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Montana commission on behavioral health system set to begin its work

Montana State Capitol
Posted at 5:42 PM, Jul 17, 2023

HELENA — During the Montana Legislature’s 2023 session, lawmakers agreed to set aside $300 million over the coming years, to make an investment in a “behavioral health system for future generations.” This week, the commission set up to make recommendations for 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-based programs for people with behavioral health needs or developmental disabilities.

“This remaking of the developmental and behavioral system is a big, big deal,” he told MTN.

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

“We have a community crisis issue,” Keenan said. “We're at the bottom of the of the cycle right now, where people who present with mental health issues are dealing with law enforcement, and then the decision is either go to jail or go to the hospital. That’s not a system. That's not adequate 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 a spot on the commission and authority to pick five other lawmakers in consultation with House and Senate leadership. The other legislative members will be 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.

Gov. Greg Gianforte appointed the other three members. They are Charlie Brereton, director of the Montana Department of Public Health and Human Services; Patrick Maddison, CEO of Flathead Industries, which provides services for adults with developmental disabilities; and Janet Lindow, executive director and co-founder of the Rural Behavioral Health Institute, 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’re making a generational investment in our behavioral health and developmental disabilities service delivery systems,” Gianforte said in a statement. “With it, we’ll expand intensive and community-based services so Montanans have access to the care they deserve. We’ll also improve the quality of services at the state hospital in Warm Springs and other state-run health care facilities, better ensuring the safety of patients and providers.”

The commission is scheduled to hold its first meeting on Thursday. Keenan said they’re likely to have two additional meetings by the middle of September. Their report laying out initial recommendations is due July 1, 2024.

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

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

As the commission begins its work, Keenan says they’re hoping for robust public comment to help them identify the places they need to be looking.

“We need to know the gaps,” he said. “Primarily, I think, where we need to start, is start thinking about the family level – start right in that basic institution within our communities. Families – what are they faced with should they end up with a crisis in developmental disabilities or in mental health? Who do they call? What do they do? Where do they look for help?”

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

“I know that I have some proving up to do to both sides: to the people that supported it – and I appreciate that – and also to prove up to the people that don't think that this can be accomplished,” he said.