State officials are making plans to invest $80 million over the next five years to expand community-based services for individuals with severe and disabling mental illnesses.

Under an existing Medicaid waiver benefit option, the funding will increase the number of individuals already receiving community-based services, according to a press release. Known as Montana Medicaid Severe and Disabling Mental Illness - Home and Community Based Services Waiver, the program has delivered over $9 million in local services over the past two years. Currently, the program serves 357 Montanans each year, and under the proposal, that number is expected to expand to 750 by 2025.

“We must ensure that those who want to stay in their home and community have the support and resources to do so,” Gov. Steve Bullock said in a prepared statement. “This funding will address a significant need in our state and dramatically increase the state’s ability to help more Montanans through community-based services, as opposed to more expensive options such as in a nursing facility.”

To fund the advancement, the Montana Department of Public Health and Human Services plans to use $2.4 million in unspent funds to match an additional $4.6 million from the Centers for Medicare and Medicaid Services (CMS), each year.

The plan is contingent on approval from CMS, but according to the press release, since it is already part of the existing health department’s federal waiver, officials are confident it will be approved.

The proposal would serve more individuals discharged from the Montana State Hospital, Montana Mental Health Nursing Care Center, and individuals accessing the Money Follows the Person program that reduces the use of institutionally based services and increases the use of home and community-based services.

Waivers allow states to customize services for key populations. This specific waiver enables Montana to help people continue living in their homes and/or communities, rather than in a more expensive option such as a nursing facility, hospital or state-operated facility. Services included are case management, specialized medical equipment and supplies, non-medical transportation, peer support and more.

The proposal, which factors out to about $16 million annually for the next five years, comes about three years after nearly $50 million was stripped from the state health department’s budget in 2017 following the Montana Legislative session. One of the most significant financial blows that year was dealt to case management — a slash that prompted the laying off of dozens of case managers statewide. The cuts and subsequent staff reductions also forced multiple vital mental-health clinics and nonprofits to close their doors or abate services, particularly in rural corners of the state where they were needed most.

Since 2017, however, budget improvements have been made, including a $30 million restoration to the health department in 2018. While the reinstatement certainly helped, many providers said it simply wasn’t enough. One source told the Daily Inter Lake in 2018 the cuts had “dismantled a system that took decades to build.”

But in a recent interview, Bullock said rebuilding Montana’s mental-health system will be one of his primary focuses during his remaining 11 months as governor.

“What I can continue to do on that [the mental health front] is not only institutionalize the funding sources, but work to coordinate some of the efforts along the way, do all I can do to remove the stigma and also ensure we’re trying to remove barriers to access to care,” Bullock told the Daily Inter Lake.

Montanans are encouraged to submit comments on the $80 million proposal no later than 5 p.m. March 3, as the health department plans to request a five-year extension to the existing Medicaid waiver no later than March 31. A draft of the amendment and a detailed summary of changes can be viewed on the department’s website.

Comments may be emailed to Mary Eve Kulawik at mkulawik@mt.gov or mailed to P.O. Box 4210 Helena, MT 59604-4210.

Reporter Kianna Gardner can be reached at 758-4407 or kgardner@dailyinterlake.com