The Bullock administration Monday announced its plan to double the number of Montanans receiving community-based mental health care treatment over the next five years .
Some mental health care providers in the state are still stinging from nearly 3 year old state budget cuts.
Montana’s substance abuse and mental health care providers felt it when budget cuts landed on the state health department back in late 2017. Lawmakers carved almost $50 million from the agency to help balance the state budget.
The Montana Behavioral Health Alliance says upwards of 100 patient case managers lost their jobs or left through attrition. Involuntary commitment rates spiked, and law enforcement was frequently left to pick up the pieces.
Montana’s remaining behavioral health care providers rallied for more community-based services. Community-based mental health care services can include supported housing with full or partial supervision, local primary care medical services, day centers or self-help groups.
Montana’s Medicaid Director, Marie Matthews, says the Bullock administration hears those concerns and is working on a plan to do just that.
"Just like any health care condition, mental or physical, we know that individuals will be healthier, will live happier, will stay connected with their family, with their community – the things that impact health in the long term - better if they can get services in their local area."
Matthews says the state is making plans to invest $16 million of combined state and federal money annually over the next five years. That $80 million total will double capacity in existing community-based mental health treatment programs, she says. The plan is contingent on approval from the federal Centers for Medicare and Medicaid Services, or "CMS."
"We’re taking some of the unspent dollars from other areas of the Medicaid program – unspent general fund – and then we’re going to ask CMS to match those dollars to double the size of this program over the next five years."
Under an existing Medicaid waiver benefit option, the funding would double the number of adult patients over the age of 18 who could be treated each year from 357 to 750, by 2025.
State Sen. Diane Sands is vice chair of the Legislature’s joint Interim Committee on Children, Families, Health, and Human Services. The Missoula Democrat says using these dollars to provide community-based mental health care services is, “By far the most fiscally conservative and responsible way to meet this fundamental human need of mental health care."
"Right now we are spending enormous amounts of money dealing with either people not getting their needs met, or inappropriately met; such as within our corrections budget. We spend an enormous amount of money putting people into our state correctional facilities who fundamentally have a mental health problem. That’s not a smart way to spend our money," Sands says.
Republican State Sen. Al Olszewski, who’s campaigning for his party’s gubernatorial nomination agrees. Olszewski is an orthopedic surgeon from Kalispell
"My hope and prayer is as we do this we continue the collaboration between medical care, especially at the level of primary care, and mental health services. My job will be to make sure that we don’t create a new silo of care that doesn’t communicate across the state of Montana."
The state health department proposal also includes increased Medicaid rates for certain community-based group homes serving the mentally ill, personal assistance rate increases and recovery-based service options.
State Medicaid Director Marie Matthews says the Bullock Administration is confident the proposal will be approved.
"These programs exist across the nation, and have for decades. This is a program that Medicaid, both on a state and federal level, support. Additionally, it’s really important to us that people are aware of the program and participate in the public comment process if they want to."
A 30-day public comment period on the waiver option is now open.