For the past several months, The Billings Gazette has reported “State of Despair,” an in-depth series on suicide in Montana. Reporter Cindy Uken has told the stories of Montanans who have lost loved ones to suicide, and Montanans who are working to prevent this leading cause of death in our state.
Public policy alone will not eliminate the suicide problem, but policy decisions affecting mental health care can be either a help or a hindrance. With just three weeks left in our biennial legislative session, are lawmakers supporting better mental health or not?
The biggest part of that question will be answered in the Medicaid expansion debate. For mentally ill Montanans, there is no downside to extending Medicaid coverage to everyone with an income below $15,000 a year.
Thousands of seriously mentally ill people are among the state’s estimated 68,000 uninsured adults who could become eligible for Medicaid.
Because most of us get our health insurance through our employer, those who develop serious mental illnesses often lose coverage when they can’t work. They typically face years of delay between onset of debilitating illness and getting disability certification for Medicaid and Social Security. In the meantime, they risk losing opportunity to recover, regain their jobs and their healthy lives.
Matt Kuntz, executive director of NAMI-Montana summed up that dilemma in a guest opinion Monday, saying: “Expanded Medicaid coverage will make it possible for many hard-working Montanans to receive treatment for their mental illnesses and recover to rebuild their lives.”
That’s why votes for Senate Bill 395 and House Bill 590 are votes for better mental health.
House Bill 2, the major biennial budget bill, also has significant impact on Montana’s mental health care resources.
Clinics, therapists, and psychiatric treatment centers need to be compensated for their care so they can afford to keep serving Montanans. Two years ago, in the midst of the Great Recession, Gov. Brian Schweitzer rescinded a 2 percent rate increase for most Medicaid providers. They are still fighting to regain that funding. We ask lawmakers to consider that these Montana businesses support jobs and spend state money in their communities. They deserve to be reimbursed their full costs of providing quality care.
Quality is a key word in health care reform. House Bill 100 proposes to set up a pay for performance pilot project to determine how Montana can get better value and outcomes in children’s mental health services.
The bill, proposed by the interim Select Committee on Efficiency in Government, says: “Research in other states indicates that linking provider payments to desired outcomes and quality improvements results in improved access to care, better care integration and coordination, family-focused planning, earlier and less restrictive interventions, and a reduced number of treatment days.”
The bill, sponsored by Rep. Ron Ehli, R-Hamilton, was passed by the House 96-2, amended and passed from Senate committee on Tuesday. We urge senators to move this bill forward.
Community crisis services have delivered tremendous value for the dollars spent. For the past several years, lawmakers have appropriated a modest amount of funding to partially support mental health services that divert ill people from jail, hospital emergency rooms and Montana State Hospital.
The Community Crisis Center in Billings recently has received a crucial portion of its funding from the state’s crisis services appropriation. Last month the center logged 671 visits. If not for the crisis center, many of those folks would have been sitting in the Billings Clinic emergency department or seeking shelter at the county jail.
We call on all lawmakers -- particularly those in Yellowstone and neighboring counties that depend on Community Crisis Center services: Support continued funding.
Montana has been at the top of the worst-state list for suicides for many years. That tragic record isn’t going to get better until Montana does a better job of providing access to needed mental health care for all its citizens. Some of the choices our legislators make in the next three weeks will be life-or-death decisions for mentally ill Montanans.