MISSOULA — As the changes made by the Montana Legislature to Medicaid rates and reimbursements settle in, Missoula County may direct $1 million in funding from the American Rescue Plan Act to help Western Montana Mental Health shore up its budget.
Commissioners on Tuesday met with members of Western Montana Mental Health, which described its current financial situation as facing a blinding blizzard. Solving it will take collaboration, said Colleen Ruidio, the organization's interim CEO.
“This challenge that any organization, especially one of our size, has must be solved through collaboration,” said Ruidio. “It also has to be solved by us becoming extremely efficient in providing the services that we provide in a very specific way, as well as making sure we have secondary funding and additional funding available for our organization.”
Western Montana Mental Health recently opened a crisis receiving center in Missoula to provide acute care. It would like to open a similar center in Kalispell, saying its services are in need across all of western Montana.
Funding provided by Missoula County would provide a “ripple effect” up the organization, officials said. The county was awarded funding through the American Rescue Plan Act, which it can apply toward a number of services, including mental health.
“Throughout the course of the pandemic and the last legislative session, Medicaid rates and other contracts haven't kept up with the actual cost of services,” said county CAO Chris Lounsbury. “That has left a deficit, not only in the level of services we can provide, but it has left some real challenges for our largest providers here in Missoula County.”
Lounsbury said the county had earmarked a portion of its ARAP funding to create a revolving loan fund in its mental health budget in fiscal years 2025 and 2026. But it may move that up to 2024 if it can navigate a number of challenges.
Service providers like Western Montana Mental Health could tap into the fund until Medicaid reimbursement and other funding sources come it. They'd then repay the fund.
“We've been exploring the idea of providing revolving loan services that providers can tap into to carry them through as they get through this process that, as Medicaid reimbursement rates come online, they can use to back-fill the funds,” Lounsbury said. “But it creates a little challenge because we're having to create a program from whole cloth just around the guidance of the federal government without guidance from the state on what these programs would look like.”
The Legislature this year voted to fully fund Medicaid reimbursement rates after service providers painted a bleak picture of their organizations' future. A number of nursing homes had closed at the time, along with group homes, and behavioral health services were in short supply.
Service providers blamed inadequate Medicaid reimbursement rates as a primary cause. The eventual bill, signed by Gov. Greg Gianforte, increased state and federal funds by roughly $339 million over the next two fiscal years.
Ruidio described the increase on Tuesday as “long overdue.” But sticking with the weather analogy, she said they're not yet out of the storm.
“That's wonderful, but there's still a gap between when those funds are available and the operating expenses and requirements and obligations of the organization, especially as we see service requirements increasing,” said Ruidio. “We have good things happening on one side with rate increases, the Behavioral Health Alliance and collaborations. But flip the page and we also have those other things on a day-to-day basis to make sure those who need the services have those services available to them.”
Along with the increased rates and the potential support from Missoula County, Western Montana Mental Health is also searching for other funding sources. Among them, it said it plans to sell a number of properties to generate revenue.
“The availability of these (county) funds will help us have a runway to where we need to get by the end of the fiscal year,” said Doug Melton, the organization's chief financial officer. “We've got some properties listed for sale that have buy-sells on them. We just need to get from here to there and straighten this out.”
