FY 2024-25: HEALTH AND HUMAN SERVICES
Summary: As Reported by the House
House Bill 5556 (H-2) as Amended
Analysts: Sydney Brown, Kent Dell, and Kevin Koorstra
Difference: House
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 $ $ $31,000 0.2
Federal 25,806,821,200 26,755,591,000 26,703,147,900 896,326,700 3.5
Local 162,620,500 162,870,000 160,445,300 (2,175,200) (1.3)
Private 179,694,600 179,764,200 179,764,200 69,600 0.0
Restricted 3,106,634,400 3,883,861,200 3,937,264,500 830,630,100 26.7
GF/GP 6,464,135,400 6,705,498,500 6,774,198,600 310,063,200 4.8
Gross $35,734,583,000 $37,702,292,800 $37,769,528,400 $ $ $2,034,945,400 5.7
FTEs 15,861.5 15,929.5 15,897.5 36.0 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 House
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 $330,338,100
Executive includes an increase of $360.2 million Gross ($174.6 million Federal 11,973,142,000 95,619,000
GF/GP) to recognize caseload, utilization, inflation, and special financing Local 45,460,600 (3,689,200)
adjustments, and traditional FMAP cost-sharing adjustments from FMAP Private 10,547,100 (1,178,800)
increasing from 64.94% to 65.13%, less 1 quarter of 1.5% enhanced Restricted 2,418,234,100 75,359,200
FMAP provided under the federal Consolidated Appropriations Act, GF/GP $3,771,962,800 $164,227,900
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).
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 financing Local 1,714,800 36,100
adjustments for medical and behavioral health services in the Healthy Private 168,800 915,400
Michigan Plan (HMP). House concurs. 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 concurs.
House Fiscal Agency 1 5/8/2024
 FY 2023-24 FY 2024-25
Enacted House
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 (HRA) GF/GP ($292,143,000) ($167,068,000)
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 concurs.
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 increase Federal 213,100,000 (213,100,000)
of $70.2 million GF/GP) based on the removal of Disproportionate Share Restricted 91,703,600 (87,078,600)
Hospital (DSH) payments that hospitals would no longer be eligible for GF/GP ($71,303,600) $70,178,600
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 concurs.
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 concurs.
DEPARTMENT ADMINISTRATION / INFORMATION TECHNOLOGY
7. Office of the Inspector General - Fraud Framework Grant FTE 197.0 0.0
Executive includes $750,000 in additional federal authorization to realize Gross $25,869,800 $750,000
a grant awarded to the DHHS Office of Inspector General (OIG) to IDG/IDT 198,200 0
improve recipient fraud prevention for Supplemental Nutrition Assistance Federal 13,851,000 750,000
Program (SNAP) benefits. House concurs. GF/GP $11,820,600 $0
8. MiHIN Maintenance Gross NA $3,200,000
House includes $3.2 million GF/GP to provide additional system GF/GP NA $3,200,000
maintenance funding for the Michigan Health Information Network.
9. Economic Adjustments Gross NA $57,791,200
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 1, Federal NA 17,663,600
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. Restricted NA 359,900
GF/GP NA $39,097,300
10. State Employees' Retirement System (One-Time) Gross NA $700,000
House includes $700,000 GF/GP, on a one-time basis for GF/GP NA $700,000
implementation costs for House Bills 4665-4667.
COMMUNITY SERVICES AND OUTREACH
11. TANF Housing Assistance Gross NA $3,500,000
Executive includes $3.5 million federal TANF to support families involved TANF NA 3,500,000
in the child welfare system that face housing insecurity. House concurs. GF/GP NA $0
House Fiscal Agency 2 5/8/2024
 FY 2023-24 FY 2024-25
Enacted House
Major Budget Changes from FY 2023-24 Enacted Appropriations (as of 2/7/24) Change
12. Kids Food Basket Increase Gross $525,000 $500,000
House includes $500,000 GF/GP to provide an increase to the Kids Food GF/GP $525,000 $500,000
Basket program. In FY 2023-24, the program received an additional $1.0
million GF/GP in the one-time unit.
