2023 House Bill 4310

1. Amend page 17, line 16, after “5.3” by striking out “7,734,200” and inserting “7,734,300”and adjusting the subtotals, totals, and section 201 accordingly.

2. Amend page 144, line 7, after “programs,” by striking out “$150,000.00” and inserting “$150,100.00”.

1. Amend page 22, following line 27, by inserting:

“Behavioral health services

2,000,000”

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

2. Amend page 215, following line 2, by inserting:

“Sec. 1971. From the funds appropriated in part 1 for behavioral health services, the department shall allocate $2,000,000.00 to a nonprofit organization organized under the laws of this state that is exempt from federal income tax under section 501(c)(3) of the internal revenue code of 1986, 26 USC 501, and is located in a city with a population between 138,000 and 140,000 that is located in a county with a population between 881,000 and 882,000, according to the most recent federal decennial census. To be eligible for funds under this section, an organization must have current experience providing support services to immigrant children and families from Afghanistan, Iraq, Syria, Yemen, and other Middle Eastern countries, and Ukraine.”.

1. Amend page 19, line 6, after “$” by striking out “55,929,300” and inserting “60,929,300” and adjusting the totals in section 11 and enacting section 1 accordingly.

2. Amend page 149, following line 24, by inserting:

“Sec. 1404. From the funds appropriated in part 1 for community services, the department shall allocate $5,000,000.00 to area agencies on aging for home and community-based services.”.

1. Amend page 140, following line 20, by inserting:

“Sec. 1303. The department shall not contract with an organization that provides elective abortions, abortion counseling, or abortion referrals, for services that are to be funded with state restricted or state general fund/general purpose funds appropriated in part 1 for family planning local agreements. An organization under contract with the department shall not subcontract with an organization that provides elective abortions, abortion counseling, or abortion referrals, for services that are to be funded with state restricted or state general fund/general purpose funds appropriated in part 1 for family planning local agreements.

Sec. 1304. The department shall not use state restricted funds or state general funds, or allow grantees or subcontractors to use those funds, appropriated in part 1 in the pregnancy prevention program or family planning local agreements appropriation line items for abortion counseling, referrals, or services.

Sec. 1305. (1) From the funds appropriated in part 1 for family planning local agreements and the pregnancy prevention program, the department shall not contract with or award grants to an entity that engages in 1 or more of the activities described in section 1(2) of 2002 PA 360, MCL 333.1091, if the entity is located in a county or health district where family planning or pregnancy prevention services are provided by the county, the health district, or a qualified entity that does not engage in any of the activities described in section 1(2) of 2002 PA 360, MCL 333.1091.

(2) The department shall give priority to counties or health districts where no contracts or grants currently exist for family planning or pregnancy prevention services before contracting with or awarding grants to an entity that engages in 1 or more of the activities described in section 1(1) of 2002 PA 360, MCL 333.1091,if that entity is located in a county where family planning and pregnancy prevention services are provided by the county, the health district, or another qualified entity that does not engage in the activities described in section 1(1) of 2002 PA 360, MCL 333.1091.”.

2. Amend page 147, following line 21, by inserting:

“Sec. 1347. The department shall not use state restricted funds or state general funds appropriated in part 1, or allow grantees or subcontractors to use those funds, for abortion counseling, referrals, or services, or for any activities regarding human cloning or research in which a human embryo or embryos are destroyed or discarded.”.

1. Amend page 4, following line 12, by inserting:

“Diaper assistance payments

4,404,400”

2. Amend page 23, line 20, by striking out all of line 20.

3. Amend page 25, line 9, by striking out all of lines 9 and 10 and adjusting the subtotals, totals, and section 201 accordingly.

4. Amend page 55, following line 24, by inserting:

“Sec. 464. From the funds appropriated in part 1 for diaper assistance payments, $4,404,400.00 of state general fund/general purpose revenue must be allocated as grants to diaper assistance programs, maternity homes, and other nonprofit agencies that distribute diapers free of charge and were established as of January 1, 2020. The funds must only be used to purchase diapering supplies”.

5. Amend page 200, line 28, by striking all of section 1934.

1. Amend page 94, following line 29, by inserting:

“Sec. 699. (1) The department must use the funds appropriated in part 1 to issue an eligibility determination for the child development and care program by no later than 15 work days after receiving an application for the child development and care program.

(2) The department must use the funds appropriated in part 1 to notify a recipient of the child development and care program and the child care provider by no later than 15 work days prior to the first work day of the month in which the subsidy will end or if the child care subsidies are reduced.

(3) If it is determined that a child development and care program child care subsidy recipient was wrongfully removed from the program, the department must issue restitution to the affected child care provider, or recipient, no later than 15 work days after the wrongful removal determination is issued.

