Disability service providers protest change in Medicaid rate increases

DPHHS Director Richard Opper

Providers of general care for the developmentally disabled are asking the public to speak out against a plan from the state Department of Public Health and Human Services to alter an increase in Medicaid dollars for raises.

DPHHS is proposing to take two-percent of a total four-percent increase in rates for these providers and distribute that money in other ways than just an equal raise to all providers. DPHHS Director Richard Opper says this could include putting in place ‘performance measures’ to give higher raises to facilities operating more successfully.

“We are always looking for ways to deliver services more efficiently and effectively,” Opper said. “So, if a provider were to come to us with a more creative way to distribute services…I think that kind of innovation needs to be rewarded.”

Opper said he does not have specifics as to what those performance measures may be, and says that’s important, because it’s something he thinks the Department should negotiate with some of the providers of services for the developmentally disabled.

“There has not been any outreach,” said Missoula Developmental Service Corporation CEO Fran Sadowski, who points out these new increased rates go into effect on July first. “So, if that’s his (Opper’s) intent, when is it gonna happen?”

The 2013 Legislature approved two-percent rate increases across the board for providers of Medicaid Services. However, lawmakers singled out providers of services for the developmentally disabled for the larger, four-percent, increases. Sadowski said it’s not unusual for one type of provider to receive a larger increase. She says providers of services for the developmentally disabled have not seen an increase in their rates since 2009.

“We’re not getting rich on this type of increase,” Sadowski said. “Some folks are just trying to stay afloat.”

Sadowski said the disabled patients of facilities like her’s are often under 24-hour care, and if those places shut down the patients may end up on the streets, in a nursing home, or at the state’s institution in Boulder, the Montana Developmental Center. She said MDC costs taxpayers more per patient than community-based centers.

Sen. Mary Caferro (D-Helena)

Sen. Mary Caferro (D-Helena)

Sen. Mary Caferro, D-Helena, led the legislative effort to have higher rate increases for providers of services to the developmentally disabled. She does not at all approve of the idea to make any of the rate increases performance-based.

“There was nothing in the (bill’s) language about distribution options, there are no options,” she said. “It would be wonderful if the executive would respect the legislature and follow legislative intent.”

Opper said the Department wants to negotiate on the plan proposal, adding a straight four-percent increase is not off the table. The public comment period for the proposal ends May 30th

Bullock announces Department Directors for DPHHS, Administration and Montana Lottery

Governor-Elect Steve Bullock has tapped current Director of the Department of Environmental Quality Richard Opper to head the Montana Department of Public Health and Human Services.

Opper says he knew he wanted to play a role in the Bullock administration. He says it would have been easier for him to stay at DEQ “but what I wanted to do was serve them in the way they thought I could provide the best service to them and to the state.”

Opper’s background has been in environmental work, so his DEQ appointment made sense in that regard. But Bullock says he wanted Opper at DPHHS for his proven management ability.

“There are great people in that agency that have the policy and the substantive expertise,” Bullock said. “I think that Richard has the management expertise.”

“My job as I see it is not to learn everything there is to know about people’s jobs, they know their jobs, they know their work really well. My job as a manager is to help make those productive staff even more productive if I can, get obstacles out of their way try to find funding for them to do their job adequately,” Opper said.

A recent survey ranked Montana as the 29th healthiest state in the nation. Opper says he’d like to work on the factors which pull that ranking down.

Bullock has tapped Helena resident Sheila Hogan to head the Department of Administration. She has lead the Helena based Career Training Institute since 1992. She says after 20 years in the private sector, she’s ready for a tenure in state government.

“Getting to know the staff and getting ready for the legislature,” she said about her preparations.

Bullock says he’s keeping Montana Lottery director Angela Wong in her position. Wong has been in role since February of 2011 and the lottery has seen record sales increases in that time.

“She’s got her hands around the job, she’s really been doin a good job and something we want to continue to have the revenues and have effective management,” he said.

Revenue from the lottery goes into the state’s general fund. Wong says improving customer service and marketing strategies has really helped the lottery.

“We’ve started down a really great road with just again historic sales over the last year and I see that continuing,” she said.

