We went into the session with some very good proposals from interim committees and the Sentencing Commission. These included bipartisan proposals to expand waiver slots for senior and long term care by 200 over the biennium to address a waiting list of over 500, to create an interdisciplinary committee to review our antiquated guardianship laws, provide funding for the area agencies on aging and for respite services, funding for housing to transition people from prison to the community, licensure of peer support specialists for people with mental illness, suicide prevention efforts, and reforms to the current sexual assault laws to more appropriately address how sexual assault actually occurs.
These proposals were great ideas and many were successful through the process. However, given the tight budget and lower than predicted revenue for the biennium, those that had fiscal implications had a much more difficult time. The funding for the area agencies on aging and the funding for respite services did not materialize. In addition, although the proposal for additional waiver slots for senior and long term care along with increased rates for assisted living services passed through both houses, in the last days of the session, it was made contingent upon certain revenue projections that are likely unrealistic.
Fortunately, the guardianship committee proposal was ultimately passed, as was peer support certification, sexual assault reform, transitional housing, suicide prevention, as well as new proposals such as certifications for board certified behavior analysts, a requirement that insurance cover mental health and substance abuse care as they cover physical illness claims, provide a new assisted living licensure to help divert people with Alzheimer’s or dementia from involuntary commitment at the Montana State Hospital, prohibit DPHHS rules from discriminating against children in foster care, require habilitation services under the Healthy Montana Kids Plan, and require DPHHS to comply with the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) requirements from federal Medicaid law.
Given the budget situation this session, we saw no provider rate increases in the budget. As providers of mental health, developmental disability, and personal care services have fallen far behind in their ability to provide a living wage to their employees, address deferred maintenance and cover fixed costs, the absence of an increase in Medicaid reimbursement rates dealt a real blow to these community systems that provide essential services to people with disabilities. There were some proposals to increase wages for some of these workers. Although it was well acknowledged that the current wages are unacceptable, increased wages for direct care workers was generally unsuccessful. Fortunately, a study of the developmental disability services system in Montana, which identify this as one of the issues to be addressed, was passed by the legislature to be addressed in the interim.
There were other disappointments this session as well. A proposal to keep a 12 bed unit on the Montana Developmental Center (MDC) campus open to provide crisis services passed. The MDC closure process has been very successful so far but is not yet finished. Therefore this decision is quite premature. We strongly believe that crisis services should be established throughout the state, instead of concentrated on the MDC campus. We still see abuse and neglect rates that are unacceptable at MDC, and we have no reason to believe that this will improve once it is reduced to 12 beds from the current 23.
We also were very disappointed that proposals to provide special education to students up to 22 years old as well as address special education funding failed. After an excellent hearing where many parents and advocates spoke convincingly about the need for these services to extend to age 22, the cost of the proposal was just too much during a legislative session with such a tight budget.
Proposals to give due process to people found guilty of felonies but mentally ill before they are sent to the prison, and to ban solitary confinement of inmates with mental illness also did not survive the process. However, we were happy to see that interim studies of the use of solitary confinement in our adult and youth correctional facilities as well as the purpose of all of our correctional facilities both passed the legislature.
We were happy to see the demise of measures to make misdemeanor assault into a felony if the victim was a nurse, allow up to a year in jail for public nuisance offenses by homeless people, ban people from using the bathroom that does not correspond to the gender on their birth certificate, which would inexplicably burden people with disabilities with personal care attendants of a different gender, and penalize the “fraudulent” use of a service animal, where there is no means to demonstrate the non-fraudulent use of them.