MontanaSB 51669th Legislature, Regular Session (2025)SenateWALLET

Update licensing requirements for facilities licensed by the department of public health and human services

Sponsored By: Mike Yakawich (Republican)

Became Law

Health Care ServicesHealth

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Bill Overview

Analyzed Economic Effects

6 provisions identified: 3 benefits, 0 costs, 3 mixed.

Medicaid may cover planned home births

Montana Medicaid may cover planned home births for low‑risk pregnancies. The birth must be attended by a licensed certified nurse‑midwife or a licensed direct‑entry midwife. Coverage includes prenatal and postpartum care. Low‑risk status follows standards set by the licensing board.

Stronger licensing and definitions for health facilities

Operating a health care facility requires a state license that lasts 1 to 3 years and must be displayed. The department inspects new facilities within 45 days of application and readiness, and makes unannounced inspections before renewals. It can issue a provisional license for up to 1 year for specific reasons, including noncompliance after inspection, no patients to survey, pending accreditation, or extra review time. The law updates which places count as health care facilities, including hospitals, critical access hospitals, hospices, dialysis centers, outpatient surgery and primary care centers, rehab and long‑term care, adult day‑care, public health centers, and related medical offices. Home health agency standards must match federal law. The law defines substance use disorder facilities. It also clarifies what is an abortion clinic and excludes hospitals, critical access hospitals, rural emergency hospitals, outpatient surgical centers, and providers giving abortion‑inducing drugs to fewer than five patients a year.

Rural emergency hospitals recognized statewide

The law defines rural emergency hospitals using federal law and lets the state designate them. Health insurance rules now treat these hospitals as covered facilities. The trauma system also recognizes them through updated facility definitions. This helps rural communities keep access to recognized emergency care sites.

New rules for assisted living and foster care

The law sets clear admission and stay rules for assisted living categories A–D. Category A cannot include people who need restraints, locked care, stage 3 or 4 pressure ulcers, G- or J-tubes, or ongoing skilled nursing beyond medicine. Category B allows limited skilled care and needs a practitioner’s written order and a health check every quarter with a practitioner visit that quarter. Category C is for severe cognitive impairment without danger to self or others. Category D is for people who need help with two or more daily activities or are a danger, and it requires a monthly health check and a detailed written order on behaviors, when short-term restraint is allowed, the care plan, and time limits. Some court-ordered individuals cannot be placed in Category D. The department creates placement rules, appeals, and training; standard forms are available but voluntary. The law also defines “light personal care” in adult foster care as help with bathing, dressing, and hair grooming and supervising, but not giving, prescription medicines.

Tighter oversight of disability community homes

Community homes for people with developmental disabilities must be licensed and inspected every year. The department may issue one 60‑day temporary license if there are unavoidable delays and can reduce or make a license provisional if abuse is substantiated or standards are not met. Licenses cannot be sold or transferred and must be displayed. The department sets health, safety, and operating standards by rule. Homes now generally serve two to six people. Homes normally may not exceed eight people, but the department can approve up to 12 in writing and can waive limits for homes licensed before this law.

Child care emergency meds and licensing

In a child-care emergency, staff may give medicine with a medical professional’s written OK, or with verbal direction from a practitioner, emergency responder, or 9‑1‑1—if the child is taken for follow-up care. Non-emergency doses need written permission that names the child, shows dates and dosage, and is signed by a parent or guardian. Giving medicine the wrong way is barred. Staff who follow these rules cannot be prosecuted for injury. The department can now grant a provisional child-care license for up to one year, but only if the provider is working toward meeting standards.

Sponsors & Cosponsors

Sponsor

Mike Yakawich
Republican • Senate

Cosponsors

Josh Kassmier
Republican • Senate
Valerie Moore
Republican • House

Roll Call Votes

All Roll Calls

Yes: 295 • No: 1

Senate vote • 4/11/2025

Do Concur

Yes: 99 • No: 0