State commission to reform Montana's mental health system launches

A new state commission dedicated to rebuilding Montana’s mental health system met for the first time last week.

“This is such a huge and complex problem. We really want to narrow it down to the most pressing needs that we have at this point in time,” said Rep. Bob Keenan, R-Bigfork, who is one of two Flathead Valley legislators on the board, after the group’s inaugural meeting July 20.

Keenan is chair of the commission, spearheading the effort at the request of Gov. Greg Gianforte. This past session, he carried the commission’s parent legislation, House Bill 872, which provides $300 million in funding for a revamped state behavioral health system. There is roughly $70 million available to spend in the biennium.

The group is tasked with developing a report with recommendations to give to Gianforte by July 2024. According to Keenan, the commission is representative of every branch of government. Five legislators and three governor-appointed members make up the body, which is staffed by the state Department of Public Health and Human Services.

There are two Democrats serving on the commission, one of whom is Rep. Dave Fern, D-Whitefish. Fern said the group’s top task is developing a diagnosis and treatment plan.

“How we are going to spend the money is almost a secondary thing at this point,” Fern said. “Right now we are looking at what the major problems facing Montanans are.”

During last week’s meeting, the committee identified seven priorities for consideration. They range from the lack of a comprehensive statewide crisis system to lack of rural care to the capacity of the mental health system for children.

“Capacity was the big word of the day,” Keenan said of the meeting.

Montana’s mental health system is broken, Keenan said. Repairing it will take multiple years, he estimated.

From high suicide rates to a rise in homelessness and substance use disorders, there are a lot of facets of mental health commission members expect to study. The group is also slated to focus on reforming the Montana State Hospital in Warm Springs.

“We have to think about long term sustainability, considering what the future will look like,” Fern said.

Keenan has spent the past few months preparing for the commission, he said. His advance work has included talking to county commissioners, health care providers, court officials and police departments as well as looking at other states’ programs. It's important to understand what the system needs, Keenan said.

“Right now we are trying to set general priorities and then we can develop strategies for those priorities,” Keenan said.

Keenan and Fern both said that the Legislature bolstered the group’s early efforts this past season by approving the use of roughly $330 million in state and federal funds to support Medicaid rate increases to reimburse health care providers. Medicaid providers historically have been underfunded in the state. Given an already small and struggling workforce, they hope increasing provider rates will alleviate some of that stress.

“Thankfully, that sets some foundation for the work we have to do,” Fern said.

Even if the state creates excellent programs, Keenan said, those initiatives will fall flat without a proper workforce. Fern pointed to the shrinking pool of mental health facilities, particularly in the Flathead and surrounding counties. Lake House, a Western Montana Mental Health Center crisis facility in Polson, closed in late winter owing in part to staffing shortages.

“Representing the Flathead, I know that we have some pretty drastic situations and impacts on facilities or operations we've shuttered over the years,” Fern said. “I’d like to see more services for our area.”

The commission will meet roughly every six weeks with another meeting scheduled for September. The group’s inaugural gathering lasted about six hours.

Between now and the next get-together, members plan to speak with stakeholders in an effort to understand their needs. They are accepting comments from interested parties — patients, families, advocates and providers — until Aug. 11.

“I am absolutely convinced that we are going to have a good result,” Keenan said.

Reporter Kate Heston can be reached at kheston@dailyinterlake.com or 758-4459.