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Montana Legislature overrides vetoes of two bills making changes at State Hospital

The Montana State Hospital is about to see changes after the Montana Legislature’s override of vetoes on two bills.  (Courtesy of Keith Schubert)
By Blair Miller Daily Montanan

The Montana Legislature successfully overrode two more of Gov. Greg Gianforte’s vetoes, according to polling results released Thursday evening, both on broadly supported bills that make changes at the Montana State Hospital.

The legislature overrode vetoes of House Bill 29, sponsored by Rep. Jennifer Carlson, R-Manhattan, and Senate Bill 4, sponsored by Sen. Jen Gross, D-Billings, which Gianforte issued amendatory vetoes for just ahead of the full body adjourning on May 2, then vetoed outright since lawmakers did not have time to consider the amendments.

The overrides of both vetoes mean three of eight vetoes that have been mailed out to lawmakers for poll overrides and returned to the Secretary of State’s Office have succeeded. Just one of the vetoes Gianforte issued in the 2021 session was overridden, and the Legislature was still in session. Prior to that, no vetoes had been overridden in 18 years, the Helena Independent Record reported.

Lawmakers also successfully overrode the governor’s veto of House Bill 693, a right-to-know bill, earlier this month. There are still 11 other bills and 11 line-item veto poll overrides out for consideration by lawmakers. Each chamber can override a veto if two-thirds of the members vote in favor of the override.

Both of the new overrides involve changes at the state hospital in Warm Springs, which lawmakers and the Gianforte administration each advocated for this session after the Centers for Medicare and Medicaid Services revoked its certification last year.

“After decades of past administrations kicking the can down the road at MSH, we must improve conditions and services at MSH and protect vulnerable patients from abuse and neglect,” the governor wrote in his amendatory veto of SB 4. “This legislative session, I’m proud to have worked alongside you to propose and support investments that will do just that.”

HB 29 would stop the state from involuntarily committing people with a primary diagnosis of Alzheimer’s disease, dementia or traumatic brain injury to the state hospital unless they have injured themselves or others, or threaten to do so. It builds upon current law regarding discharging a person with those conditions unless certain conditions are met to make the law more stringent.

The bill says it is the Legislature’s intent to both end the involuntary commitment of people with those diagnoses and to develop community services for them. The bill forces the Department of Public Health and Human Services to come up with and implement a plan by June 30, 2025, to be sure people with Alzheimer’s, dementia or TBIs have access to community-based services and assisted living facilities.

That includes establishing a transition committee composed of legislators, governor’s appointees, and health care representatives to monitor the effort. By July 1, 2025, the bill directs the department to transition people with those diagnoses out of the state hospital and into the community facilities.

A fiscal note for the bill said there were generally few skilled nursing facilities willing to take the people with those diagnoses and that DPHHS assumed most of them would be placed into the Mental Health Nursing Care Center in Lewistown. It said the review committee would cost about $40,000 in one-time money.

But Carlson wrote a rebuttal to the fiscal note, saying that some of the assumptions about how long, and how many staff, would be needed to carry out the changes in her bill. She also said the work could be done in two years, not four, and that the assumption that people would be transferred only to the Lewistown facility and the cost be borne by the state was incorrect because federal Medicaid money would cover 65% of the cost of using the community-based services instead.

“No costs should be incurred due to this bill after the effective date when the bill says the work should be done – June 30, 2025. Future commitments to MSH of individuals with Severe Disabling Mental Illness are not affected by this change, except that beds will open up for people who need intensive treatment for mental illness,” Carlson wrote.

Gianforte had said in his amendatory veto letter he appreciated the effort to transfer those patients to “more appropriate” care settlings but said the bill “fails to provide an effective, lawful mechanism to accomplish the intent of the legislation.”

He said the bill was too restrictive and failed to consider other mental health disorders in combination with the ones in the bill and how they could put a person at risk of becoming a danger to themselves or others if they cannot provide for themselves.

“House Bill 29 either represents a deep misunderstanding of or a failure to acknowledge the fundamental concepts underpinning the need for involuntary commitments of individuals suffering from serious mental illness,” Gianforte wrote in the veto letter.

He took further issue with there being a “nonexistent” or “very short supply” of community facilities where the people could go and questioned DPHHS’s authority to transfer patients. He said the committee would duplicate reviews of DPHHS’s transfer efforts by standing and interim legislative committees.

His amendments sought to strike the “unworkable” 2025 timelines for the transition efforts, eliminated the “costly new subcommittee” and took out what he called the “improper focus on ‘primary diagnosis.’”

But since Gianforte called for the amendments on the same day the Senate voted to abruptly adjourn the session, there was no way for lawmakers to consider the amendments and send the bill and SB 4 back to the governor’s desk. He outright vetoed both HB 29 and SB 4 on May 11.

Since both bills passed each chamber with wide bipartisan support – 140 votes for HB 29 and 149 votes for SB 4 – the legislature could consider overriding the outright vetoes.

According to the Secretary of State’s Office, the HB 29 override got 67 votes in the House and 39 in the Senate. The SB 4 override passed with 72 votes in the House and 39 in the Senate.

SB 4 will require the DPHHS director to provide reports of abuse or neglect at the Montana State Hospital to Disability Rights Montana, the federally mandated organization that oversees protections and advocacy for people with disabilities, including in state facilities.

While Gianforte wrote in his amendatory veto letter that he supported the push for more transparency and accountability, the bill was “legally insufficient.” He offered amendments that would require the state hospital, not the DPHHS director, to issue the reports, which he said was already being done in reporting to the Board of Visitors.

“An amendment I offer ensures standardized reporting, which will provide a universal understanding of information, providing clarity to all parties and actionable next steps to support patients,” Gianforte wrote.

Only 28 lawmakers voted against overriding his veto of the measure, though 11 others did not vote.

Another bill of Carlson’s, House Bill 37, which required Child Protective Services to get a warrant before removing children from homes unless it involves an emergency, failed to get the votes necessary for an override. It received 37 votes in the Senate but only 60 of the 67 necessary in the House to override the veto.

This year’s adjournment and the governor’s vetoes have led to some standoffs among lawmakers, several have said, about votes on veto override polls and bills still awaiting the signature of Senate President Jason Ellsworth, R-Hamilton, before they are sent to Gianforte’s desk.

Those include House Bill 2, the budget bill that contains Medicaid provider rate funding that could help some of the community facilities in HB 29 pay for their costs of care. Other bills and line-item vetoes still out for override polling must be returned between Tuesday and June 29, depending on when they were sent out.

Daily Montanan is part of States Newsroom, a network of news bureaus supported by grants and a coalition of donors as a 501c(3) public charity. Daily Montanan maintains editorial independence.