Disability Advocates Sue State Over Medicaid Cuts
July 31, 2018
HELENA – Disability rights advocates from across Montana sued the state today, alleging cuts to Medicaid reimbursement rates imposed by the Department of Public Health and Human Services are illegal and put Montanans with physical and mental disabilities at serious risk of institutionalization.
"This lawsuit is the direct result of unlawful and unconstitutional decisions by the state that threaten significant and long-lasting harm to Montanans and their families," said Beth Brenneman, attorney for Disability Rights Montana. "The new rates have wreaked havoc on the community-based Medicaid services system. With this action today, we join providers and recipients of Medicaid services across the state in demanding an immediate end to these cuts."
Plaintiffs in the lawsuit, which was filed in state District Court in Helena, include organizations that serve Montanans with developmental disabilities, mental illness and serious physical disabilities, as well as individuals who receive services through those providers.
The lawsuit is the second filed this summer in state District Court against the state and the department over Medicaid cuts that were initially the result of actions by the 2017 Legislature. In June, the Montana Health Care Association, which represents nursing homes and assisted living centers, sued the state and the department over the cuts.
Last summer, the department proposed cuts to Medicaid reimbursement rates of 3.47 percent, arguing the move was necessary to implement budget cuts included in Senate Bill 261. The department later reduced those cuts to 2.99 percent. But while initially saying they would last for only a matter of months, the department then decided to extend the cuts through fiscal year 2019.
The plaintiffs argue that the cuts were made in an "arbitrary, unlawful and unconstitutional manner," including by improperly targeting the cuts to community-based services for those with disabilities.
"The Department failed to follow almost every requirement of the Montana Administrative Procedure Act in proposing the rate cuts," the lawsuit states. "The rule-making notices of the cuts to Medicaid rates proposed by the Department in late June 2017 were not based on information in existence at the time of the cuts, but were done ‘in anticipation’ of such information. They were not supported by any official documentary or fiscal evidence."
Although Gov. Bullock announced last week that surplus revenue will be used to "backfill" economic losses, the lawsuit notes that legal action, including a temporary restraining order against the state, are still necessary because it remains unclear when or how the rates will be restored, or how programs will be refunded.
"The petitioners have not been made whole. And the question of the department’s blatant violation of MAPA remains unresolved," the plaintiffs state in their application for a restraining order.
Since the cuts were implemented, Medicaid providers across the state have been forced to stop providing certain services entirely, closed offices or ended services to individuals who previously had received them. Without assistance, many currently receiving community-based services could be forced into institutional settings.
Prior to the rate reductions, for instance, targeted case management services for individuals with mental illness were reimbursed at $18.22 for 15 minutes per adult, and $19.45 for 15 minutes for a child. After rate cuts, the reimbursement rates were $8.19 per 15 minutes for both children and adults. Such cuts have had a devastating impact on community-based mental health services.
Given that these cuts were to multiple Medicaid providers, the effects have been felt throughout the system. "My sons who have severe physical disabilities lost critical supports because of these cuts," said Vicki LaFond Smith of her sons who are plaintiffs in the action. "The cuts caused us to lose good staff we trusted, and finding new staff is going to be hard even with the rates restored, as they were already low paying jobs."
The seven-count lawsuit also accuses the state of violating the Americans with Disabilities Act
For Media Inquiries Contact: Beth Brenneman 406-449-2344
Click here for a .PDF copy
Now Hiring: Paralegal
Disability Rights Montana seeks to hire an experienced Paralegal. The Paralegal works under the supervision of the Attorney Work Group to support and assist staff attorneys to carry out the legal priorities, objectives, and casework of the agency.
Applicant must be self-motivated, have the ability to problem solve through research, demonstrate proficient writing skills, have fluent computer knowledge, and be able to communicate effectively with people with disabilities, family members, and providers.
Applicant must also be familiar with Federal and Montana Rules of Civil Procedure, Federal and Montana Rules of Evidence, Federal and Montana Uniform District Court Rules, local court rules, and applicable citation manuals.
Applicant must have a minimum of three years of qualifying experience, a diploma, degree, or certification in paralegal studies, or work equivalent.