13. Statewide Emergency Shelter Support (One-Time) Gross NA $2,750,000
Executive includes $7.3 million GF/GP to support statewide emergency GF/GP NA $2,750,000
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.
14. Preweatherization Services (One-Time) Gross $0 $10,000,000
Executive includes $5.0 million GF/GP to draw down the federal GF/GP $0 $10,000,000
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.
15. Housing Supports (One-Time) Gross $0 $2,500,000
House includes $2.5 million GF/GP for the following: GF/GP $0 $2,500,000
• Amity Foundation - renovations to transitional housing ($1.8 million).
• Lodge of Hope - tribal homeless shelter operations ($750,000).
CHILDREN'S SERVICES AGENCY – CHILD WELFARE
16. 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 concurs.
17. Child Caring Institution Rate Restructure FTE NA 0.0
Executive includes $38.0 million Gross ($30.3 million GF/GP) to Gross NA $25,376,500
restructure contracts to private residential child placing agencies to Local NA 5,075,300
provide upfront funding based on available beds rather than a per child GF/GP NA $20,301,200
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.
18. TANF Swap Gross NA $0
Executive includes $40.0 million GF/GP increase to offset a $40.0 million TANF NA (40,000,000)
TANF reduction within child welfare staffing lines. Funding will be GF/GP NA $40,000,000
reappropriated to fund new supports to low-income families. House
concurs.
House Fiscal Agency 3 5/8/2024
 FY 2023-24 FY 2024-25
Enacted House
Major Budget Changes from FY 2023-24 Enacted Appropriations (as of 2/7/24) Change
19. Raise the Age Fund Elimination Gross $13,150,000 ($13,150,000)
Executive reduces funding by $13.2 million GF/GP through the GF/GP $13,150,000 ($13,150,000)
elimination of the Raise the Age Fund. House concurs.
20. Family Preservation Program Increase FTE 34.0 0.0
House includes $12.2 million TANF revenue to support community - Gross $56,987,700 $12,200,000
based family preservation and prevention programming to keep children TANF 43,228,500 12,200,000
in their homes and out of foster care. Federal 5,053,600 0
GF/GP $8,705,600 $0
21. Foster Care Administrative Rate Increase Gross NA $11,847,000
House includes $11.8 million Gross ($5.5 million GF/GP) to provide a TANF NA 2,355,000
$5.00 increase to the administrative rate for private foster care agencies. Federal NA 4,003,400
The administrative rate would increase from $55.20 to $60.20. GF/GP NA $5,488,600
22. Raise the Age Reimbursement Rate Reduction Gross NA ($9,000,000)
Executive reduces funding by $9.0 million GF/GP through the lowering GF/GP NA ($9,000,000)
of the state reimbursement rate to counties for 17-year-old juvenile
offenders from 100% to 50% resulting from the statutory change
implemented in PA 297 of 2023. House concurs.
23. Juvenile Justice Investments FTE NA 21.0
Executive includes $11.9 million Gross ($10.7 million GF/GP) and Gross NA $6,912,300
authorizes an additional 21.0 FTE positions to implement Local NA 1,180,500
recommendations from the Governor's Task Force on Juvenile Justice GF/GP NA $5,731,800
Reform. Funding will be used in part to support staffing at the two state
residential facilities, Bay Pines and Shawono Center. Amount also
includes $5.0 million GF/GP on a one-time basis for capital
improvements at the two state residential facilities. House concurs but
does not include the $5.0 million GF/GP in the one-time unit.
24. Title IV-E Payments to Unlicensed Relatives Gross NA $0
Executive includes $10.0 million GF/GP savings due to a recent federal Federal NA 10,000,000
rule change that allows federal Title IV-E funds to now be used to provide GF/GP NA ($10,000,000)
payments to unlicensed relatives. Previously, the state only received IV-
E reimbursement for placements with licensed caregivers. Payments to
unlicensed relatives were exclusively funded by GF/GP. House concurs.