance bonus incentive
plans.
By September 30, 2015, the department of community health
shall make recommendations for a performance bonus incentive plan
for long-term care managed care providers of up to 3% of their
medicaid
Medicaid capitation payments, consistent with other
managed care performance bonus incentive plans. These payments
shall comply with federal requirements and shall be based on
measures that identify the appropriate use of long-term care
services and that focus on consumer satisfaction, consumer choice,
and other appropriate quality measures applicable to community-
based and nursing home services. Where appropriate, these quality
measures shall be consistent with quality measures used for similar
services implemented by the integrated care for duals demonstration
project. This subsection applies whether or not either or both of
the waivers requested under this section are approved, the patient
protection and affordable care act is repealed, or the state
terminates or opts out of the program established under this
section.
(5)
By September 30, 2016, the department of community health
shall implement a pharmaceutical benefit that utilizes co-pays at
appropriate
levels allowable by the centers Centers
for medicare
Medicare
and medicaid services Medicaid Services to encourage the
use of high-value, low-cost prescriptions, such as generic
prescriptions when such an alternative exists for a branded product
and 90-day prescription supplies, as recommended by the enrollee's
prescribing provider and as is consistent with section 109h and
sections
9701 to 9709 of the public health code, 1978 PA 368, MCL
333.9701 to 333.9709. This subsection applies whether or not either
or both of the waivers requested under this section are approved,
the patient protection and affordable care act is repealed, or the
state terminates or opts out of the program established under this
section.
(6)
The department of community health shall work with
providers, contracted health plans, and other departments as
necessary to create processes that reduce the amount of uncollected
cost-sharing and reduce the administrative cost of collecting cost-
sharing. To this end, a minimum 0.25% of payments to contracted
health plans shall be withheld for the purpose of establishing a
cost-sharing compliance bonus pool beginning October 1, 2015. The
distribution of funds from the cost-sharing compliance pool shall
be based on the contracted health plans' success in collecting
cost-sharing
payments. The department of community health shall
develop the methodology for distribution of these funds. This
subsection applies whether or not either or both of the waivers
requested under this section are approved, the patient protection
and affordable care act is repealed, or the state terminates or
opts out of the program established under this section.
(7)
By June 1, 2014, the department of community health shall
develop a methodology that decreases the amount an enrollee's
required contribution may be reduced as described in subsection
(1)(e) based on, but not limited to, factors such as an enrollee's
failure to pay cost-sharing requirements and the enrollee's
inappropriate utilization of emergency departments.
(8) The program described in this section is created in part
to extend health coverage to the state's low-income citizens and to
provide health insurance cost relief to individuals and to the
business community by reducing the cost shift attendant to
uncompensated care. Uncompensated care does not include courtesy
allowances
or discounts given to patients. The medicaid Medicaid
hospital cost report shall be part of the uncompensated care
definition
and calculation. In addition to the medicaid Medicaid
hospital
cost report, the department of community health shall
collect and examine other relevant financial data for all hospitals
and evaluate the impact that providing medical coverage to the
expanded population of enrollees described in subsection (1)(a) has
had on the actual cost of uncompensated care. This shall be
reported for all hospitals in the state. By December 31, 2014, the
department
of community health shall make an initial baseline
uncompensated care report containing at least the data described in
this subsection to the legislature and each December 31 after that
shall make a report regarding the preceding fiscal year's evidence
of the reduction in the amount of the actual cost of uncompensated
care compared to the initial baseline report. The baseline report
shall use fiscal year 2012-2013 data. Based on the evidence of the
reduction in the amount of the actual cost of uncompensated care
borne by the hospitals in this state, beginning April 1, 2015, the
department
of community health shall proportionally reduce the
disproportionate share payments to all hospitals and hospital
systems for the purpose of producing general fund savings. The
department
of community health shall recognize any savings from
this reduction by September 30, 2016. All the reports required
under this subsection shall be made available to the legislature
and
shall be easily accessible on the department of community
health's
department's website.
(9) The department of insurance and financial services shall
examine the financial reports of health insurers and evaluate the
impact that providing medical coverage to the expanded population
of enrollees described in subsection (1)(a) has had on the cost of
uncompensated care as it relates to insurance rates and insurance
rate change filings, as well as its resulting net effect on rates
overall. The department of insurance and financial services shall
consider the evaluation described in this subsection in the annual
approval of rates. By December 31, 2014, the department of
insurance and financial services shall make an initial baseline
report to the legislature regarding rates and each December 31
after that shall make a report regarding the evidence of the change
in rates compared to the initial baseline report. All the reports
required under this subsection shall be made available to the
legislature and shall be made available and easily accessible on
the
department of community health's department's website.
(10)
The department of community health shall explore and
develop a range of innovations and initiatives to improve the
effectiveness and performance of the medical assistance program and
to
lower overall health care costs in this state. The department of
community
health shall report the results of
the efforts described
in this subsection to the legislature and to the house and senate
fiscal agencies by September 30, 2015. The report required under
this subsection shall also be made available and easily accessible
on
the department of community health's department's website. The
department
of community health shall pursue a broad range of
innovations and initiatives as time and resources allow that shall
include, at a minimum, all of the following:
(a)
The value and cost-effectiveness of optional medicaid
Medicaid benefits as described in federal statute.
(b) The identification of private sector, primarily small
business, health coverage benefit differences compared to the
medical assistance program services and justification for the
differences.
(c) The minimum measures and data sets required to effectively
measure the medical assistance program's return on investment for
taxpayers.
(d) Review and evaluation of the effectiveness of current
incentives for contracted health plans, providers, and
beneficiaries with recommendations for expanding and refining
incentives to accelerate improvement in health outcomes, healthy
behaviors, and cost-effectiveness and review of the compliance of
required contributions and co-pays.
(e) Review and evaluation of the current design principles
that serve as the foundation for the state's medical assistance
program to ensure that the program is cost-effective and that
appropriate incentive measures are utilized. The review shall
include, at a minimum, the auto-assignment algorithm and
performance bonus incentive pool. This subsection applies whether
or not either or both of the waivers requested under this section
are approved, the patient protection and affordable care act is
repealed, or the state terminates or opts out of the program
established under this section.
(f) The identification of private sector initiatives used to
incent
incentivize individuals to comply with medical advice.
(11)
By December 31, 2015, the department of community health
shall review and report to the legislature the feasibility of
programs recommended by multiple national organizations that
include,
but are not limited to, the council Council of state
governments,
State Governments, the national conference National
Conference
of state legislatures, State Legislatures, and the
American
legislative exchange council, Legislative
Exchange
Council, on improving the cost-effectiveness of the medical
assistance program.
(12)
By January 1, 2014, the department of community health in
collaboration with the contracted health plans and providers shall
create financial incentives for all of the following:
(a) Contracted health plans that meet specified population
improvement goals.
(b) Providers who meet specified quality, cost, and
utilization targets.
(c) Enrollees who demonstrate improved health outcomes or
maintain healthy behaviors as identified in a health risk
assessment as identified by their primary care practitioner who is
licensed, registered, or otherwise authorized to engage in his or
her health care profession in this state. This subsection applies
whether or not either or both of the waivers requested under this
section are approved, the patient protection and affordable care
act is repealed, or the state terminates or opts out of the program
established under this section.
(13) By October 1, 2015, the performance bonus incentive pool
for contracted health plans that are not specialty prepaid health
plans shall include inappropriate utilization of emergency
departments, ambulatory care, contracted health plan all-cause
acute 30-day readmission rates, and generic drug utilization when
such
an that alternative exists for a branded product and
consistent with section 109h and sections 9701 to 9709 of the
public
health code, 1978 PA 368, MCL 333.9701 to 333.9709, as a
percentage of total. These measurement tools shall be considered
and weighed within the 6 highest factors used in the formula. This
subsection applies whether or not either or both of the waivers
requested under this section are approved, the patient protection
and affordable care act is repealed, or the state terminates or
opts out of the program established under this section.
(14)
The department of community health shall ensure that all
capitated payments made to contracted health plans are actuarially
sound. This subsection applies whether or not either or both of the
waivers requested under this section are approved, the patient
protection and affordable care act is repealed, or the state
terminates or opts out of the program established under this
section.
(15)
The department of community health shall maintain
administrative costs at a level of not more than 1% of the
department
of community health's department's
appropriation of the
state medical assistance program. These administrative costs shall
be capped at the total administrative costs for the fiscal year
ending September 30, 2016, except for inflation and project-related
costs required to achieve medical assistance net general fund
savings. This subsection applies whether or not either or both of
the waivers requested under this section are approved, the patient
protection and affordable care act is repealed, or the state
terminates or opts out of the program established under this
section.
(16)
By October 1, 2015, the department of community health
shall establish uniform procedures and compliance metrics for
utilization by the contracted health plans to ensure that cost-
sharing requirements are being met. This shall include
ramifications for the contracted health plans' failure to comply
with performance or compliance metrics. This subsection applies
whether or not either or both of the waivers requested under this
section are approved, the patient protection and affordable care
act is repealed, or the state terminates or opts out of the program
established under this section.
(17)
Beginning October 1, 2015, the department of community
health
shall withhold, at a minimum, 0.75%
of payments to
contracted health plans, except for specialty prepaid health plans,
for the purpose of expanding the existing performance bonus
incentive pool. Distribution of funds from the performance bonus
incentive pool is contingent on the contracted health plan's
completion of the required performance or compliance metrics. This
subsection applies whether or not either or both of the waivers
requested under this section are approved, the patient protection
and affordable care act is repealed, or the state terminates or
opts out of the program established under this section.
(18)
By October 1, 2015, the department of community health
shall withhold, at a minimum, 0.75% of payments to specialty
prepaid health plans for the purpose of establishing a performance
bonus incentive pool. Distribution of funds from the performance
bonus incentive pool is contingent on the specialty prepaid health
plan's completion of the required performance of compliance metrics
,
which that shall include, at a minimum, partnering with other
contracted health plans to reduce nonemergent emergency department
utilization, increased participation in patient-centered medical
homes, increased use of electronic health records and data sharing
with other providers, and identification of enrollees who may be
eligible
for services through the veterans administration. Veterans
Administration. This subsection applies whether or not either or
both of the waivers requested under this section are approved, the
patient protection and affordable care act is repealed, or the
state terminates or opts out of the program established under this
section.
(19)
The department of community health shall measure
contracted health plan or specialty prepaid health plan performance
metrics, as applicable, on application of standards of care as that
relates to appropriate treatment of substance use disorders and
efforts to reduce substance use disorders. This subsection applies
whether or not either or both of the waivers requested under this
section are approved, the patient protection and affordable care
act is repealed, or the state terminates or opts out of the program
established under this section.
(20) By September 1, 2015, in addition to the waiver requested
in
subsection (1), the department of community health shall seek an
additional
waiver from the United States department Department of
health
Health and human services Human Services that requires
individuals who are between 100% and 133% of the federal poverty
guidelines and who have had medical assistance coverage for 48
cumulative months beginning on the date of their enrollment into
the program described in subsection (1) to choose 1 of the
following options:
(a) Change their medical assistance program eligibility
status, in accordance with federal law, to be considered eligible
for federal advance premium tax credit and cost-sharing subsidies
from the federal government to purchase private insurance coverage
through an American health benefit exchange without financial
penalty to the state.
(b) Remain in the medical assistance program but increase
cost-sharing requirements up to 7% of income. Required
contributions shall be deposited into an account used to pay for
incurred health expenses for covered benefits and shall be 3.5% of
income but may be reduced as provided in subsection (1)(e). The
department
of community health may reduce co-pays as provided in
subsection (1)(e), but not until annual accumulated co-pays reach
3% of income.
(21)
The department of community health shall notify enrollees
60 days before the end of the enrollee's forty-eighth month that
coverage under the current program is no longer available to them
and that, in order to continue coverage, the enrollee must choose
between the options described in subsection (20)(a) or (b).
(22)
The department of community health shall implement a
system for individuals who fail to choose an option described under
subsection (20)(a) or (b) within a specified time determined by the
department
of community health that enrolls those individuals into
the option described in subsection (20)(b).
(23) If the waiver requested under subsection (20) is not
approved
by the United States department Department
of health
Health
and human services Human Services by December 31, 2015,
medical coverage for individuals described in subsection (1)(a)
shall no longer be provided. If the waiver is not approved by
December
31, 2015, then by January 31, 2016, the department of
community
health shall notify enrollees that
the program described
in subsection (1) shall be terminated on April 30, 2016. If a
waiver requested under subsection (1) or (20) is approved and is
required to be renewed at any time after approval, medical coverage
for individuals described in subsection (1)(a) shall no longer be
provided if either renewal request is not approved by the United
States
department Department of health Health and human services
Human Services or if a waiver is canceled after approval. The
department
of community health shall give enrollees 4 months'
advance notice before termination of coverage based on a renewal
request not being approved as described in this subsection. A
notification described in this subsection shall state that the
enrollment was terminated due to the failure of the United States
department
Department of health Health and human services
Human
Services to approve the waiver requested under subsection (20) or
renewal of a waiver described in this subsection.
