Both bodies of the Michigan Legislature are making progress on their Department of Health and Human Services (MDHHS) FY 2023 budgets.
The Senate Appropriations Committee reported their version—Senate Bill 828—to the Senate floor on Wednesday, while the House Appropriations Committee reported their version—House Bill 5784—to the House floor on Wednesday as well.
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SB 828 appropriates $32.5 billion in total funds and $5.8 billion General Fund/General Purpose (GF/GP) to MDHHS. According to bill sponsor Sen. Rick Outman (R-Mount Pleasant), the bill prioritizes increased funding for Program of All-Inclusive Care for the Elderly (PACE) programs, Medicaid fee-for-service dental reimbursement rates, and behavioral health homes.
HB 5784 appropriates $32.9 billion in total funds and $6 billion GF/GP to the department. According to Kent Dell, Senior Fiscal Analyst at the House Fiscal Agency, the budget increases funding for the Michigan Crisis and Access Line (MiCAL), the Medicaid bundled reimbursement rate for methadone, as well as funding for a new in-patient psychiatric hospital, and health workforce development initiatives.
Both bills also have language related to abortion, but they differ in their approach to prohibit funding and advertise an adoption alternative.
Senate budget bill
Outman says this budget aims to get funds to those in need and not to state and legislative bureaucrats and administrative overhead. In doing so, he says this budget will expand elderly care, Medicaid dental reimbursements, and behavioral health services.
This budget allocates $31 million of gross, one-time appropriations to PACE programs in Michigan that focus on COVID relief efforts. This appropriation increases funding to these programs by 15% compared to last fiscal year.
Other one-time appropriations in the Senate MDHHS budget include $15 million gross for pandemic relief for residential childcare facilities, $10 million gross for the Jail Diversion Fund, and $7.6 million gross toward a grant program to retain rural primary care doctors.
The budget also increases Medicaid fee-for-service dental reimbursement rates by $41 million. Rates for Medicaid dental care would also increase for ambulatory surgical centers and outpatient hospitals by $10.7 million gross, which is more than Gov. Whitmer’s budget proposal calls for.
Michigan’s behavioral health homes are also a key component of the Senate’s budget. It allocates $16.8 million gross to expand the number of behavioral health homes in Prepaid Inpatient Health Plan (PIHP) regions six and seven. The funds will also be used to expand opioid health homes in PIHP regions six, seven, and ten.
On abortion policy, the budget has language “prohibiting funding in the form of a grant, reimbursement, contract, or any other type of payment from being provided to an entity that provides elective abortion services, abortion counseling, or abortion referrals, or subcontracts with an entity that engages in those activities.”
This budget is waiting to be heard on the Senate floor.
House budget bill
The House’s MDHHS budget focuses mainly on behavioral health and workforce expansion efforts.
The budget allocates $3 million GF/GP to continue to support the MiCAL hotline statewide. This call center will act as a secondary support line to the national 988 crisis line once it launches in July of this year—and will serve as the main crisis stabilization service number to those who might not be covered by 988 services, like rural Michiganders.
To expand access to methadone to combat substance use disorder, the bill appropriates $5.4 million gross ($1.2 million GF/GP) to increase the Medicaid bundled reimbursement rate for administering and servicing methadone to $19.
In the effort to continue expanding access to behavioral health services, the House budget adds $85 million in one-time GF/GP funding to construct a new Hawthorn Center—an intensive, inpatient, psychiatric care center—for children and adolescents in replacement of the current center. This center would have an estimated capacity of over 260 staffed inpatient beds.
To help staff this new psychiatric center, the budget allocates $5 million in GF/GP for four projects to increase the number of psychiatric-mental health nurse practitioners, provide social workers training in crisis stabilization management, and provide training for direct care workers.
This budget, similarly to the Senate budget, also invests in the behavioral health homes and the Jail Diversion Fund.
The House budget also has language to restrict funds for providers practicing abortions and abortion-related activities, but also includes $50,000 to provide notice and information to providers and the public about this restriction.
Another line item allocates $10 million GF/GP to fund marketing programs that promote adoption of infants and to develop educational materials to promote adoption as an alternative to abortion.
This budget is waiting to be heard on the House floor.