Approved BHSFG Commission Initiatives

Community-Based Court-Ordered Evaluation and Stabilization Near-Term Initiative Documents

A total of $7.5 million in state funds is now available to incentivize community-based COEs and stabilization and restoration services to address a longstanding backlog in evaluations at the Montana State Hospital Forensic Mental Health Facility (FMHF, also known as Galen). These community-based COEs can occur in jails, the provider’s office, in private hospitals, other community-settings, or via telehealth.

Update as of Feb. 27, 2025: DPHHS has facilitated and paid for 40 court-ordered evaluations (COEs) and evaluation-related activities that were conducted in community settings. Since July 2024, these evaluations have occurred in 15 counties across Montana. Additionally, the 15 counties that have utilized this NTI are among those counties with the highest rates of court-ordered fitness evaluations, which aligns with the Department’s strategy to prioritize the onboarding of certain counties with greatest need.  In addition, there are seven providers who are regularly conducting court-ordered evaluations on behalf of DPHHS.

• Recommendation for Grants to Incentivize Community-Based Court Ordered Evaluations (mt.gov)
• Governor Gianforte Invests $17.5 Million To Boost Community-Based Behavioral Health and Developmental Disabilities Care (mt.gov)
• DPHHS Launches $7.5M Program to Address Court-Ordered Forensic Fitness Evaluation Backlog

This initiative will provide up to $15.8 million to increase residential bed capacity. Funding will be used to provide one-time grants to congregate community living providers who primarily serve individuals with a serious mental health or developmental disability diagnosis. The goal of the grants is to stabilize or increase residential service provision as needed across the state and build sustainable capacity. Allowable uses of the grant funds include the cost of new facility purchase/build, existing facility upgrades/maintenance, hiring and training staff, and revenue supplementation due to low volume/lack of economies of scale through startup.

Update as of Feb. 27, 2025: The Residential Bed Capacity Grant has been processing invoices to providers since Sept. 16, 2024. A total of $4.5 million has been paid out through 77 invoices received. Thirteen projects have been billed to completion. From those 13 completed projects, 48 new residential beds have been or will be created, 18 beds have been or will be reopened, and 57 existing residential beds have been maintained. Invoices have been processed for residential facilities in 15 counties across the state.

The Residential Bed Capacity Grant agreement period spans from Sept. 16, 2024, through March 16, 2026. This agreement period is almost a third of the way through and almost a third of the approved amount has been dispersed to awardees.

The Department expects to continue receiving and paying invoices over a multi-year period for the authorized amount of $15.8 million for a projected total of 241 new beds, 94 reopened beds and 655 maintained beds statewide.

The list of counties that have received funding include: Missoula, Lincoln; Silver Bow, Gallatin, Lewis and Clark, Flathead, Valley, Yellowstone, Carbon, Cascade, Lake, Musselshell, Hill, Deer Lodge, and Sanders.

• Recommendation for Grants to Increase Residential Bed Capacity (mt.gov)
• Governor Gianforte Invests $17.5 Million To Boost Community-Based Behavioral Health and Developmental Disabilities Care (mt.gov)
• DPHHS Launches Grant Program to Increase Residential Bed Capacity
• Governor Gianforte Invests $15.8 Million to Increase Community-Based Behavioral Health and Developmental Disabilities Care
• Residential Bed Capacity Grant Award Information

This initiative will provide one-time grants to existing Mobile Crisis Response and new Crisis Receiving and Stabilization providers. The goal of the funding is to stabilize and sustain Mobile Crisis Response programs and increase Crisis Receiving Stabilization service capacity across Montana.

Mobile Crisis Response Update as of Feb. 27, 2025: This funding is intended to support existing mobile crisis response (MCR) programs that were operating at the time Governor Gianforte approved this NTI. Each program can use the funds to cover operational costs accrued that are not otherwise covered by Medicaid, private insurance, and other claim reimbursements.

Many programs are in the process of submitting initial claims or are not currently operating and therefore have yet to receive funding.

The counties that were awarded funding were Flathead, Gallatin, Lewis and Clark, Lincoln, Missoula, Silver Bow, and Yellowstone.

Crisis Receiving and Stabilization Services Update as of Feb. 27, 2025: This NTI uses a total of $4 million in BHSFG funding to support infrastructure costs associated with opening or reopening crisis receiving and stabilization facilities across the state.

These funds were awarded through an RFP for the existing Crisis Diversion Grant (CDG) program. The contracts for the CDG program were executed at the end of CY 2024 and cover a 3-year period. This program allowed county and tribal government agencies to apply for state funding to support local efforts aimed at diverting individuals experiencing crises from escalating to a point of needing higher levels of care, such as the Montana State Hospital.

