HOUSE BILL NO. 6046
A bill to amend 1939 PA 280, entitled
"The social welfare act,"
(MCL 400.1 to 400.119b) by adding sections 89 and 89a.
the people of the state of michigan enact:
Sec. 89. As used in this section and section 89a:
(a) "Community health worker" means an individual who meets all of the following conditions:
(i) Is a frontline public health worker.
(ii) Is a trusted member of the community and has an unusually close understanding of the community served that enables the individual to serve as an intermediary between health or social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery.
(iii) Builds individual and community capacity by increasing health knowledge and self-sufficiency through a range of activities, including, but not limited to, outreach, community education, informal counseling, social support, or advocacy.
(b) "Community violence" means an intentional act of interpersonal violence committed by an individual who is not intimately related to the victim.
(c) "Community violence prevention services" means evidence-informed, trauma-informed, culturally responsive, supportive, and nonpsychotherapeutic services provided by a violence prevention professional, within or outside of a clinical setting.
(d) Community violence prevention services include, but are not limited to, peer support and counseling, mentorship, conflict mediation and crisis intervention, targeted case management, referrals to certified or licensed health care or social services providers, community and school support services, patient education and screening services, group and individual health education and health coaching, health navigation, transitions of care support, and screening and assessment for nonclinical and social needs, provided by a violence prevention professional to do all of the following:
(i) Promote improved health outcomes and positive behavioral change.
(ii) Prevent injury recidivism.
(iii) Reduce the likelihood that victims of acts of community violence will commit or promote violence.
(g) "Violence prevention professional" means a prevention professional who meets all the requirements of section 89a(2).
Sec. 89a. (1) Beginning on the effective date of the amendatory act that added this section, the department shall provide coverage under the medical assistance program for an eligible individual who was referred by a health professional to receive community violence prevention services from a prevention professional or community health worker, after the health professional determines that the individual who has been violently injured is at significant risk of experiencing violent injury or has experienced chronic exposure to community violence. The department shall seek any federal approvals necessary to implement this section, including, but not limited to, any state plan amendments or federal waivers by the federal Centers for Medicare and Medicaid Services.
(2) To be eligible for reimbursement for services provided under this section, a prevention professional or community health worker must be certified as a qualified violence prevention professional. A prevention professional or community health worker seeking certification as a qualified violence prevention professional shall do all of the following:
(a) Complete at least 6 months of full-time equivalent experience in providing community violence prevention services or youth development services through employment, volunteer work, or as part of an internship experience.
(b) Complete a training and certification program for violence prevention professionals, as approved by the department.
(c) Complete annually at least 4 hours of continuing education in the field of community violence prevention services.
(d) Satisfy any other requirements established by the department for certification as a violence prevention professional.
(3) To implement this section, the department shall do all of the following:
(a) Establish a technical advisory group that consists of all of the following individuals:
(i) Three members representing a community-based organization that currently supports community violence programs, including, but not limited to, street outreach, hospital-linked, and hospital-based violence prevention programs.
(ii) One member representing a national organization that provides technical assistance for emerging community violence intervention programs.
(iii) One member representing a hospital that currently operates a hospital-based violence prevention program in this state.
(iv) One member representing a hospital or hospitals in this state that do not currently operate a hospital-based violence prevention program.
(v) One member of an academic institution in this state with knowledge of community violence intervention strategies.
(vi) Three members representing medical assistance managed care organizations in geographically diverse areas of this state.
(vii) Two members representing health care clinicians with experience in medical assistance billing and experience providing trauma care as a result of community violence.
(viii) Two designees from the department, 1 of which is from the office of community violence and the other of which works on medical assistance related issues.
(ix) One designee from an agency that manages the registration or certification of community health workers.
(b) Within 180 days after the effective date of the amendatory act that added this section, approve at least 1 national training and certification program for certified violence prevention professionals and establish a process to approve at least 2 community-based training programs. A program approved under this subdivision must include at least 35 hours of training that addresses any of the following:
(i) The profound effects of trauma and violence and the basics of trauma-informed care.
(ii) Community violence prevention strategies, including, but not limited to, crisis intervention, de-escalation, conflict mediation and retaliation prevention related to community violence, case management, and advocacy practices.
(iii) The patient privacy and health insurance portability and accountability act of 1996, Public Law 104-191.
(c) Ensure that an entity that employs or contracts with a violence prevention professional to provide community violence prevention services must do all of the following:
(i) Maintain documentation that the violence prevention professional has met all of the conditions described in subsection (2).
(ii) Ensure that the violence prevention professional provides community violence prevention services in compliance with any applicable standards of care, rules, regulations, and governing law of this state or the United States.
(4) The department, in consultation with the technical advisory group described under subsection (3), shall do all of the following:
(a) Issue guidance on the use of community violence prevention services for beneficiaries who access these services under the medical assistance program.
(b) Determine allowable rates for community violence prevention services based on the medical assistance program fee-for-service outpatient rates for the same or similar services, or any other data deemed reliable and relevant by the technical advisory group. The technical advisory group shall recommend and request that the department allocate funds for the purposes of awarding grants to support community-based organizations' access to training and qualified certification and other necessary capacity-building expenses for the successful implementation and accessibility of the violence prevention services benefit.
(5) This section does not alter the scope of practice for any health professional or authorize the delivery of health care services in a setting or in a manner that is not currently authorized.
(6) This section must be implemented only to the extent that federal financial participation is available, and any necessary federal approvals have been obtained.