(24) Individuals described in 42 CFR 440.315 are not subject
to the provisions of the waiver described in subsection (20).
(25)
The department of community health shall make available
at least 3 years of state medical assistance program data, without
charge,
to any vendor considered qualified by the department of
community
health who indicates interest in
submitting proposals to
contracted health plans in order to implement cost savings and
population health improvement opportunities through the use of
innovative information and data management technologies. Any
program or proposal to the contracted health plans must be
consistent with the state's goals of improving health, increasing
the quality, reliability, availability, and continuity of care, and
reducing the cost of care of the eligible population of enrollees
described in subsection (1)(a). The use of the data described in
this subsection for the purpose of assessing the potential
opportunity and subsequent development and submission of formal
proposals to contracted health plans is not a cost or contractual
obligation
to the department of community health or the state.
(26)
If the department of community health does not receive
approval for both of the waivers required under this section before
December 31, 2015, the program described in this section is
terminated.
The department of community health shall request
written
documentation from the United States department Department
of
health Health and human services Human Services that if the
waivers described in this section are rejected causing the medical
assistance program to revert back to the eligibility requirements
in
effect on the effective date of the amendatory act that added
this
section, March 14, 2014, excluding any waivers that have not
been renewed, there shall be no financial federal funding penalty
to the state associated with the implementation and subsequent
cancellation of the program created in this section. If the
department
of community health does not receive this documentation
by
December 31, 2013, the department of community health shall not
implement the program described in this section.
(27) This section does not apply if either of the following
occurs:
(a)
If the department of community health is unable to obtain
either of the federal waivers requested in subsection (1) or (20).
(b) If federal government matching funds for the program
described in this section are reduced below 100% and annual state
savings and other nonfederal net savings associated with the
implementation of that program are not sufficient to cover the
reduced
federal match. The department of community health shall
determine and the state budget office shall approve how annual
state savings and other nonfederal net savings shall be calculated
by June 1, 2014. By September 1, 2014, the calculations and
methodology used to determine the state and other nonfederal net
savings shall be submitted to the legislature.
(28)
The department of community health shall develop,
administer, and coordinate with the department of treasury a
procedure for offsetting the state tax refunds of an enrollee who
owes a liability to the state of past due uncollected cost-sharing,
as allowable by the federal government. The procedure shall include
a
guideline that the department of community health submit to the
department of treasury, not later than November 1 of each year, all
requests for the offset of state tax refunds claimed on returns
filed or to be filed for that tax year. For the purpose of this
subsection, any nonpayment of the cost-sharing required under this
section owed by the enrollee is considered a liability to the state
under section 30a(2)(b) of 1941 PA 122, MCL 205.30a.
(29) For the purpose of this subsection, any nonpayment of the
cost-sharing required under this section owed by the enrollee is
considered a current liability to the state under section 32 of the
McCauley-Traxler-Law-Bowman-McNeely lottery act, 1972 PA 239, MCL
432.32, and shall be handled in accordance with the procedures for
handling a liability to the state under that section, as allowed by
the federal government.
(30)
By November 30, 2013, the department of community health
shall convene a symposium to examine the issues of emergency
department overutilization and improper usage. By December 31,
2014,
the department of community health shall submit a report to
the legislature that identifies the causes of overutilization and
improper emergency service usage that includes specific best
practice recommendations for decreasing overutilization of
emergency departments and improper emergency service usage, as well
as how those best practices are being implemented. Both broad
recommendations and specific recommendations related to the
medicaid
Medicaid program, enrollee behavior, and health plan
access issues shall be included.
(31)
The department of community health shall contract with an
independent third party vendor to review the reports required in
subsections (8) and (9) and other data as necessary, in order to
develop a methodology for measuring, tracking, and reporting
medical cost and uncompensated care cost reduction or rate of
increase reduction and their effect on health insurance rates along
with recommendations for ongoing annual review. The final report
and recommendations shall be submitted to the legislature by
September 30, 2015.
(32) For the purposes of submitting reports and other
information or data required under this section only, "legislature"
means the senate majority leader, the speaker of the house of
representatives, the chairs of the senate and house of
representatives appropriations committees, the chairs of the senate
and house of representatives appropriations subcommittees on the
department
of community health budget, and the chairs of the senate
and house of representatives standing committees on health policy.
(33) As used in this section:
(a) "Patient protection and affordable care act" means the
patient protection and affordable care act, Public Law 111-148, as
amended by the federal health care and education reconciliation act
of 2010, Public Law 111-152.
(b) "Peace of mind registry" and "peace of mind registry
organization" mean those terms as defined in section 10301 of the
public
health code, 1978 PA 368, MCL 333.10301.
(c) "State savings" means any state fund net savings,
calculated as of the closing of the financial books for the
department
of community health at the end of each fiscal year, that
result from the program described in this section. The savings
shall result in a reduction in spending from the following state
fund
accounts: adult benefit waiver, non-medicaid non-Medicaid
community mental health, and prisoner health care. Any identified
savings from other state fund accounts shall be proposed to the
house of representatives and senate appropriations committees for
approval to include in that year's state savings calculation. It is
the intent of the legislature that for fiscal year ending September
30, 2014 only, $193,000,000.00 of the state savings shall be
deposited in the roads and risks reserve fund created in section
211b of article VIII of 2013 PA 59.
(d) "Telemedicine" means that term as defined in section 3476
of the insurance code of 1956, 1956 PA 218, MCL 500.3476.
Sec.
105e. (1) There is appropriated for the department of
community
health and the department of
corrections to supplement
appropriations for the fiscal year ending September 30, 2014 an
adjusted gross appropriation of $1,524,903,500.00 appropriated from
$1,704,523,500.00 in federal revenues, $13,145,000.00 in other
state restricted revenues and a negative appropriation of
$192,765,000.00 in state general fund/general purpose revenue.
(2)
There is appropriated for the department of community
health
for medicaid Medicaid reform
a gross appropriation of
$1,549,115,700.00 appropriated from $1,704,523,500.00 in federal
revenues, $13,145,000.00 in other state restricted revenues, and a
negative appropriation of $168,552,800.00 in state general
fund/general purpose revenue with $1,395,876,600.00 for medical
services reform, $288,646,900.00 for mental health reform, and
$40,000,000.00 for administration, and negative appropriations to
reflect savings with $1,072,200.00 for plan first family planning
waiver,
$14,723,900.00 for medicaid Medicaid
adult benefits waiver,
$6,680,600.00
for medicaid Medicaid adult benefits waiver (mental
health),
and $152,931,100.00 for community mental health non-
medicaid
non-Medicaid services.
(3) There is appropriated for the department of corrections a
negative adjusted gross appropriation of $24,212,200.00 in state
general fund/general purpose revenue with a negative appropriation
of $3,566,600.00 for prison re-entry and community support,
including a negative $377,200.00 for prisoner re-entry local
service providers and a negative $3,189,400.00 for prisoner re-
entry department of corrections programs; a negative appropriation
of
$8,066,100.00 for substance abuse use disorder testing and
treatment services in field operations administration; and a
negative appropriation of $12,579,500.00 for prisoner health care
services in health care.
(4) The appropriations in subsections (1), (2), and (3) for
the
department of community health for medicaid Medicaid reform
are
not available for expenditure until approval of the federal waiver
in section 105d(1), except that the funds associated with
administrative expenses are available for immediate expenditure.
The administrative expenditures shall not exceed $20,000,000.00 in
general
fund. The department of community health shall enter into
memoranda of understanding with departments that incur
administrative expenditures related to the program identified in
section 105d(1).
Sec.
105f. (1) The director of the department of community
health
and the director of the department
of insurance and
financial services shall establish a Michigan health care cost and
quality advisory committee consisting of 8 or more members.
(2)
The director, of the department of community health, or
his
or her designee, and 1 department of community health staff
member and the director of the department of insurance and
financial services, or his or her designee, and 1 department of
insurance and financial services staff member are members of the
committee established in subsection (1). The chairs and minority
vice chairs of the senate and house health policy committees or
their designees are members of the committee. The committee members
shall elect a chairperson and appoint additional members to the
advisory committee established in subsection (1) necessary to
perform the duties prescribed in this section.
(3) The advisory committee established in subsection (1) shall
issue a report by December 31, 2014 with recommendations on the
creation of a database on health care costs and health care quality
in this state. This report shall be transmitted to the legislature
and
made available on the department of community health's
department's and the department of insurance and financial
services'
service's websites. The advisory committee shall include
in the report at least all of the following:
(a) A review of existing efforts across the United States to
make health care cost and quality more transparent.
(b) A review of proposed legislation in this state to make
health care cost and quality more transparent.
(c) A review of any existing standards governing the operation
of similar databases.
(d) A consideration of both price and quality of health care
services rendered in this state.
(e) Transparency and privacy issues.
(f) The possible impact of uncompensated care on commercial
insurance rates.
(g) Other methods to accurately estimate the uncompensated
care impact on commercial insurance rates.
(4) This section applies whether or not either or both of the
waivers requested under section 105d are approved, the patient
protection and affordable care act is repealed, or the state
terminates or opts out of the program established under this
section.
Sec. 106. (1) A medically indigent individual is defined as:
(a) An individual receiving family independence program
benefits or an individual receiving supplemental security income
under title XVI or state supplementation under title XVI subject to
limitations imposed by the director according to title XIX.
(b) Except as provided in sections 106a and 106b, an
individual who meets all of the following conditions:
(i) The individual has applied in the manner the
department of
community
health prescribes.
(ii) The individual's need for the type of medical assistance
available under this act for which the individual applied has been
professionally established and payment for it is not available
through the legal obligation of a public or private contractor to
pay or provide for the care without regard to the income or
resources
of the patient. The state department and the department
of
community health are is subrogated to any right of recovery that
a patient may have for the cost of hospitalization, pharmaceutical
services, physician services, nursing services, and other medical
services
not to exceed the amount of funds expended by the state
department
or the department of community health for the care and
treatment of the patient. The patient or other person acting in the
patient's behalf shall execute and deliver an assignment of claim
or other authorizations as necessary to secure the right of
recovery
to the department. or the department of community health.
A payment may be withheld under this act for medical assistance for
an injury or disability for which the individual is entitled to
medical care or reimbursement for the cost of medical care under
sections
3101 to 3179 chapter 31 of the insurance code of 1956,
1956 PA 218, MCL 500.3101 to 500.3179, or under another policy of
insurance providing medical or hospital benefits, or both, for the
individual unless the individual's entitlement to that medical care
or
reimbursement is at issue. If a payment is made, the state
department, or
the department of community health, to enforce its
subrogation right, may do either of the following: (a) intervene or
join in an action or proceeding brought by the injured, diseased,
or disabled individual, the individual's guardian, personal
representative, estate, dependents, or survivors, against the third
person who may be liable for the injury, disease, or disability, or
against contractors, public or private, who may be liable to pay or
provide medical care and services rendered to an injured, diseased,
or disabled individual; (b) institute and prosecute a legal
proceeding against a third person who may be liable for the injury,
disease, or disability, or against contractors, public or private,
who may be liable to pay or provide medical care and services
rendered to an injured, diseased, or disabled individual, in state
or federal court, either alone or in conjunction with the injured,
diseased, or disabled individual, the individual's guardian,
personal representative, estate, dependents, or survivors. The
state department may institute the proceedings in its own name or
in the name of the injured, diseased, or disabled individual, the
individual's guardian, personal representative, estate, dependents,
or survivors. As provided in section 6023 of the revised judicature
act
of 1961, 1961 PA 236, MCL 600.6023, the state department, or
the
department of community health, in
enforcing its subrogation
right, shall not satisfy a judgment against the third person's
property that is exempt from levy and sale. The injured, diseased,
or disabled individual may proceed in his or her own name,
collecting
the costs without the necessity of joining the state
department,
the department of community
health, or the state as a
named party. The injured, diseased, or disabled individual shall
notify
the state department or the department of community health
of the action or proceeding entered into upon commencement of the
action
or proceeding. An action taken by the state , the state
department,
or the department of community
health in connection
with the right of recovery afforded by this section does not deny
the injured, diseased, or disabled individual any part of the
recovery beyond the costs expended on the individual's behalf by
the
state department or the department. of community health. The
costs of legal action initiated by the state shall be paid by the
state. A payment shall not be made under this act for medical
assistance for an injury, disease, or disability for which the
individual is entitled to medical care or the cost of medical care
under the worker's disability compensation act of 1969, 1969 PA
317, MCL 418.101 to 418.941; except that payment may be made if an
appropriate application for medical care or the cost of the medical
care has been made under the worker's disability compensation act
of 1969, 1969 PA 317, MCL 418.101 to 418.941, entitlement has not
been finally determined, and an arrangement satisfactory to the
state
department or the department of
community health has been
made for reimbursement if the claim under the worker's disability
compensation act of 1969, 1969 PA 317, MCL 418.101 to 418.941, is
finally sustained.
