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Broad Recommendations for Next Montana Governor

By March 2, 2020November 24th, 2020No Comments
General Recommendations –  Focus on Departmental management during first biennium. Specifically by asking leaders within the Departments how they should be measured, adjusting those measurements as necessary based upon Governor’s vision, then moving forward with analyzing the outcomes of the Departments based upon the adjusted outcome measurements.

  • Representative Nancy Ballance had developed an outcome measurement plan for DPHHS in partnership with Director Hogan. That plan was abandoned due to the budget cuts of 2017. Can it be revived at the next Legislative session?

Maintain focus on research-based suicide prevention strategies.  Bipartisan efforts by the Montana Legislature have led to the implementation of research-based suicide prevention strategies in communities across Montana. While there are real questions in how to evaluate these programs, the overall concept has ensured that Montana taxpayer money is only being spent on programs that have already been demonstrated to be effective. [Disclaimer – Matt Kuntz has a bias in this recommendation because he manages the Youth Aware of Mental Health (YAM) program for Montana State University, but he advocated for this type of effort years before taking over the YAM program.]

Work with AMDD and others to see how Montana’s mental health crisis services programs can continue to be adjusted to best serve Montanans. This covers the spectrum from the availability of Mental Health Professional Persons to determine what level of care is appropriate, to effective use of community crisis resources, etc. Additionally, how are our community providers interfacing with the Department of Veterans Administration?

Continue to develop Montana’s Mental Health workforce – In the past decade, Montana has made important steps to expand its mental health workforce: including the development of a Psychiatric Residency and advanced practice nursing programs, the formalization of peer support services, etc. Montana must continue to modernize and optimize its workforce development efforts to make sure it does not fall further behind in the national shortage of mental health service providers.

Continue to improve the State of Montana’s effort to provide affordable housing. Affordable housing is a critical and challenging issue nationwide, especially for people with disabilities. It is a complex issue within the State partly because affordable housing funding is managed by the Department of Commerce and the healthcare and disability services are managed by the Department of Public Health and Human Services.

Legal system and corrections. Continue efforts to ensure that Montana’s criminal justice system serves the dual role of keeping Montana communities safe while rehabilitating the vast majority of offenders to eventually live and work in the communities.
 
Work to do in the Interim to Potentially Make Essential Changes in Second Biennium
Interim Committee Analysis – Analyze Medicaid’s Fee-for-service system to determine whether it makes sense to develop other models of care within the system and what legislative changes would need to occur to make those models possible. (This will specifically include Medicaid Managed Care which has failed before in Montana).
Interim Committee Analysis – Montana’s Mental Health treatment system has changed dramatically in the last decade based upon a variety of factors such as the Affordable Care Act, the 2017 DPHHS budget cuts, changing demographics, etc. Some of these changes were wonderful. Some of the changes were not. It is important to understand how we are serving Montanans with serious mental illness in communities across the state (urban, rural, tribal, etc.) What is going well? Where are the gaps in services? How are communities adjusting to the varieties of providers? Additional considerations to look at:

  • Highlight Federally Qualified Health Centers contracting with Mental Health Centers to provide care for Montanans with mental health conditions.
  • How are we using telehealth? How should we be using telehealth? Are there any lessons from Sweetgrass County’s telehealth program for the rest of the state?

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