(4) The department shall submit quarterly reports to the report recipients required in section 246 of this part on the implementation of this section. The report shall include, but not be limited to, all of the following:

(a) The number of applications received during the previous quarter.

(b) The number of determinations that were issued within 15 work days of application receipt during the previous quarter.

(c) The number of program removals that were determined to be wrongful removals during the previous quarter.”.

1. Amend page 45, following line 16, by inserting:

“Sec. 237. (1) Any department, agency, board, commission, or public officer that receives funding under part 1 shall not:

(a) Require as a condition of accessing any facility or receiving services that an individual provide proof that he or she has received a COVID-19 vaccine except as provided by federal law or as a condition of receiving federal Medicare or Medicaid funding.

(b) Produce, develop, issue, or require a COVID-19 vaccine passport.

(c) Develop a database or make any existing database publicly available to access an individual’s COVID-19 vaccine status by any person, company, or governmental entity.

(d) Require as a condition of employment that an employee or official provide proof that he or she has received a COVID-19 vaccine. This subdivision does not apply to any hospital, congregate care facility, or other medical facility or any hospital, congregate care facility, or other medical facility operated by a local subdivision that receives federal Medicare or Medicaid funding.

(2) A department, agency, board, commission, or public officer may not subject any individual to any negative employment consequence, retaliation, or retribution because of that individual’s COVID-19 vaccine status.

(3) Subsection (1) does not prohibit any person, department, agency, board, commission, or public officer from transmitting proof of an individual’s COVID-19 vaccine status to any person, company, or governmental entity, so long as the individual provides affirmative consent.

(4) If a department, agency, board, commission, subdivision, or official or public officer is required to establish a vaccine policy due to a federal mandate, it must provide exemptions to any COVID-19 vaccine policy to the following individuals:

(a) An individual for whom a physician certifies that a COVID-19 vaccine is or may be detrimental to the individual’s health or is not appropriate.

(b) An individual who provides a written statement to the effect that the requirements of the COVID-19 vaccine policy cannot be met because of religious convictions or other consistently held objection to immunization.

(5) As used in this section, “public officer” means a person appointed by the governor or another executive department official or an elected or appointed official of this state or a political subdivision of this state.”.

1. Amend page 20, line 15, after “services” by striking out “6,052,043,500” and inserting “6,058,626,900”.

2. Amend page 20, line 16, after “plan” by striking out “5,731,542,200” and inserting “5,735,759,200”.

3. Amend page 20, line 20, after “therapy” by striking out “788,221,800” and inserting “789,221,800”.

4. Amend page 21, line 1, after “services” by striking out “255,498,400” and inserting “256,398,000”.

5. Amend page 21, line 11, after “revenues” by striking out “14,071,555,300” and inserting “14,080,859,500” and adjusting the subtotals, totals, and section 201 accordingly.

1. Amend page 11, line 22, after “services” by striking out “3,145,163,500” and inserting “3,146,663,500”.

2. Amend page 12, line 6, after “revenues” by striking out “3,008,268,900” and inserting “3,009,248,700”.

3. Amend page 12, line 8, after “revenues” by striking out “5,218,700” and inserting “246,900”.

4. Amend page 20, line 17, after “services” by striking out “4,880,300” and inserting “6,380,300”.

5. Amend page 21, line 11, after “revenues” by striking out “14,071,555,300” and inserting “14,072,535,100”.

6. Amend page 22, following line 25, by inserting:

“Assisted outpatient treatment services

15,000,000”

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

“Children and adolescents with serious emotional disturbance navigator program

2,000,000”

8. Amend page 25, following line 2, by inserting:

“Virtual behavioral health urgent care

2,000,000”

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

9. Amend page 113, line 20, by striking out all of section 928.

10. Amend page 170, line 8, after “shall” by striking out “maintain the rates in place as of September 30, 2023 for private duty nursing services for Medicaid beneficiaries under the age of 21” and inserting “increase the rates for private duty nursing services for all Medicaid beneficiaries”.

11. Amend page 215, following line 2, by inserting:

“Sec. 1974. From the funds appropriated in part 1 for virtual behavioral health urgent care, the department shall allocate $2,000,000.00 to a 24/7 crisis agency that has served the state for at least 50 years and is headquartered in a county with a population between 1,200,000 and 1,400,000 according to the most recent federal decennial census to provide virtual behavioral health urgent care including, but is not limited to the following:

(a) Assisting a patient in returning to a non-urgent state of being and providing immediate relief from the symptoms associated with depression, anxiety, and other mental health disorders.

(b) Filling in the gap between the patient’s next appointment with their established medical provider and the possibility of running out of medication.

(c) Assisting the patient experiencing symptoms associated with low acuity mental health disorders until they can make an appointment with a psychiatrist.

