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Bill would let state use CHIP/tobacco settlement proceeds for home visiting, waivers
Summary
House Bill 576 would expand permissible uses of Healthy Montana Kids/CHIP match and a tobacco settlement subaccount to fund home visiting, Part C early intervention, the Big Sky (11‑15) waiver and the 0208 developmental disabilities waiver. Supporters say the HMK fund balance (about $32 million estimated) can be repurposed to help waiting lists and sustain services as federal match declines.
Representative Jane Gillette told the committee House Bill 576 is intended to give future legislatures flexibility to direct state special revenue funds (the Healthy Montana Kids/CHIP match and a tobacco settlement subaccount) toward narrow populations and programs with high need: home visiting, Part C early intervention services, the Big Sky (11-15) waiver for elderly and disabled Montanans and the 0208 waiver for developmental disabilities.
Gillette stressed she did not touch tobacco prevention funding (a separate 32 percent allocation) and said the bill draws instead from the 17 percent tobacco settlement slice that supports the CHIP match. She explained the policy rationale: CHIP enrollment has declined while the state’s HMK fund balance has grown, creating an opportunity to redirect surplus state special revenue to critical home- and community-based services.
Kim Aiken, chief of finance and operations at DPHHS, testified the department supports HB 576 and projected the HMK fund balance would be about $32,000,000 at the end of the state fiscal year. Provider and disability advocates — including Spring Meadow Resources, Easterseals Goodwill Northern Rocky Mountain, the Montana Association of Community Disability Providers and Family Outreach — said the change would reduce wait lists for developmentally disabled individuals and help sustain services without increasing the general fund.
Legislators asked who would decide how reallocated funds are spent; Representative Gillette answered that the legislature retains authority rather than delegating unrestricted control to the department. Representative Close asked whether declining CHIP enrollment is a function of the unwinding from the public health emergency or of changing demographics; the sponsor said the decline predated the unwind and is likely tied to changing wealth and FMAP calculations, though she did not provide a definitive study.
Vice Chair Howe cautioned that an expanded list of permissible uses could create a scenario in which a revenue shortfall reduces CHIP eligibility in the future; DPHHS said it would monitor fund sustainability and avoid over-expenditure. The hearing closed with the sponsor urging the committee for a "do pass."
