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FY 2024-25 HEALTH AND HUMAN SERVICES BUDGET

S.B. 767 (S-1): COMMITTEE OF THE WHOLE REC.

(as reported)

 

FULL-TIME EQUATED (FTE) CLASSIFIED

POSITIONS/FUNDING SOURCE

FY 2023-24

YEAR-TO-DATE*

FY 2024-25

COMMITTEE OF THE WHOLE REC.

CHANGES FROM

FY 2023-24 YEAR-TO-DATE

AMOUNT

PERCENT

FTE Positions.............................................................

15,855.5

15,883.5

28.0

0.2

GROSS......................................................................

35,734,583,000

37,710,684,000

1,976,101,000

5.5

Less:

 

 

 

 

Interdepartmental Grants Received............................

14,676,900

14,707,900

31,000

0.2

ADJUSTED GROSS...................................................

35,719,906,100

37,695,976,100

1,976,070,000

5.5

Less:

 

 

 

 

Federal Funds..........................................................

25,806,821,200

26,724,399,200

917,578,000

3.6

Local and Private......................................................

342,315,100

333,953,700

(8,361,400)

(2.4)

TOTAL STATE SPENDING.........................................

9,570,769,800

10,637,623,200

1,066,853,400

11.1

Less:

 

 

 

 

Other State Restricted Funds....................................

3,106,634,400

3,954,505,700

847,871,300

27.3

GENERAL FUND/GENERAL PURPOSE.....................

6,464,135,400

6,683,117,500

218,982,100

3.4

PAYMENTS TO LOCALS............................................

1,907,484,900

1,841,088,600

(66,396,300)

(3.5)

*As of February 7, 2024.

 

Major Boilerplate Changes from FY 2023-24 Year-to-Date:

1.    Deletions. The Senate removed sections 213, 233, 238, 246, 533, 535, 544, 715, 809, 851, 964, 1312, 1313, 1342, 1501, 1505, 1616, 1625, 1673, 1699, 1792, 1815, 1832, 1857, 1858, 1896, 1913, 1914, 1918, 1921, 1922, 1923, 1925, 1926, 1928, 1932, 1933, 1936, 1937, 1943, 1944, 1950, 1951, 1954, 1955, 1956, 1959, 1960, 1961, 1962, 1963, 1965, 1966, 1967, 1968, 1969, 1970, 1972, 1974, 1975, 1976, 1977, 1978, 1979, 1980, 1981, 1982, 1985, 1986, 1988, 1989, 1990, 1992, 1995, 1999, 2000, 2001, 2002, 2003, 2004, 2005, 2006, 2007, 2008, and 2009.

2.    Renumbering. The Senate renumbered Sec. 1162 to 1967 (Trauma Recovery Center Pilot), 1620(3) to 1631(2)(e) (Medicaid Prescription Copayments), 1644(2) to 1645(2) (Non-Direct Care Wage Increase), 1964 to 1924(1)(d) (Sickle Cell Center of Excellence), 1997 to 1961 (HYPE Athletics), and 1998 to 462 (Cody Rouge- Senior University).

3.    New Sections. The Senate added Sec. 213 (Work Project Lapse Language), 214 (Timely Payment of AG Billing), 303 ( DHHS Limited Defined Benefit), 458 (Homeless Shelter Data), 459 (Housing First), 467 (Volunteer Income Tax Assistance), 512 (Foster Care Luggage), 548 (Foster Care Reimbursement), 612 (LSAM), 916 (Mosaic Counseling), 1011 (NAYA), 1061 (New Psychiatric Hospital Update), 1064 (Corrections Officer Pension), 1146 (MEDSV), 1148 Black Health Movement, 1223 (Pharmaceutical Access), 1224 (Office of Suicide Prevention), 1302 (MIHP Carseats), 1403 (Senior Nutrition), 1506 (LTC Ombudsman), 1508 (Reproductive Health Privacy), 1632 (Medicaid Orthodontic Benefit), 1691 (Mental Health in Schools), 1787 (Medicaid Speech Therapy), 1789 (FQHC Increase), 1793 (Anesthesia Medicaid Rates), 1794 (Peer Recovery Medicaid), 1795 (MiChoice Expansion), 1796 (Medicaid Office Visit Increase), 1805 (Dual Approval Nursing Home Beds), and 1921 through 1995 (New One-Time Appropriation Sections).

