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MSIA UPDATE Legislative Week 1

The Legislature Returns – and the Intrigue Begins!

”No one pretends that democracy is perfect or all-wise. Indeed it has been said that democracy is the worst form of Government….except for all those other forms that have been tried from time to time.…"

Winston S Churchill, 11 November 1947

Every legislative session has its moments and issues. It is rare however that a major issue identifies itself during the first week, let alone the first day.

Intrigue # 1

Lets start with the simple stuff – there is a new electronic bill/committee tracking system, and I have not yet mastered it. Thus far those I have spoke with hate it – and I don’t disagree. Doesn’t matter – the decision is made, the implementation done (as far as it goes) and this is the system. All that to say, I am less confident that I have captured everything than I have been in prior years. We’ll figure it out – but it might take a couple of weeks.

Attached is a list of bill requests that may impact our business. They are culled from keywords “Workers’ Compensation,” “Labor” and “Insurance.” The new system does not yet list bills by the statute they are amending. For example, Montana WC law is in Title 39, Chapter 71. It would have been helpful to search the bills amending that title or chapter. Creating an automated tracking list continues to elude me, and I do not know if the new system provides updates when a bill is scheduled for a hearing. So at this point, it’s all manual on my part.

Intrigue # 2

This year, unlike prior years, the Legislative Counsels’ office has determined that ‘junque files’ are private information. Junque files are the correspondence and communication behind a bill. Typically they identify who has an idea or has requested a bill from the legislator. Typically, we can learn what’s behind the proposal, as well as who or what groups are behind the proposal. That’s not the case this year – and it’s driving all of us nutz (usually a short drive on a good road). Fortunately some bills, like Olsen’s Choice of Provider proposal (LC 660) or Reavis’s PTSD Coverage for Police & First Responders proposal (LC 1564) are easy to pick out by the title. Others, not so much.

There are clearly some legislators who are more relevant to our issues than others – but everyone can request a bill draft – regardless of how serious they may be.

When a request is made by a legislator to change a law, an LC (Legislative Counsel) # is assigned to that request. As the bill is developed – if it is developed – it is available to that legislator and anyone that legislator chooses to share it with. Some become public record, most do not, until they are introduced and are assigned either a House Bill (HB) or Senate Bill (SB) number. Many bill requests – LCs – do not get developed nor introduced. As well, some of them are just vehicles for issues that may crop up later in the session. At some point, legislators can no longer request bills – they must use a bill request already created to amend the section of law they are concerned with. Bill requests are subject to the section of law – and most are “Generally Revise….” (on the sheet, “Gen Rev”) whatever law the legislator is interested in. That LC number, with that title, can be used for just about anything in that broad section of law.

There are only two bills we are concerned with that have been formally introduced so far:


HB 143 / Etchart / R- BIL          

This bill was expected and will permit PAs who have at least 8000 hours of work under the supervision of a physician to be a treating physician under the workers’ compensation law. The bill is likely scheduled for a hearing in the House Business & Labor Committee on Thursday Jan 16. MSIA supports this bill to provide additional medical resources to injured workers. This kind of proposal has been or will be enacted in a number of other states.


SB 109 / Hertz / R-Polson     

This bill was also expected and will permit PT’s (Physical Therapists) to be treating physicians under Montana Workers’ Compensation law. MSIA is opposed to this proposal as while there is a valuable place for PTs in our system, they do not have prescribing authority, the U & T Guidelines provide for lots of PT, and according to NCCI MT already pays more per visit and more than comparison states for PT services per claim. It seems to us, this proposal is a solution in search of a problem. This bill will not be scheduled for a hearing at least until the week of Jan 20.


LC 2254 / Nicastro / R-BIL             

This bill has language, but has not yet been formally introduced, though it is likely to be set for hearing in the House Business & Labor Committee for Thursday Jan 16. This bill addresses the WC Court decision in Raniey v National Union Fire Insurance. In that decision, the judge found that the law required the 14 day notice to injured workers even after their physician has fully and finally released them to full duty. MSIA supports this bill.

Here are some dates to keep in mind - -

  • 2/22 Last Day to Introduce General (as opposed to revenue/appropriations) bills
  • 3/4    Transmittal Day for General Bills – bills have to be through originating Chamber (or else they are ‘dead’)
  • 3/26 Last Day to Introduce Revenue/Appropriations Bills
  • 4/11 Transmittal Day for Amendments to General Bills (changes to original language from the bill as it left the original Chamber)
  • 4/23 Transmittal Day for Revenue/Appropriation Amendments
  • 4/30 Scheduled Legislative Day 90 – Last day

 

Bills that are ‘dead’ are never actually dead, dead until the legislature goes home. Rules are rules, until the legislature needs to change them. So the above dates are somewhat hard, and somewhat malleable. For example, a legislator can add a $100 appropriation to study the issue they are proposing in a general bill and it is now an appropriation bill. 

