Legislative Briefs - Week 16

Committee Tables Bill for One-Time Stabilization for Struggling Nursing Homes

Lawmakers have tabled a bill that would have given a one-time emergency stabilization payment of $5 million from the state general fund to the Department of Public Health and Human Services for nursing homes.

Rep. Jennifer Carlson, R-Manhattan, sponsored House Bill 891, which would have given emergency relief money to nursing homes that have stayed open and are 60 miles away from another nursing home.

"I know that the Appropriations Committee has done a lot, and you guys probably are right now with Section B and rates, and getting nursing homes enough to stay open, but this problem has been going on for enough years that I really think it's appropriate to help stabilize some of these nursing homes that might just need a boost," Carlson said.

Eleven nursing homes closed their doors in 2022 in Montana.

HB 891 originally attempted to appropriate about $41 million from the general fund to stabilize nursing homes, but was heavily amended by the House Appropriations Committee to drop that number down to $5 million. Following the amendment, the committee passed the bill unanimously, and then the House passed the bill with heavy bi-partisan support on a vote of 83-15 on April 3. The Senate Finance and Claims Committee then tabled the bill on a party-line vote 13-6 on April 17.

Margaret MacDonald, a former state senator representing Big Sky 55+, was the only supporter of the bill to testify at the Senate Finance hearing. She said this bill would give nursing homes the boost they need to get out of the "deep water" they have been in over the past few years.

"These facilities have been operating way under water for month after month after month, and this bill helps the department to at least identify those that we might lose, and try and keep their doors open for that time period before the new fiscal year starts," MacDonald said.

She said this bill is an important piece of the puzzle to give nursing homes immediate help, and allow them to keep their operations going before the new budget kicks in.

No opponents testified against the bill at the hearing.

Sen. Chris Pope, D-Bozeman, raised questions on a section of the amendment about what timely payments mean in the bill, and shared concerns over the vagueness of the wording and on whether DPHHS could spread this over time.

"That is actually one of my issues with this amendment. To be honest with you it's very vague, and it really just says that as the department decides to do it, and I am not a fan of that. Frankly I think it should be written what we're going to do and when we're going to do it, and who's going to decide. I think that's a lot better policy than saying that at their discretion they might do this one thing," Carlson said in response to Pope.

Carlson said the original intent of the bill was to provide these emergency funds before June 15, and before the new fiscal year kicks in on June 30.

Bill That Would Make Organizations Suing Over Hunting, Fishing and Trapping Pay Bonds

A bill on Gov. Greg Gianforte's desk would require a judge to place a bond and collect securities from plaintiffs who are seeking injunctions that prevent the ability to hunt or harvest wild game in the state.

Rep. Jedediah Hinkle, R-Belgrade, is sponsoring House Bill 419, which he said would strengthen a portion of the Montana Constitution that gives residents the rights to hunt and harvest through the "Heritage Clause."

"It's a great bill. It's a design to eliminate the process of hurting people through legal assaults and lawsuits," Sen. John Fuller, R-Kalispell, who carried the bill in the Senate, said.

HB 419 also creates language in Montana law that outlines the process of individuals or groups seeking injunctions or restraining orders that would directly undermine the constitutional right to hunt, fish and trap, and states that, "The amount of the written undertaking must be the greater of $50,000 or a reasonable estimation of the aggregate losses to all persons whose opportunities are diminished by the injunction or restraining order."

The bill passed the House on a party-line vote 65-33 on Feb. 23 and passed the Senate on party-lines again 33-17 on April 18. The bill now awaits Gov. Greg Gianforte's signature before becoming law.

"Time and time again we watch lawsuits that are ultimately won by the defendant, and the process is the punishment, and so the financial toll on these individuals as they defend themselves is astronomical," Fuller said.

No supporters of the bill spoke during the floor discussion on the bill.

Sen. Willis Curdy, D-Missoula, spoke against the bill during the Senate floor debate, and said this essentially makes it so individuals who want to place an injunction against agencies like Fish, Wildlife and Parks would need to have the financial capabilities to put up a $50,000 bond.

"It basically denies Montanans' rights to challenge their government and hinders access and equal protection of the law. This is another one of the pay-to-play bills that we've seen come across this body in the last couple weeks," Curdy said.

He said it would have a decimating impact on local hunting and angling groups, and could impact the right to hunt, trap or fish in Montana. He said out-of-state groups would have no problems generating cash for bonds to move forward with injunctions if this bill were passed.

Lawmakers Stall Tax Credits for Health Care Preceptors Overseeing Clinical Rotations

The Senate Finance and Claims Committee tabled a bill, which would have created a who oversee student clinical practices, but are not paid for their service.