 


FY 2023-24 Year-to-Date Appropriation..................................................

$35,734,583,000

$6,464,135,400

 

 

 

CHANGE FROM
FY 2023-24
Y-T-D

FY 2024-25 RECOMMENDED
APPROPRIATION

Gross

GF/GP

Gross

GF/GP

Baseline Adjustments

 

 

 

 

  1.   Medicaid and Title XXI Match Rate Adjustment. The base Medicaid match rate will increase from 64.94% to 65.13% and the CHIP match rate will increase from 75.46% to 75.59%.

0

(27,046,100)

NA

NA

  2.   Medicaid Actuarial Soundness Adjustments. The Senate included increases for managed care entities that provide Medicaid services to reflect the Federal requirement that capitation rates be actuarially sound.

496,691,300

134,479,300

NA

NA

  3.   Base and Caseload. The Senate included funding for projected caseload costs in the Medicaid, Public Assistance, and Child Welfare programs.

(634,903,500)

298,131,200

NA

NA

  4.   Medicaid Special Financing and Provider Tax Adjustments. The Senate included adjustments to special payments to hospitals that are funded with provider tax revenue.

75,951,800

(34,730,800)

NA

NA

  5.   Medicaid Redetermination Savings. The Senate included savings from the resumption of Medicaid redeterminations in April 2023.

(402,517,900)

(106,887,800)

NA

NA

  6.   Managed Care Rule Changes. The Senate included adjustments related to a Federal Managed Care Rule that include an increase in the maximum allowable amount of Hospital Rate Adjustment payments ($2.3 billion Gross and a reduction of $167.1 million GF/GP), elimination of Disproportionate Share Hospital (DSH) Payments (reduction of $233.5 million Gross and an increase of $71.3 million GF/GP), and the utilization of GF/GP to maintain the DSH payments that went to universities ($3.5 million Gross and GF/GP).

2,090,864,500

(92,264,400)

NA

NA

  7.   Other CSB Items. The Senate included funding to support other current services baseline adjustments, comprised mainly of costs related to Medicare Buy-In Compliance ($27.3 million Gross and GF/GP), various changes in Federal authorization ($22.5 million Gross and $0 GF/GP), funding for the Waskul settlement ($11.5 million Gross and $4.0 million GF/GP), the expiration of the enhanced FMAP ($0 Gross and $57.7 million GF/GP), and third party-liability savings from Medicare Buy-In Compliance (reduction of $53.0 million Gross and $18.5 million GF/GP).

27,897,100

95,978,200

NA

NA

  8.   Removal of FY 2023-24 One-Time Projects.

(347,413,400)

(317,450,000)

0

0

  9.   Economic Adjustments. Included $57,723,100 Gross and $39,042,000 GF/GP for total economic adjustments.

57,723,100

39,042,000

NA

NA

New Programs/Program Increases

 

 

 

 

10.   Certified Community Behavioral Health Clinics (CCBHC). The Senate expanded the CCBHC demonstration project to additional sites.

135,642,700

25,000,000

501,837,800

81,146,200

11.   TANF Swap and Program Increases. The Senate swapped $40.0 million in TANF funding for GF/GP in child welfare staffing lines and then combined the freed up TANF with $40.0 million in additional funds to support an increase in the FIP small child supplement and an expansion to older children ($24.5 million Gross and $0 GF/GP), a Housing First Initiative ($20.0 million Gross and $0 GF/GP), an extension of FIP time limits ($12.8 million Gross and $0 GF/GP), and child welfare housing assistance ($10.8 million Gross and $0 GF/GP).

