Montana’s June 2 primary election is less than a month off, and candidates are busy carving out positions, and campaigning as best they can during the COVID-19 pandemic.
Some of them participated in last Thursday's online forum discussing what health care providers say is the state’s rapidly deteriorating behavioral health system.
Montana’s mental health and substance abuse treatment providers were weakened by state budget cuts in 2017 and 2018, when state revenue fell short of projections. Providers now say the novel coronavirus pandemic is undercutting them even more in lost revenue, and interrupting their delivery of care.
The Behavioral Health Alliance of Montana, which represents about 30 addiction and mental health care providers, says group homes have seen a 100% increase in costs. They also say calls to crisis lines have doubled during the pandemic and the system’s remaining case managers are stretched to the limit
The Alliance’s online candidate forum was structured as an educational event, not a debate. However, Democratic gubernatorial candidate Whitney Williams pointed to Gov. Steve Bullock’s administration for the current state of Montana's behavioral health services. Mike Cooney, Bullock’s lieutenant governor, is Whitney’s opponent in next month's Democratic primary.
"And in 2017, my opponent Mike Cooney’s administration, and the Legislature, cut $150 million from these two years for health programs that really do help Montanans," she said.
Cooney was not online to respond. The Alliance says he originally agreed to participate in the forum, but withdrew earlier in the week saying his schedule had changed. The campaign vowed to respond to the Alliance’s questions at a later date. Cooney’s running mate, Casey Schreiner, was also unable to attend.
Republican gubernatorial candidate Rep. Grep Gianforte also did not attend the forum. His running mate, Kristen Juras, took his place. Juras said Gianforte generally supports the concept of bringing Certified Community Behavioral Health Centers to Montana.
These Centers are emerging Medicaid providers offering a range of mental health and substance use disorder services. Juras added that Gianforte likes the idea, but does not think they’re a one-size-fits-all solution.
"We would absolutely support it in those communities where it is a good fit," Juras said. "But we also need to figure out how to bring behavioral health access and services to our rural communities, and they may not have the resources to staff one of these comprehensive centers."
Juras also said Gianforte, if elected, would immediately replace state health department director Sheila Hogan.
Montana Attorney General Tim Fox, who is also seeking the Republican gubernatorial nomination, recently released a list of mental health policy goals. Fox stated there must be a comprehensive and coordinated approach to behavioral health care in Montana.
"And we want to keep the kids in their homes in particular, and in their communities, in order to avoid the need for inpatient and residential treatment," Fox said. "We know that this can lower the cost. We know that this, again, will bring better healthcare outcomes. This certainly would decrease in-patient psychiatric stays, ER visits."
State Sen. Al Olszewski, a third candidate in the GOP primary, predicts a tempestuous 2021 legislative session. He did vow that, if elected, he would increase funding for mental healthcare providers.
"Coming into 2021 — our Legislature — we’re gonna hit a fiscal crisis that’s going to make 2017 look like child’s play," he said. "And I am not afraid to enter into the conversation about opening up our coal trust and using the body for this rainy-day crisis. We will not ration the money to you as providers because quite honestly, you have no reserves."
In March, lawmakers sitting on the state’s appropriations committees said Montana was flush with cash reserves heading into the COVID-19 pandemic. They did not expect troubled finances to cause a special session before their regular meeting in 2021.
All of the candidates attending Thursday's forum touted the potential benefits of telemedicine providing mental health and substance abuse treatment care. Primary candidates running for attorney general and state auditor also attended the forum.