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State hospital officials and lawmakers press need for capital fixes and a subacute behavioral‑health facility
Summary
Senators and the Montana State Hospital CEO described aging infrastructure at Warm Springs and urged investment in capital maintenance and a new subacute step‑down facility to reduce long inpatient stays and free acute beds for patients in crisis.
Lawmakers heard detailed testimony about capital needs at the Montana State Hospital (Warm Springs campus) and a state proposal to use BISFIG capital funds, alongside other capital requests, to invest in facility upgrades and a subacute step‑down facility intended to reduce long lengths‑of‑stay in acute, high‑cost beds.
Senator Jason Esp, who described travel and stakeholder outreach while serving on the BISFIG commission, said the state is considering multiple tracks for the $75 million capital allocation originally set in HB 872, including upgrades to existing state hospital facilities, investment in new state‑owned campuses or a subacute step‑down facility to fill system gaps. He noted the need for a long‑term, systematic capital planning process.
Dr. Flanagan, CEO of the Montana State Hospital, described the operational impact of extended stays and aging infrastructure. He said the hospital’s generators and boilers are beyond their projected useful life, that staff support facilities remain inadequate after a prior building loss, and that maintenance investments have been piecemeal. On patient flow he told the committee: “In fiscal year 2015, there were 0 patients who had been there for 365 days. In fiscal year 24, there were 35 patients that had been there for 365 days. That's 40 beds.” Dr. Flanagan said patients who remain in the acute facility because there is no step‑down option take capacity from other people in acute crisis and increase state costs.
Why a subacute facility: Witnesses said a subacute or step‑down setting would allow patients to continue recovery in a less restrictive, lower‑cost environment once the immediate acute crisis has been managed, easing the path to discharge and reducing readmissions. Committee members asked for integrated cost estimates covering House Bill 5 capital items already proposed for the hospital plus any new BISFIG capital investment, and staff agreed to provide a consolidated schedule and cost breakdown.
Ending: The committee scheduled follow‑up work sessions to review capital cost breakdowns, operational staffing needs and how BISFIG capital funds would interact with other HB5 line items and long‑term planning for state facilities.