Medicaid will be one of the topics that remove the oxygen in the chambers of the Capitol this year. Montana first passed Medicaid Expansion under Obamacare in 2015. We renewed it in 2019, adding some work requirements, and at the last moment, added a 6-year sunset – June 30, 2025.

Leadership in both House and Senate are strongly opposed to it – based on conservative ideology. Both the Speaker and Senate President admit their caucuses are split on the issue. What we do not know at this point, is what price leadership and the conservatives will extract to have the bills progress, let alone pass, should that happen. Medicaid will likely have an impact on behavioral health, hospital regulation and who knows what else. One way or another if leadership cannot kill Medicaid Expansion, there will be a cost, and it is likely to be steep.

I bring it up because many of majority party legislators we routinely work with are part of the “Solutions Caucus” (see below) and are in favor of the extension. When they start that process, what other bills, proposals or committee assignments might be impacted? We just don’t know.

Intrigue # 3 – this is the big one.

Speaking of potentially steep political costs – the Senate majority had adopted preliminary rules before the session started, that failed on Monday Jan 6 – the first day of session. The caucuses get together before the session and select leaders and agree to preliminary rules. Those decisions are typically ratified the first day os session. Not so this year.

You need some background here to appreciate the full story – both Speaker Brandon Ler (R-Savage) and Senate President Matt Regier (R-Kalispell) had to defeat primary opponents supported by Governor Gianforte (R), to get re-elected. As a way to say ‘we noticed’ (maybe) the Senate in their preliminary rules created a new Executive Branch Review Committee, which ostensibly would review the Governor’s Appointments (as well as require the Governor to re-submit the holdover leaders) and other Executive Branch stuff (it was never made clear what else) before making a recommendation to the full Senate for approval/rejection. To my knowledge there has never been such a Committee before.

On the opening day of the session, Senator Jason Ellsworth (R-Hamilton), last sessions’ Senate President and this sessions’ loser of that post to Regier (last sessions’ House Speaker – this is his first session in the Senate), made a motion to adopt different rules. Ellsworth worked with the Dem minority and his proposal passed 27-23. Among other things the new rules reduced the the Executive Branch Review Committee from a Standing Committee to an on-call committee and reassigned the members to other committees. The impact was strengthening the Dems counts on those other Committees and adding more moderate R’s to some of the Committees.

As a result, most work in the Senate stopped because leadership lost the vote on the rules. There were few, if any, Committee hearings and the Senate has been grappling with this since then. As of late this afternoon, and expected into next week, the issues remained unresolved, and I don’t know of any Senate Committee actions or hearings scheduled yet for next week. Certainly there is nothing scheduled for what we care about..

The “Solutions Caucus” – generally moderate Republicans - has enough members in both Chambers to affect what they think they need to affect, if the Dems work with them. Importantly for us, both House Appropriations Chair Llew Jones (R-Conrad) and House Bus & Labor Committee Chair Ed Buttrey (R-GTF) are considered members of the Solutions Caucus.  

What’s next? Stay tuned – I don’t know but we will provide another UPDATE next week.

Welcome New MSIA Member - Collage Rehabilitation Partners/Learning Services

Since 1984, Collage Rehabilitation Partners has provided comprehensive post-acute rehabilitation and supported living in residential and non-residential settings. These settings differ in size, intensity and staffing, based upon the specific needs of the individuals we serve. Our treatment teams have years of experience and are dedicated to providing specialized treatment that will result in positive outcomes. Appropriate post-acute rehabilitation requires resources that offer expert treatment, regardless of where the services are located. Our specialized programs allow regional access and a transition closer to home when goals are met. Understandably, some people are reluctant to travel from home to receive care, but for our patients, the opportunity to participate in a premier program is a short-term sacrifice for a long-term, successful outcome.

Return to work is a common goal among the people we serve and our teams embrace this challenge. Once a client is ready to begin the process of community re-entry, vocational planning becomes critical.  Return to work is complex and success is correlated with a number of things including severity of injury, pre-injury employment type, age of worker, behavioral and cognitive barriers, family and community support, and available employment opportunities.  Successful return to work relies on an individual’s ability to utilize strategies, work independently, follow nonverbal cues, as well as, motor control and ambulation, and self-awareness related to deficits, abilities, job selection and performance.  It also relies on the availability of a rehabilitation team with expertise in return to work for individuals with brain injury. For more information, contact Katie Geiger at 719-291-1500 or Katie.geiger@learningservices.com.

See you next week!