FY 2023-24: HEALTH AND HUMAN SERVICES
Summary: As Passed by the House
House Bill 4310 (H-2) as Amended
Analysts: Sydney Brown, Kent Dell, and Kevin Koorstra
Difference: House
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 $ $ ($19,100) (0.1)
Federal 23,693,049,100 25,803,271,500 25,933,867,600 2,240,818,500 9.5
Local 170,002,300 154,718,100 149,465,200 (20,537,100) (12.1)
Private 185,596,800 190,660,700 190,660,700 5,063,900 2.7
Restricted 3,132,592,800 3,050,326,400 3,070,326,400 (62,266,400) (2.0)
GF/GP 6,242,365,800 6,497,737,000 6,595,454,300 353,088,500 5.7
Gross $33,438,302,800 $35,711,390,600 $35,954,451,100 $ $ $2,516,148,300 7.5
FTEs 15,690.5 15,834.5 15,778.5 88.0 0.6
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."
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 House
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 concurs.
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 concurs.
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 concurs.
House Fiscal Agency 1 5/11/2023
 FY 2022-23 FY 2023-24
Year-to-Date House
Major Budget Changes from FY 2022-23 YTD Appropriations (as of 2/8/23) Change
4. Direct Care Wage Increase Gross $405,058,900 $350,112,500
Executive includes $210.1 million Gross ($74.5 million GF/GP) to SFRF 0 70,000,000
support a $1.50 per hour wage increase for direct care workers. Current Federal 259,091,400 180,785,100
year funding reflects recent appropriations for the $2.35 hourly wage GF/GP $145,967,500 $99,327,400
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.
5. Long-Term Care: Non-Clinical Staff Wage Increase Gross $1,792,051,000 $0
Executive includes $90.0 million Gross ($31.7 million GF/GP) to Federal 1,198,936,400 0
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. GF/GP $249,619,500 $0
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 $12,577,000
$6.9 million Gross ($3.5 million GF/GP) is on a one-time basis and Federal 870,300 5,041,600
authorizes 11.0 FTE positions (6.0 on a one-time basis). CCWIS will GF/GP $2,502,900 $7,535,400
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.
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 concurs.
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 concurs.
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 concurs. Federal 22,148,000 (1,119,900)
Private 36,700 0
Restricted 497,400 0
GF/GP $30,752,100 ($849,100)
10. Legal Services Gross NA ($12,300,000)
House removes $12.3 million GF/GP from ongoing legal-cost funding to GF/GP NA ($12,300,000)
recognize available funds currently available for legal services through
work project-retained funds from previous fiscal years.
11. Lapse Reductions Gross NA ($6,806,600)
House reduces multiple line items throughout the budget to recognize GF/GP NA ($6,806,600)
$6.8 million GF/GP available from historical end-of-year lapses to the
General Fund.
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 FY 2022-23 FY 2023-24
Year-to-Date House
Major Budget Changes from FY 2022-23 YTD Appropriations (as of 2/8/23) Change
12. 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 concurs. Private NA (56,000)
Restricted NA (64,100)
GF/GP NA ($4,191,700)
COMMUNITY SERVICES AND OUTREACH
13. Diaper Assistance TANF Swap – One-Time Gross $4,404,400 ($2,904,400)
Executive includes $4.4 million GF/GP as TANF replacement to allow TANF 4,404,400 (2,904,400)
administrative funds to be given to non-profits checking program GF/GP $0 $0
eligibility prior to distribution. House decreases TANF funding $2.9
million to leave $1.5 million and moves to one-time unit.
14. Crime Victim's Rights Sustaining Fund – One-Time Gross NA $60,000,000
House deposits $60.0 million GF/GP into a new Crime Victim's Rights GF/GP NA $60,000,000
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.
15. 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 $16,500,000
support programs. The additional GF/GP would supplement recent Federal 103,046,200 (3,500,000)
federal VOCA awards and Michigan CVRF to support the obligations Restricted 18,448,200 20,000,000
related to the programs. NOTE: The Crime Victim Rights program would GF/GP $102,600 $0
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.
16. Kids Food Basket – One-Time Gross $525,000 $1,525,000
House includes $1.0 million GF/GP in the one-time unit for the Kids Food GF/GP $525,000 $1,525,000
Basket program. Program also receives $525,000 GF/GP in ongoing
funding.
17. 2-1-1 Community Information Exchange (CIE) – One-Time Gross $2,950,000 $2,000,000
House includes $2.0 million GF/GP in the one-time unit for 2-1-1 GF/GP $2,950,000 $2,000,000
Statewide Calling system upgrades. 2-1-1 also receives $3.0 million
GF/GP in ongoing funding.
CHILDREN’S SERVICES AGENCY – CHILD WELFARE
18. 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 concurs.
House Fiscal Agency 3 5/11/2023
 FY 2022-23 FY 2023-24
Year-to-Date House
Major Budget Changes from FY 2022-23 YTD Appropriations (as of 2/8/23) Change
19. 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 concurs.
20. 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 concurs.
21. Foster Family Maintenance Payment Increase Gross NA $12,049,300
Executive includes $19.3 million Gross ($7.8 million GF/GP) to fund an TANF NA 1,771,600
8% increase to daily maintenance payments for foster parents, adoptive Federal NA 4,921,900
parents, and juvenile guardians. The increase would put Michigan’s daily Local NA 468,600
maintenance payment above the national average. House includes GF/GP NA $4,887,200
$12.0 million Gross ($4.9 million GF/GP) to fund a 5% increase to daily
maintenance payments.
22. Foster Care Respite Services – One-Time Gross NA $13,895,000
Executive includes $15.1 million GF/GP to implement a statewide foster GF/GP NA $13,895,000
care respite network to provide temporary, occasional relief to existing
foster parents with the goal of keep existing foster homes open. Funding
would be used for daily rate payments to licensed and closed foster
homes for short-term respite services as well as for the creation of six
specialized caregiver support contracts. House includes $13.9 million
GF/GP on a one-time basis to support short-term respite services and
does not fund the creation of six specialized caregiver support contracts.
23. Foster Care Education Pilot Program Gross $0 $1,744,100
Executive includes $1.7 million in federal funding to establish a Federal 0 1,744,100
scholarship program in partnership with state universities to provide GF/GP $0 $0
tuition stipends, field placements, and cover other educational expenses
for students seeking a Bachelor of Social Work or Master of Social Work.
In exchange, students are obligated to work for Michigan child welfare
agencies for one year. House concurs.
24. Elim