(iii) The individual has an annual income that is below, or
subject to limitations imposed by the director and because of
medical expenses falls below, the protected basic maintenance
level. The protected basic maintenance level for 1-person and 2-
person families shall be at least 100% of the payment standards
generally used to determine eligibility in the family independence
program. For families of 3 or more persons, the protected basic
maintenance level shall be at least 100% of the payment standard
generally used to determine eligibility in the family independence
program. These levels shall recognize regional variations and shall
not exceed 133-1/3% of the payment standard generally used to
determine eligibility in the family independence program.
(iv) The individual, if a family independence program related
individual and living alone, has liquid or marketable assets of not
more than $2,000.00 in value, or, if a 2-person family, the family
has liquid or marketable assets of not more than $3,000.00 in
value.
The department of community health shall establish
comparable liquid or marketable asset amounts for larger family
groups. Excluded in making the determination of the value of liquid
or marketable assets are the values of: the homestead; clothing;
household effects; $1,000.00 of cash surrender value of life
insurance, except that if the health of the insured makes
continuance of the insurance desirable, the entire cash surrender
value of life insurance is excluded from consideration, up to the
maximum provided or allowed by federal regulations and in
accordance
with department of community health rules; the fair
market value of tangible personal property used in earning income;
an amount paid as judgment or settlement for damages suffered as a
result
of exposure to agent orange, Agent
Orange, as defined in
section
5701 of the public health code, 1978 PA 368, MCL 333.5701;
and a space or plot purchased for the purposes of burial for the
person. For individuals related to the title XVI program, the
appropriate resource levels and property exemptions specified in
title XVI shall be used.
(v) Except as provided in section 106b, the individual is not
an inmate of a public institution except as a patient in a medical
institution.
(vi) The individual meets the eligibility standards for
supplemental security income under title XVI or for state
supplementation under the act, subject to limitations imposed by
the
director of the department of community health according to
title XIX; or meets the eligibility standards for family
independence program benefits; or meets the eligibility standards
for optional eligibility groups under title XIX, subject to
limitations
imposed by the director of the department of community
health
according to title XIX.
(c) An individual is eligible under section
1396a(a)(10)(A)(i)(VIII) of title XIX. This subdivision does not
apply if either of the following occurs:
(i) If the department of community health is
unable to obtain a
federal waiver as provided in section 105d(1) or (20).
(ii) If federal government matching funds for the program
described in section 105d are reduced below 100% and annual state
savings and other nonfederal net savings associated with the
implementation of that program are not sufficient to cover the
reduced
federal match. The department of community health shall
determine and the state budget office shall approve how annual
state savings and other nonfederal net savings shall be calculated
by June 1, 2014. By September 1, 2014, the calculations and
methodology used to determine the state and other nonfederal net
savings shall be submitted to the legislature.
(2) As used in this act:
(a) "Contracted health plan" means a managed care organization
with
whom the state department or the department of community
health
contracts to provide or arrange for
the delivery of
comprehensive health care services as authorized under this act.
(b)
"Federal poverty guidelines" 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 section 673(2) of subtitle B of title
VI
of the omnibus budget reconciliation act of 1981, 42 USC 9902.
(b) (c)
"Medical institution"
means a state licensed or
approved hospital, nursing home, medical care facility, psychiatric
hospital, or other facility or identifiable unit of a listed
institution certified as meeting established standards for a
nursing home or hospital in accordance with the laws of this state.
(d)
"Title XVI" means title XVI of the social security act, 42
USC
1381 to 1383f.
(3) An individual receiving medical assistance under this act
or
his or her legal counsel shall notify the state department or
the
department of community health when filing an action in which
the
state department or the department of
community health may have
a right to recover expenses paid under this act. If the individual
is enrolled in a contracted health plan, the individual or his or
her legal counsel shall provide notice to the contracted health
plan in addition to providing notice to the state department.
(4)
If a legal action in which the state department ,
the
department
of community health, or a contracted health plan, or all
3
both, have a right to recover expenses paid under this act
is
filed and settled after November 29, 2004 without notice to the
state
department ,
the department of community health, or
the
contracted
health plan, the state department , the department of
community
health, or the contracted health
plan may file a legal
action against the individual or his or her legal counsel, or both,
to recover expenses paid under this act. The attorney general shall
recover any cost or attorney fees associated with a recovery under
this subsection.
(5)
The state department or the department of community health
has first priority against the proceeds of the net recovery from
the settlement or judgment in an action settled in which notice has
been provided under subsection (3). A contracted health plan has
priority
immediately after the state department or the department
of
community health in an action
settled in which notice has been
provided
under subsection (3). The state department , the
department
of community health, and a
contracted health plan shall
recover the full cost of expenses paid under this act unless the
state
department ,
the department of community health, or
the
contracted health plan agrees to accept an amount less than the
full amount. If the individual would recover less against the
proceeds of the net recovery than the expenses paid under this act,
the
state department , the department of community health, or
contracted
health plan , and
the individual shall share equally in
the proceeds of the net recovery. As used in this subsection, "net
recovery" means the total settlement or judgment less the costs and
fees incurred by or on behalf of the individual who obtains the
settlement or judgment.
Sec. 106a. (1) This section shall be known and may be cited as
the "Michigan freedom to work for individuals with disabilities
law".
(2)
The department of community health shall establish a
program to provide medical assistance to individuals who have
earned income and who meet all of the following initial eligibility
criteria:
(a) The individual has been found to be disabled under the
federal supplemental security income program or the social security
disability income program, or would be found to be disabled except
for earnings in excess of the substantial gainful activity level as
established
by the United States social security
administration.Social Security Administration.
(b) The individual is at least 16 years of age and younger
than 65 years of age.
(c) The individual has a countable income level of not more
than 250% of the current federal poverty guidelines for a family of
1.
(d)
The individual's assets meet the medicare Medicare part D
extra
help low income subsidy (LIS) and medicare Medicare savings
program (MSP) asset limit, as adjusted annually.
(e) The individual is employed on a regular and continuing
basis.
(3) The program is limited to the medical assistance services
made available to recipients under the medical assistance program
administered under section 105.
(4) Without losing eligibility for medical assistance, an
individual who qualifies for and is enrolled under this program is
permitted to do all of the following:
(a) Accumulate personal savings and assets not to exceed
$75,000.00.
(b) Accumulate unlimited retirement and individual retirement
accounts with income from employment while enrolled in the freedom
to work for individuals with disabilities program. Assets described
in this subdivision shall remain excluded from eligibility
consideration
for other medicaid Medicaid
programs for the
individual even if he or she loses eligibility under this section.
(c) Have temporary breaks in employment that do not exceed 24
months if the temporary breaks are the result of an involuntary
layoff or are determined to be medically necessary or for
relocation necessary due to employment in this state.
(d) Work and have income that exceeds the amount permitted
under section 106, but shall not have unearned income that exceeds
250% of the federal poverty guidelines.
(5)
The department of community health shall establish a
premium that is based on the enrolled individual's earned and
unearned income. An enrolled individual shall pay a sliding fee
scale monthly premium based on an annual review of total gross
income as follows:
(a) No premium for individuals with gross income less than
138% of the federal poverty guidelines for a family of 1.
(b)
Beginning the effective date of the 2014 amendatory act
that
amended this subdivision, January
14, 2015, a premium of up to
7.5% per month of gross income for individuals who have total gross
income between 138% of the federal poverty guidelines for a family
of 1 and $75,000.00 annual adjusted gross income.
(c) A premium of 100% of the average freedom to work program
participant cost for an enrolled individual with adjusted gross
income over $75,000.00 annually.
(d) The premium for an enrolled individual shall generally be
assessed on an annual basis based on the annual return required to
be filed under the internal revenue code of 1986 or other evidence
of earned income and shall be payable on a monthly basis. The
premium shall be adjusted during the year when a change in an
enrolled individual's rate of annual income changes.
(6) Revenue received from premiums collected under this
section shall not exceed $3,000,000.00 per year.
(7) If the terms of this section are inconsistent with federal
regulations governing federal financial participation in the
medical
assistance program, the department of community health may,
to the extent necessary, waive any requirement set forth in
subsections (1) to (6).
(8) As used in this section:
(a) "Adjusted gross income" means that term as defined in
section 62 of the internal revenue code of 1986, 26 USC 62.
(b) "Countable income", "earned income", and "unearned income"
mean those terms as used by the department in determining
eligibility for the medical assistance program administered under
this act.
(c)
"Federal poverty guidelines" 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 section 673(2) of subtitle B of title
VI
of the omnibus budget reconciliation act of 1981, 42 USC 9902.
Sec.
106b. (1) The state medicaid Medicaid
plan shall require
the
department of community health to suspend rather than terminate
an individual's medical assistance when either of the following
applies:
(a) The individual becomes an inmate residing in a public
institution but otherwise remains eligible for medical assistance.
(b) An inmate was not eligible for medical assistance when he
or she entered the public institution but is subsequently
determined to be eligible for medical assistance while in the
public institution.
(2)
The department of community health shall redetermine the
medical assistance eligibility of the individual.
(3) Upon notification that an individual described in
subsection (1) is no longer an inmate residing in a public
institution,
the department of community health shall reinstate the
individual's medical assistance if the individual is otherwise
eligible for medical assistance.
(4) This section does not extend medical assistance
eligibility to an otherwise ineligible individual or extend medical
assistance to an individual if matching federal funds are not
available to pay for the medical assistance.
(5)
This section applies to the department, of community
health,
a state agency to which the
department of community health
has delegated these functions as provided under section 105c, or a
private
or nonprofit entity with which the department of community
health
has contracted to perform these
functions as provided under
section 105c.
(6) As used in this section:
(a) "Public institution" means 1 of the following:
(i) An inpatient program operated by the department of
community
health for treatment of individuals
with serious
emotional disturbance or serious mental illness.
(ii) A local correctional facility as that term is defined in
section 2 of the local corrections officers training act, 2003 PA
125, MCL 791.532.
(iii) A correctional facility as that term is defined in section
15 of the corrections code of 1953, 1953 PA 232, MCL 791.215.
(iv) A youth correctional facility operated by the department
of corrections or a private vendor under section 20g of the
corrections code of 1953, 1953 PA 232, MCL 791.220g.
(b) "Serious emotional disturbance" and "serious mental
illness" mean those terms as defined in section 100d of the mental
health code, 1974 PA 258, MCL 330.1100d.
Sec. 107. (1) In establishing financial eligibility for the
medically indigent, income shall be disregarded in accordance with
standards established for the related categorical assistance
program.
For medical assistance only, income shall include includes
the amount of contribution that an estranged spouse or parent for a
minor child is making to the applicant according to the standards
of
the department, of community health, or according to a court
determination,
if there is a court determination. Nothing in this
This
section eliminates does not eliminate the responsibility of
support established in section 76 for cash assistance received
under this act.
(2)
The department of community health shall apply a modified
adjusted gross income methodology in determining if an individual's
annual income level is below 133% of the federal poverty
guidelines.
Sec. 108. A medically indigent person as defined under section
106(1)(a) is entitled to all the services enumerated in section
109. A medically indigent person as defined under section 106(1)(b)
is entitled to medical services enumerated in section 109(1)(a),
(c), and (e). He or she is entitled to the services enumerated in
section 109(1)(b), (d), and (f) to the extent of appropriations
made available by the legislature for the fiscal year. Medical
services shall be rendered upon certification by the attending
licensed physician and dental services shall be rendered upon
certification of the attending licensed dentist that a service is
required for the treatment of an individual. The services of a
medical institution shall be rendered only after referral by a
licensed physician or dentist and certification by him or her that
the services of the medical institution are required for the
medical or dental treatment of the individual, except that referral
is not necessary in case of an emergency. Periodic recertification
that medical treatment that extends over a period of time is
required
in accordance with regulations of the department of
community
health is a condition of continuing
eligibility to
receive medical assistance. To comply with federal statutes
governing
medicaid, Medicaid, the department of community health
shall provide early and periodic screening, diagnostic, and
treatment services to eligible children as it considers necessary.
Sec. 109. (1) The following medical services may be provided
under this act:
(a) Hospital services that an eligible individual may receive
consist of medical, surgical, or obstetrical care, together with
necessary drugs, X-rays, physical therapy, prosthesis,
transportation, and nursing care incident to the medical, surgical,
or obstetrical care. The period of inpatient hospital service shall
be the minimum period necessary in this type of facility for the
proper care and treatment of the individual. Necessary
hospitalization to provide dental care shall be provided if
certified by the attending dentist with the approval of the
department. of
community health. An individual who is receiving
medical treatment as an inpatient because of a diagnosis of
tuberculosis or mental disease may receive service under this
section, notwithstanding the mental health code, 1974 PA 258, MCL
330.1001 to 330.2106, and 1925 PA 177, MCL 332.151 to 332.164. The
department
of community health shall pay for hospital services
according to the state plan for medical assistance adopted under
section
10 and approved by the United States department Department
of
health Health and human services.Human Services.
