Interim Committee Narrows Focus of DD Study

Committee: Children, Families, Health, & Human Services Interim Committee
Author: Sue O'Connell
Posted on April 6, 2018

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A legislative committee decided last month to focus its study of services for adults with developmental disabilities on crisis services, direct-care worker wages, and the way in which services are reimbursed.

At a March 22-23 meeting, members of the Children, Families, Health, and Human Services Interim Committee also acted on subcommittee recommendations for a study of health care price transparency and asked that a formal objection to medical marijuana rules be drafted for review at their May meeting.

Committee members spent March 22 working on the House Joint Resolution 24 study of community services for adults with developmental disabilities. They heard presentations on the behavior consultation team used in Montana and on crisis services in other states, as well as on the ways that other states pay for community services.

The committee also:

• learned that the Department of Public Health and Human Services is holding weekly meetings to talk with DD providers about reimbursement and other issues, focusing first on reimbursement for transportation services;
• received information on changes proposed by DPHHS to the Medicaid waiver that funds community-based services for people with developmental disabilities; and
• toured several day programs and group homes operated by Westmont, a Helena provider.

On March 23, the committee continued its review of Medicaid expansion by hearing from a national consultant about recent waivers approved by the federal government. The waivers will allow Arkansas, Indiana, and Kentucky to require that expansion enrollees and some other Medicaid recipients work or participate in certain other “community engagement” activities in order to remain in the program. The waivers also will let the states put other restrictions on their Medicaid programs. Those range from limitations on retroactive eligibility to disenrollment for failure to provide required paperwork or documentation.

Several Montana health care providers representing both large and small hospitals and community mental health centers discussed how Medicaid expansion has affected their payment mix, the services they provide, and the patients they serve. And two people who have qualified for Medicaid expansion told committee members how the ability to obtain health care services has affected their lives.

The committee also:

• received updates on DPHHS activities, including three new programs designed to improve child protective services and the department’s plan to continue a 2.99% Medicaid provider rate reduction into Fiscal Year 2019;
• received and acted on recommendations from the subcommittee looking at the HJR 20 study of health care price transparency, accepting all proposals except one involving continued work on prescription drug prices; and
• reviewed a request from the Revenue and Transportation Interim Committee to formally object to the administrative rules that DPHHS adopted for the medical marijuana program. RTIC asked the committee to recommend that the rules be amended to address how much space is allowed for marijuana plant production, the standards for laboratories and product testing, and the department’s plan to phase in licensing over the next 8 months.

The committee asked staff to draft a formal objection for review and potential action in May after DPHHS officials said the agency will propose new rules on some of those topics. Because DPHHS has already adopted the rules at issue, a committee objection would not stop the rules from going into effect as scheduled on April 10. Instead, it could have an effect if a lawsuit were filed to challenge the rules.

The next meeting of the committee is May 14 in Helena. For more information about the meeting or the activities of the committee, visit the committee's website or contact Sue O'Connell, committee staff.

Committee Website: www.leg.mt.gov/cfhhs
Committee Staff: soconnell@mt.gov or 406-444-3597