Advocacy Needed. Preserving Montana’s Mental Illness Treatment System

By August 17, 2017November 24th, 20209 Comments
NAMI Montana has been working hard on the issues surrounding the impending mental health budget cuts. This is a major issue in Montana and here are some relevant posts if you need to get up to speed.

As described in those links, the cuts in the case management rates could have  catastrophic impacts on access to counseling and psychiatry in Montana’s mental illness treatment system due to the low rates that Montana Medicaid reimburses mental health centers for counseling and psychiatry. These services were previously subsidized by case management rates. That will no longer be possible after these budget cuts.

NAMI Montana is opposing those rate cuts, but we feel it’s important to take steps to protect our mental illness treatment system if the rate cuts do go forward. NAMI Montana has identified the possibility of having mental health centers contract to provide their services through local Federally Qualified Health Centers (FQHCs), and potentially local Rural Health Clinic (RHCs) as path to making counseling and psychiatry sustainable through the FQHC’s higher reimbursement rate for those services. We have been in initial talks with the Montana Healthcare Foundation about their The Partnerships for Better Health grant program that could provide funding to help communities plan and implement this effort. That grant process is open now, so it’s imperative that communities begin pulling together a team to submit a grant.

Please take a few minutes to send an email to contact your local FQHC/RHC and mental health centers to ask them to take on the challenge of making public counseling and psychiatric care sustainable in your community. Here are links to the contact information for each of these types of facilities around our state.

You can also contact your county commissioners asking them to take on this challenge in your community. County commissioners are integral decision-makers about their community’s mental illness treatment system and they can bring this issue to the forefront. You can find the email address for the commissioners from every Montana county at this link.

We have also included a draft message below if you find that to be a helpful place to start.


Dear ____________,

I am a resident of _____________County. I am concerned about how the State of Montana’s upcoming cuts to mental health case management will impact the ability to access counseling and psychiatry in our county. I am asking you to advocate for the Federally Qualified Health Center (FQHC) or Rural Health Clinic (RHC) that serves our county to establish a contract with a mental health center to provide psychiatry and counseling for people with serious mental illness. This contractual arrangement will allow psychiatry and counseling for this population to be reimbursed in a sustainable manner through the FQHC.

NAMI Montana has had initial conversations with the Montana Mental Health Trust and it appears that the effort to plan and establish this kind of contractual arrangement would be eligible for the Partnership for Better Health Grant offered in this grant cycle by the Montana Healthcare Foundation. You can find out more about this grant opportunity at this link.​

Here is the example from the Foundation’s Request for Proposal that NAMI Montana recommends the FQHC reference in their grant request:

Direct collaboration among community agencies (for example, sharing personnel or facilities), such as local health departments, rural hospitals, community mental health and substance use disorder treatment organizations, and community health centers to address a major health issue: Initiatives that seek to address an important health challenge—such as serving the needs of the aging population, reducing childhood injuries, or improving diabetes outcomes—through new inter-agency collaborations. Given the challenges of recruiting health professionals and the limited funding available in many rural communities, health outcomes could be improved if the region’s health-focused organizations sought ways to collaborate and share resources.

Thank you,

__/Your Name/______


The NAMI family in Montana really appreciates your effort. We are going to need all hands on deck in order to prevent these budget cuts from having lasting catastrophic impacts.

Thank you,
Matt Kuntz

Executive Director
NAMI Montana


  • Megan says:

    As someone who has poured over the regs, spoken at length with dphhs, played with our books, etc… we can as a non profit mental health center stay afloat. Things are different for sure but it is very possible. What on earth are you all talking about?

  • Emily says:

    Seriously? Maybe they’re talking about the fact that there is already a severe lack of funding for mental health in this state. Speaking as a mom to a SED kid who has been deemed a danger to the home, removed from 3 group home/treatment centers and is now at risk of being thrown into foster care because of lack of funding- I beg to differ.
    I’ve spent hours upon hours on the phone with DPHHS, Medicaid, Magellan, Children’s Mental Health, and state resource specialists. Guess what the problem is? Budget cuts!!

  • Matt Kuntz says:

    Thanks for your message, Megan. You didn’t mention which mental health center you work for. I am glad that your center is in financial position where you can weather this storm without any changes. I’ve talked with a large number of mental health centers in this state and many of them are already planning major lay-offs for both case managers and clinicians. For those mental health centers, we are hoping that this type of contracting arrangement will allow them to continue providing clinical services without going deeper into the red.

  • RyAnn Christman says:

    I can tell you that my son (age 20) is struggling with post traumatic concussion syndrome at age 20. I called and could not get him in ANYWHERE until October with a reputable mental health professional to assist him, as mental health is also effected greatly from any traumatic injury to the head. I worry constantly about him. His physician is busy until end of September, his Ortho doc saw him right away but the specialist is out all the way to October 18th. In the mean time he needs a mental health professional. Not all are the same in that field and those who are legitimate are full. We are facing a constantly on going mental health crisis, and lacking the operating power and finances to fulfill the needs of our very own….cutting it is never the answer. If we truly want what is best for our community we would adjust the way mental health providers are approved and allow for MORE PROFESSIONAL help instead of cutting the finances and expecting improvement.

  • Mary Johnson says:

    Can you list which ones are planning layoffs? I am a clinician. I have heard of one agency that is definitely cutting a ton of case management and my agency is trying to hold on before deciding anything ( or that is what they have told us), but everyone is nervous. I wholheartedly agree with other comments that budget cuts will for certain create access problems and will impact the community as a whole. the layoffs will too because a whole bunch of people will be job hunting at once (I hear many already are?) I appreciate this NAMI article. Non profit agencies have other funding streams sometimes so that might be why the commenter is confused about all the fuss. But for profit agencies rely on medicaid dollars for a lot of these services, entirely.

  • someone who has been there says:

    its terrible and you are right 🙁 Meanwhile go to physical therapists they know so much about concussion now and its a very good place to start while you wait for other services. Look for physical therapists who specialize in concussion treatment.

  • Matt Kuntz says:

    Hi Mary, I don’t think it would be appropriate for NAMI MT to mention the agencies that discussed lay-offs before they get the final numbers and then reach out to staff. They also may take steps such as the one described here to alter the reimbursement rate for clinical staff in order to prevent lay-offs. There isn’t a one-size-fits-all move to address these challenges. We are just hoping to open up the discussion to options like this one to preserve services that are otherwise in jeopardy.

  • Megan says:

    I’m happy to speak with you. I’ve worked in the field for years and the system is very difficult to navigate.

  • Megan says:

    I’m with Sunburst. I was in Helena a ton last session(did we testify together?). We need to talk. Our “financial” position is very easy to explained. No one on our team makes 6 figures, we pinch pennies, fund raise and work our butts off to provide the best service possible. These cuts hurt, they really hurt but we will not shut our doors, we will not dismiss our incredible team of case managers and we will not reduce pay or benefits. The bigger question should be if we can do it (it’s profoundly hard) then why not everyone else?

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