May 19, 2024

Montana Commission on Behavioral Health System to Begin Work

HELENA – During the 2023 session of the Montana Legislature, lawmakers agreed to set aside $300 million over the next few years, to invest in a “behavioral health system for future generations.” This week, the commission set up to make recommendations on how to invest that money is set for its first meeting.

Rep. Bob Keenan, R-Bigfork, sponsored House Bill 872, which established a new state account that can be used to fund state and community programs for people with behavioral health needs or developmental disabilities.

“Redoing the development and behavior system is a big thing,” he told MTN.

Under HB 872, $225 million will be put into the new account. Permitted uses include studying and planning a comprehensive behavioral health system, planning and operating state care facilities, acquiring or renovating property to establish state facilities, and investing in community-based providers to stabilize, support service delivery increase the workforce and service capacity. Another $75 million will go into the state’s long-range construction fund for future capital projects in the behavioral health system.

“We have a community crisis,” Keenan said. “We’re at the bottom of the cycle right now, where people with mental health issues are dealing with law enforcement, and then the decision is to go to jail or go to the hospital. That is not a system. That is not enough community support. Families – when they have a crisis, they don’t know who to call.”

The bill also established a commission that will make recommendations on how to invest the money. On Monday, the members of that commission were officially announced.

HB 872 gave Keenan’s presence on the commission and the authority to select five other legislators in consultation with House and Senate leadership. The other legislative members are Rep. Michele Binkley, R-Hamilton; Rep. Dave Fern, D-Whitefish; Rep. Mike Yakawich, R-Billings; Sen. Ellie Boldman, D-Missoula; and Sen. John Esp, R-Big Timber.

The other three members were appointed by Gov. Greg Gianforte. They are Charlie Brereton, director of the Montana Department of Public Health and Human Services; Patrick Maddison, CEO of Flathead Industries, which provides services to adults with developmental disabilities; and Janet Lindow, executive director and co-founder of the Institute for Rural Behavioral Health, which advocates for youth mental health services in rural areas.

“After decades of previous administrations applying Band-Aids and kicking the can down the road, we are making a generational investment in our behavioral health and developmental disabilities service delivery systems,” Gianforte said in a statement. “In addition, we will expand intensive community-based services so Montanans have access to the care they deserve. We will also improve the quality of services at the state hospital in Warm Springs and other state-run health care facilities, to better ensure the safety of patients and providers.”

The Commission is scheduled to hold its first meeting on Thursday. Keenan said they will likely have two more meetings by mid-September. Their report outlining the initial recommendations is due 1 July 2024.

Although HB 872 allocated $225 million to the behavioral health fund, it only appropriated $70 million of that for spending over the next two years. Keenan said it will likely be a six- to eight-year project to really build the system’s capacity, but it’s important for the commission to take good steps now.

“We’re going to be trying to eat an elephant, and it’s really going to be one bite at a time,” he said.

As the commission begins its work, Keenan says they’re hoping for strong public input to help them identify where they want to search.

“We need to know the gaps,” he said. “Primarily, I think, where we need to start is to start thinking at the family level – start right in that basic institution within our communities. Families – what do they face if they have a developmental disability or mental health crisis? Who do they call? What do they do? Where are they looking for help?”

During debates at the Legislature, some lawmakers raised concerns about HB 872 laying out broad outlines with very little detail – especially because of the huge amount of money involved. Keenan said he understands the questions, but they felt it was important to give the commission the freedom to chart the best way forward.

“I know that I have some things to do for both sides: with the people who supported him – and I understand that – and also to create up for those who don’t think this can be achieved,” he said .

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