1. MALA Annual Conference Lansing Center Lansing, MI Wednesday May 9, 2018, 10:30 a.m. Licensing Update from AFC & Camps Licensing Division
Jerry Hendrick, Area Manager, Grand Rapids
Jay Calewarts, Director, AFC & Camps Licensing Division

2. LARA/Bureau Overview Shelly Edgerton, LARA Director
Larry Horvath, BCHS Bureau Director
Currently there are 4 Divisions:
AFC and Camps Division (includes AFC, HFA and camps)
Child Care Licensing Division
Federal Survey and Certification Division
Health Facilities Licensing, Permits & Support Division

3. BCHS Organizational Overview
Larry Horvath
Bureau Director
Mark Jansen, Director
Child Care Licensing
Division
Jay Calewarts, Director
Adult Foster Care &
Camps Division
Heather Hosey, Director
Health Facility Licensing, Permits, and Support Division
Michelle Roepke, Director
Federal Survey & Certification Division
Steve Gobbo
Deputy Bureau Director
BCHS Organizational Overview
State Licensed
Child Care Group Homes/Centers
State Licensed
Adult Foster Care Homes
Adult Foster Care/Child Camps
Homes for the Aged
State Licensed
Freestanding Surgical Outpatient Facilities
Hospice Agencies & Residences
Hospitals
Nursing Homes
Substance Use Disorder Programs
Other Functions
Complaint Intake
Nurse Aide Training Program
Nurse Aide Registry
FOIA
Federal Certification
Ambulatory Surgical Centers
Clinical Laboratory Services
Comprehensive Outpatient Rehabilitation Facilities
Dialysis Centers
Home Health Agencies
Hospice Agencies & Residences
Hospitals
Nursing Homes
Outpatient Physical Therapy (OPT)/Speech Pathology Providers
Portable X-Ray Suppliers
Rural Health Clinics

4. Michigan Covered Providers
No. of Providers
Type
State License
Federally Certified
9,242
Child Care Homes & Centers
Yes No
8,258
Clinical Laboratory Services (CLIA)
4,214
Adult Foster Care Homes
1,166
Substance Use Disorder Programs
1,054
Adult Foster Care/Child Camps
556
Home Health Agencies
460
Nursing Homes/LTC Facilities
261
Homes for the Aged
209
Dialysis Centers (ESRD)
169
Hospitals
170
Rural Health Clinics
153
Freestanding Surgical Outpatient Facilities
152
OPT/Speech Pathology Providers
142
Hospice Agencies 64
Inpatient Psychiatric Hospitals/Units 17
Hospice Residences 9
Organ Transplant Facilities 7
Portable X-Ray Providers 5
Comprehensive Outpatient Rehab (CORF) 3
Community Mental Health Centers
Michigan Covered Providers
(As of January 2018)
Some federal oversight for organ procurement organizations (1) and federally qualified health centers (241).
52,297 Certified Nurse Aides Registered

5. AFC & Camps Org Chart

6. AFC Coverage Map

7. HFA Coverage Map

8. PA 167 of 2017
Modifies the Part 201 (General Provisions section) and 213 (Home for the Aged section) of the Public Health Code
Signed into law on November 9, 2017
Took effect on February 11, 2018
PA 167 can be found at:

9. PA 167 Changes Lower the minimum age from 60 to 55 years old
Cap on Background Checks Starting 10/1/18
40 checks for facilities with fewer than 100 beds
50 checks for facilities with 100 or more beds

10. PA 167 Changes Redefines Supervised Personal Care
(2) “Supervised personal care” means the direct guidance or hands-on assistance with activities of daily living offered by a facility to residents of the facility that include 2 or more of the following services provided by the facility to any resident for 30 or more consecutive days as documented in the resident’s service plan:

11. Supervised Personal Care
(a) Direct and regular involvement by staff in assisting a resident with the administration of the resident’s prescription medications, including direct supervision of the resident taking medication in accordance with the instructions of the resident’s licensed health care professional.
(b) Hands-on assistance by staff in carrying out 2 or more of the following activities of daily living: eating, toileting, bathing, grooming, dressing, transferring, and mobility.
(c) Direct staff involvement in a resident’s personal and social activities or the use of devices to enhance resident safety by controlling resident egress from the facility.

12. Existing Facilities can be Reviewed to Board and Care
Beginning on the effective date of the amendatory act that added this subsection, the bureau of fire services shall amend the rules to allow facilities in existence on or before the effective date of the amendatory act that added this subsection and continuously operating up to the time of application for a home for the aged license to be reviewed and inspected to comply with the provisions of chapter 18 or 19 or chapter 32 or 33 of the national fire protection association standard number 101.

13. Exemption from HFA Licensure
There are now 4 ways to be exempt from HFA licensure (MCL a)
Food provider is unrelated to care or board provider or both
2) Room, board and care are related however this relationship was in effect for 2 years before applying for exemption and residents can choose care provider of their choice
3) CCRC with a licensed nursing home on campus
4) Room and care are not related and residents can choose care provider of their choice

14. Exemption from HFA Licensure
Exemptions 1 & 2 on previous slide must be approved by December 31, 2019 (except to a successor owner, operator, or governing body…)
Exemptions 3 & 4 on previous slide do not have a cut off date
Department has up to 60 days to act on an exemption application
HFA exemption application can be found at:

15. AFC Legislation Introduced
HB 5505 & HB 5506
Capacity of 1 or 2 don’t need to be licensed
Raises licensing fees for first time since 1992
4 or less residents and all CMH consumers can file for an exemption
Creates authority for emergency closure management
Requires facility to pay for staff background checks

16. AFC Legislation Introduced
SB 744 & SB 745
6 or less residents and all receive community living supports and/or personal care, the person(s) providing the personal care, supervision or protection are not related to the person(s) providing the room and board
Modifies the Zoning Enabling Act so that these facilities must be considered residential

17. AFC Legislation Introduced
SB 962
Would allow “co-occurring enhanced crisis residential program” to be dually licensed as and AFC and SUD program
Currently only about 15 programs that would qualify for dual licensure

18. AFC Council Rule Review
MCL (5) The rules shall be reviewed by the council not less than once every 5 years.
Have begun to review of AFC special certification rules
Hope to have draft AFC special certification rule changes ready for public comment by late summer/early fall
Once completed, plan to review other rule sets
Any proposed rule changes you may have, please send to me at

19. BCAL 1326-A Changes
Renamed to BCAL 1326A – FP (for applicant/licensee, licensee designee, and owner, partner or director who has regular access)
Adult Foster Care Licensing Information Request form BCHS-AFC 100 (for adult house hold members, administrators and responsible persons).
Note that administrators and a responsible person have to be fingerprinted though the Workforce Background Check Program

20. BCAL 1326-A Changes

21. License Look-up Website
Server crashed which housed and linked all reports to license look-up page
IT still working to restore reports and link them to correct facility
Encourage you to look-up your facility and notify us if something is missing or needs to be removed

22. A License is Required (AFC)
Provision of supervision
Provision of personal care
Provision of protection
Provision of room and board
Twenty-four hours a day
Five or more days a week
Two or more consecutive weeks for compensation

23. HCBS Requirements of HCBS and licensing can be met
See joint communication on HCBS rule and licensing issue
Make sure a detailed assessment is completed

24. Questions & Answers
Website:
Lansing Office Address:
611 W. Ottawa Street
Ottawa Building, 1st Floor
PO Box 30664
Lansing MI, 48909