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Committee hears bill to establish certified community behavioral health clinics and change payments
Summary
Lawmakers heard testimony supporting House Bill 574, which would authorize certified community behavioral health clinics (CCBHCs) in Montana, set payment through an encounter/PPS rate, require a broad set of services and create an incentive program for quality outcomes. Supporters said pilots show improved access and reduced costly hospital and jail use.
Representative Jane Gillette, sponsor of House Bill 574, told the House Health and Human Services Committee the bill would authorize Certified Community Behavioral Health Clinics and set payment through an encounter-rate (prospective payment system) rather than fee-for-service, enabling clinics to provide services not typically billable under per-visit fees.
"This is a bill which authorizes the payment and establishment of what are called certified community behavioral health clinics," Gillette said, describing required services that include targeted case management, peer and family support, outreach and primary-care screening and obligations to coordinate with hospitals and law enforcement.
Proponents from across the state described operational gains from pilot programs and urged lawmakers to pass the bill. Matt Koontz, executive director of the National Alliance on Mental Illness (NAMI) Montana, called the measure "the right bill at the right time," saying it reflects years of study to rebuild Montana’s behavioral health financing after a 2017 collapse. Jackie Jant of the Department of Public Health and Human Services told the committee CCBHCs provide 24/7 crisis response, reduce wait times, serve people regardless of ability to pay and support evidence-based practices and continuous quality improvement.
Providers and local officials said the CCBHC model fosters integrated care that reduces avoidable emergency-department use, jail placements and hospital readmissions. Jeff Keller, CEO of Remark Foundation, said HB 574 would expand access to 24/7 crisis care and substance-use treatment and called the model a "game changer" for keeping people out of jails and emergency rooms.
Committee members pressed sponsors and witnesses on workforce and financing details. Representative Kelly asked whether clinic staff could assist with forensic evaluations in jails; the sponsor and witnesses said full forensic evaluations typically require psychiatrists or specially trained psychiatric providers, though local providers can sometimes provide lower-level evaluations that help release people from custody. Representative Buttry asked about the bill’s resilience to changes in Medicaid funding; witnesses said the model is designed to stand on its own but would likely see fewer providers if Medicaid funding were dramatically reduced.
Gillette noted that funding for initial implementation is included in the Section B appropriations for the biennium and that four pilots already operate in the state; she also said the department sought but did not receive a full implementation grant and instead used a planning grant to spin up pilot sites. She closed by urging the committee for "due pass." The committee closed the hearing without taking a vote.
