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Montana politics, elections and legislative news

In Wake Of Cuts, State Health Department Considering Alternative Case Management System

More than 40 people came to the DPHHS hearing on Medicaid cuts Feb. 1, 2018 in Helena.
Corin Cates-Carney
More than 40 people came to the DPHHS hearing on Medicaid cuts Feb. 1, 2018 in Helena.

When Montana lawmakers and the governorcut $49 million from the state health department earlier this year, it disrupted care for thousands of Montana’s most vulnerable residents. Over 100 case management jobs were cut. Now, the health department is meeting with contractors about the possibility of redesigning the system.

The cuts and restorations to Medicaid rates in Montana during the state’s budgeting issues was not easy on the people who need that care, or the medical community that serves them.  

“The last year for Medicaid has been particularly difficult as we’ve had to decrease rates because of budget reductions,” says Marie Matthews, Montana’s Medicaid director.

Matthews says along with restoring of some of that cut funding, the state is also looking at changing its system for delivering and paying for case management services.

Case management can be used to give individual attention to a person with a chronic disease, substance use disorder, developmental disability, or behavioral health needs.

When Montana’s Medicaid budget was cut last year, many providers stopped or provided less of that care. That’s according to Mary Windecker. She represents more than 30 providers as the executive director of the Behavioral Health Alliance of Montana.

“That left a lot of people who were living in the communities with the help of case management very vulnerable, "Windecker says. "And we saw a huge increase in people seeking help in emergency departments, physician waiting rooms, critical access hospitals, and a 30 percent increase to the Montana State Hospital system.”

Windecker is scheduled to present at the DPHHS meetings later this week about different best practice models for delivering case management. Just under a dozen providers and health care  advocacy groups are also scheduled to present.

State Medicaid Director Marie Matthews says her agency has not committed to making any changes yet to its case management care models, and there’s no specific timeline to do so.

“There have been no decisions made,” she says.

Public comment about possible changes to the state’s case management system will be taken at the end of the second day of meetings, Thursday. The meeting agenda is available here.

Mathews says Governor Steve Bullock’s next two-year budget is set to come out November 15, and that could give a clearer picture on the administration’s larger spending plans and priorities within state health department heading into the 2019 legislative session.

Corin Cates-Carney manages MTPR’s daily and long-term news projects. After spending more than five years living and reporting across Western and Central Montana, he became news director in early 2020.
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