Proposed Budget Overview by Executive, House, & Senate

Welcome! This has been an interesting budget already and its not even finalized yet. In this article, we will discuss some of the differences between the Executive, House, and Senate budgets for the DHHS committee. The legislature and Governor will be working on combining these differences over the next month. This year timelines are slightly pushed back but there’s good reason for this. 

This is the first time the Democrats have had control in some capacity in over a decade. Therefore, it only makes sense that there have been some procedural delays. For instance, the vote out of the House and Senate were two weeks later than what we normally expected. With that being said, we anticipate a June finalization of the budget, which is in alignment of the previous years. 
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As the year goes on, some articles will be specifically focused on one piece of policy or one concept of political hospital news. If you would like to see anything specific in these newsletters, please do not hesitate to reach out to Allisyn Mattice. 

Overview 
The DHHS budget is the largest budget the state operates. When the Governor came out with her recommendation, she included a 6.8% increase over FY 23 budget with a gross total of $35.7 billion. That’s an increase of $2.3 billion from last year’s budget. 
When the House passed its budget, it even included a higher amount than the Governor’s recommendation. Its recommendation was a 7.5% increase over FY 23 with $2.5 billion gross increase. The Senate came in with the lowest increase at 6.2% with a $2 billion increase from last year’s budget. 

These numbers are enormous, but so is this budget. It encompasses all the Medicaid costs, numerous public assistance programs, foster care, behavioral health, child support, public health, IT system services for all the individual programs, and numerous FTEs to make this budget work for the people of the State of Michigan. Further, while it seems expansive, most of the funding is tied up in federal or restricted dollars; therefore, leaving the legislature with little room to finance personal projects. 
Industry Watch List 

Overall, all three budgets focused on behavioral health care, public health, and medical services. Below I will be focusing on major additions or changes from the three recommendations. It is very important to remember that even though these programs may have been included by both the legislative chambers and the Executive, this is not the final budget. The areas below are just a summary of where one chamber may have spent the majority of its funds. This is not to say these projects or programs below are guaranteed funding or not guaranteed funding. However, it does show the areas where the legislature or Executive have found to be priorities. The final budget is expected to be complete sometime in June. 

Behavioral Health 
The Executive and House included $5 million in its proposed budget for behavioral healthcare recruitment. The House continued to expand its recruitment efforts by creating a $10 million grant program for two-year accelerated social work degree programs. In order to receive the grant to offset the cost of the accelerated social work degree, the individual must work in the public behavioral health sector within two years of completion. The House also included $1 million for Autism Navigators and another $1 million appropriation for the Western Wayne Substance Use disorder project. Furthermore, the House included numerous one-time appropriations worth $66.2 million for a series of behavioral health organizations. Including in this list is $4 million for CEI to create and expand crisis stabilization services capacity on the McLaren Greenlawn Behavioral Health Campus. Further additions include $8 million for reimbursement for inpatient psychiatric treatment, $4 million for Western Michigan University’s Autism Center, $1.6 million for Genemarkers and $500,000 to Memorial Hospital for a six-bed crisis residential unit. While the Senate did not include as much for individual behavioral health projects, it did include costs for a permanent supportive housing pilot program and a new FQHC payment model worth $15 million. 

Maternal Health 
The Senate, House, and Executive poured a great deal of funding into maternal health and healthy babies. All three supported a grant program ($5 million in the Senate, $10 million in the House and Executive) for CenteringPregnancy sites, which are group sessions for pregnant women. The Senate and Governor provided $10 million for incentive expansions from the Alliance for Innovation in Maternal Health at hospitals. The House included $5 million for the initiative with the goal of reducing death, injury, disparities, and SUD for pregnant mothers. Additionally, the trio expanded eligibility for family planning services up to 200% of the poverty line and supported perinatal quality collaboration. This is an excellent area for the legislature to consider bolstering and we are happy to be included in the House budget for $1.5 million to McLaren Thumb region for its OB/GYN services. 

Hospital Specific 
The MHA received $75 million of its asks in the Senate and $91 million in the House. This includes funding for Level I and Level II trauma hospitals in Michigan and numerous areas of Medicaid uplifts, such as outpatient reimbursements. However, there were additional hospital entities that also received funding in one or the other budgets. The House included $1 million for Trinity St. Mary’s Mobile mammography machine. Both the House and the Senate included $8 million for Corewell Health’s psychiatric GME program and funding at some levels for Mary Free Bed Children rehabilitation. U of D dental received $2 million from the House and Helen Newberry Joy Hospital received $12 million for hospital renovations. Additionally, the Senate included a $10 million pilot program for medical debt relief. This pilot project allows a nonprofit organization to purchase bundles of medical debt and pay it off for patients who are below poverty levels.