FY 2023-24: HEALTH AND HUMAN SERVICES
Summary: As Passed by the Senate
Senate Bill 190 (S-1) as Amended
Analysts: Sydney Brown, Kent Dell, and Kevin Koorstra
Difference: Senate
FY 2022-23 YTD FY 2023-24 FY 2023-24 FY 2023-24 FY 2023-24 From FY 2022-23 YTD
as of 2/8/23 Executive House Senate Conference Amount %
IDG/IDT $14,696,000 $14,676,900 $14,676,900 $14,676,900 $ ($19,100) (0.1)
Federal 23,693,049,100 25,803,271,500 25,933,867,600 25,741,217,300 2,048,168,200 8.6
Local 170,002,300 154,718,100 149,465,200 154,718,100 (15,284,200) (9.0)
Private 185,596,800 190,660,700 190,660,700 185,660,700 63,900 0.03
Restricted 3,132,592,800 3,050,326,400 3,070,326,400 3,050,326,400 (82,266,400) (2.6)
GF/GP 6,242,365,800 6,497,737,000 6,588,454,200 6,352,763,900 110,398,100 1.8
Gross $33,438,302,800 $35,711,390,600 $35,947,451,000 $35,499,363,300 $ $2,061,060,500 6.1
FTEs 15,690.5 15,834.5 15,778.5 15,734.0 43.5 0.3
Notes: (1) FY 2022-23 year-to-date figures include mid-year budget adjustments through February 8, 2023. (2) Appropriation
figures for all years include all proposed appropriation amounts, including amounts designated as “one-time.” (3) "House" means
House Bill 4310 (H-2), as amended, as passed by the House.
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 2022-23 FY 2023-24
Year-to-Date Senate
Major Budget Changes from FY 2022-23 YTD Appropriations (as of 2/8/23) Change
MEDICAID – GENERAL
1. Traditional Medicaid Cost Adjustments Gross $16,581,775,400 $74,396,800
Executive includes an increase of $74.4 million Gross (reduction of Federal 10,703,491,400 128,783,900
$28.8 million GF/GP) to recognize caseload, utilization, and inflation Local 38,994,800 (16,849,000)
adjustments, and traditional FMAP cost-sharing adjustments from FMAP Private 13,748,800 (14,400)
increasing from 64.71% to 64.94%, plus 1 quarter of 1.5% enhanced Restricted 2,339,439,900 (8,739,600)
FMAP provided under the federal Consolidated Appropriations Act, GF/GP $3,486,100,500 ($28,784,100)
2023, for medical and behavioral health services in the traditional
Medicaid program. Compared to FY 2021-22 expenditures, and
including actuarial soundness adjustments in item #3, State Budget
Office forecasts an average annual increase of 4.9%. House and Senate
concur.
2. Healthy Michigan Plan Cost Adjustments Gross $5,799,632,800 $329,175,400
Executive includes an increase of $329.2 million Gross ($66.5 million Federal 5,211,580,900 296,257,800
GF/GP) to recognize caseload, utilization, and inflation adjustments for Local 2,021,400 0
medical and behavioral health services in the Healthy Michigan Plan Private 1,381,600 0
(HMP). Compared to FY 2021-22 expenditures, and including actuarial Restricted 486,516,000 (33,608,300)
soundness adjustments in item #3, State Budget Office forecasts an GF/GP $98,132,900 $66,525,900
average annual increase of 5.9%. House and Senate concur.
House Fiscal Agency 1 5/24/2023
 FY 2022-23 FY 2023-24
Year-to-Date Senate
Major Budget Changes from FY 2022-23 YTD Appropriations (as of 2/8/23) Change
3. Actuarial Soundness Gross NA $346,629,200
Executive includes $346.6 million Gross ($92.5 million GF/GP) to Federal NA 254,134,200
support an estimated 2.5% actuarial soundness adjustment for prepaid GF/GP NA $92,495,000
inpatient health plans (PIHPs), 2.5% for Medicaid Health plans, 3.1% for
Program of All-includes Care for the Elderly (PACE), 3.0% for home- and
community-based services, 2.0% for Integrated Care Organizations (MI
Health Link), and 1.0% for Healthy Kids Dental. House and Senate
concur.
4. Direct Care Wage Increase Gross $405,058,900 $91,048,900
Executive includes $210.1 million Gross ($74.5 million GF/GP) to Federal 259,091,400 58,767,500
support a $1.50 per hour wage increase for direct care workers. Current GF/GP $145,967,500 $32,281,400
year funding reflects recent appropriations for the $2.35 hourly wage
increase. Sections 231 and 1644 are related boilerplate. House concurs
and adds $140.0 million Gross ($24.8 million GF/GP) for an additional
$1.00 per hour increase on a one-time basis. Senate includes $91.0
million Gross ($32.3 million GF/GP) to support a $0.65 per hour wage
increase.
