Date: February 26 2024

Kaitlin Price, Office of the Governor
Jon Ebelt, Department of Public Health and Human Services

Governor Gianforte, DPHHS Announce New Behavioral Health Care Services

New federal action allows state to further strengthen behavioral health care system

HELENA, Mont. – Governor Greg Gianforte and Department of Public Health and Human Services (DPHHS) Director Charlie Brereton today announced an expansion of behavioral health services for Montanans.

The announcement comes after the Centers for Medicare and Medicaid Services (CMS) approved a waiver sought by DPHHS to provide three new Medicaid funded services as part of the state’s Healing and Ending Addiction through Recovery and Treatment (HEART) program.

“After decades of applying Band-Aids to our broken system and kicking the can down the road, we’re making great strides in our overall effort to build up the state’s continuum of care for those struggling with behavioral health,” Gov. Gianforte said. “We continue to make substantial progress in filling the gaps in our system, and I applaud DPHHS for their tireless efforts to get this across the finish line.”

The waiver will allow DPHHS to provide three new services as part of the state’s Medicaid program. The services will help Montanans struggling with addiction and mental health conditions find and keep stable housing, provide incentives to those meeting treatment goals, and provide services to incarcerated individuals in the 30 days before their release from the state prison system.

The HEART Initiative, of which the waiver is a component, invests state and federal funding to expand treatment and recovery services for individuals with mental health and substance use disorders. Introduced by Governor Gianforte in his first week in office, HEART supports a full continuum of substance abuse prevention and treatment programs for communities.

“Our DPHHS team has put tremendous work into negotiating Montana’s HEART waiver on behalf of Governor Gianforte, and we’re proud to announce this significant milestone that opens new treatment doors for individuals,” Dir. Brereton said. “Through the HEART Initiative and other reform efforts, we will continue building a sustainable behavioral health system of care for struggling Montanans in need of help.”

The new services, referred to as Tenancy Supports, Contingency Management, and Justice-Involved Reentry Services, were allocated through the federal 1115 waiver as approved by CMS.

The first initiative, Tenancy Supports, will help Medicaid recipients with a diagnosed severe mental illness or a substance use disorder who are experiencing housing instability or homelessness to find and keep stable housing.

Eligible individuals must have at least one risk factor such as being homeless or at risk of homelessness, history of frequent or lengthy stays in an institutional setting, or frequent emergency department visits or hospitalizations. DPHHS has established a provider workgroup to guide the implementation of tenancy support services. The group’s first meeting was held January 30, 2024.

The second service, Contingency Management, will allow individuals in treatment to earn small motivational incentives for meeting treatment goals and will be available to Medicaid members age 18 and older, with a diagnosed stimulant use disorder.

Dir. Brereton added, “This model has demonstrated robust outcomes for individuals with stimulant disorder, including reduction or cessation of drug use and longer retention in treatment.”

The third support, Justice-Involved Reentry Services, expected to begin in late 2025, will provide targeted Medicaid services for eligible justice-involved populations 30-days prior to release, age 18 and older, who have a substance use disorder and/or mental health diagnosis.

Eligible individuals will receive services such as care management, limited community-based clinical consultation services in person or via telehealth, and medication.

In the coming months, training will be available to providers interested in both Tenancy Supports and Contingency Management before both programs become available to Medicaid members this fall.