(b) An eligible individual may receive physician services
authorized
by the department. of community health. The service may
be furnished in the physician's office, the eligible individual's
home, a medical institution, or elsewhere in case of emergency. A
physician shall be paid a reasonable charge for the service
rendered. Reasonable charges shall be determined by the department
of
community health and shall not be
more than those paid in this
state for services rendered under title XVIII.
(c) An eligible individual may receive nursing home services
in a state licensed nursing home, a medical care facility, or other
facility or identifiable unit of that facility, certified by the
appropriate authority as meeting established standards for a
nursing home under the laws and rules of this state and the United
States
department Department of health Health and human
services,
Human Services, to the extent found necessary by the attending
physician, dentist, or certified Christian Science practitioner. An
eligible individual may receive nursing services in an extended
care services program established under section 22210 of the public
health
code, 1978 PA 368, MCL 333.22210, to the extent found
necessary by the attending physician when the combined length of
stay in the acute care bed and short-term nursing care bed exceeds
the
average length of stay for medicaid Medicaid hospital
diagnostic
related group reimbursement. The department of community
health
shall not make a final payment
under title XIX for benefits
available under title XVIII without documentation that title XVIII
claims
have been filed and denied. The department of community
health
shall pay for nursing home services
according to the state
plan for medical assistance adopted according to section 10 and
approved
by the United States department Department
of health
Health
and human services. Human Services. A county shall reimburse
a county maintenance of effort rate determined on an annual basis
for
each patient day of medicaid Medicaid
nursing home services
provided to eligible individuals in long-term care facilities owned
by the county and licensed to provide nursing home services. For
purposes of determining rates and costs described in this
subdivision, all of the following apply:
(i) For county owned facilities with per patient day updated
variable costs exceeding the variable cost limit for the county
facility, county maintenance of effort rate means 45% of the
difference between per patient day updated variable cost and the
concomitant nursing home-class variable cost limit, the quantity
offset by the difference between per patient day updated variable
cost and the concomitant variable cost limit for the county
facility. The county rate shall not be less than zero.
(ii) For county owned facilities with per patient day updated
variable costs not exceeding the variable cost limit for the county
facility, county maintenance of effort rate means 45% of the
difference between per patient day updated variable cost and the
concomitant nursing home class variable cost limit.
(iii) For county owned facilities with per patient day updated
variable costs not exceeding the concomitant nursing home class
variable cost limit, the county maintenance of effort rate shall
equal zero.
(iv) For the purposes of this section: "per patient day updated
variable costs and the variable cost limit for the county facility"
shall be determined according to the state plan for medical
assistance; for freestanding county facilities the "nursing home
class variable cost limit" shall be determined according to the
state plan for medical assistance and for hospital attached county
facilities the "nursing class variable cost limit" shall be
determined
pursuant to under the state plan for medical assistance
plus $5.00 per patient day; and "freestanding" and "hospital
attached" shall be determined according to the federal regulations.
(v) If the county maintenance of effort rate computed under
this section exceeds the county maintenance of effort rate in
effect as of September 30, 1984, the rate in effect as of September
30, 1984 shall remain in effect until a time that the rate computed
under this section is less than the September 30, 1984 rate. This
limitation remains in effect until December 31, 2017. For each
subsequent county fiscal year the maintenance of effort may not
increase by more than $1.00 per patient day each year.
(vi) For county owned facilities, reimbursement for plant costs
will continue to be based on interest expense and depreciation
allowance unless otherwise provided by law.
(d) An eligible individual may receive pharmaceutical services
from a licensed pharmacist of the person's choice as prescribed by
a
licensed physician or dentist and approved by the department. of
community
health. In an emergency, but not
routinely, the
individual may receive pharmaceutical services rendered personally
by a licensed physician or dentist on the same basis as approved
for pharmacists.
(e) An eligible individual may receive other medical and
health
services as authorized by the department. of community
health.
(f) Psychiatric care may also be provided according to the
guidelines
established by the department of community health to the
extent of appropriations made available by the legislature for the
fiscal year.
(g) An eligible individual may receive screening, laboratory
services, diagnostic services, early intervention services, and
treatment for chronic kidney disease under guidelines established
by
the department. of community health. A clinical laboratory
performing a creatinine test on an eligible individual under this
subdivision shall include in the lab report the glomerular
filtration rate (eGFR) of the individual and shall report it as a
percent of kidney function remaining.
(2) The director shall provide notice to the public, according
to applicable federal regulations, and shall obtain the approval of
the committees on appropriations of the house of representatives
and senate of the legislature of this state, of a proposed change
in the statewide method or level of reimbursement for a service, if
the proposed change is expected to increase or decrease payments
for that service by 1% or more during the 12 months after the
effective date of the change.
(3)
As used in this act:
(a)
"Title XVIII" means title XVIII of the social security
act,
42 USC 1395 to 1395kkk-1.
(b)
"Title XIX" means title XIX of the social security act, 42
USC
1396 to 1396w-5.
(c)
"Title XX" means title XX of the social security act, 42
USC
1397 to 1397m-5.
Sec.
109c. (1) The department of community health shall
include, as part of its program of medical services under this act,
home-
or community-based services to eligible persons individuals
whom
the department of community health determines would otherwise
require nursing home services or similar institutional care
services under section 109. The home- or community-based services
shall
be offered to qualified eligible persons individuals who are
receiving inpatient hospital or nursing home services as an
alternative to those forms of care.
(2) The home- or community-based services shall include
safeguards adequate to protect the health and welfare of
participating
eligible persons, individuals,
and shall be provided
according
to a written plan of care for each person. individual.
The services available under the home- or community-based services
program shall include, at a minimum, all of the following:
(a)
Home delivered Home-delivered
meals.
(b) Chore services.
(c) Homemaker services.
(d) Respite care.
(e) Personal care.
(f) Adult day care.
(g) Private duty nursing.
(h) Mental health counseling.
(i) Caregiver training.
(j) Emergency response systems.
(k) Home modification.
(l) Transportation.
(m) Medical equipment and supply services.
(3) This section shall be implemented so that the average per
capita expenditure for home- or community-based services for
eligible
persons individuals receiving those services does not
exceed the estimated average per capita expenditure that would have
been
made for those persons individuals
had they been receiving
nursing home services, inpatient hospital, or similar institutional
care services instead.
(4)
The department of community health shall seek a waiver
necessary
to implement this program from the federal department
United
States Department of health Health and
human services, Human
Services, as provided in section 1915 of title XIX, 42 USC 1396n.
The
department of community health shall request any modifications
of the waiver that are necessary in order to expand the program in
accordance with subsection (9).
(5)
The department of community health shall establish policy
for
identifying the rules for persons individuals receiving
inpatient hospital or nursing home services who may qualify for
home- or community-based services. The rules shall contain, at a
minimum, a listing of diagnoses and patient conditions to which the
option of home- or community-based services may apply, and a
procedure
to determine if the person individual
qualifies for home-
or community-based services.
(6)
The department of community health shall provide to the
legislature and the governor an annual report showing the detail of
its home- and community-based case finding and placement
activities. At a minimum, the report shall contain each of the
following:
(a)
The number of persons individuals
provided home- or
community-based services who would otherwise require inpatient
hospital services. This shall include a description of medical
conditions, services provided, and projected cost savings for these
persons.
(b) The number of persons provided home- or community-based
services who would otherwise require nursing home services. This
shall include a description of medical conditions, services
provided, and projected cost savings for these persons.
(c) The number of persons and the annual expenditure for
personal care services.
(d) The number of hearings requested concerning home- or
community-based
services and the outcome of each hearing which that
has been adjudicated during the year.
(7) The written plan of care required under subsection (2) for
an
eligible person individual
shall not be changed unless the
change
is prospective only, and the department of community health
does both of the following:
(a) Not later than 30 days before making the change, except in
the
case of emergency, consults with the eligible person individual
or, in the case of a child, with the child's parent or guardian.
(b) Consults with each medical service provider involved in
the change. This consultation shall be documented in writing.
(8)
An eligible person individual
who is receiving home- or
community-based services under this section, and who is
dissatisfied with a change in his or her plan of care or a denial
of any home- or community-based service, may demand a hearing as
provided in section 9, and subsequently may appeal the hearing
decision to circuit court as provided in section 37.
(9)
The department of community health shall expand the home-
and community-based services program by increasing the number of
counties in which it is available, in conformance with this
subsection. The program may be limited in total cost and in the
number of recipients per county who may receive services at 1 time.
Subject to obtaining the waiver and any modifications of the waiver
sought
under subsection (4), the program shall be expanded as
follows:
(a)
Not later than July 14, 1995, home- and community-based
services
shall be available to eligible applicants in those
counties
that, when combined, contain at least 1/4 of the
population
of this state.
(b)
Not later than July 14, 1996, home- and community-based
services
shall be available to eligible applicants in those
counties
that, when combined, contain at least 1/2 of the
population
of this state.
(c)
Not later than July 14, 1997, home- and community-based
services
shall be available to eligible applicants in those
counties
that, when combined, contain at least 3/4 of the
population
of this state.
(d)
Not later than July 14, 1998, home-
and community-based
services shall be available to eligible applicants on a statewide
basis.
(10)
The department of community health shall work with the
office of services to the aging in implementing the home- and
community-based services program, including the provision of
preadmission screening, case management, and recipient access to
services.
Sec. 109e. (1) As used in this section:
(a) "Abortion" means the intentional use of an instrument,
drug, or other substance or device to terminate a woman's pregnancy
for a purpose other than to increase the probability of a live
birth, to preserve the life or health of the child after live
birth, or to remove a dead fetus. Abortion does not include the use
or prescription of a drug or device intended as a contraceptive.
(b) "Health care professional" means an individual licensed or
registered
under article 15 of the public health code, Act No. 368
of
the Public Acts of 1978, being sections 333.16101 to 333.18838
of
the Michigan Compiled Laws.MCL
333.16101 to 333.18838.
(c) "Health facility or agency" means a health facility or
agency
licensed under article 17 of Act No. 368 of the Public Acts
of
1978, being sections 333.20101 to 333.22260 of the Michigan
Compiled
Laws.the public health code,
MCL 333.20101 to 333.22260.
(2) A health care professional or a health facility or agency
shall not seek or accept reimbursement for the performance of an
abortion knowing that public funds will be or have been used in
whole or in part for the reimbursement in violation of section
109a. of
Act No. 280 of the Public Acts of 1939, being section
400.109a
of the Michigan Compiled Laws, as added by Act No. 59 of
the
Public Acts of 1987.
(3) A person who violates this section is liable for a civil
fine
of up to $10,000.00 per violation. The department of community
health
shall investigate an alleged
violation of this section and
the
attorney general, in cooperation with the department, of
community
health, may bring an action to
enforce this section.
(4)
Nothing in this This section restricts does not restrict
the right of a health care professional to discuss abortion or
abortion services with a patient who is pregnant.
(5) This section does not create a right to an abortion.
(6) Notwithstanding any other provision of this section, a
person shall not perform an abortion that is prohibited by law.
Sec.
109f. (1) The department of community health shall
support
the use of medicaid Medicaid
funds for specialty services
and
supports for eligible medicaid Medicaid
beneficiaries with a
serious mental illness, developmental disability, serious emotional
disturbance,
or substance abuse use disorder. Medicaid-covered
specialty services and supports shall be managed and delivered by
specialty
prepaid health plans chosen by the department of
community
health with advice and
recommendations from the specialty
services panel created in section 109g. The specialty services and
supports
shall be carved out from the basic medicaid Medicaid
health care benefits package.
(2) Specialty prepaid health plans shall be considered
medicaid
Medicaid managed care organizations as described in
section 1903(m)(1)(A) of title XIX of the social security act, 42
USC
1396b, and shall be are responsible for providing defined
inpatient services, outpatient hospital services, physician
services,
other specified medicaid Medicaid
state plan services,
and
additional services approved by the centers Centers for
medicare
Medicare and medicaid services Medicaid Services under
section 1915(b)(3) of title XIX of the social security act, 42 USC
1396n.
As medicaid Medicaid managed care organizations, specialty
prepaid
health plans are subject to the quality assurance
assessment
fee described in section 224b of the insurance code of
1956,
1956 PA 218, MCL 500.224b.section
3f of the use tax act, 1937
PA 94, MCL 205.93f.
Sec. 109g. (1) The governor shall create a specialty services
panel
within the department of community health to review and make
determinations regarding applications for participation submitted
by community mental health services programs or other managing
entities.
