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Montana legislator: Surplus could help fix mental health for generations

Montana State Hospital
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HELENA — At a time of crisis for the Montana State Hospital, Montana State Rep. Llew Jones, R-Conrad, proposed using the budget surplus to create a state-funded regional mental health care network for Montana.

The U.S. Centers for Medicare and Medicaid withdrew accreditation from the state hospital earlier this year, which was another funding cut for a facility still strapped from a series of budget cuts in 2017. Leadership shake ups and a chronic hiring problem have caused morale in the hospital to plummet as employees complain about lack of training and support from leadership. The state hospital in Warm Springs is not producing the patient outcomes the state wants, Jones said.

However, data shows patients do better in smaller, regional facilities, Jones said.

"As we look at address the situation in Warm Springs," Jones said. "To take care of those folks who are struggling with mental issues, severely mentally ill, we can potentially use some of this (one time only) dollars to bring this system more regional."

By making a big investment in Montana's mental health network during the upcoming session, Jones said the state would lift the burden of solving this problem for future generations. If done right, Jones said the state might end up spending fewer dollars, resulting in a permanent tax cut in the future, instead of a one-time rebate.

Montana State Rep. Danny Tenenbaum, D-Missoula, sits on the Montana State Legislature's Children, Families, Health and Human Services Interim Committee, which can exert some oversight powers on the Montana Department of Public Health and Human Services and the Montana State Hospital. Jones' idea was long overdue, Tenenbaum said.

“A regional system of smaller care facilities spread across Montana would be a dramatic improvement for people living with mental illnesses," Tenenbaum said. "And also their loved ones, who want the best possible care for them.”

Jesse Mullen, who is running to represent the Montana State senate district that encompasses the state hospital, said he is wary of Jones’ plan because Jones discussed reducing funds to Warm Springs.

“We absolutely need extensive mental health care across Montana," Mullen said. "That doesn’t mean that we have to reduce resources at the state hospital. Now, if he were to say, 'Let’s regionalize the mental health care system while we also buttress Warm Springs,' I would be completely on board with him."

The discussion of what to do with mental health services and the state hospital will require robust discussion during the next session, Jones said. Lawmakers will need to hold multiple hearings in front of committee, look at unintended consequences of the plan and figure out how the Warm Springs facility would fit into the plan, Jones said.

“We certainly won't be able to not have the facility exist in its entirety," Jones said. "But what is the path forward? And if not now, when are we going to address suicide? And when are we going to address these mental health issues?”

State Rep. Ed Stafman chairs the State Legislature's health interim committee. Stafman said he was glad to hear Jones wants to fund better mental health facilities next session, however, from Stafman's perspective the state and the Department of Public Health and Human Services can't wait to give Warm Springs the money it needs to function.

“The department has been very interested in studying Warm Springs and studying rate structures," Stafman said. "But it’s not enough when your house is on fire. We need to take action now and god knows we have the money.”

In July letter to Gov. Greg Gianforte, the interim committee asked the state to raise Medicaid provider reimbursement rates this fiscal year because, according to the letter, "Our mental health system will only continue to deteriorate if providers must wait another year for a significant increase in rates."

Stafman said he would convey the governor’s response to lawmakers at the committee’s final meeting on Aug. 26.