STATE BUDGET UPDATE

The Legislature was not in session this week and there was no action on the House side but in two marathon sessions Wednesday and Thursday, the Senate Appropriations Committee reported out 16 individual state department budgets. The plan is for the full Senate to vote on all budgets next week.  Perhaps the biggest message through both days was that the Senate versions of the budgets are works-in-progress and that all issues are still up for discussion. 
 
DCH Budget

Very few changes were made to the version reported from the DCH subcommittee last week  - keeping Medicaid rates, eligibility categories and covered services intact. The major cuts still remain the entire Graduate Medical Education line and all of the Healthy Michigan Fund. Together these two areas would cut nearly $67 million of General Fund (GME - $57 million and HMF 10 million.)    

During the deliberations Senator Moolenaar, chair of the DCH subcommittee, did offer an amendment that was adopted that added boilerplate saying "if funds become available, it is the intent of the legislature that funding for graduate medical education be increased".  Without funds attached at some point in the process, the language means little.   

The Democratic vice-chair of the DCH subcommittee, Senator Vince Gregory offered several amendments to restore items including all of GME and all of the Healthy Michigan Fund but both were defeated on party-line votes. 

The only HMF program to get any positive mention in the bill was boilerplate language instructing DCH to find funds to continue to fund MCIR and MCIR related functions at the same levels as 2011.  This would mean that the department would have to find the money elsewhere (about $2.1 million).  Senator Caswell raised concern in the deliberations that the legislature should find the money.   

Finally, the Senate version also cuts non-Medicaid mental health services by another $5.1 million from $8.4 million recommended by the Governor to $13.5 million.
 
The bill still contains a cut of $1.6 million to Local Public Health, the amount recommended by the Governor (the House has doubled this amount in their subcommittee action).
 
K-12 School Aid Budget

Funding for School and Community Based Health Centers remains at current year levels in the version of the bill reported out to the Senate floor.   ____________________________________________________________________________________  

The Centers for Medicare and Medicaid Services (CMS) recently announced that it has awarded Michigan a a nearly $1 million innovation contract to develop ways to improve care and services for individuals dually eligible for Medicare and Medicaid, known as dual eligibles.

Michigan is one of 15 states to receive a CMS contract to plan for integration of care for dual eligibles. The goals are to eliminate duplication of services, expand access to needed care and improve the lives of people enrolled in both Medicare and Medicaid while lowering costs.

"This good news is a key step in continuing to reinvent Michigan," Governor Rick Snyder in a released statement. "Integrating care for those who are eligible for both Medicaid and Medicare really is a win-win for our state. Vulnerable recipients will benefit through better coordinated and higher quality care, and Michigan taxpayers will benefit by ensuring resources are spent wisely."

Dual eligibles account for 16 to 18 percent of enrollees in Medicare and Medicaid, but roughly 25 to 45 percent of spending in these programs, respectively. In Michigan, these beneficiaries represent 12 percent of total Medicaid enrollment and account for 38 percent of total Medicaid spending. They currently must navigate two very different systems in Medicare and Medicaid. The CMS contract will enable the Michigan Department of Community Health to plan ways to improve their access to better and more coordinated care, at a lower cost.

"Michigan is grateful for this opportunity to enhance our efforts to improve the coordination of Medicare and Medicaid benefits for dual-eligible beneficiaries," said Olga Dazzo, Director of the Michigan Department of Community Health. "Under this project the state will collaborate with key stakeholders to ensure that planning decisions are made in the best interests of Michigan's dual eligible population."
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