Montana behavioral health commission discusses ideas to address service backlogs

Behavioral Health System for Future Generations Commission
Behavioral Health System for Future Generations Commission
Posted at 6:16 PM, Oct 13, 2023

MISSOULA — A state commission tasked with planning for the future of Montana’s behavioral health system is moving forward with some early proposals, aimed at addressing service backlogs.

The Behavioral Health System for Future Generations Commission held a meeting Friday in Missoula, at the University of Montana. There, they laid out two initial ideas for “near-term initiatives” that they believe could have a quick impact on behavioral health services.

“I'm really excited that we're finally at the point where we can put some money and some initiatives into the communities, where there is such a lack,” said Rep. Bob Keenan, R-Bigfork, who chairs the commission.

The first proposal would direct up to $10 million, to provide one-time grants to help stabilize or expand residential care facilities that serve adults with mental health needs, children with severe emotional disturbances and people with developmental disabilities. The money would cover some of the costs to repair existing facilities, open or reopen new ones or train new staff.

Leaders said, because of the state’s increase in Medicaid provider rate, they’re expecting increases in available staffing and services. However, they said providers will also face upfront costs as they try to expand services, and these grants could help them get over that initial hurdle.

“We need skin in the game as well, and so I greatly respect the fact that that is not a full payment – not completely put upon the taxpayers to pull that together,” said Patrick Maddison, CEO of Flathead Industries, which operates residential services for people with developmental disabilities. “It does give us capacity and additional capital to complete those projects or to initiate those projects.”

The second proposal would provide up to $7.5 million over two years, to allow local governments to contract with providers in their communities to perform forensic fitness evaluations – court-ordered mental health evaluations on people accused of committing a crime and who may not be fit to stand trial. Leaders said, currently, those evaluations generally have to be done at the Montana State Hospital’s Forensic Mental Health Facility in Galen. That – along with a rising number of people undergoing treatment at the Galen facility to be restored to fitness for trial – has led to a significant backlog. As of this week, leaders reported more than 60 people were waiting for admittance to the facility.

These proposals are still in their early stages. Keenan said they will present them to legislative interim committees in the coming months and continue to take feedback.

“This is not the final step with this initiative,” he said. “It’s not something that will be implemented right away.”

Behavioral Health System for Future Generations Commission

The commission is tasked with putting together a report to the governor next year, with recommendations on how to spend $300 million the Legislature set aside this year for investing in the behavioral health system. Charlie Brereton, director of the Montana Department of Public Health and Human Services, said they also plan to keep looking for near-term ideas, as they study specific aspects of the system.

“They reflect commonsense, actionable ideas to address largely known, worsening problems throughout Montana's BH and DD systems,” he said.

Also during Friday’s meeting, the commission held a series of panel discussions focusing on the state’s crisis system.

Scott Molloy, program director with the Montana Healthcare Foundation, said there’s already been a significant change in attitudes around these issues over the last few years.

“Behavioral health is now seen as everyone’s business,” he said.

Stakeholders talked about a model called “Crisis Now,” which sets out three key needs for people going through a mental health crisis – someone to call, someone to respond and somewhere to go.

“Someone to call” includes the 988 suicide prevention and mental health crisis lifeline, now in its second full year of operation. “Someone to respond” can include mobile crisis units to deescalate situations, and “somewhere to go” highlights the ongoing need for space where people can receive longer-term stabilization care.

Commission leaders said it’s important for them to get out and around the state to hear from all corners of Montana. Their next meeting is scheduled for Dec. 1 in Kalispell.