Most Montana Medicaid rates have not increased for several years. The Legislature budgeted a 2 percent rate increase in fiscal year 2009, but Gov. Brian Schweitzer rescinded it because state revenue projections were dropping sharply.
Nonprofit organizations and small businesses across Montana were counting on that 2 percent increase to help cover rising operating costs and deferred maintenance. When the state revenue picture improved, hospitals, nursing homes, mental health care providers and others made their case to an interim legislative committee. Lawmakers passed a bill in 2011 that would have restored that cut, but Gov. Brian Schweitzer vetoed it. Again, care providers went to the interim committee on children and families, asking for a one-time payment to restore one year of a 2-percent rate increase. That request became House Bill 12, sponsored by Rep. Carolyn Pease-Lopez, D-Billings. HB12 passed the House 79-21 and passed the Senate 39-11. Then Gov. Steve Bullock vetoed it and signed a state budget that will provide only 2 percent Medicaid rate increases in this biennium. That won’t put most providers even close to catching up with their costs.
Override the veto
Because HB12 passed each chamber with two-thirds of the votes, lawmakers are being polled for a veto override. Lawmakers should again vote for HB12 so that health and human service providers across the state will get the modest measure of financial support they were promised six years ago.
Nursing homes, children’s mental health providers and other Montana care organizations have been cutting staff, using up reserves and struggling to retain underpaid workers.
“We viewed it as a necessity,” Pease-Lopez said of HB12. “A lot of these providers are hurting, they’re not getting the pay they need.” She noted that the state has a “very healthy ending fund balance.”
“I’ve never been in this position before,” said Pease-Lopez, who is in her third House term. “I have always supported the governor’s veto.” But she said HB12 is a bill she believes in and she will vote to override Bullock’s veto.
“We’re losing $56 a day on every Medicaid nursing home resident,” said Kent Burgess, CEO for St. John’s Lutheran Ministries. “We usually have about 80 Medicaid residents. That was a $1.6 million financial loss on Medicaid last year. Burgess said neither St. John’s nor any other nursing home can continue to sustain such losses.
“In Eastern Montana, they’re just getting killed,” said Kathy McGowan, who lobbies for mental health centers, sheriffs and child care providers. “Everything is so much more expensive than it was.”
In Sidney, Eastern Montana Mental Health Center workers can no longer afford to pay rent, McGowan said. One worker reported that she has to hold down three jobs, including her mental health job, to cover her rent.
Mental health funds run out
“Our wages are not competitive with the rest of the area, so we lose a lot of folks to other organizations, said Barbara Mettler, executive director of the Mental Health Center that serves Yellowstone and 10 neighboring counties.
The regional center will run out of money next week for Mental Health Services Plan clients until the new state fiscal year starts July 1, Mettler said. Current clients will continue to be served, but the center may not be able to accept new clients, she said. MHSP provides limited treatment for indigent, seriously mentally ill Montanans who don’t qualify for Medicaid.
MHSP is one of several non-Medicaid programs that would get a one-year, one-time appropriation from HB12, if it became law. Other non-Medicaid programs in the bill include senior services and child care providers for low-income working families.
However, most of the $6.4 million HB12 general fund appropriation will go to Medicaid providers, such as nursing homes, doctors and children’s mental health care. The federal government matches state Medicaid funds 2 to 1. Thus, spending $6.4 million from the general fund, would pump an estimated $19 million into Montana’s economy.
When The Gazette spoke with Rep. Duane Ankney, R-Colstrip, last week, the chairman of the House Appropriations Committee said two bills should be passed despite the governor’s vetoes: HB12 and House Bill 218, which would provide infrastructure grants for oil-impacted communities. Monday’s Gazette opinion urged lawmakers to override the HB218 veto.
Today we call on Democrats and Republicans to vote for HB12 — in fairness to the providers who care for Montana’s oldest, youngest and most vulnerable citizens. It’s a $6.4 million investment with an immediate $12 million return. Montana care providers desperately need this shot in the arm to stay in business.