Governor Bullock Announces Plan to Invest $80 Million in Community Mental Health Services over Five Years

Proposal would double number of individuals to be served

• February 03 2020

Governor Steve Bullock today announced the State of Montana is making plans to invest $16 million per year over the next five years, or $80 million total, to add capacity to existing community-based services for individuals with severe and disabling mental illness.

“We must ensure that those who want to stay in their home and community have the support and resources to do so,” said Governor Bullock. “This funding will address a significant need in our state and dramatically increase the state’s ability to help more Montanans through community-based services, as opposed to more expensive options such as in a nursing facility.”

Under an existing Medicaid waiver benefit option, this funding will more than double the number of individuals already receiving services. Currently, the program serves 357 individuals each year, and under this proposal that number will expand to 750 by 2025.

“This is a major investment in Montana, and we’re thrilled about this opportunity,” Department of Public Health and Human Services (DPHHS) Director Sheila Hogan said, “We look forward to working with our federal partners to make this happen.”

The proposal will serve more individuals discharged from Montana State Hospital, Montana Mental Health Nursing Care Center, and individuals accessing the Money Follows the Person program. Director Hogan said all Montanans deserve the chance to be served in their own community. “This plan is an important step forward in making this a reality for hundreds of people this program serves,” she continued. 

The plan is contingent on approval from the Centers for Medicare and Medicaid Services (CMS), but it is part of an existing DPHHS federal waiver and the administration is confident it will be approved.

DPHHS will request no later than March 31, 2020 a five-year extension to the existing Medicaid waiver effective July 1, 2020. Montanans are encouraged to submit comment no later than 5 p.m. on March 3, 2020.

The existing program is called the Medicaid Severe and Disabling Mental Illness (SDMI) - Home and Community Based Services (HCBS) Waiver. The HCBS Waiver is a partnership between the State of Montana and CMS. In the past two years, the program has delivered over 9 million dollars in local services. To fund this advancement in community services, DPHHS will utilize 2.4 million dollars in unspent funds to match an additional 4.6 million dollars from CMS each year.

Waivers allow states to customize services for key populations. This specific waiver enables Montana to help people continue living in their homes and/or communities, rather than in a more expensive option such as a nursing facility, hospital, or state-operated facility.

Services included are case management, specialized medical equipment and supplies, non-medical transportation, adult day care, respite, private duty nursing, community transition, peer support and more. 

Montana Medicaid members can apply to receive these services if they meet a nursing home level of care, have an approved SDMI diagnosis and level of impairment, and are 18 years of age or older. The proposed changes to the waiver renewal include changes in the number of members served and the services offered. 

Other improvements to the existing waiver are also being included such as increased Medicaid rates for specific community-based group homes serving the mentally ill, personal assistance service rate increases, and recovery-based service options.

The draft of the 1915(c) HCBS SDMI Waiver amendment and a detailed summary of changes is available for review at:

https://dphhs.mt.gov/amdd/mentalhealthservices/severedisablingmentalillness-sdmi-homeandcommunitybased-hcbs-waiverprogram.

Comments can be directed to Mary Eve Kulawik, Medicaid State Plan Amendment and Waiver Coordinator, at mkulawik@mt.gov; or mailed to: Director’s Office, PO Box 4210, Helena, MT 59604-4210.