Department of Public Health and Human Services leaders told the subcommittee that state run health care facilities continue to face high census and acuity, require one‑on‑one staffing for a growing share of patients, and still rely on contracted clinical staff even as the department reduces traveler spending.

Director Charlie Brereton said DPHHS continues work to reform and stabilize seven state facilities, including the Montana State Hospital in Warm Springs. He described facility funding requests that include one‑time operations and wage standardization for the biennium. Brereton said the department has limited authority to slow 24/7 admissions for civil and forensic commitments and must keep beds operational regardless of vacancy rates.

The agency reported operational improvements: contract staffing costs across facilities decreased by about 6% in state fiscal 2024 versus 2023 (approximately a $4 million reduction overall), and Montana State Hospital traveler costs declined roughly 8% in the same period. The department credited wage increases, a $7,500 recruitment incentive program and revised contracting terms for some of the improvement. Brereton said, “we did fill 27 clinical staff positions in calendar year 2024, which represents about 15% of our clinical staff vacancies.”

The department said pressures remain: MSH census was more than 10% higher in state fiscal 2025 compared with 2023, and clients needing one‑on‑one staffing have increased by more than 80% because of acuity and the department’s efforts to reduce chemical restraints.

As part of operational responses, the agency leased a temporary site called MSH Grasslands (on a Helena campus) and transferred 18 patients there in November 2024 to preserve capacity while Warm Springs upgrades proceed; the department expects construction at Warm Springs to take about 12–18 months. DPHHS also said it continues recruitment and marketing campaigns targeted at clinicians and direct care staff to reduce reliance on travelers.

Ending: The subcommittee asked for further facility‑level fiscal detail and staffing projections during upcoming health care facilities division hearings.