Rep. Kenneth Walsh, R-Twin Bridges, sponsored House Bill 496, which would have given health preceptors tax credits of $1,000 per clinical rotation, up to $5,000 per year. The tax credits would not be available to licensed individuals who are contracted or paid to oversee educational clinical trials.

"What the current situation is that it's getting more and more difficult to find those preceptors so that the students can get those clinical hours and remain. The good thing is if they can find students that go to school here in Montana, one because they're good schools, two they have a good quality experience, they'll typically stay back in the state, develop their own practices, and become part of the communities," Walsh said at the bill's hearing on April 18. "I think, as we say: Rural areas struggle – I think if we can give more preceptors in those areas then we can get those students to take up residency there."

The bill passed the House of Representatives on a narrow vote of 54-43 on March 29, and was transferred over to the Senate where it passed a second reading vote 27-23 on April 18. All 16 Democrats and 11 Republicans voted yes on the bill with 23 Republicans voting no. Following the Senate vote, HB 496 was referred to the Senate Finance and Claims Committee, where the bill was killed on a nearly party-line vote 12-7 on April 19.

HB 496 would have taken $57,000 from the state general fund in 2025, and that would increase every year until 2027 where it would reach $174,000 during that fiscal year.

Jean Branscum, chief executive officer of the Montana Medical Association, was the only individual to testify at the hearing and she spoke in support of the bill. She said this program is necessary in Montana and would have a large impact on medical providers across the state.

"It pays for those individuals once they've gone through the schooling they go into a clinical study, and they have preceptors that kind of do that on-the-job training, and we have that happening now, but preceptors aren't paid to do that. They do that on a volunteer basis. We have a big growth in medical schools and other schooling, so the demand for preceptors has made that availability space pretty tight," Branscum said.

She said with the demand, people are willing to pay for preceptors, but Montana schools are currently not doing that, and this would be an innovative way to provide incentive to get more professionals into these programs.

Sen. Greg Hertz, R-Polson, was one of the senators who voted no on the bill, and spoke against it during the floor discussion. He said if the state really wants to encourage health care preceptors to partake in these clinics, then Montana should follow in the footsteps of other states and provide a stipend to health care professionals.

"It would be like adjunct professors at universities who would get $900, $1,000, $1,500. If we quit giving them stipends, I assume we wouldn't have too many adjunct professors at the universities either. This tax credit is going to be used by maybe 50 to 200 people out of our 500 tax returns that are filed. It just brings back another tax credit that we tried to eliminate," Hertz said.

He said this bill is a worthy project and touches on an issue worth looking at, but all this bill would do is add clutter to the tax code that lawmakers have tried to reduce throughout the session.

Bill That Would Add Regulations and Licensing Fees for Abortion Clinics Passes

Lawmakers have passed a bill to the governor's desk that would make it so abortion clinics will be treated the same as hospitals, and have to follow the same regulations and pay mandatory fees.

Rep. Lola Sheldon-Galloway, R-Great Falls, is sponsoring House Bill 937, which creates a $450 annual licensing fee that abortion clinics have to pay to cover the cost of annual inspections of clinics, and gives rulemaking authority to the Department of Health and Human Services.

"The opposition will say they are regulated, but every listed organization that regulated them proves they are actually self-regulated. As of today, none of our state agencies do any inspections to regulate these facilities," said Sen. Theresa Manzella, R-Hamilton, who carried the bill in the Senate. "Opposition will say private doctors' offices aren't inspected, but the department says surgeries aren't done in doctors' offices."

Manzella said abortions can occasionally be deemed as surgical procedures that need state oversight, but that it has been made clear abortion clinics are here to stay, so it's the Legislature's duty to keep them in check.

"Passing this bill will give us the ability to oversee these clinics, keeping them as a safe environment for the protection of women," Manzella said.

The bill passed the House of Representatives on a party-line vote of 66-33 on April 4, and passed the Senate 27-20 on April 20.

No Senators who supported the bill spoke in favor of it during the floor discussion.

Sen. Shannon O'Brien, D-Missoula, spoke against the bill during the Senate floor discussion on April 19. She said all healthcare providers and facilities already follow rigorously developed standards of care to ensure safety of patients and staff.

"I must also share that this is unnecessary regulation. These clinics and these medical providers are in compliance and must be in compliance with federal standards, including the Occupational Safety and Health Administration, Health Insurance Portability and Accountability Act of 1996, and other federal legislation. I'll share that facility overregulation, it simply makes no sense, especially when applied to medication abortion," O'Brien said.

She said this bill is straight from a national anti-abortion playbook, and the Legislature can do better than pass legislation that hinders healthcare access for women.

Caven Wade is a student reporter with the UM Legislative News Service, a partnership of the University of Montana School of Journalism, the Montana Broadcasters Association, the Montana Newspaper Association and the Greater Montana Foundation. He can be reached at [email protected].