(2) The specialty services panel shall consist of the
following members, appointed by the governor:
(a)
The director of the department of community health or his
or her representative.
(b)
Two members who represent the department, of community
health,
excluding an individual appointed
under subdivision (a).
(c) The director of the department of technology, management,
and budget or his or her representative.
(d) Four members who represent primary consumers or family
members.
(e) Five members who represent other stakeholders, including,
but not limited to, 1 representative each from the statewide
advocacy organizations representing adults with serious mental
illness, children with serious emotional disturbance, individuals
with
substance abuse use disorders, and individuals with
developmental disabilities. At least 1 member appointed under this
subdivision shall be a county commissioner.
(3) No member appointed under subsection (2)(d) or (e) shall
provide direct services or represent providers who provide services
for reimbursement under this act to an individual who qualifies for
specialty services.
(4) Members of the specialty services panel shall serve for
terms of 4 years or until a successor is appointed, whichever is
later, except that, of the members first appointed, 4 shall serve
for 1 year, 5 shall serve for 2 years, and 4 shall serve for 3
years.
(5) If a vacancy occurs on the specialty services panel, the
governor shall make an appointment for the unexpired term in the
same manner as the original appointment.
(6) A member of the specialty services panel shall make known
any matter in which that member has a potential conflict of
interest.
(7) The specialty services panel shall remain in existence to
serve
in an advisory capacity to the director of the department of
community
health regarding performance and
quality relating to
medicaid
Medicaid specialty services and supports. The panel shall
meet no less than 2 times a year. The panel shall have access to
all aggregate quality management information gathered by the
department
of community health relating to the managing entities.
Sec.
109h. (1) If the department of community health develops
a prior authorization process for prescription drugs as part of the
pharmaceutical services offered under the medical assistance
program administered under this act, it shall not require prior
authorization for the following single source brand name, generic
equivalent of a multiple source brand name, or other prescription
drugs:
(a) A central nervous system prescription drug that is
classified as an anticonvulsant, antidepressant, antipsychotic, or
a noncontrolled substance antianxiety drug in a generally accepted
standard medical reference.
(b) A prescription drug that is cross-indicated for a central
nervous system drug exempted under subdivision (a) as documented in
a generally accepted standard medical reference.
(c) Unless the prescription drug is a controlled substance or
the prescription drug is being prescribed to treat a condition that
is excluded from coverage under this act, a prescription drug that
is recognized in a generally accepted standard medical reference as
effective in the treatment of conditions specified in the most
recent
diagnostic Diagnostic and statistical manual Statistical
Manual
of mental disorders Mental Disorders published by the
American
psychiatric association. Psychiatric
Association. The
department or the department's agent shall not deny a request for
prior authorization of a controlled substance under this
subdivision unless the department or the department's agent
determines that the controlled substance or the dosage of the
controlled substance being prescribed is not consistent with its
licensed indications or with generally accepted medical practice as
documented in a standard medical reference.
(d) A prescription drug that is recognized in a generally
accepted standard medical reference for the treatment of and is
being prescribed to a patient for the treatment of any of the
following:
(i) Human immunodeficiency virus infections or the
complications of the human immunodeficiency virus or acquired
immunodeficiency syndrome.
(ii) Cancer.
(iii) Organ replacement therapy.
(iv) Epilepsy or seizure disorder.
(2) This section does not apply to drugs being provided under
a contract between the department and a health maintenance
organization.
(3) As used in this section:
(a) "Controlled substance" means that term as defined in
section
7104 of the public health code, 1978 PA 368, MCL 333.7104.
(b)
"Cross-indicated" means a drug which that is
used for a
purpose generally held to be reasonable, appropriate, and within
community standards of practice even though the use is not included
in
the federal food Food and drug administration's Drug
Administration's approved labeled indications for that drug.
(c)
"Department" means the department of community health.
(c) (d)
"Prescriber" means that
term as defined in section
17708
of the public health code, 1978 PA 368, MCL 333.17708.
(d) (e)
"Prescription" or
"prescription drug" means that term
as
defined in section 17708 of the public health code, 1978 PA 368,
MCL 333.17708.
(e) (f)
"Prior authorization"
means a process implemented by
the
department of community health that conditions, delays, or
denies the delivery of particular pharmaceutical services to
medicaid
Medicaid beneficiaries upon application of predetermined
criteria by the department or the department's agent for those
pharmaceutical services covered by the department on a fee-for-
service
basis or pursuant according
to a contract for those
services. The process may require a prescriber to verify with the
department or the department's agent that the proposed medical use
of a prescription drug being prescribed for a patient meets the
predetermined criteria for a prescription drug that is otherwise
covered under this act or require a prescriber to obtain
authorization from the department or the department's agent before
prescribing or dispensing a prescription drug that is not included
on a preferred drug list or that is subject to special access or
reimbursement restrictions.
Sec.
109k. Effective October 1, 2013, a A community mental
health services program established by a single charter county that
has situated totally within that county a city having a population
of at least 500,000 shall comply with sections 204(4) and 205 of
the mental health code, 1974 PA 258, MCL 330.1204 and 330.1205,
before
contracting with the department of community health as a
specialty prepaid health plan to provide specialty services and
supports.
Sec.
109l. The department of community health and
contracted
health plans shall utilize a process for maximum allowable cost
pricing reconsiderations that must be available and provided to
providers and pharmacists. This process must include identification
of
3 national drug codes, if there are 3 or more available, and or
all available national drug codes, if there are fewer than 3, for
the drug in question that are actually available and deliverable by
a Michigan licensed wholesaler or a Michigan licensed manufacturer
and
would fall into the department of community health's
department's or contracted health plans' maximum allowable cost
pricing. The process must be completed in 10 business days, with
all notification to the pharmacy in either written or electronic
form.
The department of community health and contracted health
plans cannot be held accountable for failing to provide information
for
to which they do not have access.
Sec.
111a. (1) The director, of the department of community
health,
after appropriate consultation with
affected providers and
the medical care advisory council established according to federal
regulations, may establish policies and procedures that he or she
considers appropriate, relating to the conditions of participation
and requirements for providers established by section 111b and to
applicable
federal law and regulations, to assure ensure that the
implementation and enforcement of state and federal laws are all of
the following:
(a) Reasonable, fair, effective, and efficient.
(b) In conformance with law.
(c) In conformance with the state plan for medical assistance
adopted under section 10 and approved by the United States
department
Department of health Health and human
services.Human
Services.
(2) The consultation required by this section shall be
conducted in accordance with guidelines adopted by the state
department
of community health according to section 24 of the
administrative
procedures act of 1969, 1969 PA 306, MCL 24.224.
(3) Except as otherwise provided in section 111i, the director
of
the department of community health shall
develop, after
appropriate consultation with affected providers in accordance with
guidelines, forms and instructions to be used in administering the
program.
Forms developed by the director of the department of
community
health shall be, to the extent
administratively feasible,
compatible with forms providers are required to file with 1 or more
other third party payers or with 1 or more regulatory agencies and,
to the extent administratively feasible, shall be designed to
facilitate use of a single form to satisfy requirements imposed on
providers by more than 1 payer, agency, or other entity. The forms
and instructions shall relate, at a minimum, to standards of
performance by providers, conditions of participation, methods of
review of claims, and administrative requirements and procedures
that
the director of the department of community health considers
reasonable
and proper to assure ensure
all of the following:
(a) That claims against the program are timely, substantiated,
and not false, misleading, or deceptive.
(b) That reimbursement is made for only medically appropriate
services.
(c) That reimbursement is made for only covered services.
(d) That reimbursement is not made to those providers whose
services, supplies, or equipment cost the program in excess of the
reasonable value received.
(e) That the state is a prudent buyer.
(f) That access and availability of services to the medically
indigent are reasonable.
(4) As used in subsection (3), "prudent buyer" means a
purchaser who does 1 or more of the following:
(a) Buys from only those providers of services, supplies, or
equipment to medically indigent individuals whose performance, in
terms of quality, quantity, cost, setting, and location is
appropriate to the specific needs of those individuals, and who, in
the case of providers who receive payment on the basis of costs,
comply with the prudent buyer concept of titles XVIII and XIX.
(b) Pays for only those services, supplies, or equipment that
are needed or appropriate.
(c) Seeks to economize by minimizing cost.
(5)
The director of the department of community health shall
select providers to participate in arrangements such as case
management, in supervision of services for recipients who
misutilize or abuse the medical services program, and in special
projects for the delivery of medical services to eligible
recipients. Providers shall be selected based upon criteria that
may include a comparison of services and related costs with those
of the provider's peers and a review of previous participation
warnings or sanctions undertaken against the provider or the
provider's employer, employees, related business entities, or
others
who have a relationship to the provider, by the medicaid,
medicare,
Medicaid, Medicare, or other health-related programs. The
director
of the department of community health may consult with the
appropriate peer review advisory committees as appointed by the
department. of
community health.
(6)
The director of the department of community health shall
give notice to each provider of a change in a policy, procedure,
form, or instruction established or developed under this section
that affects the provider. For a change that affects 1 or more
types of providers, a departmental bulletin or updating insert to a
departmental manual mailed 30 days before the effective date of the
change
shall constitute constitutes
sufficient notice. The
department
of community health may provide notice required under
this subsection via United States mail or electronic mail.
(7)
The director of the department of community health may do
all of the following:
(a) Enroll in the program for medical assistance only a
provider who has entered into an agreement of enrollment required
by section 111b(4), and enter into an agreement only with a
provider who satisfies the conditions of participation and
requirements for a provider established by sections 111b and 111i
and the administrative requirements established or developed under
subsections (1), (2), and (3) with the appropriate consultation
required by this section.
(b) Enforce the requirements established under this act by
applying the procedures of sections 111c to 111f. If in these
procedures
the director of the department of community health is
required to consult with professionals or experts before first
utilizing
these individuals in the program, the director of the
department
of community health shall have
given the opportunity to
review
their professional credentials to the appropriate medicaid
Medicaid peer review advisory committee.
(c) Except as otherwise provided in section 111i, develop with
the appropriate consultation required by this section and require
the form or format for claims, applications, certifications, or
certifications and recertifications of medical necessity required
by section 108, and develop specifications for and require
supporting documentation that is compatible with the approved state
medical assistance plan under title XIX.
(d) Recover payments to a provider in excess of the
reimbursement
to which the provider is entitled. The department of
community
health shall have a priority lien
on any assets of a
provider for any overpayment, as a consequence of fraud or abuse,
that
is not reimbursed to the department. of community health.
(e) Notwithstanding any other provisions of this act, before
payment of claims, identify for examination for compliance with the
program of medical assistance, including but not limited to medical
necessity, the claims submitted by a particular provider based upon
a determination that the provider's claims for disputed services
exceed the average program dollar amount or volume of the same type
of services, submitted by the same type of provider, performed in
the same setting, and submitted during the same period. In order to
carry out the authority conferred by this subdivision, the director
of
the department of community health shall
notify the provider in
the form of registered mail, receipted by the addressee, or by
proof of service to the provider, or representative of the
provider,
of the state department of community health's
department's intent to impose specific conditions and controls
before authorizing payment for specific claims for services. The
notice shall contain all of the following:
(i) A list of the particular practice or practices disputed by
the
state department of community health and a factual description
of the nature of the dispute.
(ii) A request for specific medical records and any other
relevant supporting information that fully discloses the basis and
extent to which the disputed practice or practices were rendered.
(iii) A date certain for an informal conference between the
provider or representative of the provider and the state department
of
community health to resolve the
differences surrounding the
disputed practice or practices.
(iv) A statement that unless the provider or representative of
the provider demonstrates at the informal conference that the
disputed practice or practices are medically necessary, or are in
compliance with other program coverages, specific conditions and
controls may be imposed on future payments for the disputed
practice or practices, and claims may be rejected, beginning on the
sixteenth day after delivery of this notice.
(8) For any provider who is subject to a notice of intent to
impose specific conditions and controls before authorizing payment
for specific claims for services, as specified in subsection
(7)(e),
the state department of community health shall afford that
provider an opportunity for an informal conference before the
sixteenth day after delivery of the notice under subsection (7)(e).
If the provider fails to appear at the conference, or fails to
demonstrate that the disputed practice or practices are medically
necessary or are in compliance with program coverages, the state
department, of
community health beginning on the sixteenth day
following receipt of notice by the provider, is authorized to
impose specific conditions and controls before payment for the
disputed practice or practices and may reject claims for payments
for
the practice or practices. The state department, of community
health,
within 5 days following the
informal conference, shall
notify the provider of its decision regarding the imposition of
special conditions and controls before payment for the disputed
practice or practices. Upon the imposition of specific conditions
and controls before payment, the provider upon request shall be
entitled to an immediate hearing held in conformity with chapter 4
and
chapter 6 of the administrative procedures act of 1969, 1969 PA
306,
MCL 24.271 to 24.287 and 24.301 to
24.306, if any of the
following occurs:
(a) The claim for services rendered is not paid within 30 days
of the provider's compliance with the conditions imposed.