5. Long-Term Care: Non-Clinical Staff Wage Increase Gross $1,792,051,000 $70,129,900
Executive includes $90.0 million Gross ($31.7 million GF/GP) to Federal 1,198,936,400 45,411,200
increase non-clinical nursing facility staff hourly wages by $3.85, amount Local 6,618,800 0
would reflect the current $2.35 direct care wage increase, plus the Private 6,100,000 0
additional $1.50 proposed for the current cohort of direct care workers. Restricted 330,776,300 0
House does not include. Senate includes $70.1 million Gross ($24.7 GF/GP $249,619,500 $24,718,700
million GF/GP) to support a $3.00 per hour wage increase.
DEPARTMENT ADMINISTRATION & INFORMATION TECHNOLOGY
6. Comprehensive Child Welfare Information System (CCWIS) FTE 0.0 11.0
Executive includes $12.6 million Gross ($7.5 million GF/GP), of which Gross $3,373,200 $5,653,100
$6.9 million Gross ($3.5 million GF/GP) is on a one-time basis and Federal 870,300 1,578,200
authorizes 11.0 FTE positions (6.0 on a one-time basis). CCWIS will GF/GP $2,502,900 $4,074,900
replace the Michigan Statewide Child Welfare Information System
(MiSACWIS) with the implementation of 9 cloud-based modules over the
course of 3 to 5 years. Currently, 1 module is complete and 3 modules
are in development. House concurs. Senate concurs with ongoing
funding but includes a $100 placeholder for one-time module
development funding.
7. Relational Data Computer Usage Costs Gross NA $3,255,800
Executive includes $3.3 million Gross ($1.2 million GF/GP) to support Federal NA 2,056,000
DTMB data storage and processing for child welfare-related information GF/GP NA $1,199,800
regarding family data for each case. Increased costs are correlated with
caseloads. House and Senate concur.
8. Information Technology Inflationary Costs Gross NA $6,384,200
Executive includes $6.4 million Gross ($5.0 million GF/GP) for inflation- Federal NA 1,412,600
related cost increases for IT contracts with: Dewpoint, Guidesoft, Tibco, GF/GP NA $4,971,600
CGI Technologies and Solutions, Deloitte Consulting, Optum
Government Solutions, Gainwell, Accenture, SourceHOV, Acro Service
Corp, Crystal Lighting, and Altarum Institute. House and Senate concur.
9. Property Management – Lease Cancellation Cost Reductions Gross $64,701,200 ($2,134,600)
Executive includes a reduction of $2.1 million Gross ($849,100 GF/GP) IDG/IDT 599,100 0
to recognize a reduction in property costs related to multiple lease TANF 10,667,900 (165,600)
cancellations in Kalamazoo, Lansing, and Okemos. House and Senate Federal 22,148,000 (1,119,900)
concur. Private 36,700 0
Restricted 497,400 0
GF/GP $30,752,100 ($849,100)
House Fiscal Agency 2 5/24/2023
 FY 2022-23 FY 2023-24
Year-to-Date Senate
Major Budget Changes from FY 2022-23 YTD Appropriations (as of 2/8/23) Change
10. Economic Adjustments Gross NA ($8,508,000)
Executive Reflects a net cost reduction of $8.5 million Gross ($4.2 million IDG/IDT NA (19,100)
GF/GP) for negotiated salary and wage increases (2.0% on October 1, TANF NA (1,150,000)
2023), actuarially required retirement contributions, worker’s Federal NA (3,018,000)
compensation, building occupancy charges, rent, and other economic Local NA (9,100)
adjustments. House and Senate concur. Private NA (56,000)
Restricted NA (64,100)
GF/GP NA ($4,191,700)
COMMUNITY SERVICES AND OUTREACH
11. Diaper Assistance TANF Swap Gross $4,404,400 $0
Executive includes $4.4 million GF/GP as TANF replacement to allow TANF 4,404,400 (4,404,400)
administrative funds to be given to non-profits checking program GF/GP $0 $4,404,400
eligibility prior to distribution. House decreases TANF funding by $2.9
million to leave $1.5 million and moves to one-time unit. Senate concurs
with Executive and moves program to new Healthy Moms, Healthy
Babies unit.
12. Crime Victim's Rights Sustaining Fund – One-Time Gross NA $0
House deposits $60.0 million GF/GP into a new Crime Victim's Rights GF/GP NA $0
Sustaining Fund for the purpose of providing 3 years of funding to offset
declines in federal Victims of Crime Act (VOCA) funding and Michigan
Crime Victim Rights Fund (CVRF). NOTE: The Crime Victim Rights
program would also be transferred from Community Services and
Outreach Unit to Health Policy and Initiatives Unit. Senate does not
include.
