FY 2024-25: HEALTH AND HUMAN SERVICES
Summary: As Reported by the Senate
Senate Bill 767 (S-1) as Amended
Analysts: Sydney Brown, Kent Dell, and Kevin Koorstra
Difference: Senate
FY 2023-24 From FY 2023-24
Enacted FY 2024-25 FY 2024-25 FY 2024-25 FY 2024-25 Enacted
as of 2/7/24 Executive House Senate Conference Amount %
IDG/IDT $14,676,900 $14,707,900 $14,707,900 $14,707,900 $ $31,000 0.2
Federal 25,806,821,200 26,755,591,000 26,703,147,900 26,724,399,200 917,578,000 3.6
Local 162,620,500 162,870,000 160,445,300 154,189,500 (8,431,000) (5.2)
Private 179,694,600 179,764,200 179,764,200 179,764,200 69,600 0.0
Restricted 3,106,634,400 3,883,861,200 3,937,264,500 3,954,505,700 847,871,300 27.3
GF/GP 6,464,135,400 6,705,498,500 6,768,198,600 6,683,117,500 218,982,100 3.4
Gross $35,734,583,000 $37,702,292,800 $37,763,528,400 $37,710,684,000 $ $1,976,101,000 5.5
FTEs 15,861.5 15,929.5 15,897.5 15,889.5 28.0 0.2
Note: Appropriation figures for FY 2024-25 include all proposed appropriation amounts, including amounts designated as "one-
time."
Overview
The Department of Health and Human Services (DHHS) includes programs and services to assist Michigan's most
vulnerable families, including public assistance programs, protecting children and assisting families by administering
foster care, adoption, and family preservation programs and by enforcing child support laws, and funding for behavioral
health (mental health and substance use disorder), public health, aging, crime victim, and medical services programs,
including Medicaid and the Healthy Michigan Plan.
FY 2023-24 FY 2024-25
Enacted Senate
Major Budget Changes from FY 2023-24 Enacted Appropriations (as of 2/7/24) Change
MEDICAID – GENERAL
1. Traditional Medicaid Cost Adjustments Gross $18,219,346,600 $360,221,100
Executive includes an increase of $360.2 million Gross ($174.6 million Federal 11,973,142,000 115,081,800
GF/GP) to recognize caseload, utilization, inflation, and special Local 45,460,600 (3,689,200)
financing adjustments, and traditional FMAP cost-sharing adjustments Private 10,547,100 (1,178,800)
from FMAP increasing from 64.94% to 65.13%, less 1 quarter of 1.5% Restricted 2,418,234,100 75,359,200
enhanced FMAP provided under the federal Consolidated GF/GP $3,771,962,800 $174,648,100
Appropriations Act, 2023, for medical and behavioral health services
in the traditional Medicaid program. House includes an increase of
$330.3 million Gross ($164.2 million GF/GP). Senate concurs with the
Executive.
2. Healthy Michigan Plan Cost Adjustments Gross $5,915,913,200 ($69,234,600)
Executive includes a reduction of $69.2 million Gross ($6.0 million Federal 5,311,479,200 (61,520,200)
GF/GP) to recognize caseload, utilization, inflation, and special Local 1,714,800 36,100
financing adjustments for medical and behavioral health services in Private 168,800 915,400
the Healthy Michigan Plan (HMP). House and Senate concur. Restricted 487,171,700 (2,616,400)
GF/GP $115,378,700 ($6,049,500)
3. Actuarial Soundness Gross NA $496,691,300
Executive includes $496.7 million Gross ($134.5 million GF/GP) to Federal NA 362,212,000
support an estimated 3.0% actuarial soundness adjustment for prepaid GF/GP NA $134,479,300
inpatient health plans (PIHPs), 3.5% for Medicaid Health plans, 5.6%
for Program of All-inclusive Care for the Elderly (PACE), 4.0% for
home- and community-based services, 1.0% for Integrated Care
Organizations (MI Health Link), and 2.5% for Healthy Kids Dental.
House and Senate concur.
House Fiscal Agency 1 5/29/2024
 FY 2023-24 FY 2024-25
Enacted Senate
Major Budget Changes from FY 2023-24 Enacted Appropriations (as of 2/7/24) Change
4. Federal Managed Care Rule – Hospital Rate Adjustment Gross $2,309,438,000 $2,320,864,500
Executive includes an increase of $2,320.9 million Gross (reduction of Federal 1,723,448,100 1,720,074,600
$167.1 million GF/GP) from increased Hospital Quality Assurance Restricted 878,132,900 767,857,900
Assessment Program (QAAP)-funded Hospital Rate Adjustments GF/GP ($292,143,000) ($167,068,000)
(HRA) payments that are able to be increased under recent federal
rule changes. The corresponding GF/GP adjustments are associated
with a statutory state retainer that is tied to the federal share of these
QAAP-funded hospital payments. House and Senate concur.
