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Committee advances bill to split Montana health agency after heated debate over costs and care
Summary
Lawmakers advanced HB 851 to create a new Department of Health Services by moving state-run health care facilities out of the Department of Public Health and Human Services. Proponents said the split would improve oversight and patient care; opponents warned of duplication, higher administrative costs and disrupted Medicaid billing. The committee approved the bill 15–4.
Representative Jay Fitzpatrick introduced HB 851, proposing to split the Department of Public Health and Human Services (DPHHS) into two agencies: a retained Department of Public Health and Human Services (handling income assistance, Medicaid, public health) and a new Department of Health Services to oversee state health care facilities, veterans homes and institutional behavioral-health programs.
Fitzpatrick framed the proposal as an efficiency and accountability measure. "Small is beautiful," he said in closing, arguing that a smaller, mission-specific agency could be more responsive to facilities such as Warm Springs State Hospital and veterans homes and reduce long-standing management problems.
Proponents included veterans' advocates, facility foundations and unions. Bill Willing, a former Montana Board of Veterans Affairs chair, and Dave Williamson (Southwest Montana Veterans Home Foundation) told the committee the new department would deliver better hands-on medical care and help recruit and retain facility leadership. Jennifer Weigand (Montana Federation of Public Employees) and Matt Kuntz (NAMI Montana) argued that specialized oversight could improve patient outcomes and staff morale.
Opponents, including the Behavioral Health Alliance of Montana and the Montana Association of Disability Services, said splitting DPHHS risks creating a siloed system that would complicate Medicaid billing, increase administrative costs, and undo recent facility improvements. Mary Windecker warned that moving Medicaid‑tied providers under a new department could bifurcate administration and harm continuity of care, and she urged the committee to let ongoing LFD audits complete before creating a new agency.
Informational witnesses including Dr. Douglas Harrington, state medical officer, cautioned the bill would likely restore many senior management positions eliminated in prior reorganizations and could increase duplicative HR, legal and fiscal functions. Dr. Harrington said the bill, as drafted, appeared to increase administrative overhead rather than reduce it.
At executive action Vice Chair Quorum moved HB 851 "do pass." After discussion and a roll-call vote the bill passed out of committee 15 yes, 4 no and will go to the floor for further consideration.