Governor Elect Bullock has been more gradual in his cabinet appointments than the two administrations before him. He says he hasn’t been paying much mind to that.

“To date, we just about have all the department heads and personal staff put together and what I wanted to do was actually sit down and talk to people,” Bullock said.

He says he plans to roll out his final appointments in the coming days.

He takes office January 7th.

Bullock selects Tracy Stone-Manning to head Department of Environmental Quality


MT Gov.-Elect Steve Bullock introduces Tracy Stone-Manning as new DEQ Director Friday

MT Gov.-Elect Steve Bullock introduces Tracy Stone-Manning as new DEQ Director Friday

Incoming Montana Governor Steve Bullock has announced his selection for Director of the Department of Environmental Quality.

Bullock has chosen Tracy Stone-Manning, a former natural resources adviser to Senator Jon Tester who was the lead staffer on Tester’s Forest Jobs and Recreation Act. Stone-Manning also previously served as the Executive Director of the Clark Fork Coalition and the Five Valleys Land Trust in Missoula. Governor-Elect Bullock says Stone-Manning has worked with people of diverse backgrounds across the state.

“To do that,” Bullock said, “Tracy has had to build coalitions with groups not always used to sitting at the same table, from the logging industry to wilderness advocates. And it will always take in addition to firm and good administration that sort of bringing people together in coalition building to continue the work done at DEQ.”

Stone-Manning will replace outgoing DEQ Director Richard Opper. She says she wants to continue building on his work.

“And I look forward to creating a place and continuing a place where there is a permitting process that is fair, that is predictable that delivers both jobs and the protected landscapes that we so enjoy,” she said.

Steve Bullock will be sworn in as Montana’s next Governor January 7th. He has been periodically announcing members of his cabinet through the interim.

Council submits oil pipeline safety report to Governor

A council charged with reviewing the safety of oil pipelines in Montana has submitted its draft-final report to the Governor.

Governor Brian Schweitzer established this review council following last summer’s silvertip oil spill in the Yellowstone River. The Directors of the Montana Departments of Natural Resources and Conservation, Transportation and Environmental Quality sit on the Council.

DEQ Director Opper says the Montana Oil Pipeline Safety Review Council compiled its reports after meetings with federal regulators, citizens and companies who develop technologies to better detect pipeline leaks.

The rupturing of the Exxon Silvertip pipeline spilled over 60 thousand gallons into the Yellowstone River last July. It was a big spill that made international news. Opper says it did result in some positives.

“Now, I say that knowing that there are people who suffered terribly because their property was inundated with oil but some good things came out of this,” Opper said.

He says the state ended up getting a lot of information from the federal government it didn’t have before—like exact details on Montana’s network of pipelines and which rivers they intersect.

“We at the state really didn’t know where these crossings were. We didn’t know how many of them there were. We didn’t know what products were being carried,” he said.

The Federal Pipeline and Hazardous Materials Safety Administration did have this data. That agency also increased its inspections of pipelines in the state. Plus, Opper says after the Yellowstone spill, the public started noticing exposed and deteriorating pipes crossing streams. He says those problem crossings were identified and fixed before the start of our current runoff season.

“It’s hard to put a price on some of the problems that were averted because of this but I do know a lot of repair work has gone into some of the most difficult and problematic crossings and I think we’re a lot safer now than we would have been had this spill not occured,” he said.

As for the Yellowstone Spill, Opper says the bulk of that cleanup took place last Summer. There are parts of the spill that have been left. Opper says in these places cleaning the oil would do more harm than good.

“We’d have to rip out a willow grove to get a three-inch bathtub ring out for example,” Opper said. “Or we’d have to plow a new road for example, which would do a lot of damage or we’d spread weed infestations.”

In those spots, the oil has been left to weather away.

“Which it will do, it’s fairly benign, not a threat to wildlife, more of a nuisance now, the stuff we left behind,” Opper said.

Opper says the state does not have much regulatory authority regarding pipelines. The review council did not ask for more authority. Their final report recommends continuing to build the relationship with the federal government to keep the state’s new pipeline database up to date.

The report is out for public comment right now. The council will submit the final report to the Governor in mid-July.