Montana State Legislature

HJR 24: DD Services for Adults

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HJR 24: DD Services for Adults

The 2017 Legislature approved House Joint Resolution 24 requesting a study of community services for adults with developmental disabilities. In a post-session poll of study priorities, legislators ranked the study 10th among the 20 study resolutions approved in 2017.

HJR 24 asks that the committee look into the following items:

  • the number of developmentally disabled adults who are receiving community services and the number who are waiting for services;
  • the length of time individuals spend on the waiting list for services;
  • the factors used to determine the amount of money the state will pay for services provided in the community;
  • the limitations placed on the use of the funds and how the limitations affect the ability of community providers to offer services;
  • the transition of developmentally disabled individuals from school-based services to community-based services, including the sharing of information among service providers;
  • service delivery models used in other states;
  • barriers to reducing the waiting list or providing community-based services in a more timely manner;
  • whether steps should be taken to update or revise the way that payments are determined or provided; and
  • whether steps could be taken to reduce the amount of time individuals must wait to obtain community services.

The committee adopted a schedule of activities for the study at its Sept. 11, 2017, meeting. Also at that meeting, the committee received information on the number of individuals receiving services, the waiting list for services, the types of services individuals may receive, and the process the state uses for determining how much Medicaid funding an individual will receive for community services. In January 2018, the committee heard about matters related to the transition of youth from school services to community services. Community providers also spoke about the concerns they have about the current rate structure and about workforce problems facing providers across the state. In March 2018, the committee learned about models for crisis response in Montana and elsewhere and also toured several programs and facilities operated by West Mont, a Helena provider. Members asked that further research on crisis services, assessment tools, worker wages, and funding flexibility be prepared for their May meeting.

In May, the committee heard in more detail about how the executive branch develops the budget proposal for developmental disabilities services. Members also reviewed additional research on topics identified in March and asked that staff prepare bill drafts for review and public comment in June on the following topics:

  • requiring use of the Supports Intensity Scale to assess the level of a support a person would need in the community;
  • requiring provider rates to be tied to the Consumer Price Index;
  • implementing the direct-care worker wage increase that was approved in House Bill 638 in 2017 but put on hold when revenues fell short of target levels;
  • requiring use of daily or monthly reimbursement rates, rather than hourly rates, for certain services;
  • directing that unspent general fund monies appropriated to match federal Medicaid funds for the developmental disabilities program be put into a special revenue account and be used for specified purposes;
  • establishing crisis services based on the model used in New Mexico; and
  • requiring the Department of Public Health and Human Services to review the costs and benefits of its rules and policies to eliminate practices that are duplicative or not cost effective.

The committee asked for changes to the bill drafts in June, after taking public comment. Members reviewed and took public comment on the revised bill drafts in September and approved seven bills for introduction in the 2019 legislative session. The committee also approved a final report on the study.

Legislation

Bill Drafts Approved for the 2019 Legislature

The LC number in parentheses behind the title of each bill is the official draft number assigned to the bill. It can be used for tracking the bill's progress throughout the legislative session.

Staff Reports

Related Links and Study Materials

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