Lawmakers debate bill to guarantee legislator access to Montana State Hospital; health officials warn of patient‑privacy and CMS risks

Representative Donovan Hawk introduced House Bill 403 to give state legislators statutory access to Montana State Hospital for oversight and constituent advocacy. "The purpose of this bill is to allow unimpeded access for state legislators to our state hospital," Hawk told the House Health and Human Services committee.

Supporters said the change responds to a history of restricted visits and to serious incidents at the hospital. Patrick Yawake, representing the Blackfeet Tribe, Fort Belknap Indian Community and Chippewa Cree Tribe of Rocky Boy, told the committee that a facility had previously lost Medicaid and Medicare funding after abuse and neglect investigations that he said led to four deaths and multiple reports. "With legislative access, respectful patient privacy, these legislators can be an advocate and a first responder for Montana State Hospital patients," Yawake said.

Opponents included Paula Stannard, chief legal counsel for the Department of Public Health and Human Services, who argued the bill's phrasing—"immediate, unlimited access at all times"—could "inevitably disrupt patient care, interfere with patient privacy and confidentiality rights" and jeopardize the hospital's ability to meet Centers for Medicare & Medicaid Services (CMS) Conditions of Participation. Stannard pointed to two independent oversight entities—the Montana Mental Disabilities Board of Visitors and Disability Rights Montana—that already have statutory access and investigative authority.

Douglas Harrington, interim health facilities division executive director, and Dr. Kevin Flanagan, CEO of Montana State Hospital, described operational changes and said the hospital now has permanent leadership and improved culture. Harrington said the hospital recently received a two‑year license from the Office of Inspector General after earlier temporary licensure. Flanagan welcomed legislative visits but emphasized process: "any and all legislators are welcome to visit. We in fact have a policy around the process that would go through, in order to allow that to happen," he said, explaining registration, notice and patient‑consent processes to avoid interfering with treatment.

Committee members questioned whether unannounced or unfettered access would be treated like agency unannounced surveys, whether the bill's language mirrored statutes for prison visits, and whether the bill would impair recertification efforts. Flanagan and Harrington repeatedly said that access is already possible by request and that the bill's plain language—especially phrases such as "immediate" and "unlimited"—raises compliance concerns with federal patient‑privacy and CMS standards.

Representative Hawk said the statutory language was modeled on prior prison‑access language and offered to work on amendments. Committee staff and members requested that DPHHS provide the number of reports made to Disability Rights Montana and the Board of Visitors in recent years; Stannard said the department would provide that information.

Dr. Flanagan provided the hospital's capacity and recent census: the facility is staffed for 174 beds (114 at the main hospital and 60 at Sprague) and had a census of about 165 on the morning of the hearing.

The committee closed the hearing on HB 403 with no action; members signaled willingness to consider amended language that balances oversight and compliance with patient‑privacy and CMS requirements.