5. Federal Managed Care Rule – DSH Payment Adjustments Gross $233,500,000 ($230,000,000)
Executive includes a net reduction of $230.0 million Gross (net Federal 213,100,000 (213,100,000)
increase of $70.2 million GF/GP) based on the removal of Restricted 91,703,600 (87,078,600)
Disproportionate Share Hospital (DSH) payments that hospitals would GF/GP ($71,303,600) $70,178,600
no longer be eligible for as a result of the HRA increase. Changes
include:
• Eliminating Hospital QAAP-funded Outpatient DSH ($185.0
million Gross ($21.0 million GF/GP cost)).
• Removing Certified Public Expenditure DSH GF/GP savings
($61.5 million GF/GP).
• Eliminating Regular DSH ($45.0 million Gross ($11.2 million
GF/GP)) and using $4.6 million restricted Health and Safety Fund
repurposed to offset GF/GP.
• Changing University DSH ($3.5 million) to 100% GF/GP grant.
House and Senate concur.
6. Medicare Buy-In Compliance Adjustments Gross NA ($25,709,700)
Executive includes a net reduction of $25.7 million Gross (increase of Federal NA (34,522,400)
$8.8 million GF/GP) to increase $27.3 million GF/GP associated with GF/GP NA $8,812,700
state costs to cover Medicare Part B premiums for individuals whose
income is above 120% of federal poverty. eligible for both Medicare
and Medicaid (dually-eligibles) and reduce $53.0 million Gross ($18.5
million GF/GP) based on assumed Medicaid savings from additional
individuals being covered under Medicare Part B. House and Senate
concur.
DEPARTMENT ADMINISTRATION / INFORMATION
TECHNOLOGY
FTE 197.0 0.0
7. Office of the Inspector General - Fraud Framework Grant Gross $25,869,800 $750,000
Executive includes $750,000 in additional federal authorization to IDG/IDT 198,200 0
realize a grant awarded to the DHHS Office of Inspector General (OIG) Federal 13,851,000 750,000
to improve recipient fraud prevention for Supplemental Nutrition GF/GP $11,820,600 $0
Assistance Program (SNAP) benefits. House and Senate concur.
8. MiHIN Maintenance Gross NA $1,500,000
House includes $3.2 million GF/GP to provide additional system GF/GP NA $1,500,000
maintenance funding for the Michigan Health Information Network.
Senate includes $1.5 million GF/GP.
9. Economic Adjustments Gross NA $57,723,100
Executive reflects increased costs of $57.8 million Gross ($39.1 million IDG/IDT NA 31,000
GF/GP) for negotiated salary and wage increases (5.0% on October Federal NA 17,650,800
1, 2024), actuarially required retirement contributions, worker's Local NA 309,700
compensation, building occupancy charges, rent, and other economic Private NA 329,700
adjustments. House concurs. Senate does not include adjustments for Restricted NA 359,900
unclassified salaries. GF/GP NA $39,042,000
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 FY 2023-24 FY 2024-25
Enacted Senate
Major Budget Changes from FY 2023-24 Enacted Appropriations (as of 2/7/24) Change
10. State Employees' Retirement System Gross NA $12,700,000
House includes $700,000 GF/GP, on a one-time basis for GF/GP NA $12,700,000
implementation costs for House Bills 4665-4667. Senate includes
$12.7 million GF/GP on an ongoing basis for implementation costs and
for limited defined benefit for additional frontline DHHS workers.
COMMUNITY SERVICES AND OUTREACH
11. TANF Housing Assistance Gross NA $10,750,000
Executive includes $3.5 million federal TANF to support families TANF NA 10,750,000
involved in the child welfare system that face housing insecurity. GF/GP NA $0
House concurs. Senate includes $10.8 million federal TANF and
includes short-term hoteling and shelter construction in funding.
12. Michigan 2-1-1 Increase Gross $2,900,000 $5,000,000
Executive includes $1.0 million GF/GP to provide an increase the Federal $2,900,000 $5,000,000
United Way's 2-1-1 service. House concurs. Senate includes $5.0 GF/GP
million GF/GP.
13. Kids Food Basket Increase (One-Time) Gross $525,000 $2,000,000
House includes $500,000 GF/GP to provide an increase to the Kids GF/GP $525,000 $2,000,000
Food Basket program. In FY 2023-24, the program received an
additional $1.0 million GF/GP in the one-time unit. Senate includes
$2.0 million GF/GP on a one-time basis.
