During the COVID-19 pandemic, Montana lost about 100 beds in places where people received behavioral health services because staff weren’t available — but a commission working on the issue is taking proposals that will put $10 million into increasing capacity.
The Montana Department of Public Health and Human Services announced this week it is accepting proposals for one-time grants aimed at adding to the number of residential beds in the state after the losses.
The announcement is part of a $300 million investment into behavioral health and developmental disabilities services called the Behavioral Health System for Future Generations funding.
“We’re thrilled to announce that the application portal is now live for the first round of BHSFG funding,” said health department Director Charlie Brereton in a statement. “We encourage eligible health care providers to submit their proposals as quickly as possible so we can increase bed capacity across the state and ensure more Montanans have access to the services they need.”
The program intends to stabilize or increase residential services in Montana and build capacity “while ensuring more Montanans can be served in clinically appropriate settings closer to home,” the health department said.
During the pandemic, the state lost 100 beds, or roughly 25% of its capacity, to serve many children and some adults, said Mary Windecker, with the Behavioral Health Alliance of Montana. Many people who needed help had to leave the state to get care when facilities closed doors or cut beds.
In an interview, Windecker said she appreciates the commission addressing how to allocate the $300 million is working quickly and listening to ideas from people on the ground.
“They understand that these are low hanging fruit, that we can reopen these facilities and reopen these beds and reopen these crises facilities and get help to the people much more quickly than waiting until the next legislative session,” said Windecker, executive director.
With support from Gov. Greg Gianforte and the Montana Legislature through House Bill 872, the commission is working on both near- and longer-term initiatives to fill gaps in services in Montana with the $300 million.
Matt Bugni, with AWARE, said his organization operates 45 group homes across the state, and eight of them are closed, hopefully temporarily. He said AWARE will apply for a grant, and the money would help on a couple of fronts.
First, the group homes need maintenance in order to get ready for licensure, and the funds support that expense, he said. Also, it’s costly to train and hire skilled staff to work in those intense environments, and with years of low Medicaid reimbursements, organizations such as AWARE don’t have cash reserves.
“We have capacity to serve 213 people in our residences,” Bugni said. “But we’re currently serving about 150 because of staffing shortage.”
Bugni said the grants will help, as will the “historic rate increases to Medicaid.” He also said there’s sometimes a funding incentive to bring on a lot of clients at once, but the grants allow facilities to bring clients on board at an appropriate pace and “serve with success.”
The money addresses one piece of the puzzle, and more work is needed, including regulatory changes to help the behavioral health field, Bugni said. Also, some people want to work and could be trained, but they may also have child care costs or other challenges, so he’s said it’s important to work on removing barriers to employment as well.
In August, Windecker said the Behavioral Health Alliance of Montana submitted its suggestions for shorter-term projects to the commission, and reopening closed adult and children’s group homes and shelters was among them. She said new facilities might also be able to expand.
“We’re really excited they’ve listened to us,” she said.
The startup expenses the grants will support are not typically part of an annual budget and are out of reach for a lot of facilities that have been underfunded through Medicaid.
“As Medicaid rate increases went into effect over the last few months, what we didn’t have was startup capital to reopen many of those houses that closed or to purchase or remodel houses that were available,” Windecker said. “Our feeling was that before we build new facilities or acute care centers or mini state hospitals, we should reopen the existing vacant ones and make good use of that.”
An online portal to submit funding proposals is open at Submittable and will run through March 8, 2024, according to the Department of Public Health and Human Services. Money can be used for new facility purchases or builds, existing facility upgrades, hiring and training staff, and supplementing revenue.
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