Legislative Analysis
Phone: (517) 373-8080
COMMUNITY VIOLENCE PREVENTION SERVICES http://www.house.mi.gov/hfa
House Bill 6046 as introduced Analysis available at
Sponsor: Rep. Christine Morse http://www.legislature.mi.gov
Committee: Health Policy
Complete to 12-12-24
SUMMARY:
House Bill 6046 would amend the Social Welfare Act to require the Department of Health
and Human Services (DHHS) to provide coverage under the medical assistance program
for an eligible individual who was violently injured and referred by a health professional
to receive community violence prevention services from a prevention professional or
community health worker because the health professional has determined that the
individual is at significant risk of experiencing violent injury or has experienced chronic
exposure to community violence.
Community violence prevention services would mean evidence-informed, trauma-
informed, culturally responsive, supportive, and nonpsychotherapeutic services
provided by a violence prevention professional, within or outside of a clinical
setting. These services would include at least peer support and counseling,
mentorship, conflict mediation and crisis intervention, targeted case management,
referrals to certified or licensed health care or social services providers, community
and school support services, patient education and screening services, group and
individual health education and health coaching, health navigation, transitions of
care support, and screening and assessment for nonclinical and social needs,
provided by a violence prevention professional to do all of the following:
• Promote improved health outcomes and positive behavioral change.
• Prevent injury recidivism.
• Reduce the likelihood that victims of acts of community violence will
commit or promote violence.
Prevention professional would mean an individual who works in a program aimed
at addressing specific patient needs, such as suicide prevention, violence
prevention, alcohol avoidance, drug avoidance, or tobacco prevention, and
reducing the risk of relapse, injury, or reinjury to the patient.
Community health worker would mean an individual who meets all of the
following:
• The individual is a frontline public health worker.
• The individual is a trusted member of the community with an unusually
close understanding of the community that enables them to be an
intermediary between health or social services and the community to
facilitate access to services and improve the quality and cultural competence
of service delivery.
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 • The individual builds individual and community capacity by increasing
health knowledge and self-sufficiency through a range of activities, such as
outreach, community education, informal counseling, social support, or
advocacy.
Community violence would mean an intentional act of interpersonal violence
committed by an individual who is not intimately related to the victim.
To be eligible for reimbursement for services provided as described above, a prevention
professional or community health worker would have to be certified as a qualified violence
prevention professional. To be certified, a prevention professional or community health
worker would have to do all of the following:
• Complete at least six months of full-time equivalent experience in providing
community violence prevention services or youth development services through
employment, volunteer work, or as part of an internship experience.
• Complete a DHHS-approved training and certification program for violence
prevention professionals.
• Annually complete at least four hours of continuing education in the field of
community violence prevention services.
• Satisfy any other certification requirements established by DHHS.
DHHS would have to ensure that an entity that employs or contracts with a violence
prevention professional to provide community violence prevention services does all of the
following:
• Maintains documentation that the professional has met the requirements described
above.
• Ensures that the professional provides community violence prevention services in
compliance with any applicable standards of care, rules, regulations, and governing
law of this state or the United States.
DHHS would have to establish a technical advisory group with the following members:
• Three members representing a community-based organization that currently
supports community violence programs, such as street outreach, hospital-linked,
and hospital-based violence prevention programs.
• One member representing a national organization that provides technical assistance
for emerging community violence intervention programs.
• One member representing a hospital that currently operates a hospital-based
violence prevention program in Michigan.
• One member representing a Michigan hospital that does not currently operate a
hospital-based violence prevention program.
• One member of an academic institution in Michigan who has knowledge of
community violence intervention strategies.
• Three members representing medical assistance managed care organizations in
geographically diverse areas of the state.
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 • Two members representing health care clinicians with experience in medical
assistance billing and experience providing trauma care as a result of community
violence.
• Two DHHS designees, one from the Office of Community Violence and one who
works on issues related to medical assistance.
• One designee from an agency that manages the registration or certification of
community health workers.
DHHS would have to do all of the following in consultation with the technical advisory
group:
• Issue guidance on the use of community violence prevention services for
beneficiaries who access these services under the medical assistance program.
• Determine allowable rates for community violence prevention services based on
the medical assistance program fee-for-service outpatient rates for the same or
similar services, or any other data deemed reliable and relevant by the technical
advisory group. The technical advisory group would have to recommend and
request that DHHS allocate funds for the purposes of awarding grants to support
community-based organizations’ access to training and qualified certification and
other necessary capacity-building expenses for the successful implementation and
accessibility of the violence prevention services benefit.
Within 180 days after the bill takes effect, DHHS would have to approve at least one
national training and certification program for certified violence prevention professionals
and establish a process to approve at least two community-based training programs. A
program approved under these provisions would have to include at least 35 hours of
training that addresses any of the following:
• The profound effects of trauma and violence and the basics of trauma-informed
care.
• Community violence prevention strategies, including crisis intervention, de-
escalation, conflict mediation and retaliation prevention related to community
violence, case management, and advocacy practices.
• The federal Patient Privacy and Health Insurance Portability and Accountability
Act.
The bill states that it would not alter the scope of practice for any health professional or
authorize the delivery of health care services in a setting or a manner not currently
authorized.
The bill could be implemented only to the extent that federal financial participation is
available, and any necessary federal approvals have been obtained. The department would
have to seek any federal approvals necessary to implement the bill, including any state plan
amendments or federal waivers by the federal Centers for Medicare and Medicaid Services.
Proposed MCL 400.89 and 400.89a
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FISCAL IMPACT:
Costs to the state’s Medicaid program would be dependent upon federal approval of
Michigan’s Medicaid State Plan Amendment (or other waiver request, if needed), the
establishment of specific reimbursement rates, utilization, and the annually updated
Federal Medical Assistance Percentage (FMAP), which designates the federal match for
state Medicaid expenditures – Michigan’s FMAP for FY 2024-25 is 65.13%. Using hourly
reimbursement rates in the state of Illinois for individually and group-based violence
prevention community support team services, the FY 2024-25 FMAP, and an estimated
number of hours of service, the traditional Medicaid program could incur costs ranging
from $1.5 million Gross ($500,000 GF/GP) to $1.7 million Gross ($600,000 GF/GP).
Apart from state Medicaid costs, the bill would increase state expenditures to the
Department of Health and Human Services by an indeterminate amount and have no fiscal
impact on local units of government. The fiscal impact of the bill would be dependent on
the administrative cost of providing violence prevention services. Under the provisions of
the bill, DHHS would be required to create certification requirements and provide access
to trainings for individuals seeking to become violence prevention professionals, in
addition to approving no less than two community-based training programs. The
department must also establish a technical advisory board, issue guidance on community
prevention services, and determine rates for medical assistance outpatient rates. The
department is authorized to seek federal funds to support these services which may offset
or decrease the amount of GF/GP required to operate this program.
Legislative Analyst: Rick Yuille
Fiscal Analysts: Kent Dell
Sydney Brown
■ This analysis was prepared by nonpartisan House Fiscal Agency staff for use by House members in their
deliberations and does not constitute an official statement of legislative intent.
House Fiscal Agency HB 6046 as introduced Page 4 of 4


Statutes affected:
Substitute (H-2): 400.1, 400.119
House Introduced Bill: 400.1, 400.119
As Passed by the House: 400.1, 400.119
As Passed by the Senate: 400.1, 400.119
House Concurred Bill: 400.1, 400.119