14. Statewide Emergency Shelter Support (One-Time) Gross NA $0
Executive includes $7.3 million GF/GP to support statewide GF/GP NA $0
emergency shelter operations. Amount includes $4.5 million GF/GP to
support families involved in the child welfare system with housing
security, $2.0 million GF/GP to support construction of family shelters,
and $750,000 GF/GP for short term hoteling. House includes $2.0
million GF/GP to support construction of family shelters and $750,000
GF/GP for short term hoteling. Senate does not include.
15. Preweatherization Services (One-Time) Gross NA $0
Executive includes $5.0 million GF/GP to draw down the federal GF/GP NA $0
Infrastructure, Investment, and Jobs Act (IIJA) grant matching funds
for weatherization assistance. The 5-year annual IIJA grant amount is
$41.8 million. House includes funding as preweatherization services
and provides additional $5.0 million GF/GP. Senate does not include.
16. Housing Supports (One-Time) Gross $0 $5,000,200
House includes $2.5 million GF/GP for the following: GF/GP $0 $5,000,200
• Amity Foundation - renovations to transitional housing ($1.8
million).
• Lodge of Hope - tribal homeless shelter operations ($750,000).
Senate includes $5.0 million GF/GP for the following:
• Grants to faith-based organizations that provide housing services
and activities ($5.0 million).
• Holy Cross Services- building purchase and renovations ($100
GF/GP placeholder).
• MiSIDE- combined housing and childcare project in Detroit ($100
GF/GP placeholder).
17. Diaper Assistance Grants Gross $4,404,400 $10,000,000
Senate includes $10.0 million federal TANF to expand diaper TANF 2,202,200 10,000,000
assistance grants and allow for diapering supplies to be distributed in GF/GP $2,202,200 $0
bulk and includes local county offices to the list of eligible recipients.
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 FY 2023-24 FY 2024-25
Enacted Senate
Major Budget Changes from FY 2023-24 Enacted Appropriations (as of 2/7/24) Change
18. Housing First Initiatives- Tiny Villages/Non congregate Gross NA $20,000,000
Shelter TANF NA 20,000,000
Senate includes $20.0 million federal TANF to fund the construction of GF/GP NA $0
two tiny home villages and non-congregate shelter for homeless
individuals and families.
19. Cody Rouge Senior University Gross NA $400,000
Senate includes $400,000 GF/GP to Cody Rouge Senior University to GF/GP NA $400,000
improve connectivity and computer skills for seniors. In FY 2023-24,
the program received $400,000 GF/GP on a one-time basis.
20. CEDAM Free Tax Preparation Placeholder Gross NA $100
Senate includes $100 GF/GP placeholder to Community Economic GF/GP NA $100
Development Association of Michigan to expand Volunteer Income
Tax Assistance program into counties that do not have a current site.
21. Community Impact Center (One-Time) Gross $0 $5,000,000
Senate includes $5.0 million in restricted revenue to Wayne Metro Restricted 0 5,000,000
Community Action Agency to establish a community center and GF/GP $0 $0
campus at the site of an old elementary school.
CHILDREN'S SERVICES AGENCY – CHILD WELFARE
22. Child Welfare Caseload Adjustments Gross $791,319,100 ($2,137,300)
Executive reduces funding for child welfare programs by $2.1 million TANF 72,896,400 (2,646,800)
Gross (increases $16.2 million GF/GP) as follows: Federal 210,841,500 (12,193,600)
• Adoption Subsidies is reduced by $16.6 million Gross ($4.4 million Local 33,295,400 (5,106,100)
GF/GP). Private 1,500,000 3,300
• Child Care Fund is increased by $2.0 million Gross ($10.2 million Restricted 2,000,000 1,615,800
GF/GP). GF/GP $470,785,800 $16,190,100
• Foster Care Payments is increased by $13.5 million Gross ($11.5
million GF/GP).
• Guardianship Assistance Program is reduced by $1.0 million
Gross ($681,600 GF/GP).
Amount includes $291,900 GF/GP increase from changes in the FY
2024-25 FMAP up to 65.13% and a backout of the final quarter of
pandemic-related E-FMAP. House and Senate concur.
23. Child Caring Institution Rate Restructure FTE NA 0.0
Executive includes $38.0 million Gross ($30.3 million GF/GP) to Gross NA $100
restructure contracts to private residential child placing agencies to Local NA 0
provide upfront funding based on available beds rather than a per child GF/GP NA $100
per day payment. Amount includes $464,600 Gross ($343,100 GF/GP)
to fund additional 6.0 FTE positions provided within the Department
Administration and Management unit to administer the rate restructure.
House includes $25.4 million Gross ($20.3 million GF/GP) to fund 600
residential beds, a 9% increase to current per diem rates to support
employee retention and recruitment, and a rate for unfilled residential
beds that is 90% of the filled bed rate. Amount does not include funding
for 6.0 additional FTE positions. Senate includes a $100 GF/GP
placeholder.
24. TANF Swap Gross