80,000,000

40,000,000

NA

NA

12.   Medicaid Reimbursement Rate Increases. The Senate increased rates for a number of Medicaid services including those provided at Federally Qualified Health Centers ($54.7 million Gross and $14.5 million GF/GP), office visits ($40.2 million Gross and $10.0 million GF/GP), ABA Behavioral Technicians ($34.4 million Gross and $12.0 million GF/GP), and an increase to private duty nursing rates ($8.1 million Gross and $2.8 million GF/GP).

194,906,900

49,068,500

NA

NA

13.   Other New Programs and Program Increases. The Senate included other funding increases, mainly comprised of an increase to foster care administration and maintenance payment rates ($15.0 million Gross and GF/GP), elimination of the Medicaid birth expenses recovery program ($13.7 million Gross and $4.8 million GF/GP), creation of a limited hybrid pension for DHHS workers ($12.0 million Gross and GF/GP), implementation of the MI Healthy Life initiatives ($7.0 million Gross and $2.5 million GF/GP), increase to the HMHB program for Doula Care and the Medicaid MIHP ($5.3 million Gross and $1.5 million GF/GP), and an increase for 2-1-1 ($5.0 million Gross and GF/GP) .

87,472,000

66,906,000

NA

NA

Eliminations/Reductions

 

 

 

 

14.   County Reimbursement for Juvenile Justice Services to 17 Year-Olds. The Senate eliminated the Raise the Age Fund in accordance with the provisions of PA 297 of 2023 ($13.2 million Gross and GF/GP) and recognized a reversion of the Child Care Fund reimbursement rate for 17-year olds from 100% to 50% ($9.0 million Gross and GF/GP).

(22,150,000)

(22,150,000)

0

0

15.   Office of Inspector General Recoveries. The Senate added 14.0 FTEs and assumed savings from the audits performed by the increased staffing.

(17,094,600)

(3,500,000)

NA

NA

16.   Other Program Reductions. The Senate included other funding reductions comprised of savings from early exit from FAP reinvestment oversight ($3.7 million Gross and GF/GP), and removal of funding for Cherry Health ($1.5 million Gross and GF/GP).

(6,719,200)

(6,719,200)

NA

NA

One-Time Appropriations

 

 

 

 

17.   Continuation of FY 2023-24 One-Time Projects. The Senate maintained current year projects including multicultural integration funding ($8.6 million Gross and GF/GP), and CVI grants ($5.0 million Gross and $0 GF/GP).

13,850,100

13,850,100

13,850,100

13,850,100

18.   New FY 2024-25 One-Time Projects. The Senate included funding to support water affordability ($24.8 million Gross and $0 GF/GP), creation of a MEAP stabilization fund ($24.8 million Gross and $0 GF/GP), juvenile justice capital investment pool ($14.0 million Gross and GF/GP), a trauma recovery center pilot ($8.0 million Gross and GF/GP), and medical debt relief ($8.0 million Gross and GF/GP).

145,900,100

82,900,100

145,900,100

82,900,100

Other

 

 

 

 

19.   Other Items. The Senate recognized savings from the offset of GF/GP funding using available Health and Safety Fund revenue ($0 Gross and $4.6 million GF/GP), and recognition of GF/GP savings from a Federal rule change allowing Title IV-E reimbursement for unlicensed caregivers ($0 Gross and $10.0 million GF/GP).

0

(15,625,000)

NA

NA

 

 

 

 

 

 

Total Changes...............................................................................................

$1,976,101,000

$218,982,100

 

FY 2024-25 COMMITTEE OF THE WHOLE REC............................................

$37,710,684,000

$6,683,117,500

 

 

Date Completed: 5-8-24 Fiscal Analyst: Ellyn Ackerman, Humphrey Akujobi, and John Maxwell