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Senate committee tables bill to shift assisted‑living funding to Community First Choice
Summary
Senate Bill 100 proposed moving some assisted‑living recipients from the Big Sky waiver to Community First Choice (CFC), a change proponents said would raise federal participation and yield net general‑fund savings; after fiscal questions and debate about entitlement risks and data gaps, the Finance and Claims committee tabled the bill.
Senate Bill 100, the Senior Care Facility Access Stabilization Act, would direct Montana’s Department of Public Health and Human Services to move certain assisted‑living individuals from the Big Sky waiver into Community First Choice (CFC) by January 2026, increasing federal participation in the program and changing how some services are funded.
Sponsor Sen. Becky Beard said the switch would increase federal participation in the services and produce general‑fund savings by reducing more expensive nursing‑home placements. "Moving some of these individuals on the wait list to the CFC program will therefore provide savings to Montana's general funds," Beard said during the hearing.
Proponents focused on the fiscal note. Rose Hughes, executive director of the Montana Healthcare Association, handed out an annotated fiscal summary and described the note’s components: an estimated $1.2 million in first‑year savings (rising to about $2.5 million in subsequent years) from shifting assisted‑living to CFC, plus case‑management savings of roughly $750,000 the first year and $1.5 million in later years. She cautioned that the fiscal note also shows costs to serve additional people on wait lists and a line item that reduces the net savings reported in the note.
Kristen Page Nye of AARP Montana and other senior‑advocacy witnesses urged support, saying available savings could substantially reduce current wait lists for assisted living and redirect resources to higher‑need waiver recipients. "From that cost savings, then we can take care of the wait list for assisted living," Nye said.
Agency witnesses answered senators’ questions but identified data limitations. Jean Hermanson, Medicaid chief financial manager, and Lindsey Carter, administrator for senior long‑term care, said the department had limited information on average lengths of stay in assisted living and on how many people from other waiver populations might become CFC‑eligible. Hermanson noted the fiscal note used a 1% annual caseload growth assumption and that per‑person costs are driven by daily assisted‑living rates multiplied by 365 days.
Opponents were not recorded in the hearing; the central concerns raised by committee members were fiscal uncertainty and entitlement risk. Senator Turner warned that converting services to CFC "becomes an entitlement," which could remove wait lists and expand enrollments beyond current estimates if demand changes over time.
During executive action, a motion to "do pass" SB100 resulted in an 11‑11 tie and failed. A subsequent motion to table the bill carried and the committee tabled SB100.
The committee record shows extensive questions about the fiscal assumptions and the availability of data on assisted‑living capacity and lengths of stay. If the bill is revived, senators indicated they would want clearer data on likely caseload growth, bed capacity constraints and the net fiscal impact after accounting for new people served under the CFC option.
The Finance and Claims committee tabled SB100; no formal policy changes were enacted during this session’s action on the bill.
