PDF Version or HTML Version

Introduction

This outline is designed to be a ready reference to health programs and spending by the state of Michigan.

Health Programs Defined

Health programs defined in this outline are those that have the primary purpose of: promoting the public health; preventing health problems; maintaining and improving personal health; identifying threats to health; and, treating physical and mental disease. There are four principal ways in which the state addresses these goals:

1. Direct Provision. The state employs persons and runs facilities such as state mental hospitals, laboratories and prison infirmaries that provide direct health services.
2. Purchase. The state purchases health services from a broad range of individuals and organizations through programs like Medicaid and state employee health insurance. Grants are included in this category since the state is most often providing funds with the expectation that the work conducted will result in findings and service deliveries that assist in future policy making and allocation decisions for the purchase of services. General support funds for community mental health programs, local health departments, substance abuse agencies and area agencies on aging are included here since the state is purchasing the services they provide through the provision of these funds.
3. Subsidization. Michigan provides funds to organizations and individuals to provide general assistance in carrying out health related functions the state wishes to financially support. Examples include support of medical schools at public universities, and monies provided to support certain non-profit agencies.
4. Regulation. The state regulates health providers through licensing and certification, authorizes certain capital expenditures by health agencies and licenses persons who practice medicine and provide other health services. It licenses health insurers and health maintenance organizations.

Health Spending Defined

Amounts shown in this outline are based upon appropriations for the fiscal year 2000-2001 (October 2000 through September 2001). This differs from actual expenditure amounts because not all funds may be spent within the given fiscal year and/or supplemental appropriations and transfers between or among items may alter the amounts originally authorized within any given year.

Appropriation amounts are the timeliest indicator of the financial commitment to health by the state, however, because they are almost always determined prior to the beginning of a fiscal year. Actual expenditure data are not usually available until six months after the close of the fiscal year.

The outline is based on the line item titles used in appropriations acts for the departments of state government. Some cover a broad range of programs and others are quite specific. Narratives for each topic reflect this.

Sources of Funds

All funds expended by the State of Michigan are to be authorized through appropriations acts which include funds from a number of sources including the Federal Government, Constitutionally dedicated tax revenues, fees, locally collected revenues and a variety of other sources (See Appendix A). The outline shows both the expenditure amount authorized and the source(s) of revenue(s) from which the expenditures are to be made. If amounts available from the source(s) are less than included in the appropriation act, spending is to be reduced accordingly. If amounts are greater, a supplemental appropriation can be granted by another appropriations act.

State/State and Local/Local

Programs directly provided by the state or which are purchased, regulated or subsidized without local fiduciary responsibility are defined as State programs. State and Local designations include areas where state and local units of government (including school districts) share fiduciary responsibilities. Local programs are those where local units receive funds from the state and are fully responsible for both administrative and fiduciary functions.

Administrative Costs

Every department of Michigan government is authorized funds for the costs of administering its various programs. Often referred to as "Management and General", these amounts pay for such functions as executive direction, finance and budget, information technology, and, human resources. These are not included in the outline. Administrative costs directly associated with a program, such as staffing, are included here.

Website

In the website version of the outline, underlined words may be used to go directly to pertinent web sites.

Statistics

Each outline topic contains limited statistical information. In some instances, comparative information for previous years is also presented. If the program is new, or statistical information is not available, this section does not appear.

CRC wishes to thank the Department of Community Health, the Office of the State Budget, and House Fiscal Agency for their assistance in preparation of this document.

Any comments, questions, or suggestions should be directed to Stu Paterson.

Last Updated May 30, 2006