(b) The claim is rejected.
(c)
The provider notifies the state department of community
health
by registered mail that the
provider does not intend to
comply with the specific conditions and controls imposed, and the
claim for services rendered is not paid within 30 days after
delivery of this notice.
(9) The hearing provided for under subsection (8) shall be
conducted in a prompt and expeditious manner. At the hearing, the
provider
may contest the state department of community health's
department's decision to impose specific conditions and controls
before payment. Subsequent hearings may be conducted at the
provider's request only if the claims have not been considered at a
prior hearing and reflect issues that also have not been considered
at a prior hearing, or if a claim for services rendered is not paid
within 60 days after the provider's compliance with the conditions
imposed.
(10) The authority conferred in subsection (8) with respect to
the claims submitted by a particular provider does not prohibit the
state
department of community health from examining claims or
portions of claims before payment of the claims to determine their
compliance
with the program of medical assistance program, in
compliance
with law. The director of the department of community
health
may take additional action under
subsection (8) during the
pendency of an appeal taken under subsection (8).
(11)
If in the department of community health's department's
opinion, the provider shifts his or her claims from the disputed
services addressed under subsection (7)(e) to other claims that
fall
under the purview of subsection (7)(e), the director of the
department
of community health may impose the
claims review process
of this section immediately upon delivery of the notice of that
imposition to the provider as provided in subsection (7)(e).
(12)
If in the department of community health's department's
opinion, claims similar to the disputed services addressed under
subsection (7)(e) are shifted to another provider in the same
corporation, partnership, clinic, provider group, or to another
provider in the employ of the same employer or contractor, the
director
of the department of community health may impose the
claims review process of this section immediately upon delivery of
notice of that imposition to the new provider as provided in
subsection
(7)(e). The department of community health shall afford
the new provider an opportunity for an immediate informal
conference within 7 days under subsection (8) after the initiation
of the claims process.
(13)
The director of the department of community health may
request a provider to open books and records in accordance with
section
111b(7) and may photocopy, at the state department of
community
health's department's expense, the records of a medically
indigent individual. The records shall be confidential, and the
state department shall use the records only for purposes directly
and specifically related to the administration of the program. The
immunity
from liability of a provider subject to the director of
the
department of community health's director's
authority under
this subsection is governed by section 111b(7).
(14)
The director of the department of community health shall
not pay for services, supplies, or equipment furnished by a
provider, or shall recover for payment made, during a period in
which the provider does not have on file with the state department
of
community health disclosure forms
as required by section
111b(19).
(15)
The director of the department of community health shall
make payments to, and collect overpayments from, the provider,
unless the provider and the provider's employer satisfy the
conditions prescribed in section 111b(25), (26), and (27), in which
case
the director of the department of community health may make
payments directly to, and collect overpayments from, the provider's
employer.
(16)
The director, of the department of community health, with
the appropriate consultation required by this section, may develop
specifications for and require estimated cost and charge
information to be submitted by a provider under section 111b(13)
and the form or format for submission of the information.
(17)
If the director of the department of community health
decides that a payment under the program has been made to which a
provider is not or may not be entitled, or that the amount of a
payment is or may be greater or less than the amount to which the
provider
is entitled, the director, of the department of community
health,
except as otherwise provided in
this subsection or under
other applicable law or regulation, shall promptly notify the
provider
of this decision. The director of the department of
community
health shall withhold notification
to the provider of the
decision upon advice from the department of the attorney general or
other state or federal enforcement agency in a case where action by
the department of the attorney general or other state or federal
enforcement agency may be compromised by the notification. If the
director
of the department of community health notifies a provider
of a decision that the provider has received an underpayment, the
state
department of community health shall reimburse the provider,
either directly or through an adjustment of payments, in the amount
found to be due.
Sec.
111i. (1) The commissioner of office of financial and
director of the department of insurance and financial services
shall establish a timely claims processing and payment procedure to
be used by health professionals and facilities in billing for, and
qualified health plans in processing and paying claims for,
medicaid
Medicaid services rendered. The commissioner director of
the department of insurance and financial services shall consult
with
the department, of community health, health professionals
and
facilities, and qualified health plans in establishing this timely
payment procedure.
(2) The timely claims processing and payment procedure
established
by the commissioner director
of the department of
insurance and financial services under subsection (1) shall provide
for all of the following:
(a) That a "clean claim", for the purposes of this section,
means a claim that does at a minimum all of the following:
(i) Identifies the health professional or health facility that
provided treatment or service, including a matching identifying
number.
(ii) Identifies the patient and plan.
(iii) Lists the date and place of service.
(iv) Is for covered services.
(v) Is certified pursuant according to section 111b(17) and
has the identifying information required under section 111b(21).
(vi) If necessary, substantiates the medical necessity and
appropriateness of the care or service provided.
(vii) If prior authorization is required for certain patient
care or services, includes any applicable authorization number, as
appropriate.
(viii) Includes additional documentation based upon services
rendered as reasonably required by the payer.
(b)
A universal system of coding to be used on all medicaid
Medicaid claims submitted to qualified health plans.
(c) That a claim must be transmitted electronically or as
otherwise
specified by the commissioner director
of the department
of insurance and financial services and a qualified health plan
must be able to receive a claim transmitted electronically.
(d) That a health professional and facility must bill a
qualified health plan within 1 year after the date of service or
date of discharge from the health facility.
(e) That after a health professional or facility has submitted
a claim to a qualified health plan, the health professional or
facility shall not resubmit the same claim to the qualified health
plan unless the time frame in subdivision (f) has passed or as
provided in subdivision (h).
(f) Except as otherwise provided in this subdivision, that a
clean claim must be paid within 45 days after receipt of the claim
by the qualified health plan. For a pharmaceutical clean claim, the
clean claim must be paid within the industry standard time frame
for
paying the claim as of the effective date of this subdivision
June 20, 2000, or within 45 days after receipt of the claim by the
qualified health plan, whichever is sooner. A clean claim that is
not paid within this time frame shall bear simple interest at a
rate of 12% per annum.
(g) That a qualified health plan must state in writing to the
health professional or facility any defect in the claim within 30
days after receipt of the claim.
(h) That 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 qualified
health plan shall pay the claim within 30 days after the defect is
corrected.
(i) That a qualified health plan must notify the health
professional
or facility and the commissioner director of the
department of insurance and financial services of the defect if a
claim or a portion of a claim is returned from a health
professional or facility under subdivision (h) and remains
defective for the original reason or a new reason.
(j) An external review procedure for adverse determinations of
payment as provided in subsections (4) and (5). The costs for the
external review procedure shall be assessed as determined by the
commissioner.director of the department of insurance and
financial
services.
(k) Penalties to be applied to health professionals, health
facilities, and qualified health plans for failing to adhere to the
timely claims processing and payment procedure established under
this section.
(l) A system for notifying the licensing entity for health
maintenance organizations, qualified health plans, and other health
care insurers if a penalty is incurred under subdivision (k).
(3) If a qualified health plan determines that 1 or more
covered services listed on a claim are payable, the qualified
health plan shall pay for those services and shall not deny the
entire claim because 1 or more other covered services listed on the
claim are defective or because 1 or more other services listed on
the claim are not covered services.
(4)
The commissioner director
of the department of insurance
and financial services shall establish an external review procedure
as provided in this subsection and subsection (5). A health
professional or facility may request an external review by the
commissioner
director of the department of
insurance and financial
services of a qualified health plan's adverse determination if the
health professional or facility makes the request not later than 30
days after receipt of a notice under subsection (2)(i). Within 10
days
after a request for an external review, the commissioner
director of the department of insurance and financial services
shall complete a preliminary review to determine whether the
external review may proceed or request more information from the
health professional, facility, or the qualified health plan. The
health professional, facility, or the qualified health plan shall
supply
the commissioner director
of the department of insurance and
financial services with the requested information not later than 10
business days after receipt of the request for information from the
commissioner.
director of the department of
insurance and financial
services. Not later than 5 business days after receipt of any
information
requested by the commissioner, the commissioner
director of the department of insurance and financial services, he
or she shall complete a preliminary review to determine whether the
external
review may proceed. If the commissioner director of the
department of insurance and financial services determines that the
external
review may not proceed, the commissioner he or she shall
notify in writing the health professional or facility of the
specific reasons for the determination and may permit the health
professional or facility to reapply for a preliminary review by the
commissioner.
director of the department of
insurance and financial
services.
If the commissioner director of the department of
insurance and financial services determines that the external
review
may proceed, the commissioner he
or she shall notify in
writing the health professional or facility and the qualified
health plan and shall require the qualified health plan to provide
not later than 7 business days after the notice any information
used by the qualified health plan in making the adverse
determination. Failure by a health professional or facility or
qualified
health plan to provide the commissioner director of the
department of insurance and financial services with requested
information
permits the commissioner him
or her to terminate a
review and issue a decision reversing or affirming an adverse
determination.
(5)
If the commissioner director
of the department of
insurance and financial services determines that an external review
may
proceed, the commissioner he
or she shall immediately assign an
independent review organization to conduct the external review.
Only an independent review organization meeting qualifications
established
by the commissioner director
of the department of
insurance and financial services shall be assigned to conduct an
external review. The independent review organization may request
the health professional or facility and the qualified health plan
to provide information and shall review all pertinent information
submitted by the health professional or facility and the qualified
health
plan along with the terms of coverage under the medicaid
Medicaid plan. The independent review organization shall make a
written recommendation that includes the rationale and supporting
documentation and any recommendation for an assessment of interest
to
the commissioner director
of the department of insurance and
financial services not later than 30 days after being assigned as
the
review organization. The commissioner director of the
department of insurance and financial services shall notify in
writing the health professional or facility and the qualified
health plan of his or her decision reversing or affirming the
qualified health plan's adverse determination and shall include the
principal reasons for the decision not later than 15 days after
receipt of the assigned independent review organization's
recommendation. If an adverse determination is reversed, the
qualified health plan shall immediately pay the claim and any
interest
assessed by the commissioner.director
of the department of
insurance and financial services.
(6)
Beginning not later than October 1, 2000 and continuing
thereafter,
the The department of community health shall not
enter
into or renew a contract with a qualified health plan unless the
qualified health plan agrees to follow the timely claims processing
and payment procedure established under this section and requires
health professionals and facilities under contract with the
qualified health plan to follow the timely claims processing and
payment
procedure established under this section. The department of
community
health shall not enter into or
renew a contract with a
qualified
health plan unless the commissioner director of the
department of insurance and financial services determines that the
qualified health plan satisfies all of the following:
(a) Is a health maintenance organization licensed or issued a
certificate of authority in this state.
(b) Uses standardized claims as outlined in the provider
contract and accepts claims submitted electronically in a generally
accepted format.
(c) Demonstrates the ability to provide all required or
covered
medicaid Medicaid services including covered specialty care
to the estimated number of enrollees on a regional basis.
(d) Meets the criteria for delivering the comprehensive
package
of services under the department of community health's
department's comprehensive health plan.
(7)
The commissioner shall report to the senate and house of
representatives
appropriations subcommittees on community health by
October
1, 2001 on the timely claims processing and payment
procedure
established under this section.
(7) (8)
It is not a fraudulent act for a
health professional
or facility to submit a claim under this section that includes 1 or
more rendered services that are determined not covered services.
(8) (9)
As used in this section, :
(a)
"Medicaid" means the program of medical assistance
established
under section 105.
(b)
"Qualified "qualified
health plan" means, at a minimum,
an
organization that meets the criteria for delivering the
comprehensive
package of services under the department of community
health's
department's comprehensive health plan.
Sec.
111k. (1) Beginning October 1, 2007, the The department
of
community health shall ensure that,
as a condition of
participation and funding, all health professionals, facilities, or
health
maintenance organizations receiving medicaid Medicaid
payments under this act are in substantial compliance with federal
standards for lead screening for children enrolled in
medicaid.Medicaid.
(2)
The department of community health shall determine the
statewide average of lead screening being performed on children who
are
enrolled in medicaid Medicaid
on October 1, 2007 and shall
determine
whether the rate of children who are enrolled in medicaid
Medicaid receiving a lead screening is substantially in compliance
with the federal standards for lead screening for children enrolled
in
medicaid. Medicaid. If the rate of children who are enrolled in
medicaid
Medicaid receiving a lead screening is below 80%, the
director
of the department of community health shall present to the
senate and house health policy committees a written report
detailing why the rate is not in substantial compliance with the
federally
required standards for lead screening and the department
of
community health's department's
recommendations for improving
the rate. If the statewide lead screening testing rate does not
equal
or exceed 80% for medicaid-enrolled Medicaid-enrolled
children
by October 1, 2007, the department of community health
may,
with funds appropriated for medicaid Medicaid managed care or
medicaid
Medicaid fee for services, contract with community
agencies to provide the percentage of lead screening tests needed
to reach an 80% lead screening testing rate. A contracting
organization that meets or surpasses contract performance
requirements is entitled to share in financial bonuses awarded
under the performance bonus program and receive not less than 10%
of the beneficiaries who do not voluntarily select a specific
health plan at the time of managed care enrollment in addition to
any other auto assignments to which the contracting organization is
entitled.
