DPHHS outlines behavioral‑health investments, Medicaid unwinding figures and Montana State Hospital reform

Charlie Brereton, director of the Montana Department of Public Health and Human Services, told the House Health and Human Services Committee that the department will focus this biennium on behavioral‑health and developmental‑disability system reforms, Medicaid eligibility redetermination and stabilizing state‑run health facilities.

Brereton said the 2023 Legislature cleared what he described as a historic $300,000,000 appropriation under House Bill 872 to support behavioral‑health reforms and that a statewide Behavioral Health System for Future Generations (BISFIC) commission produced more than 20 recommendations. "That effort was largely driven by the historic $300,000,000 that the legislature cleared in 2023," Brereton said. He added that portions of the commission's recommendations were included in the governor's proposed 2027 biennium budget.

On Medicaid eligibility, Brereton summarized the federal public‑health emergency (PHE) unwinding process: the department reviewed the eligibility of nearly 330,000 Montanans and said the process resulted in an approximate reduction of 129,000 individuals from Medicaid rolls. "This process... included the review of the eligibility of nearly 330,000 Montanans," Brereton said, adding the department would provide more operational detail when requested.

Brereton also described agency work to implement Medicaid provider rate increases passed in the 2023 session and said the department continues reforms of seven state‑run health facilities, including the Montana State Hospital (MSH) in Warm Springs. On MSH, he introduced the facility's newly recruited CEO, Dr. Kevin Flanagan, and said the administrator role was reclassified to recruit a physician CEO. Brereton said several complex construction and capital projects must be completed—he estimated 12 to 18 months—before DPHHS will be positioned to apply for federal recertification from the Centers for Medicare & Medicaid Services (CMS).

The director emphasized DPHHS's statewide footprint — "nearly 3,000 employees statewide" and a roughly $7,000,000,000 biennial budget — and urged committee members to request follow‑up briefings or data. He also introduced practice leaders and division administrators for the department's finance, IT, Medicaid, human services and public‑health teams and provided contact information in an organizational packet for members seeking more detail.

Next steps noted by staff included delivering an acronym 'cheat sheet' to new members, providing a system‑by‑system breakdown of which IT systems are hosted internally or by vendors, and scheduling joint work sessions with other budget committees to review detailed budget proposals and implementation timelines.

The committee did not take formal action on budget items at the meeting; the department said staff were available to provide the requested documents and follow‑up briefings as legislators pursue specific bill discussions this session.