Montana commission recommends $30M+ in ARPA spending for health care initiatives

Montana State Capitol
Posted at 7:39 PM, Sep 09, 2022

HELENA — A state advisory committee has finalized its recommendations on how to spend more than $30 million in federal American Rescue Plan Act funding for health care initiatives.

At a meeting Friday, the ARPA Health Advisory Commission backed six proposals from the Montana Department of Public Health and Human Services. DPHHS director Charlie Brereton said their focus was on “one-time-only” funding opportunities.

One of the biggest planned expenditures would be $15.5 million to support the state and local public health workforce and data systems. That includes money to continue county and tribal public health positions created through ARPA funding that was set to expire next June – eight epidemiologists and about 13 disease intervention specialists, public health nurses and other positions. The funding will now extend them through November 2027.

The Association of Montana Public Health Officials supported the proposal, saying public health departments have struggled with workforce capacity, and the addition of ARPA funding had helped them rebuild that.

Some Republican lawmakers on the commission opposed the plan, saying they were concerned it was essentially creating permanent positions that the state might eventually have to pay for.

“This was the whole narrative the whole time that the Legislature was worried about, planting a seed we’re going to have to water later on,” said Rep. Matt Regier, R-Kalispell.

Brereton said DPHHS has made clear to local governments that this funding is for a limited time, but the federal government may well provide continued funding in the future.

“There would be no expectation, certainly under my leadership here at DPHHS, that the state would put forth general fund dollars to continue these positions,” he said.

The commission also voted to authorize another $14.4 million to a program that provides COVID-19 testing resources for schools and child care facilities so that they can remain open for in-person services.

Last year, the commission made about $18 million available for this initiative. So far, schools have only used about $5.2 million of that.

Brereton said federal rules heavily limited what other options they had for spending this money. He said the CDC allowed it to be expanded to child care after it was initially open only to K-12 schools, but they rejected several other requests for more flexibility. He said DPHHS wanted to be ready to spend the full amount available in case of an unexpected need.

In one case, leaders were able to redirect unused funds. The commission approved shifting $2.5 million to provide one-time $1,250 payments to support about 2,000 children in temporary foster care placements. Leaders said people caring for children involved with the Child and Family Services Division have been hit particularly hard by inflation.

The money had originally been set aside for families that receive Supplemental Nutrition Assistance Program benefits, to encourage individuals to get new or improved employment. DPHHS distributed just under $129,000 to 186 families through that program. Brereton said they had exhausted their efforts to connect eligible households with the benefit, including contacting all SNAP recipients and following up directly with those who appeared to qualify.

Rep. Mary Caferro, D-Helena, said she was grateful for the foster care assistance proposal, and she hoped the state would continue looking at the possibility of raising foster care payments.

“It’s hard to put a dollar amount on the value of investing in children who have been abused or neglected,” she said.

Other recommendations the commission endorsed Friday include:

  • $1.2 million for the State Public Health Laboratory to upgrade its equipment for testing for COVID and other diseases, and to conduct wastewater testing to monitor disease trends.
  • $866,000 to support Montana Area Agencies on Aging, create a strategic plan for senior centers and train health insurance counselors to work with Native Americans.
  • $121,000 to support the workforce at Montana’s four Centers for Independent Living, which serve people with disabilities.

As with all ARPA advisory commission recommendations, Gov. Greg Gianforte must give final approval before the money is officially allocated.