March 2022 Update from BHAM

How about that!! The calendar has rolled over into March. There is only one thing to know and remember about this month: When we all look outside and see some halfway decent weather, that’s called “Fake Spring.” Its sole purpose is to get our hopes up so when winter comes roaring back with a vengeance later this month after giving us a glimpse of the good life, we will remember who is in charge. And then we will all retreat back into our holes until we are solidly into May.

On that note, enjoy our latest monthly update!

President Biden on Behavioral Health:

President Biden releases his plan to address the mental health and substance use crisis in the United States. It includes funding for Certified Community Behavioral Health Centers (CCBHCs), a model which BHAM is currently vetting along with our state partners. 

Click this link to read more.

Crisis at Montana State Hospital:

The Federal Centers for Medicaid/Medicare (CMS) has found the Montana State
Hospital patients to be in imminent jeopardy due to the workforce crisis across the
behavioral health system in Montana. There will be an emergency hearing of the
Children’s, Families, Health and Human Services Interim Committee, which oversees
DPHHS, on Friday, March 4 at 1:00 p.m. You can sign up to offer public comment or
view the hearing here:

This is a very frustrating situation given the many years that numerous administrations
and legislatures have received about insufficient funding for the behavioral health
system by providers, patients, advocates, and families. Due to the 2017-2018 budget cuts
to community-based mental health and substance use disorder treatment, more people
were sent to acute settings such as the Montana State Hospital and when the pandemic
hit, the workforce became even more limited. The behavioral health system needs to be
sufficiently funded as a continuum just as medical healthcare is funded. Until that time,
the state and legislature will move from crisis to crisis as has happened in the past year
first for CSCT and now the MSH.

Provider Rate Study Deadline March 4, 2022: 

DPHHS is working with Guidehouse to complete the study for behavioral health providers funded by the 2021 Legislature. The survey was released February 2, 2022 and providers until March 4, 2022 to fill it out. It is a comprehensive survey that looks at actual costs of providing care as well as reimbursement for individual programs. Guidehouse hopes to have completed their work on behavioral health by summer 2022 so that DPHHS can make recommendations to the 2023 Legislature.

Comprehensive School and Community Treatment (CSCT) Continues to Struggle:

The school-based mental health program, CSCT, continues to struggle with the changes
made by the 2021 Legislature. The legislature moved administration of this invaluable
program to Office of Public Instruction (OPI) from DPHHS. To date, hundreds of kids
have lost access to the program as school districts have decided not to continue it
because of a lack of understanding of how the new model works. More expensive and
higher levels of care are trying to prepare for more kids requiring these services as
CSCT participation is reduced, but the behavioral health workforce shortage is making
that preparation even more difficult.

As CSCT participation is decreasing, providers are working with DPHHS to expand the
availability of Home Support Services (HSS). Home Support Services is a similar
program to CSCT but works with kids and families in their homes to try and reduce the
number of children moving to more expensive care in residential programs. HHS funding was cut in 2018 and the providers and Children’s Mental Health Bureau were working to recreate this program when the pandemic hit. Now with the near collapse of CSCT, a renewed focus is placed on trying to serve these families in their homes.

Children Out-of-State Taskforce:

Due to the dire workforce shortage in hiring behavioral healthcare workers, many agencies have closed homes and are unable to staff available beds for kids requiring psychiatric therapeutic residential treatment or therapeutic group home care. BHAM has begun a Children’s Out-of- State Taskforce and is meeting with Children and Family Services Division and DPHHS to try and come up with solutions to this difficult problem. Currently, out-of-state providers are paid more to take Montana kids and have less oversight on quality. Everyone agrees keeping Montana kids in Montana is a high priority!

Healthcare Worker Daycare Stipends:

BHAM led the charge in suggesting daycare stipends for behavioral healthcare workers due to the low reimbursement by Medicaid and the lack of affordable access for behavioral health workers. Applications are now available for healthcare workers to have Best Beginning scholarships if they earn below 250% Federal Poverty Level. This will give some of our direct care staff much-needed financial help.

Please reach out to me if there is anything you need. When we work together, we can solve all the problems out there!

Stay safe. Stay healthy.

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