November 2024 Update from BHAM - Behavioral Health Alliance of Montana

It’s a significant and noteworthy moment of time here in Montana, with an unprecedented amount of attention on Montana’s behavioral health systems, including the healthcare system at-large. At the end of September, the Behavioral Health System for Future Generations (BHSFG) Commission presented the final report to Governor Gianforte on September 30, 2024, which identified 22 recommendations and 11 Near Term Initiatives to improve the behavioral health and developmental disabilities system in Montana (more about that below). We are also weeks away from Montana’s 2025 Legislative Session, which starts on January 6, 2025, where renewing Medicaid Expansion will be one of the top initiatives discussed. The next few months are sure to have a great impact on the future of behavioral health in Montana.

Platform for Legislative Session:

Here is BHAM’s platform for the Legislative Session, with additional information and talking points here.

Medicaid Expansion:

As mentioned above, one of the top initiatives we’ll be focusing on is the continuation of Medicaid Expansion in Montana. Keeping “Medicaid Expansion” is not as obvious of an initiative as it sounds. The decision the legislators have to make this session is not to further expand Medicaid coverage to individuals, but rather, to continue the expanded Medicaid coverage that was initially passed by the Montana Legislature in 2015 and renewed again in 2019.

Page 9 of the BHSFG Commission Report states: “Montana’s expansion of Medicaid has resulted in steadily increased access to mental health and substance use disorder services, including alcohol and drug services, psychotherapy, and other services. In 2021, the state provided rehabilitative mental health services to over 50,000 adults and 21,000 youth enrolled in Medicaid. While Montana’s overall Medicaid spending increased from approximately $2B in 2019 to $2.2B in 2021, overall state spending decreased (from $460M to $430M), with the federal government picking up the difference.”

And as the Montana Budget and Policy Center explains perfectly in their report, “Medicaid expansion supports Montana’s health care system, strengthens our labor force, improves our economy, and supports access to care for all Montanans. If expansion is not renewed in 2025, our health care system risks drastic consequences, including provider closures and rising rates of uninsurance. Montana lawmakers should permanently renew Medicaid expansion in 2025 to keep Montanans healthy.”

Here are some other resources and reports that are helpful in providing information and details about the importance of renewing Medicaid Expansion in Montana.

What Losing Medicaid Expansion Could Mean for Montana | MTHF, MHA, Manatt

Medicaid in Montana | Montana Healthcare Foundation

Behavioral Health System for Future Generations (BHSFG):

The Behavioral Health System for Future Generations (BHSFG) Commission presented the final report to Governor Gianforte on September 30, 2024 and we eagerly await a response from the Governor.

Along with the 22 recommendations and 11 Near-Term Initiatives that were identified earlier in the BHSFG Commission meetings, this final report also labels 8 of the recommendations as being “foundational recommendations” which are “needed to support the infrastructure for subsequent recommendations to succeed and/or are critical to strengthening and sustaining system operations.” The foundational recommendations are Acuity-Based Rates (1), Evaluation and Diagnostic (E&D) clinics (4), Targeted Case Management (6), Incentivize the BHDD Workforce (19), Electronic Bed Registry and 988 (9), Care Transitions Program (8), Youth Residential Rate Redesign (17) and School-Based Behavioral Health (18).