(3)
As used in this section, "medicaid" means the program of
medical
assistance administered by the state under section 105.
Sec.
111l. Beginning October 1, 2006, the The department
and
the
department of community health shall
require that all children
participants in the special supplemental food program for women,
infants, and children (WIC program) receive lead testing. Federal
funds provided for administration of the special supplemental food
program for women, infants, and children (WIC program) shall not be
used to implement or administer the provisions of this section.
Sec. 112b. As used in this section and sections 112c to 112e:
(a) "Asset disregard" means, with regard to the state's
medical assistance program, disregarding any assets or resources in
an amount equal to the insurance benefit payments that are made to
or on behalf of an individual who is a beneficiary under a
qualified long-term care insurance partnership policy.
(b) "Long-term care insurance policy" means a policy described
in chapter 39 of the insurance code of 1956, 1956 PA 218, MCL
500.3901 to 500.3955.
(c) "Long-term care partnership program" means a qualified
state long-term care insurance partnership as defined in section
1917(b) of the social security act, 42 USC 1396p.
(d) "Long-term care partnership program policy" means a
qualified
long-term care insurance policy that the commissioner of
the
office of financial and insurance services director of the
department of insurance and financial services certifies as meeting
the requirements of section 1917(b) of the social security act, 42
USC 1396p, section 6021 of the federal deficit reduction act of
2005, Public Law 109-171, and any applicable federal regulations or
guidelines.
(e)
"Medicaid" means the program of medical assistance
established
by the department of community health under section
105.
Sec.
112c. (1) Subject to subsection (5), the department of
community
health in conjunction with the office
of financial and
insurance
services and the department of human services department
of insurance and financial services shall establish a long-term
care
partnership program in Michigan this
state to provide for the
financing of long-term care through a combination of private
insurance
and medicaid. Medicaid. It is the intent of the long-term
care partnership program to do all of the following:
(a)
Provide incentives for individuals to insure ensure
against the costs of providing for their long-term care needs.
(b) Provide a mechanism for individuals to qualify for
coverage
of the cost of their long-term care needs under medicaid
Medicaid without first being required to substantially exhaust
their resources.
(c) Alleviate the financial burden on the state's medical
assistance program by encouraging the pursuit of private
initiatives.
(2) An individual who is a beneficiary of a Michigan long-term
care partnership program policy is eligible for assistance under
the state's medical assistance program using the asset disregard as
provided under subsection (5).
(3)
The department of community health shall pursue reciprocal
agreements with other states to extend the asset disregard to
Michigan residents who purchased long-term care partnership
policies in other states that are compliant with title VI, section
6021 of the federal deficit reduction act of 2005, Public Law 109-
171, and any applicable federal regulations or guidelines.
(4) Upon diminishment of assets below the anticipated
remaining benefits under a long-term care partnership program
policy, certain assets of an individual, as provided under
subsection (5), shall not be considered when determining any of the
following:
(a) Medicaid eligibility.
(b)
The amount of any medicaid Medicaid
payment.
(c) Any subsequent recovery by the state of a payment for
medical services or long-term care services.
(5)
Not later than 270 days after the effective date of the
amendatory
act that added this subsection, October
7, 2007, the
department
of community health shall apply to the United States
department
Department of health Health and human services
Human
Services
for an amendment to the state's medicaid
Medicaid state
plan to establish that the assets an individual owns and may retain
under
medicaid Medicaid and still qualify for benefits under
medicaid
Medicaid at the time the individual applies for benefits
is
are increased dollar-for-dollar for each dollar paid out
under
the individual's long-term care insurance policy if the individual
is a beneficiary of a qualified long-term care partnership program
policy.
(6) If the long-term care partnership program is discontinued,
an individual who purchased a Michigan long-term care partnership
program policy before the date the program was discontinued shall
be eligible to receive asset disregard if allowed as provided by
title VI, section 6021 of the federal deficit reduction act of
2005, Public Law 109-171.
(7)
The department of community health shall contract with the
Michigan
medicare medicaid Medicare
Medicaid assistance program or
department
of community health designated department-designated
single point of entry agencies, or both, to provide counseling
services under the Michigan long-term care partnership program.
(8)
The department, of community health, in consultation with
the
department of human services and the office of financial and
insurance and financial services, shall develop a notice to
consumers detailing in plain language the pertinent provisions of
qualified state long-term care insurance partnership policies as
they
relate to medicaid Medicaid
eligibility and shall determine
the appropriate distribution of the notice. The notice shall be
available
in a printable form on the office of financial and
department of insurance and financial services's website.
(9)
The department , the department of community health, and
the
office of financial and the department of insurance and
financial services shall post, on their respective websites,
information on how to access the national clearinghouse established
under the federal deficit reduction act of 2005, Public Law 109-
171, when the national clearinghouse becomes available to
consumers.
Sec.
112e. The department, of community health, in
consultation
with the department of human services and the office
of
insurance and financial services, may promulgate rules pursuant
according
to the administrative procedures act of
1969, 1969 PA
306,
MCL 24.201 to 24.328, as necessary
to implement the
partnership program in accordance with the requirements of section
1917(b) of the social security act, 42 USC 1396p, section 6021 of
the federal deficit reduction act of 2005, Public Law 109-171, and
applicable federal regulations or guidelines.
Sec.
112g. (1) Subject to section 112c(5), the department of
community
health shall establish and operate
the Michigan medicaid
Medicaid estate recovery program to comply with requirements
contained
in section 1917 of title XIX. The department of community
health
shall work with the appropriate
state and federal
departments and agencies to review options for development of a
voluntary
estate preservation program. Beginning not later than 180
days
after the effective date of the amendatory act that added this
section
March 28, 2008 and every 180 days thereafter, after that,
the
department of community health shall submit a report to the
senate and house appropriations subcommittees with jurisdiction
over
department of community health matters and the senate and
house fiscal agencies regarding options for development of the
estate preservation program.
(2)
The department of community health shall establish an
estate recovery program including various estate recovery program
activities. These activities shall include, at a minimum, all of
the following:
(a) Tracking assets and services of recipients of medical
assistance that are subject to estate recovery.
(b) Actions necessary to collect amounts subject to estate
recovery for medical services as determined according to subsection
(3)(a) provided to recipients identified in subsection (3)(b).
Amounts subject to recovery shall not exceed the cost of providing
the medical services. Any settlements shall take into account the
best interests of the state and the spouse and heirs.
(c) Other activities necessary to efficiently and effectively
administer the program.
(3)
The department of community health shall seek appropriate
changes
to the Michigan medicaid Medicaid
state plan and shall
apply for any necessary waivers and approvals from the federal
centers
Centers for medicare Medicare and medicaid
services
Medicaid
Services to implement the Michigan medicaid
Medicaid
estate
recovery program. The department of community health shall
seek
approval from the federal centers Centers for medicare
Medicare
and medicaid Medicaid Services regarding all of the
following:
(a) Which medical services are subject to estate recovery
under section 1917(b)(1)(B)(i) and (ii) of title XIX.
(b) Which recipients of medical assistance are subject to
estate recovery under section 1917(a) and (b) of title XIX.
(c) Under what circumstances the program shall pursue recovery
from the estates of spouses of recipients of medical assistance who
are subject to estate recovery under section 1917(b)(2) of title
XIX.
(d) What actions may be taken to obtain funds from the estates
of recipients subject to recovery under section 1917 of title XIX,
including notice and hearing procedures that may be pursued to
contest
actions taken under the Michigan medicaid Medicaid estate
recovery program.
(e) Under what circumstances the estates of medical assistance
recipients
will be are exempt from the Michigan medicaid Medicaid
estate recovery program because of a hardship. At the time an
individual
enrolls in medicaid Medicaid
for long-term care
services,
the department of community health shall provide to the
individual written materials explaining the process for applying
for a waiver from estate recovery due to hardship. The department
of
community health shall develop a
definition of hardship
according to section 1917(b)(3) of title XIX that includes, but is
not limited to, the following:
(i) An exemption for the portion of the value of the medical
assistance recipient's homestead that is equal to or less than 50%
of
the average price of a home in the county in which the medicaid
Medicaid recipient's homestead is located as of the date of the
medical assistance recipient's death.
(ii) An exemption for the portion of an estate that is the
primary income-producing asset of survivors, including, but not
limited to, a family farm or business.
(iii) A rebuttable presumption that no hardship exists if the
hardship resulted from estate planning methods under which assets
were diverted in order to avoid estate recovery.
(f)
The circumstances under which the department of community
health
may review requests for exemptions
and provide exemptions
from
the Michigan medicaid Medicaid
estate recovery program for
cases that do not meet the definition of hardship developed by the
department. of
community health.
(g) Implementing the provisions of section 1396p(b)(3) of
title XIX to ensure that the heirs of persons subject to the
Michigan
medicaid Medicaid estate recovery program will not be
unreasonably harmed by the provisions of this program.
(4)
The department of community health shall not seek medicaid
Medicaid estate recovery if the costs of recovery exceed the amount
of recovery available or if the recovery is not in the best
economic interest of the state.
(5)
The department of community health shall not implement a
Michigan
medicaid Medicaid estate recovery program until approval
by the federal government is obtained.
(6)
The department of community health shall not recover
assets from the home of a medical assistance recipient if 1 or more
of the following individuals are lawfully residing in that home:
(a) The medical assistance recipient's spouse.
(b) The medical assistance recipient's child who is under the
age of 21 years, or is blind or permanently and totally disabled as
defined in section 1614 of the social security act, 42 USC 1382c.
(c) The medical assistance recipient's caretaker relative who
was residing in the medical assistance recipient's home for a
period of at least 2 years immediately before the date of the
medical assistance recipient's admission to a medical institution
and who establishes that he or she provided care that permitted the
medical assistance recipient to reside at home rather than in an
institution. As used in this subdivision, "caretaker relative"
means any relation by blood, marriage, or adoption who is within
the fifth degree of kinship to the recipient.
(d) The medical assistance recipient's sibling who has an
equity interest in the medical assistance recipient's home and who
was residing in the medical assistance recipient's home for a
period of at least 1 year immediately before the date of the
individual's admission to a medical institution.
(7)
The department of community health shall provide written
information
to individuals seeking medicaid Medicaid
eligibility
for long-term care services describing the provisions of the
Michigan
medicaid Medicaid estate recovery program, including, but
not limited to, a statement that some or all of their estate may be
recovered.
(8)
The department of community health shall not charge
interest
on the balance of any Michigan medicaid Medicaid estate
recovery payments.
(9)
The department of community health shall not place or
record a lien on qualifying property under the tax equity and
fiscal
responsibility act of 1982, Public Law 97-424 97-248
(TEFRA).
Sec.
112i. Revenue collected through Michigan medicaid
Medicaid estate recovery activities shall be used to fund the
activities
of the Michigan medicaid Medicaid
estate recovery
program. Any remaining balances shall be treated as an expenditure
credit for long-term care support and services in the medical
services
appropriation unit of the annual department of community
health
appropriation.
Sec.
112j. (1) The department of community health may
promulgate
rules for the Michigan medicaid Medicaid
estate recovery
program
according to the administrative procedures act of 1969. ,
1969
PA 306, MCL 24.201 to 24.328.
(2) Not later than 1 year after implementation of the Michigan
medicaid
Medicaid estate recovery program and each year after that,
the
department of community health shall submit a report to the
senate and house appropriations subcommittees with jurisdiction
over
department of community health matters and the senate and
house fiscal agencies regarding the cost to administer the Michigan
medicaid
Medicaid estate recovery program and the amounts recovered
under
the Michigan medicaid Medicaid
estate recovery program.
Sec. 114. (1) The office of children and youth services is
created
as a single purpose single-purpose
entity within the
department. of
social services. The office shall be responsible for
the planning, development, implementation, and evaluation of
children and youth services conducted, administered, or purchased
by
the department under the authority of sections 114 to 123.119b.
(2)
The director, of social services, after consultation with
the governor, shall appoint an executive director of the office.
The executive director shall be accountable directly to the
director. of
social services. The executive director shall not be
within the classified civil service and shall receive compensation
as established by the legislature. The executive director shall do
the following:
(a) Represent the department in all matters and hearings
pertaining to children and youth services and programs.
(b) Serve as a special advisor to the governor on children and
youth services budgets and programs.
(c)
Advise the director of social services with respect to
children and youth services and programs conducted, administered,
or purchased by the department under the authority of sections 114
to
123, 119b, and make recommendations to the director for the
improvement of those services and programs.