Position is located in Helena, Montana. Some travel may be required. Salary is commensurate with experience. A generous benefit package includes paid time off, 403(b) retirement plan, health, life, dental, vision, long term care insurance, and professional development.
Please submit a letter of interest and resume by August 17, 2018 to:
Director of Finance & Administration
1022 Chestnut Street
Helena, MT 59601
or by email to: firstname.lastname@example.org
Dismantling of Our Community System of Services by DPHHS
Something historic is happening in Montana. The community system of services that keep people with disabilities living and contributing to their communities is being dismantled. It is also being dismantled by the Montana Department of Health and Human Services (DPHHS).
There have been many stories recently about the effects of the recent cuts to Medicaid services. They have been about cuts brought about by legislative enactments in the general 2017 legislative session, cuts brought about as a result of the November 2017 special session and more obscurely, cuts that have occurred because of contractual actions on the part of DPHHS.
These cuts have been to community services provided by private non-profit businesses. These cuts have largely not been to any institution run by MT DPHHS. This is blatantly discriminatory, as it will force people into the most restrictive settings for care. It is a travesty that will take years from which to recover.
There is plenty of blame to go around. However, now, while there is no legislature in session, we desperately need to hear from our Governor as to how we are going to right this wrong.
Although options to address this crisis are limited, they exist. We need to hear from our leader that there is a plan to address and repair our system - whether it be via options provided to him by Senate Bill 9 or a supplemental appropriation.
At a recent hearing, we heard of someone who went into psychiatric crisis and attempted suicide after receiving a letter from MT DPHHS about cuts to services. The public needs to know now that there is a plan. They need to know that our leader cares about their fate.
Click here for an explanation of how SB9 includes two funding mechanisms through which a portion of agency HB 2 budget reductions may be mitigated.
Click here for the FY 2018 General Fund Revenue Update #2 prepared by Legislative Fiscal Division.
After cutting case management, Mental Health Center looks at deeper funding cuts
Published in the Billings Gazette, January 27, 2018
By Susan Olp email@example.com
Already grappling with cuts to Medicaid reimbursement rates, the South Central Montana Regional Mental Health Center now fears it could be looking at even deeper cuts.
The Montana Department of Public Health and Human Services is proposing revising three codes relating to chemical dependency services that will affect the center’s reimbursement rates. A hearing on the changes will be held Thursday in Helena.
The Mental Health Center offers mental health and chemical dependency treatment in an 11-county area. It has offices in Billings, Hardin, Red Lodge, Columbus, Big Timber, Roundup and Lewistown. Click here to read the article in its entirety.
Gallatin loses mental health caseworkers due to state cuts
Published in the Bozeman Daily Chronicle January 27, 2018
By Katheryn Houghton, Chronicle Staff Writer
Come February, Breanna Hume’s job won’t exist. Until then, she’s trying to transfer some of her three-dozen clients who live with a destabilizing mental health illness to other case managers in Bozeman.
But her options are running out for those people who need help connecting to things like doctor’s appointments, rehab and therapy. And Hume is watching her field dwindle as a symptom of Montana lawmakers stabilizing the budget.
“It’s terrifying,” Hume said, a case manager with Winds of Change based in Bozeman. “If the people fall out of services, they will mentally decompensate. I don’t think lawmakers understand what that looks like, or that like anyone else, they’re just one life event away from being in a mental health crisis.” Click here to read the article in its entirety.
$8.9M Cut to dental services will hit Montana's elderly, disabled hardest
Holly K. Michels, firstname.lastname@example.org December 17, 2017
Helena - Dentists around the state are concerned that $8.9 million in cuts to Medicaid dental services enacted during a special session of the Legislature last month will severely impact the state's elderly and disabled.
In response to an anticipated revenue shortfall and the most expensive fire season in state history, Gov. Steve Bullock in August asked departments to propose 10 percent reductions totaling $227 million to balance the budget. Those proposals were eventually whittled down to $76 million, but cuts to dental services remained on the chopping clock when the Legislature convened last month.
States are required to provide a level of dental coverage for children covered by Medicaid and the Children's Health Insurance Program, but benefits for adults are optional. Click here to read the article in its entirety.