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Pending Case Management Budget Cuts – Call to Action

By July 10, 2017November 24th, 2020No Comments
All budget cuts are hard to explain.  I learned years ago that it’s incredibly hard to track the individual dollars moving through the mental illness treatment system. There was always someone there to claim that I got this number or that number wrong, but they didn’t have numbers that they deemed to be right either.

If that sounds frustrating, it’s because it is. However, NAMI Montana has adapted by focusing on common sense initiatives that meet our mission of supporting, educating and advocating for Montanans who live with mental illness and their family. We have two general rules that apply when we get outside of questions that are relatively simple to sort out: (1) to rely on treatments that have scientifically been proven to improve healthcare outcomes and (2) to ask for more outcome measure analysis to see how the treatment system is working based upon the funds that have been expended.

However sometimes it is impossible to avoid getting into the weeds on funding. The current round of Budget Stabilization Funding Cuts based on Senate Bill 261 are tricky and dense. They are a series of cuts required to be enacted when the amount of revenue taken in by the State of Montana is lower than expected.

Our state is currently in a low revenue situation that will likely trigger these cuts. The cuts to the mental illness treatment system are laid out in this portion of the law.

Section 22.  Coordination instruction — level 3 budget reduction — mental health targeted case management services. (1) If the amount of the certified unaudited state general fund revenue and transfers into the general fund received at the end of fiscal year 2017 is less than $2,192,000,000, as determined by the state treasurer on or before August 15, 2017, then for the biennium beginning July 1, 2017, the department of public health and human services general fund appropriation in House Bill No. 2 for the:
     (a) “Addictive and Mental Disorder Division” is reduced by $965,000 in fiscal year 2018 and $965,000 in fiscal year 2019; and
     (b) “Developmental Services Division” is reduced by $965,000 in fiscal year 2018 and $965,000 in fiscal year 2019.

These are major cuts to Montana’s public mental illness treatment system. The cuts are likely to be more dangerous that the dollar amount suggests because Montana’s mental illness treatment system is set up in a manner where case management services are used to subsidize the low billing rates for psychiatrists, psychiatric nurses, and therapists. Case management services also subsidize crisis services.

As depicted below, the current funding structure relies on case management rates to keep the rest of the mental illness treatment system funding. Those case management rates are about to be cut and it is scary to think about what the ripple out impacts could be for Montana’s entire mental illness treatment system.

While the overall bill and budget situation may be complicated, the problem is at a legal point where NAMI Montana’s response is simple. We can only ask Montana’s Department of Public Health and Human Services (DPHHS) to be incredibly careful when executing these case management cuts to ensure that they do not cripple Montana’s mental illness treatment centers. There are Montana lives and families at stake.

We have been meeting with DPHHS and mental health centers to shore up the mental health funding system in other manners to prevent these funding cuts from having catastrophic impacts. We will also begin setting plans to address this issue in the next Legislative session.

​In the meantime, we are asking all NAMI Montana supporters to please take a moment and contact Governor Steve Bullock to tell him to be incredibly careful while executing the Senate Bill 261 cuts, because Montana’s mental illness treatment system rests in the balance.

You can reach Governor Bullock at this link or leave a message for him by phone at (406) 444-3111.

Thank you,

Matt Kuntz, J.D.
Executive Director
NAMI Montana

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