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Montana lawmakers consider bill to invest $300M in behavioral health system

House Bill 872 Hearing
Posted at 6:44 PM, Mar 29, 2023

HELENA — Montana lawmakers and state agency leaders said Wednesday that they have a unique opportunity this year to invest in Montana’s behavioral health system – and it’s time to take it.

As part of his state budget proposal last year, Gov. Greg Gianforte called for directing $300 million in state funding to behavioral health. Now, lawmakers have introduced House Bill 872, which would create a framework for how that money would be distributed.

“We are here because we are fortunate to have a large surplus and we will be able to solve problems,” said Rep. Bob Keenan, R-Bigfork, who is sponsoring HB 872. “I look at this bill as an opportunity to do great things.”

The House Appropriations Committee held an initial hearing on the bill Wednesday morning.

HB 872’s title establishes its goal as supporting a “behavioral health system for future generations.” It would set aside $225 million in a new state account that would be used to fund state and community-based programs for people with behavioral health needs or developmental disabilities. Another $75 million would go into the state’s long-range building fund for future capital projects in the behavioral health system.

The money in the new state fund could be used for studying and planning a comprehensive behavioral health system, planning and operation of state care facilities, acquiring or renovating property to establish state facilities, and investing in community-based providers to stabilize service delivery, support the workforce and increase service capacity.

“We have to have a partnership of public and private,” said Keenan. “That’s how the system will work.”

HB 872 would establish a commission to make recommendations on how the money should be used. It would include four lawmakers, the director of the Montana Department of Public Health and Human Services and two other members appointed by the governor.

“To be on this committee is going to take a lot of time and a lot of work,” Keenan said. “I think it's going to be worth it. I think that Montana is positioned to really make some tremendous steps forward.”

While the commission would recommend actions, Gianforte would have the final decision on whether to adopt those recommendations.

While HB 872 sets aside $300 million, it only provides the authority to spend $70 million of that over the next two years. The 2025 Legislature will have a chance to weigh in on how the rest of the money should be used.

Keenan and DPHHS director Charlie Brereton told lawmakers the plan is “wide open” at this point, and they will carefully consider all options. However, they said there is no plan to close or privatize the Montana State Hospital at Warm Springs.

“We continue to make historic investments in the existing state-run health care facilities, but we also want to be bold,” Brereton said. “We want to think bigger and broader in this space alongside community-based providers.”

During Wednesday’s hearing, some lawmakers questioned why DPHHS didn’t have more details about how the money could be used – especially about any potential new facilities.

“Did I hear that you guys don't know what you're building?” asked Rep. Jonathan Windy Boy, D-Box Elder.

“Could the department have rushed a plan in a proposal forward and presented it to you all? We absolutely could have,” Brereton said in response. “But we've elected to hit pause, to do this in a thoughtful, data-informed, rational manner, alongside the legislature and providers and stakeholders.”

Some advocates also opposed the form of the commission, saying people who’ve dealt with behavioral health challenges and gone through the current system should be guaranteed a voice.

“Make sure that you're including the people that use the system as you design the system – not just saying, ‘Hey, we're going to hold a listening session,’ but make sure we have that seat at the table, and we're part of the decision-making process,” said Joel Peden, representing independent living centers and Disability Rights Montana.

The House Appropriations Committee took no immediate action on the bill.