Montana Democrats are proposing an immediate $20 million injection into the state’s behavioral health system, saying the system is on the verge of collapse.
House Bill 248, borne by Rep. Ed Stafman of Bozeman, would use a portion of the $2.7 billion state surplus to increase the reimbursement rate for Medicaid-funded behavioral health services in fiscal 2023.
The proposed amount was generated from data collected for a provider rate study to estimate the discrepancies between actual costs of care and the current Medicaid reimbursement rate.
The study’s findings, released in June 2022, showed that a number of tens of millions of dollars in services are underfunded and require significant government investment to continue.
As lawmakers debate how much to increase Medicaid reimbursement rates for providers in this session, the rate study will serve as a guidance document providing recommended rates for lawmakers who support or oppose rate adjustments.
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Stafman said the bill would fully fund adult and child mental health services at the recommended rate published in the Montana Provider Rate Study. Anything else could worsen access to mental health services.
The combination of the 2017 budget cuts and the COVID-19 pandemic, which has resulted in historic staffing shortages, has resulted in a significant decline in behavioral health services in recent years.
Although there are empty psychiatric beds in Montana, facilities are struggling to find adequate staff and are therefore unable to offer these beds to people in need.
“I suspect we’ve lost about half of our psychiatric beds in the last few years,” Stafman said.
Tom Livers of Shodair Children’s Hospital supported the bill, saying the hospital system has closed two small therapeutic group homes that serve younger children.
“The mental health system faces a major challenge. We are operating at a level that is unsustainable in the long term,” said Livers.
Representatives from the Montana Medical Association, the National Alliance on Mental Illness Montana Chapter and the Benefis Health System also supported the bill.
Although there were no opponents of the bill, several lawmakers expressed concerns about providing such a large dollar amount when the federal government could provide equivalent value from federal funds.
It can be difficult to know exactly what the national game will entail, Stafman said, but the system needs a significant increase in funding as soon as possible.
It is built into the bill that once the additional payments are signed for by the governor, they would be distributed immediately.
“This is a desperate situation that needs funding now. It can’t wait for the next budget,” Stafman said.