FILE - Hospital, emergency room, medicaid

(The Center Square) – A shortage of direct care workers has forced Montana behavioral health providers to close residential homes, sending children out of state for a residential treatment facility or therapeutic group home if no beds are available in the state.

The state pays more to send the children out of state and those funds are unbudgeted. The Department of Public Health and Human Services said it doesn’t have enough money to pay in-state providers because there’s no budget for it, Mary Windecker, executive director of the Behavioral Health Alliance of Montana, told The Center Square.

The alliance's goal is to ensure health equity with adequate resources to support quality services for all Montana citizens.

“They're already spending the unbudgeted amount by sending it out of state, and they do have a great deal of ARPA funding. That can't be used to backfill the budget but could certainly be used to pay providers in the short term, more to be able to hire people at a higher rate than what we currently are during this crisis,” she said.

The alliance wants the state to use the 10% federal match bump that came through with American Rescue Plan Act (ARPA) funding. The Federal Medical Assistance Percentage (FMAP) is one of the only funding sources the Montana Department of Public Health and Human Services has available for this use, she said.

“Our argument is basically this is a once-in-a lifetime crisis. Let's give it a once-in-a lifetime response,” Windecker said.

The state could do this quickly to get money to Montana providers immediately. The alliance shared examples from Iowa, Maryland and Kentucky, states that have used the 10% FMAP for provider rate increases, she said.

Ideally the state would look at revamping the system. Windecker said the state has an antiquated fee for service model. But the first priority is to keep the doors open and the lights on as the state experiences an increase of COVID-related needs in mental health and substance use disorder treatment, and nowhere near enough funds to keep people working.

“We can't have a healthy workforce in Montana if we're not putting money into the health care needed to keep them healthy,” she said.