HELENA — A state commission introduced its initial recommendations for investing millions of dollars into Montana’s behavioral health system earlier this year. Now, they’re getting lawmakers’ input before putting the final touches on their report.
The Behavioral Health System for Future Generations Commission has been thinking about and working on ways to strengthen mental health and substance abuse services in Montana for months.
Eventually, though, it will be up to the full Montana Legislature to decide on long-term funding for many of those ideas.
House Bill 872 — the bill that created the commission and set aside $300 million for the behavioral health system — required commission members to present their recommendations to state lawmakers before completing their report to Gov. Greg Gianforte.
On Tuesday, commission members made their case on why these proposals are so important.
“Once we got the bill passed and we sine died in May, I hit the road and started communicating with people,” said Rep. Bob Keenan, R-Bigfork, the commission’s chair. “I was overwhelmed with the hope that families expressed to me.”
The commission presented 22 draft recommendations on Tuesday. They included things like expanding crisis response and stabilization services, updating the state’s targeted case management program, investing in school-based behavioral health programs and adding services to help people leaving state institutions reintegrate in their communities.
Many of the ideas focused on ways to support service providers – restructuring payment models, developing training for their workers and creating education programs to encourage people to join the workforce.
All together, the recommendations would require $113 million from the special account HB 872 created. That money would go toward one-time-only costs and what leaders called “operational” funding for the first few years of a program.
However, most of them would also require ongoing funding — up to $131 million between state and federal funds.
During Tuesday’s meeting, leaders said the next major task will be prioritizing the recommendations. It’s likely only some of them will be proposed for the budget during next year’s legislative session.
“We want to ensure we're good stewards of these funds and leave a healthy balance, to ensure if some projects ultimately cost more than we project or another need arises for these funds that there is funding remaining to be available,” said Gene Hermanson, Medicaid chief financial manager for the Montana Department of Public Health and Human Services.
While the price tags for these investments are significant, commission members said Tuesday that they don’t account for how they could avert the need for spending later on.
For example, Sen. John Esp, R-Big Timber, said providing services for people leaving the State Hospital could help keep them from ending up back in the system.
“Every time you recycle back to the hospital or to Corrections or the jail, it involves much more expensive services and taxpayers pay for it,” he said. “So I think this is an area where we really need to fine-tune it and implement it. If it's done right, it should lead to lower costs and better quality of life.”
Commission members said the impacts are much more than just money.
“It will also save lives,” said Sen. Ellie Boldman, D-Missoula. “This is beyond a dynamic fiscal note. It is the facts.”
Keenan said DPHHS is currently working to rank the recommendations on things like importance, value, ability to implement and whether they are dependent on other proposals.
The commission will focus on prioritization at their next meeting on August 8, and Keenan said they’ll likely have one more meeting to finalize the report before sending it to the governor.
