Lawmaker, Health Representative, Calls for Transparency on $71 Million in DPHHS Budget – Daily Montanan

The Department of Public Health and Human Services is expected to specify a plan for the $71 million it wants lawmakers to approve in the director’s office budget, a lawmaker and medical association director said Tuesday.

Nursing homes are closing in Montana, and the governor’s office has proposed spending more money to help Medicaid providers, including that $71 million.

But without details, including how much those one-time dollars versus ongoing dollars, Rep. Mary Caferro, D-Helena, said suppliers will face uncertainty.

“The people who suffer are the people who have the services, and that’s why I’m so concerned,” Caferro said.

At the Joint Subcommittee on Health and Human Services meeting, he also said it would be “unprecedented” for lawmakers to agree to embezzle so much money without seeing the details up front.

“It would give me great comfort to know what I’m voting on,” Caferro said.

Brian Hannan, with the governor’s budget office, said lawmakers can receive regular reports on spending, and has done so in the past. Caferro said he appreciates the reports, but seeing line items only after they’ve been spent is “not usually the order” of events.

“If this (request from the governor’s office) passes, then the executive will be the approprior, not the legislature, and that’s unprecedented,” Caferro said.

In response, Health Department Director Charlie Brereton said the agency has presented budget plans, those related to the recent vendor rate study. But he said he was busy “repackaging” the information “in a way that makes sense” to the subcommittee.

“We’ve been very clear about what we intend to do with this funding,” Brereton said.

The Department of Health is the largest state government office, and the division heads presented their budgets to the subcommittee this legislative session.

Funding for short-term facilities that care for the elderly is part of the discussion. DPHHS recognized that Medicaid reimbursement rates are too low and commissioned a study of the rates, released in the fall.

The Governor’s Office proposes funding a portion of the recommended study increase for nursing homes. The Department of Health called the $25 million in one-time funds — part of the $71 million — as a “significant and historic infusion of funds.”

However, the Montana Health Care Association said the total increase is still well below actual costs and providers won’t receive any money until at least July 1, 2023. Meanwhile, 11 facilities in Montana have closed, others are struggling and the costs grow.

The filing from the director’s office noted that the $71 million for the two-year period consisted of $25 million in general funds and nearly $46 million in federal match.

At the meeting, Rose Hughes, executive director of the Montana Health Care Association, said she didn’t normally talk about funding related to the director’s office.

“But because there have been provider rate hikes in the director’s office, that’s why I’m here,” said Hughes, who represents nursing homes, assisted living facilities and home-based agencies.

Subcommittee chairman Rep. Bob Keenan R-Bigfork only took public comment at the end of the four-hour meeting.

He fired the director of DPHHS Brereton for public testimony, and the director said he had an obligation and walked out. Before leaving, however, he said he would provide information.

“We are fighting for transparency,” Brereton said at the start of the meeting.

In his testimony, Hughes said the budget clearly disclosed other sources of funding for vendors and in a specific way.

However, he said the $70 million was “dumped” into a line item and one “without many parameters and without your ability to specifically appropriate the individual programs that are supposed to receive the money.”

That’s a problem because providers need to know if they’ll be helped financially, he said. You encouraged the committee to specifically embezzle the money.

“There are suppliers out there that are on the verge of shutting down,” Hughes said. “And they want to know what you’re going to do and what their rates will be.”

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