Sec. 1975. (1) From the funds appropriated in part 1 for assisted outpatient treatment services, the department shall allocate $15,000,000.00 to reimburse CMHSPs for the costs of providing assisted outpatient treatment as de?ned in section 100a of the mental health code, 1974 PA 258, MCL 330.1100a to individuals who are not enrolled in Medicaid, who have health insurance but assisted outpatient treatment is not a covered service or is cost prohibitive, or who do not have health insurance.

(2) The department shall develop a quarterly request for reimbursement form for CMHSPs to use to request funds under this section.

(3) CMHSPs must ?ll out and submit the quarterly reimbursement request form within 90 days of the end of each calendar quarter.

Sec. 1976. From the funds appropriated in part 1 for children and adolescents with serious emotional disturbance navigator program, the department shall allocate $2,000,000.00 to contract for a children with serious emotional disturbance navigator program to assist children with serious emotion disturbance and their families access necessary behavioral health supports and services. The department of health and human services shall require any contractor receiving funds under this section to comply with, including but not limited to, an approved plan, budget, and reporting requirements.”.

1. Amend page 24, line 10, after “services” by striking out “20,920,000” and inserting “25,920,000” and adjusting the subtotals, totals, and section 201 accordingly.

2. Amend page 207, line 7, after “allocate” by striking out “$5,000,000.00” and inserting “$10,000,000.00”.

1. Amend page 24, line 17, after “program” by striking out “5,000,000” and inserting “7,000,000” and adjusting the subtotals, totals, and section 201 accordingly.

2. Amend page 209, line 4, by striking out “$5,000,000.00” and inserting “$7,000,000.00”.

3. Amend page 209, line 29, after “is” by striking out “$5,000,000.00” and inserting “$7,000,000.00”.

1. Amend page 24, following line 2, by inserting:

“Health care recruitment, retention, and training

18,000,000”

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

2. Amend page 215, following line 2, by inserting:

“Sec. 1973. (1) From the funds appropriated in part 1 for health care recruitment, retention, and training, the department shall allocate $18,000,000.00 for health care recruitment, retention, and training programming to health care employers that can demonstrate an eligible qualifying need. Health care employers must not request funds under this section for any investments related to recruitment or retention announced before December 1, 2021.

(2) The department must allocate the funds appropriated pursuant to this section to the Michigan Health and Hospital Association for administration to acute care and behavioral health care providers, of which not less than 10% appropriated pursuant to this subsection must be allocated to critical access hospitals and small and rural providers that are awarded rural access payments under section 1802(2) of article 6 of 2021 PA 87.

(3) Health care recruitment, retention, and training programming may include, but is not limited to, cash recruitment bonuses, student loan payment assistance, cash retention bonuses, tuition assistance, and other forms of training programming. The maximum amount any health care employer, except for critical access hospitals and small and rural providers that are awarded rural access payments under section 1802(2) of article 6 of 2021 PA 87, can use for cash recruitment bonuses is 25%, and the maximum amount any health care employer, except for critical access hospitals and small and rural providers that are awarded rural access payments under section 1802(2) of article 6 of 2021 PA 87, can use for cash retention bonuses is 20%.

(4) By September 30, 2024, the department must provide a report to the report recipients required in section 246 of this part on the overall efficacy of the funds appropriated in this section, including, but not limited to, the statewide outcomes of recruitment efforts, retention efforts, and training efforts to reduce statewide health care staffing vacancies. The Michigan Health and Hospital Association and other recipients shall provide data and metrics, in a manner approved by the department, to fulfill the reporting requirements of this section.”.

1. Amend page 5, line 5, after “10.0” by striking out “41,597,900” and inserting “43,597,900” and adjusting the subtotals, totals, and section 201 accordingly.

2. Amend page 67, following line 28, by inserting:

“Sec. 532. From the funds appropriated in part 1 for adoption support services, the department shall allocate $2,000,000.00 to fund a tax credit to adoptive parents. The department shall coordinate with the department of treasury to ensure timely processing and issuance of tax credits to adoptive parents.”.

1. Amend page 47, following line 17, by inserting:

“Sec. 258. (1) In collaboration with the department of education and the department of state police, the department shall promote and support initiatives in schools and other educational organizations that include, but are not limited to, training for educators, teachers, and other personnel in school settings for all of the following:

(a) The utilization of trauma-informed practices.

(b) Age-appropriate education and information on human trafficking.

(c) Age-appropriate education and information on sexual abuse prevention.

(2) The collaboration shall include the child welfare institute within the department, which provides training and education for public and private employees who work within the child protective services, foster care, adoption, and juvenile justice systems.

(3) The department shall report by March 1 of the current fiscal year on the activities and status of implementation of the requirements described in subsections (1) and (2) to the report recipients required in section 246 of this part.”.

