Bill would require DPHHS to develop payment rules for community commitments; hospitals and providers seek reimbursement for holds

Representative Mary Cafaro introduced House Bill 9 49, which would require the Department of Public Health and Human Services to establish a fee schedule and administrative rules to address payment of costs associated with commitments to community facilities. Cafaro said the bill does not oppose community commitments; rather, it asks the department to develop a plan and funding mechanism. "This bill just requires the department to figure all of this out to make sure that it is a successful effort," she said.

Proponents said the state has recognized a need for community commitment options but has not established how to pay providers who hold or care for committed patients while they await placement in the state hospital or other beds. Matt Kuntz of NAMI Montana told the committee community commitments have saved lives but that the state needs a fee schedule and administrative rules so providers are not left with uncompensated costs. Billings Clinic and Logan Health asked for a short amendment to add payment provisions for hospitals that hold committed patients when there is no available bed at the state hospital. JJ Carmody said Billings Clinic recently held a patient more than 10 days post-commitment and currently receives no payment for that time; she estimated a ballpark per-diem cost "around that thousand dollars plus a day." Jean Branscum of the Montana Medical Association also urged a due pass, citing inpatient capacity and sustainability concerns.

DPHHS and Montana State Hospital representatives were present for questions; DPHHS staff told the committee the requested late amendment could not be processed for the committee hearing but could be offered as a floor amendment. In executive action the committee adopted a motion to pass HB 9 49; committee staff said the bill includes a $5,000 appropriation and no printed fiscal note. The committee moved the bill to the floor.