Lawmakers hear bill to formalize certified community behavioral health clinics in Montana

Representative Jane Gillette opened the hearing on House Bill 574, a bill to establish certified community behavioral health clinics (CCBHCs) in Montana statute and to provide DPHHS authority to set payment methodology, service standards and incentives for performance.

The bill prescribes required services and billing practices for CCBHCs, including targeted case management, peer and family caregiver support, outreach and education, primary care screening and monitoring (either provided directly or via contract), outpatient psychiatric rehabilitation and coordination with critical access and larger hospitals to divert individuals from inpatient settings. The bill requires that private insurance be billed first with Medicaid as payer of last resort, mandates income‑based sliding fees and forbids refusing services for inability to pay. It also requires reporting on functional assessment changes and whether persons served are housed or unhoused, employed and involved with law enforcement; the department may provide incentive payments for clinics demonstrating high‑quality outcomes.

Megan Peel, administrator for the Behavioral Health and Developmental Disabilities Division at DPHHS, said the model has been prioritized in the governor’s budget and that Montana already has four mental health centers piloting CCBHC functions under SAMHSA grants. Supporters including NAMI Montana, Ability Montana, the Behavioral Health Alliance of Montana, county attorneys and disability-advocacy groups urged lawmakers to pass the bill as a way to increase timely access to care, reduce reliance on emergency departments and divert individuals from jails.

Witnesses described the behavioral health system as overwhelmed and noted that centers for independent living and other local providers often become first points of contact because of scarce options. Several witnesses asked that implementation align closely with national CCBHC standards and that administrative rules be developed with stakeholder input.

Committee members asked about subcontracting with third parties, outreach staff targeted at high Medicaid utilizers, and whether legislative policy should precede funding in future expansions of the model. DPHHS staff said clinics may contract with third parties and that outreach staff could resemble community health workers or targeted case managers who connect high users to services. The sponsor said the bill provides policy direction for an initiative the department has already begun piloting with federal grant funds and that the legislature has appropriated funding in the budget process.

Ending: The hearing closed with the sponsor and witnesses urging passage to expand community‑based behavioral health services and to better coordinate care across providers and law enforcement.