(d) Recommend to the governor and the legislature methods of
improving the effectiveness of public and private children and
youth services and programs.
(e) Recommend to the governor and the legislature appropriate
allocations of public funds for children and youth services and
programs.
(3) The department, in conjunction with the office, may
promulgate rules necessary to implement, administer, and enforce
its powers and duties as described in this act. The rules shall be
promulgated
pursuant to Act No. 306 of the Public Acts of 1969, as
amended,
being sections 24.201 to 24.315 of the Michigan Compiled
Laws.according to the administrative procedures act
of 1969.
Sec. 115f. As used in this section and sections 115g to 115t:
(a) "Adoptee" means the child who is to be adopted or who is
adopted.
(b) "Adoption assistance" means a support subsidy or a support
subsidy with medical assistance.
(c) "Adoption assistance agreement" means an agreement between
the department and an adoptive parent regarding adoption
assistance.
(d) "Adoption code" means the Michigan adoption code, chapter
X of the probate code of 1939, 1939 PA 288, MCL 710.21 to 710.70.
(e) "Adoptive parent" means the parent or parents who adopt a
child under the adoption code.
(f) "Certification" means a determination of eligibility by
the department that an adoptee is eligible for a support subsidy or
a medical subsidy, or both, or redetermined adoption assistance.
(g) "Child with special needs" means an individual under the
age of 18 years for whom the state has determined all of the
following:
(i) There is a specific judicial finding that the child cannot
or should not be returned to the home of the child's parents.
(ii) A specific factor or condition, or a combination of
factors and conditions, exists before the adoption is finalized so
that it is reasonable to conclude that the child cannot be placed
with an adoptive parent without providing adoption assistance under
this act. The factors or conditions to be considered may include
ethnic or family background, age, membership in a minority or
sibling group, medical condition, physical, mental, or emotional
disability, or length of time the child has been waiting for an
adoptive home.
(iii) A reasonable but unsuccessful effort was made to place the
adoptee with an appropriate adoptive parent without providing
adoption assistance under this act or a prospective placement is
the only placement in the best interest of the child.
(h) "Compact" means the interstate compact on adoption and
medical assistance as enacted in sections 115r and 115s.
(i) "Court" means the family division of circuit court.
(j)
"Department" means the department of human services.
(j) (k)
"Determination of care
rate" means a supplemental
payment to the standard age appropriate foster care rate that may
be justified when extraordinary care or expense is required. The
supplemental payment shall be based on 1 or more of the following
for which extraordinary care is required of the foster care
provider or an extraordinary expense exists:
(i) A physically disabled child for whom the foster care
provider must provide measurably greater supervision and care.
(ii) A child with special psychological or psychiatric needs
that require extra time and a measurably greater amount of care and
attention by the foster care provider.
(iii) A child requiring a special diet that is more expensive
than a normal diet and that requires extra time and effort by the
foster care provider to obtain and prepare.
(iv) A child whose severe acting out or antisocial behavior
requires a measurably greater amount of care and attention of the
foster care provider.
(v) Any other condition for which the department determines
that extraordinary care is required of the foster care provider or
an extraordinary expense exists.
(k) (l) "Foster
care" means placement of a child outside the
child's parental home under the department's supervision by a court
of competent jurisdiction.
(l) (m)
"Medical assistance"
means the federally aided medical
assistance program under title XIX.
(m) (n)
"Medical subsidy" means a
reimbursement program that
assists in paying for services for an adopted child who has an
identified physical, mental, or emotional condition that existed,
or the cause of which existed, before the adoption is finalized.
(n) (o)
"Medical subsidy
agreement" means an agreement between
the department and an adoptive parent regarding a medical subsidy.
(o) (p)
"Nonrecurring adoption
expenses" means reasonable and
necessary adoption fees, court costs, attorney fees, and other
expenses that are directly related to the legal adoption of a child
with special needs. Nonrecurring adoption expenses do not include
costs or expenses incurred in violation of state or federal law or
that have been reimbursed from other sources or funds.
(p) (q)
"Other expenses that are
directly related to the legal
adoption of a child with special needs" means adoption costs
incurred by or on behalf of the adoptive parent and for which the
adoptive parent carries the ultimate liability for payment,
including the adoption study, health and psychological
examinations, supervision of the placement before adoption, and
transportation and reasonable costs of lodging and food for the
child or adoptive parent if necessary to complete the adoption or
placement process.
(q) (r)
"Party state" means a
state that becomes a party to
the interstate compact on adoption and medical assistance.
(r) (s)
"Placement" means a
placement or commitment, including
the necessity of removing the child from his or her parental home,
as approved by the court under an order of disposition issued under
section 2 of chapter XIIA of the probate code of 1939, 1939 PA 288,
MCL 712A.2.
(s) (t)
"Redetermined adoption
assistance" means a payment as
determined by a certification that may be justified when
extraordinary care or expense is required for a condition that
existed or the cause of which existed before the adoption from
foster care was finalized.
(t) (u)
"Redetermined adoption
assistance agreement" means a
written agreement regarding redetermined adoption assistance
between the department and the adoptive parent of a child.
(u) (v)
"Residence state" means
the state in which the child
is a resident by virtue of the adoptive parent's residency.
(v) (w)
"Standard age appropriate
foster care rate" means the
approved maintenance payment rate that is paid for a child in
foster family care.
(w) (x)
"State" means a state of
the United States, the
District of Columbia, the Commonwealth of Puerto Rico, the Virgin
Islands, Guam, the Commonwealth of the Northern Mariana Islands, or
a territory or possession of the United States.
(x) (y)
"Support subsidy" means
payment for support of a child
who has been placed for adoption from foster care.
Sec. 115o. (1) Both of the following apply to residential care
bed space for juveniles who are within or likely to come within the
court's jurisdiction under section 2(a) or (d) of chapter XIIA of
1939 PA 288, MCL 712A.2, or committed to the department under the
youth rehabilitation services act, 1974 PA 150, MCL 803.301 to
803.309:
(a) If 1 or more appropriate juvenile residential care
providers located or doing business in this state have bed space
available, the department shall use that space rather than a space
available by a provider located or doing business in another state.
This requirement does not apply if the provider located or doing
business in another state offers a specialized program that is not
available in this state.
(b) If an excess of bed spaces is available within a security
level, the department shall use the bed spaces of private providers
with whom it has contracted and allow state owned bed spaces to go
unused
first. However, in In applying this subdivision, a bed space
that is available because a facility refused to accept a juvenile
does not count toward a surplus.
(2) As used in this section, "appropriate juvenile residential
care provider" means a private nonprofit entity domiciled in this
state
that is licensed by the department of consumer and industry
services
licensing and regulatory
affairs and that entered into 1
or
more contracts with the family independence agency department to
provide
residential care services for juveniles on or before the
effective
date of the amendatory act that added this
section.January 12, 1999.
Sec.
115s. (1) The family independence agency is authorized to
department may negotiate and enter into interstate compacts with
agencies of other states for the provision of adoption assistance
for an adoptee who is a child with special needs, who moves into or
out of this state, and on behalf of whom adoption assistance is
being provided by this state or another state party to such a
compact.
(2) When a compact is so entered into and for as long as it
remains in force, the compact has the force and effect of law.
(3) A compact authorized under this act must include:
(a) A provision making it available for joinder by all states.
(b) A provision or provisions for withdrawal from the compact
upon written notice to the parties, but with a period of 1 year
between the date of the notice and effective date of the
withdrawal.
(c) A requirement that the protections under the compact
continue in force for the duration of the adoption assistance and
are applicable to all children and their adoptive parents who on
the effective date of the withdrawal are receiving adoption
assistance
from a party state other than the one state in which
they are resident and have their principal place of abode.
(d) A requirement that each instance of adoption assistance to
which the compact applies be covered by an adoption assistance
agreement in writing between the adoptive parents and the state
child welfare agency of the state that undertakes to provide the
adoption assistance. An agreement required by this subdivision
shall be expressly for the benefit of the adopted child and be
enforceable by the adoptive parents and the state agency providing
the adoption assistance.
(e) Other provisions as may be appropriate to implement the
proper administration of the compact.
Sec. 116. (1) With respect to juvenile court probation staff
in a county that is not a county juvenile agency, the department
shall do all of the following:
(a) Develop and recommend to the supreme court standards and
qualifications for employment and other criteria designed to
develop an adequate career service.
(b) Maintain information as to court employment needs and
assist in recruiting qualified personnel.
(c) Provide, with legislative approval, a statewide system of
preservice and inservice training, which may include full or part-
time scholarships.
(d) Develop recommendations regarding the functions of the
office of county juvenile officer.
(2) The department may provide consultation and assistance
services to the juvenile probation service of the court in a county
that is not a county juvenile agency.
(3) The department shall develop a plan that permits the
voluntary transfer of county juvenile court probation staff in a
county that is not a county juvenile agency to the department by
the joint concurrence of the county board of commissioners or
county executive, as applicable, and the chief judge of the family
division of circuit court. The plan shall include procedures for
negotiations between the state, as represented by the department,
and the affected county board of commissioners or county executive,
the
county family independence agency board, and the chief judge of
the family division of circuit court for that county. The plan
shall afford juvenile court probation staff transferred under the
plan the opportunity to be employed in the state classified civil
service in compliance with procedures established by the Michigan
civil service commission. The plan shall enable the court to
maintain sufficient staff to enforce court orders and to perform
the preliminary inquiry and monitoring of court wards required by
chapter XIIA of the probate code of 1939, 1939 PA 288, MCL 712A.1
to
712A.32. The plan shall be submitted to the legislature not
later
than 18 months after the effective date of this subsection.
(4) As used in this section, "county juvenile agency" means
that term as defined in section 2 of the county juvenile agency
act, 1998 PA 518, MCL 45.622.
Sec. 117c. (1) The county treasurer is designated as the
custodian
of all money provided for the use of the county family
independence
agency, department, the family division of circuit
court, and the agency designated by the county board of
commissioners or, if a county has a county executive, chief
administrative officer, or county manager, that individual to
provide juvenile justice services. The county treasurer shall
create and maintain a child care fund. The following money shall be
deposited in the child care fund:
(a) All money raised by the county for the use of the county
family
independence agency department
for the foster care of
children with respect to whom the family division of circuit court
has not taken jurisdiction.
(b) Money for the foster care of children under the
jurisdiction of the family division of circuit court raised by the
county with the view of receiving supplementary funds for this
purpose from the state government as provided in section 117a.
(c) All funds made available by the state government for
foster care of children.
(d) All payments made in respect to support orders issued by
the family division of circuit court for the reimbursement of
government for expenditures made or to be made from the child care
fund for the foster care of children.
(e) All prepayments and refunds for reimbursement of county
family
independence agencies departments
for the foster care of
children.
(f) All funds made available to the county for the foster care
of children from any other source, except gifts that are
conditioned on a different disposition or reimbursements of the
general fund.
(g) Money for the foster care of children under the
jurisdiction of the court of general criminal jurisdiction
committed to a county facility or a court facility for juveniles in
the county in which the court of general criminal jurisdiction is
located.
(h) All payments made in respect to support orders issued by
the court of general criminal jurisdiction for the reimbursement of
government for expenditures made or to be made from the child care
fund for the foster care of children.
(2) The child care fund shall be used for the costs of
providing foster care for children under sections 18c and 117a and
under the jurisdiction of the family division of circuit court or
court of general criminal jurisdiction.
(3) The child care fund may be used to pay the county's share
of the cost of maintaining children at the Michigan children's
institute under 1935 PA 220, MCL 400.201 to 400.214, or public
wards under the youth rehabilitation services act, 1974 PA 150, MCL
803.301 to 803.309.
(4) The account for the child care fund shall be maintained
separate and apart from all other accounts of county funds. The
fund shall be used exclusively for carrying out the purposes
authorized by this act. The county board of commissioners shall
distinguish in its appropriations for the child care fund the sums
of money to be used by the family division of circuit court, the
county
family independence agency, department,
and the agency
designated by the county board of commissioners or the county
executive to provide juvenile justice services. The county
treasurer shall keep these segregated in proper subaccounts.
(5) A county annually shall develop and submit a plan and
budget for the funding of foster care services to the office for
approval. Funds shall not be distributed under section 117a except
for reimbursement of expenditures made under an approved plan and
budget. The office shall not approve plans and budget that exceed
the amount appropriated by the legislature.
(6) A county shall make and preserve accurate records of its
juvenile justice services and expenditures. Upon the department's
request, the information contained in the records shall be
available to the office.
(7) This section does not apply to a county that is a county
juvenile agency.
Enacting section 1. Sections 2, 109i, and 109j of the social
welfare act, 1939 PA 280, MCL 400.2, 400.109i, and 400.109j, are
repealed.
Enacting section 2. This amendatory act takes effect 90 days
after the date it is enacted into law.
