Montana behavioral health nonprofits largely supported recommendations submitted to the state's Behavioral Health Commission on Tuesday. The commission is advising the governor on how to spend $300 million earmarked to strengthen mental health resources in the state.
Gov. Greg Gianforte has already awarded $7.5 million to providers to conduct court-ordered forensic fitness tests and experts to work with Montanans with intellectual property to address backlogs in the state. Approved some funding allocations, including a $600,000 grant for certification and training. Initiatives for developmental disorders, etc.
The committee met to provide feedback and hear opinions on recommendations provided by the state health department regarding improving the management of behavioral health issues, expanding services, and recruiting and retaining the workforce. The recommendations include expanding access to services for people with developmental disabilities, with a total of 21 proposals proposed.
One outstanding question, however, is how to pay for the long-term costs associated with continuing the proposed program.
Mr. Gianforte signed House Bill 872 into law last year, and three members of Mr. Gianforte's office, including members of both parties, the bill's sponsor, Rep. Bob Keenan, R-Bigfork, and the Department of Public Health and Humanity, signed House Bill 872 into law. Established the “Behavioral Health System Committee for Future Generations,'' which is made up of appointees. Charlie Brereton, Service Director.
Kiernan emphasized the “future generations” part of the committee's name at the beginning of Tuesday's meeting.
“We're not going to settle everything here today,” Keenan said. “But we're going to do everything we can.”
The commission met across the state over several months to hear from nonprofits, advocates and other stakeholders and share its recommendations. The committee, which also included input from the state Department of Health and the consulting firm Guidehouse, drafted a report on alternatives for mental health care outside of state-run facilities.
Behavioral health care is a major concern in Montana as the state hospital loses federal funding, vacancies persist and the demand for care overwhelms the state.
List of recommendations:
developmental disorder
– Adjust and restructure the current 208 blanket waiver service fees
-Expand access to waived services through support for §1915(c) waivers
– Expands service options for people with dual diagnosis by adding a new 208 blanket exemption service called Enhanced Community Living.
– Redefine and reopen evaluation and diagnostic (E&D) clinics to more effectively support families.
– Conduct a detailed investigation of the current DDP waiting list management process
behavioral health
– Strengthen targeted case management (TCM) programs to improve health outcomes for targeted patients.
-Develop training programs for targeted case managers
-Implementation of Care Transition Program
-Strengthen the collaboration and support functions of the 988 call center
-Expansion of Mobile Crisis Response (MCR) to additional areas in Montana
– Introduction of new crisis stabilization and reception center services
– Expand the scope of the Certified Adult Peer Support Program by expanding eligibility and increasing applicable settings.
– Strengthen support for people experiencing homelessness with severe mental illness (SMI) and substance use disorders (SUD)
– 1) Inform Montanans about new behavioral health services and 2) Launch a campaign to increase awareness and reduce stigma around behavioral health.
-Reducing barriers to non-emergency medical transportation (NEMT) care
-Expand Family Peer Support (FPS) programs for parents and caregivers of children with behavioral health problems and developmental disabilities.
-Redesign of fee structure to improve youth residential services in the state
-Invest in school-based behavioral health initiatives
– Encourage healthcare providers to join the behavioral health workforce through tuition reimbursement
– Expand the training content available to behavioral health professionals
-Assess the feasibility of establishing a Montana community health worker (CHW) program
Recommendations for developmental disabilities
There are approximately 2,500 people with developmental disabilities using the exemption system across the state. Lindsey Carter, director of developmental disabilities programs at DPHHS, said reimbursement rates for health care providers who serve people with disabilities are the same regardless of the level of support an individual needs, so more He said health care providers won't get paid more if they have patients who need attention and care. The first recommendation is to base provider fees on an assessment of the needs of individuals with disabilities.
It was also proposed to add an exemption option to maintain independent living arrangements for people who may have family members who need support during respite care.
It will also reopen the Evaluation and Diagnostic (E&D) clinic, which will serve as a “gateway” to services across the state and reduce wait times for initial evaluations, as well as manage the current waiting list of at least 2,100 people across the state. Recommended.
Behavioral health recommendations
Approximately 10% of Montana's Medicaid population has a serious mental illness or substance abuse disorder, and the state is currently implementing targeted case management for 2,000 people, or about 2% of the Medicaid population, according to the announcement. is provided. In addition to creating training programs for eligible case managers, the state hopes to enhance what is already offered and improve provider capacity.
988 and dispatch response
The state is also considering connecting the 988 Suicide and Crisis Lifeline to access for first responders. Previously, only public safety response points (such as 9-1-1 call centers) could dispatch crisis responders, but communication between lifelines and call centers was inconsistent. The state recommends that 988 call centers be connected to mobile crisis response.
But eastern Montana lacks a mobile crisis response team, with six total in the state. Through a “hub-and-spoke model,” DPHHS has a central hub of mental health professionals that connect virtually to spokes such as emergency medical technicians and health care workers in the area who can help people in crisis. It proposes adding crisis responders to more areas of the state.
The department wants to add a new crisis stabilization center that would provide a place for mobile crisis responders to transport people in need of care. Access to stabilization centers is limited in the state, and in rural areas it can take more than four hours to reach the nearest service. The ideal outcome would be less reliance on emergency room services and less need for psychiatric hospitalization, according to the state health department.
peer support
The state already offers a certified adult peer support program that reduces stigma and minimizes the need for emergency treatment, but DPHHS is amending the program to include people with less severe mental illnesses. Trying to.
Support for unhoused people experiencing a mental health crisis
The state also aims to expand services for people experiencing homelessness with mental illness. DPHHS estimates that 2,200 Montanans are experiencing homelessness and approximately 460 are living with a serious mental illness. But the state said existing housing vouchers are difficult to access and are not very popular in the current rental market.
Recommendations include increasing funding for the existing PATH program (Project for Assistance in Transition from Homelessness) and awarding grants to new PATH programs.
The state is also considering increasing the purchasing power of housing vouchers by working with housing authorities to review fair market rents.
DPHHS will also increase access to mental health care for youth and increase the number of students screened for mental health needs at school in hopes of reducing behavioral-related incidents such as bullying. It is working.
Employee recruitment and retention
Strengthening the state's behavioral health workforce is also a top priority for the state, with recommendations including creating incentives for recruitment and retention.
The state proposes developing a tuition reimbursement program as well as expanding training for existing staff to prevent burnout. The state cites mental fatigue as the number one reason for turnover in the field.
How these proposed improvements would be paid for was one of the big questions at the end of the meeting.
The one-time cost will be covered by $300 million, but other funding sources will likely be needed to sustain the program over the long term. The DPHHS presentation suggests Medicaid reimbursement, federal grants, state general funds, and public-private partnerships as potential options.
A number of organizations, including the Montana chapter of the National Alliance on Mental Illness and the Montana State Medical Association, largely supported the commission's efforts and the state's presentation in public comment.
“We're struggling,” said Jamie Palagi, the new CEO of Helena-based Intermountain Health. “We struggle to retain employees, recruit, and continue to provide services, so the recommendations discussed today will help my organization tomorrow.”
The committee will take public comments on its recommendations before drafting its final report, which will be debated on May 20. The state health department will make a final presentation on the adopted recommendation on June 28th.
