Advocacy

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2023 Montana Legislature

At the Behavioral Health Alliance of Montana, we’re helping all of our members work to create sustainable behavioral health in Montana. Both programming and funding have to be sustainable in order to serve the citizens of Montana. Stay tuned here before and during the session as we post advocacy tips for you to move behavioral health goals forward for your community!

CERTIFIED COMMUNITY BEHAVIORAL HEALTH CENTERS (CCBHCs)

THIS BILL HB17 WAS TABLED BY HOUSE APPROPRIOATIONS. BHAM will continue to work to implement CCBHCs with DPHHS, the Governor’s office, NAMI MT, National Council on Mental Wellbeing, and other advocates of transforming the behavioral health system in Montana.

A Certified Community Behavioral Health Clinic model is designed to ensure access to coordinated comprehensive behavioral health care. CCBHCs are required to serve anyone who requests care for mental health or substance use, regardless of their ability to pay, place of residence, or age – including developmentally appropriate care for children and youth.

CCBHCs must meet standards for the range of services they provide and they are required to get people into care quickly. An important feature of the CCBHC model is that it requires crisis services that are available 24 hours a day, 7 days a week. CCBHCs are required to provide a comprehensive array of behavioral health services so that people who need care are not caught trying to piece together the behavioral health support they need across multiple providers. In addition, CCBHCs must provide care coordination to help people navigate behavioral health care, physical health care, social services, and the other systems they are involved in.

DPHHS, National Council for Mental Wellbeing, BHAM, NAMI MT and others have been educating the legislators on the Health and Human Services Committee and the Part B Budget Committee on CCBHCs. Unfortunately, some of the legislators are still struggling with understanding the model.

In an attempt to boil it down as simply as possible, we’ve come up with this description:

The Certified Community Behavioral Health Centers (CCBHC) would begin the transformational change of the behavioral health system to a comprehensive value-based reimbursement system. That means that the siloed organizations that currently receive fee-for-service would be able to work together in a continuum of care and provide wrap-around services for seriously mentally ill adults and seriously emotionally disturbed children. This is the model that FQHCs and hospitals use so we’re just asking that behavioral health providers also be able to provide care this way.

CCBHC Downloads:

Download a PDF of Mary’s CCBHC presentation from the NAMI conference here.

Find out more here Certified Community Behavioral Health Clinics (CCBHCs) | SAMHSA

Download the CCBHC FAQ’s here.

Download Mary’s BHAM Criminal Legal Reform CCBHC Presentation here.


Follow These talking points in reference to CCBHCs:

  • CCBHCs are the medical home for the seriously mentally ill/seriously emotionally disturbed population with behavioral health as the core competency. 
  • Services offered by the CCBHC are determined by the state creating a standardized platform of quality care and data. 
  • CCBHCs can alleviate overcrowding and legal issues at Montana State Hospital with greater community-based access to mental health services. The $118M in the Governor’s budget for MSH will be wasted if there are no community services to treat the person before and after hospitalizaiton.
  • CCBHCs partner with existing organizations like crisis response teams, 988 call centers, children’s facilities, substance abuse treatment centers and create efficiencies and save money. 
  • In other states, CCBHCs have saved millions of dollars in diverting care away from hospital emergency rooms and jails and into the community-based mental health and substance use treatment where it belongs. 
  • CCBHCs offer great quality with tracked outcomes by the state, which has not traditionally been done, to ensure that state dollars are being well spent. 

Feb. 16, 2023: JAS Appropriations Committee voted to implement additional rate increases for providers in all 3 sectors and also converted the $25M for one-time-only funding to the base for ongoing funding over the biennium. This brings most behavioral health programs closer to the cost of covering care, but there is still a gap with the benchmark reimbursement for many programs. Rep. Mary Caferro has introduced HB 649 that would raise rates to those recommended by the Governor’s Provider Rate Study to cover costs as identified in 2019 data. This will will be heard in Health and Human Services Committee on Feb. 24, 2023. See Talking Points below.

Jan. 3, 2023: The Governor’s proposed budget has come out and includes increases for the four sectors studied in the Medicaid Provider Rate Study: senior and long-term care, developmentally delayed, and adult and children’s mental health and substance use disorder treatment providers.

The comprehensive and objective Governor’s Medicaid rate study found that adult and children’s mental health and substance use treatment providers receive less than 85% on average of the cost of delivering that care. Obviously, a business can’t remain open if they are reimbursed less than their costs. That’s just basic Business 101.

During this legislative session, we’ll be talking with legislators about funding the full recommendations from the Governor’s study.

Advocacy Suggestions:

  • The Legislature needs to fund the full recommendations and an annual COLA for community-based behavioral health in your communities as requested in HB649.
  • We appreciate the JAS Appropriations Committee providing additional funding, but the rates remain below the basic cost of providing care and should be raised to the full recommended rates from the Governor’s rate study.
  • No business can survive being paid less than the cost of care and more homes, beds, and programs will need to be closed unless the full costs are covered.
  • My organization will need to lay off _____ FTEs and close ____ homes/programs/beds if the full cost of covering care is not covered by the Medicaid rates.
  • Advocate for an annual Medicaid cost-of-living increase for mental health and substance use providers similar to the one that physicians receive. Once we get the rates up to market, we want to make sure that another expensive rate study isn’t required in the future.
  • To learn more go to: https://montanabehavioralhealth.org/advocacy/

Provider rate study and medicaid increase
talking points

Download the talking points related to the Governor’s Medicaid Provider Rate Study here.

Toolkit: Don’t Deny Me

By law, most health plans must cover illnesses of the brain, such as depression or addiction, the same way they cover illnesses of the body, such as diabetes or cancer. Speak up about illegal denials of care! Navigate to our News and Resources page to download assets to help you spread the word.

Learn more at www.DontDenyMe.org.

#DontDenyMe