Michigan’s recently passed FY 2023 health budget focuses on behavioral health, workforce, and infrastructure

The Michigan FY 2023 $69 billion budget omnibus bill—House Bill 5783—adopted the negotiated Conference Committee Budget and was passed by the House and Senate on Friday, July 1st. It’s awaiting Gov. Gretchen Whitmer’s signature to be finalized.

The Michigan Department of Health and Human Services (MDHHS) items in the budget for FY 2023 is $200 million more than the FY 2022 year-to-date for a total of $33.4 billion. 

The Conference budget is the final step in the budgetary process and includes input from representatives of the House, Senate, and governor’s office. Similar to the Executive, House, and Senate budgets, the Conference budget includes greater investments in behavioral health, workforce pipeline, and maternal and reproductive care. However, the Conference budget differs in various ways, including by decreasing funding for reducing racial disparities. 

 

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Behavioral health funding in the Conference budget includes the House’s request of $3 million GF/GP for the Michigan Crisis and Access Line (MiCAL) to provide crisis intervention services to areas in Michigan where the federal 988 number does not reach. 

The Conference budget also includes funding to increase capacity for behavioral health inpatient facilities. It lowered this investment from $52.5 million GF/GP in the Executive budget to $41 million GF/GP. The investment also authorizes 87 FTE positions to increase capacity at the Hawthorn Center and to reimburse private providers of intensive psychiatric treatments.  

The $325 million one-time GF/GP allocated from the Executive budget for a new state-operated psychiatric hospital was moved to the Capital Outlay section of the omnibus budget. The Conference budget also makes a one-time investment of $165.6 million GF/GP for non-state psychiatric hospitals, $50 million GF/GP for competitive pediatric psychiatric infrastructure grants, $5 million GF/GP for Detroit Children’s Hospital psychiatric care, and $2.5 million GF/GP for Insight Behavioral Health in Flint. 

The Health Homes initiative in Michigan was also fully funded and includes $16.8 million gross ($2.5 GF/GP) to increase the number of counties with behavioral health homes from 37 to 42 and opioid health homes from 40 to 49. Unlike the House budget, the Conference budget does not require funds to be also used to implement intellectual or developmental disability health homes. 

Other smaller investments in the Conference budget include $10 million GF/GP for the Jail Diversion Fund and $8.3 million GF/GP for the Salvation Army Safe Harbor.

The Conference budget also includes funding to assist the health care workforce in the state, but it invests less than some of the other budgets. The Executive budget provided one-time funding of $25 million GF/GP to support behavioral health provider loan repayment programs, whereas the Conference budget only allocates $10 million GF/GP. 

The Conference budget also concurs with the House to include $5 million GF/GP for 4 projects to increase the number of psychiatric mental health nurse practitioners and provide training for direct care workers. The budget also allocates $56 million gross to a Michigan higher education program to increase access to nursing education through community colleges. 

Previous budgets had allocations and language to demonetize abortion providers and invest money in abortion alternatives. The House appropriated $50,000 GF/GP to provide notice and information to providers that MDHHS is not to use the state general fund on elective abortions, whereas the Senate language prohibits any funding from going to an entity that provides elective abortions. The Conference budget concurs with the House allocation and excludes the Senate language. 

The Conference budget also allocates a $700,000 gross increase in Temporary Assistance for Needy Families funding for Real Alternatives pregnancy and parenting services programs promoting alternatives to abortion, $1.5 million GF/GP to pregnancy resource centers, and $4 million GF/GP to expand safe housing and supportive services for underserved pregnant women. All these allocations originate from the House budget. 

While the Executive budget included a $10 million one-time GF/GP allocation for firearm injury and violence prevention initiatives, the Conference budget only includes $1 million for training and assistance for school districts for local violence prevention strategies to reduce school gun violence.

Doula care, a priority of MDHHS, also receives $1.2 million GF/GP in the Conference budget for the expansion of Healthy Moms Healthy Babies maternal and infant health and support programs. 

The Conference budget also greatly reduces allocations for new initiatives to reduce health disparities. The Executive budget allocated $20 million gross ($15 million GF/GP) for 5 new health disparities initiatives centering on racial disparities, while the Conference budget includes just $500,000 GF/GP for uterine fibroid education and outreach.