Mary Lemieux, HRD administrator, and other department staff told the subcommittee about program initiatives and recent operational changes inside the Health Resources Division.

Why it matters: these administrative and program changes affect access to care (tele‑psychiatric consultation for perinatal and pediatric providers), continuity of primary care, and short‑term budget needs for services such as extended postpartum coverage.

Perinatal and pediatric psychiatric access: HRD described PRISM for Moms, a provider‑to‑provider psychiatric consultation line initially launched in 2021 and funded in part by a subsequent HRSA grant. Lemieux said PRISM has facilitated roughly 200 psychiatric consultations supporting about 80 unique providers and addressing 154 unique patient cases between 2021 and 2024. HRD and the Early Childhood Family Supports Division consolidated PRISM and the pediatric psychiatric consultation line into a single statewide access line (described in testimony as Montana Psychiatric Access Lines) intended to simplify provider access for maternal and pediatric psychiatric consultation.

Primary care redesign: HRD described an ongoing project to redesign the state’s primary care case management programs toward a value‑based model focused on quality and outcomes. HRD contracted with Health Management Associates (HMA) to research other states’ models and gather stakeholder input; the department said it plans to implement a new program framework by June 2026, coincident with the passport to health waiver authority expiration.

Extended postpartum coverage and utilization: Lemieux said state fiscal year 2024 saw 965 members receive extended postpartum coverage (12 months after pregnancy) with nearly $1.7 million spent on claims for services including prescription drugs, dental and behavioral health. Utilization numbers HRD provided included 77 women receiving mental health services and smaller counts for dental, vision, substance use treatment and diabetes care among the extended postpartum cohort. Committee members requested additional validated data elements on program outcomes; Lemieux said the department was preparing a follow‑up document for legislators.

Operational reorganizations and staffing: HRD described an internal reorganization completed within existing positions that moved the Big Sky Rx program and one position to the Senior and Long Term Care Division, created dedicated roles for ambulance and non‑emergent medical transportation, and merged pharmacy administration with drug rebate staff to improve rebate collection. Lemieux told members the division had experienced high turnover during the public health emergency—about 70 percent turnover across its 41 budgeted positions—but said the division expects to be fully staffed for the first time in nearly five years once two open positions are filled.

Quality reporting and grants: HRD noted CMS’s August 2023 final rule requiring annual adult and child core set quality measure reporting beginning in 2024; HRD said CMS will publish validated state measure results in December 2025. The department emphasized ongoing grant work (HRSA PRISM and pediatric psychiatric access) and said it was exploring CPT codes and other billing mechanisms to support sustainability of psychiatric access services.

Ending: committee members asked HRD for additional performance measures and reporting language to support companion budget bill drafting. HRD and legislative fiscal staff agreed to continue work on identifying appropriate quantitative performance measures for primary care redesign and drug‑rebate outcomes.