Dozens speak out against state's program fee cuts

HELENA – Dozens of people lined up Thursday to urge state officials not to make proposed reductions in Medicaid and non-Medicaid services, saying they would be devastating to the thousands of Montana families that need them.

“Please, please stop cutting,” said Nicole Tucker, clinical director at Consumer Direct Care Network. “Stop unbundling services that help our most vulnerable kids.”

The state held a nearly three-hour hearing on proposed rate changes.

In its 22-page Montana Administrative Register notice, also known as a MAR, said the new rates were sparked by the Department of Public Health and Human Services having a $49 million cut to its general fund from the November legislative special session to address revenue shortfalls and to pay for a costly fire season.

The MAR outlines fees for a host of programs, including therapeutic foster care, home support services, targeted case management and physician, podiatry, psychiatric, optometric and dental services.

People warned state officials that if they did not keep the funding for the programs that would be paying for their decision in other ways, such as mental health costs for the people denied treatment.

Bill Neaves of the Dan Fox Agency, which runs therapeutic group homes, foster care and adoption programs and counseling, called the proposed cuts “shortsighted” and “misguided.”

“They will cost the state more money in the long run,” he said.

Sheila Hogan, director of the Department of Public Health and Human Services appointed to the job in late 2016 by Democratic Gov. Steve Bullock, told the audience the agency was forced to propose these changes due to decisions made at the last legislative session in which GOP leadership opposed any revenue increase proposed by Bullock.

She said the Republican lawmakers did not approve a compromise.

“The fact remains we are seeing the consequences,” she said, adding later that “These are funding reductions not any of us want to make.”

No decision was made and if approved the new rates take effect March 1. The comment period is open until Feb. 9.

DPHHS administers the state's Medicaid and non-Medicaid programs to provide health care for qualified low-income, elderly and disabled residents. The state notes that Medicaid is a public assistance program paid with state and federal funds to health care providers.

Officials said the non-Medicaid programs are paid for mostly with state funds or grants.

The Legislature delegates authority to the department to set the rates that Montana pays for covered services, the report states. 

State officials said they focused on protecting the most vulnerable and most in need, considered eliminating or restoring Medicaid programs rather than sacrifice quality, giving priority to services that use prevention to reduce disability and illness, those that treat life-threatening conditions and services that support independent or assisted living.

The MAR notes that for Fiscal Year 2018 a $2.2 million fund impact for 584 people enrolled in the dental program, $2.1 million for 376 people enrolled in inpatient hospital care, $3 million fiscal impact for 315 people in outpatient hospital care.

In FY 2019, it’s a $4.9 million cut in outpatient hospital, $3.8 million in inpatient hospital and a $4.5 million reduction in dental.

One woman, who said she was a single mother from Missoula, broke down into tears when her testimony ended.

She said the cuts would hurt her daughter.

“I’m just asking you to look at it again,” she said.

Many of the providers warned state officials they could not provide services at the proposed rates.

Barbara Cowan of the Partnership for Children said the reductions would be pared down to the point where it would be financially impossible to deliver.

“Childhood is when brains are forming,” she said. “If we do not take care of our children we will lose them.”

Rep. Mary Ann Dunwell, D-Helena, voiced frustration over the reductions.

“Blame me,” she said. “The buck stops here. None of this makes sense.”

She said if she represented the Legislature “we wouldn’t be sitting here today.”

Dunwell said she would have sought supplemental or emergency funding.

“It’s a Band-aid,” she said, adding the ideology was not in place to do something.

Pat Noonan, a former state legislator who works for AWARE Inc., which helps people mental health, emotional, and in some instances, physical disabilities, said November’s legislative special session lacked transparency.

He urged people to “exploit every loophole and resource afforded to state government to make government work for the people.”  
 

To comment
People can still submit comment to Kenneth Mordan, Department of Public Health and Human Services, office of legal affairs, PO Box 4210, Helena, MT 59604-4201, fax 406-444-9744 or email dphhslegal@mt.gov by 5 p.m. Feb. 9.