1. Amend page 44, line 17, after “235.” by striking out “(1)”.

2. Amend page 44, line 18, by striking out “restrict or interfere with” and inserting “require”.

3. Amend page 44, line 19, after “impede” by striking out “a marginalized” and inserting “any”.

4. Amend page 44, line 22, after “exercise” by striking out “the right to reproductive freedom” and inserting “rights as outlined under the State Constitution”.

5. Amend page 44, line 23, by striking out all of subsection (2).

1. Amend page 36, following line 20, by inserting:

“Sec. 214. Total authorized appropriations from all sources under part 1 for legacy costs for the current fiscal year are estimated at $270,305,800.00. From this amount, total department appropriations for pension-related legacy costs are estimated at $177,854,900.00. Total department appropriations for retiree health care legacy costs are estimated at $92,450,900.00.”.

2. Amend page 44, following line 11, by inserting:

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

3. Amend page 45, following line 16, by inserting:

“Sec. 237. (1) Any department, agency, board, commission, or public officer that receives funding under part 1 shall not:

(a) Require as a condition of accessing any facility or receiving services that an individual provide proof that he or she has received a COVID-19 vaccine except as provided by federal law or as a condition of receiving federal Medicare or Medicaid funding.

(b) Produce, develop, issue, or require a COVID-19 vaccine passport.

(c) Develop a database or make any existing database publicly available to access an individual’s COVID-19 vaccine status by any person, company, or governmental entity.

(d) Require as a condition of employment that an employee or official provide proof that he or she has received a COVID-19 vaccine. This subdivision does not apply to any hospital, congregate care facility, or other medical facility or any hospital, congregate care facility, or other medical facility operated by a local subdivision that receives federal Medicare or Medicaid funding.

(2) A department, agency, board, commission, or public officer may not subject any individual to any negative employment consequence, retaliation, or retribution because of that individual’s COVID-19 vaccine status.

(3) Subsection (1) does not prohibit any person, department, agency, board, commission, or public officer from transmitting proof of an individual’s COVID-19 vaccine status to any person, company, or governmental entity, so long as the individual provides affirmative consent.

(4) If a department, agency, board, commission, subdivision, or official or public officer is required to establish a vaccine policy due to a federal mandate, it must provide exemptions to any COVID-19 vaccine policy to the following individuals:

(a) An individual for whom a physician certifies that a COVID-19 vaccine is or may be detrimental to the individual’s health or is not appropriate.

(b) An individual who provides a written statement to the effect that the requirements of the COVID-19 vaccine policy cannot be met because of religious convictions or other consistently held objection to immunization.

(5) As used in this section, “public officer” means a person appointed by the governor or another executive department official or an elected or appointed official of this state or a political subdivision of this state.”.

4. Amend page 50, following line 6, by inserting:

“Sec. 280. By March 1 of the current fiscal year, the department shall provide a report to the report recipients required in section 246 of this part that provides all of the following for each line item in part 1 containing personnel-related costs, including the specific individual amounts for salaries and wages, payroll taxes, and fringe benefits.

(a) FTE authorization.

(b) Spending authorization for personnel-related costs, by fund source, under the spending plan.

(c) Actual year-to-date expenditures for personnel-related costs, by fund source, through the end of the prior month.

(d) The projected year-end balance or shortfall for personnel-related costs, by fund source, based on actual monthly spending levels through the end of the prior month.

(e) A specific plan for addressing any projected shortfall for personnel-related costs at either the gross or fund source level.

Sec. 289. By March 1 of the current fiscal year, the department shall provide to the report recipients required in section 246 of this part an annual report on the supervisor-to-staff ratio by department divisions and subdivisions.”.

5. Amend page 50, line 19, by striking out all of section 297 and inserting:

“Sec. 297. (1) On a quarterly basis, the department shall report to the report recipients required in section 246 of this part the following information:

(a) The number of FTE positions in pay status by civil service classification.

(b) A comparison by line item of the number of FTE positions authorized from funds appropriated in part 1 to the actual number of FTE positions employed by the department at the end of the reporting period.

(2) By March 1 of the current fiscal year, the department shall report to the report recipients required in section 246 of this part the following information:

(a) Number of employees that were engaged in remote work in 2022.

(b) Number of employees of the department authorized to work remotely and the actual number of those working remotely in the current reporting period.

(c) Estimated net cost savings achieved by the department by remote work.

(d) Reduced use of office space associated with remote work.”.

1. Amend page 22, following line 28, by inserting:

“Caregiver resource centers

9,400,000”

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

2. Amend page 215, following line 2, by inserting:

“Sec. 1980. From the funds appropriated in part 1 for caregiver resource centers, the department shall allocate $9,400,000.00 to area agencies on aging to improve services and supports to unpaid family and informal caregivers. Funding shall be distributed to area agencies on aging as a lump-sum payment using the interstate funding formula approved by the commission on services to the aging.”.