13. Crime Victim Rights GF/GP Funding FTE 17.0 0.0
Executive includes an increase of $7.9 million GF/GP for crime victims Gross $121,597,000 $4,400,000
support programs. The additional GF/GP would supplement recent Federal 103,046,200 (6,500,000)
federal VOCA awards and Michigan CVRF to support the obligations Restricted 18,448,200 0
related to the programs. NOTE: The Crime Victim Rights program would GF/GP $102,600 $10,900,000
also be transferred from Community Services and Outreach Unit to
Health Policy and Initiatives Unit. House includes $20.0 million state
restricted from the new Crime Victim's Rights Sustaining Fund. Sec.
1158 is related boilerplate. Senate concurs with Executive and includes
an additional $3.0 million GF/GP to backfill federal VOCA awards.
14. Kids Food Basket – One-Time Gross $525,000 $0
House includes $1.0 million GF/GP in the one-time unit for the Kids Food GF/GP $525,000 $0
Basket program. Program also receives $525,000 GF/GP in ongoing
funding. Senate does not include.
15. 2-1-1 Community Information Exchange (CIE) – One-Time Gross $2,950,000 $0
House includes $2.0 million GF/GP in the one-time unit for 2-1-1 GF/GP $2,950,000 $0
Statewide Calling system upgrades. 2-1-1 also receives $3.0 million
GF/GP in ongoing funding. Senate does not include.
16. School Success Partnership Reduction Gross $1,525,000 ($1,000,000
Senate includes a $1.0 million TANF reduction to the School Success TANF 1,525,000 (1,000,000)
Partnership Program line. GF/GP $0 $0
17. Runaway and Homeless Youth Gross $7,784,000 $10,000,000
Senate includes a $10.0 million Gross ($2.1 million GF/GP) to support Federal 3,103,000 0
the expansion of runaway and homeless youth capacity. Sec. 466 is TANF 3,424,800 7,853,100
related boilerplate. GF/GP $1,256,200 $2,146,900
18. Cody Rouge Community Action Alliance Senior University Gross NA $800,000
Senate includes $800,000 GF/GP for Cody Rouge Community Action GF/GP NA $800,000
Alliance's Senior University.
House Fiscal Agency 3 5/24/2023
 FY 2022-23 FY 2023-24
Year-to-Date Senate
Major Budget Changes from FY 2022-23 YTD Appropriations (as of 2/8/23) Change
19. Community Services and Outreach – One-Time Funding Gross NA $25,610,300
Senate includes $25.6 million GF/GP for the following programs: GF/GP NA $25,610,300
• Permanent Supportive Housing ($13.0 million)
• Domestic Violence/Sexual Assault VOCA Grants ($3.6 million)
• Oakland County Homeless FLEX Pilot ($2.0 million)
• Chaldean Community Foundation Affordable Housing ($2.0 million)
• Many Hands Community Services ($2.0 million)
• United Methodist ($1.0 million)
• Nazarene Community House ($1.0 million)
• Oaks Village Shelter ($1.0 million)
CHILDREN’S SERVICES AGENCY – CHILD WELFARE
20. Child Welfare Caseloads Adjustments Gross $794,170,400 ($31,086,700)
Executive includes a reduction of $31.1 million Gross ($22.8 million TANF 79,698,900 (10,091,100)
GF/GP) for FY 2023-24 based on current caseload projections as Federal 197,740,400 5,165,500
follows: Local 38,258,900 (2,112,000)
• Adoption subsidies cases reduced from 20,978 to 20,538 Private 2,700,000 (1,200,000)
• Foster Care cases reduced from 7,924 to 6,697 Restricted 2,000,000 0
• Guardianship Assistance Program cases reduced from 1,223 to GF/GP $473,772,200 ($22,849,100)
1,152
Amount includes $499,500 GF/GP savings from changes in the FY
2023-24 FMAP up to 64.94% and with a first quarter, pandemic-related
enhancement of 1.5% of additional E-FMAP. House and Senate concur.
21. Child Care Fund – Community-Based State Reimbursement Gross NA $31,534,600
Executive includes $31.5 million GF/GP to implement a recommendation GF/GP NA $31,534,600
from the Task Force on Juvenile Justice Reform to statutorily increase
the state Child Care Fund reimbursement rate from 50% to 75% for
community-based juvenile justice services. House and Senate concur.
22. Bay Pines and Shawono Center FTE 94.0 12.0
Executive includes $1.3 million Gross ($643,600 GF/GP) and Gross $11,749,500 $1,287,200
authorization for an additional 12.0 FTEs to provide services at Bay Federal 448,200 643,600
Pines and Shawono juvenile justice facilities based on a Local 5,581,000 0
recommendation from the Task Force on Juvenile Justice Reform. GF/GP $5,720,300 $643,600
House and Senate concur.
23. Foster Family Maintenance Payment Increase Gross NA $19,278,700
Executive includes $19.3 million Gross ($7.8 million GF/GP) to fund an TANF NA 2,8