The Department awarded five requests to counties of Carbon, Cascade, Flathead, Gallatin, and Lewis and Clark.

• Recommendation for Consideration – Crisis Services (mt.gov)
• Governor Gianforte Invests $8 Million to Improve Behavioral Health Crisis Response in Montana (mt.gov)

This initiative calls on DPHHS to contract with a vendor experienced in curriculum development to develop and host a Crisis Worker Certification Course that will be available for providers delivering crisis services. The certification course will ensure trainees understand specific knowledge areas such as basic suicidology, intervention strategies, and community resources. The selected vendor will collaborate with crisis provider stakeholders and DPHHS throughout the project term.

Update as of Feb. 27, 2025: DPHHS signed an agreement with the University of Montana Center for Children, Families and Workforce Development (Center) to develop a 40-hour training that will be used to train all crisis workers statewide, from 988 operators to mobile crisis responders to crisis center workers. The Center began work on this project in August 2024 and has been working internally to develop content, as well as connecting and contracting with subject matter experts on drafting individual modules within the curriculum. The Center expects to have a testable version of the training by May 2025.

• Recommendation for Consideration – Crisis Curriculum (mt.gov)
• Governor Gianforte Invests $8 Million to Improve Behavioral Health Crisis Response in Montana (mt.gov)

DD Workforce Near-Term Initiative Documents

The initiative will provide up to $350,000 to pilot a Direct Support Professionals (DSP) credentialing structure to test best practice approaches to stabilizing the DSP workforce by establishing career ladders. Additionally, $200,000 of funding is allocated through this NTI to enhance training opportunities for healthcare professionals to support individuals with Intellectual and Developmental Disabilities (IDD) seeking medical and behavioral healthcare by sponsoring 500 “seats” in the Curriculum in IDD Healthcare eLearn course.

Update as of Feb. 27, 2025: DPHHS launched a pilot program in Spring 2024 with the intent to award participating providers with funds to distribute to their DSPs for enrolling in and completing tiers in the credentialing platform. Five providers across four regions in Montana were awarded with the intention of allowing for up to 75 DSPs to earn nationally recognized credentials and corresponding bonuses.

As of February 2025, approximately 64 DSPs were enrolled in the credentialing program through NADSP. Data is being collected to determine if DSP credentialing positively impacts recruitment and retention efforts, ultimately stabilizing the DD workforce. DPHHS continues to work with providers to continue the progress of this NTI.

• Developmental Disabilities Workforce Capacity Development Recommendation for Consideration
• Governor Gianforte Invests $600,000 to Strengthen Montana’s Direct Care Workforce (mt.gov)

Family Peer Support Provider Grant Submissions

This initiative will provide up to $700,000 to create a family peer support pilot program. Funding will provide one-time grants to up to five organizations with a proven record of providing family peer support services in Montana. This initiative aims to provide Montana families with needed access to a cost-effective solution to help meet family and caretaker needs.

• Recommendation for Family Peer Support Pilot Program
• Governor Gianforte Invests $700,000 to Expand Family Peer Support Services in Montana (mt.gov)

Support for Tribes and Urban Indian Health Organizations

This initiative will provide up to $6.5 million in one-time grants to Tribal nations and Urban Indian Health Organizations (UIHOs) to support and improve behavioral health services provided in Native American communities. The funding can be used to improve, repair, or expand existing behavioral health facilities, support mobile crisis response teams, and cover transportation expenses to facilities that serve individuals with behavioral health needs in a culturally relevant manner.

• Recommendation for Support for Tribal and Urban Indian Organizations to Expand Behavioral Health and Developmental Disabilities Capacity
• Governor Gianforte Invests $6.5 Million to Support Tribal, Urban Indian Health Organizations

Fair Market Rent Reevaluation Study

This initiative will provide up to $1,000,000 to conduct a statewide study to determine the appropriate level of funding needed to help supplement housing costs for low-income Montanans served in the state’s behavioral health system. Through the study, information will be gathered on current rental rates throughout the state to help determine the funding necessary to supplement federal rental assistance.

• Recommendation for Fair Market Rent Reevaluation Study
• Governor Gianforte Invests $1 Million to Address Housing Accessibility for Montanans in Behavioral Health System

Wellness Kiosks Grant Submissions

Access to Naloxone and Fentanyl Testing Strips

This initiative will provide up to $400,000 to provide low cost, life-saving resources across the state to respond to the fentanyl and opioid crisis. The one-time funding will be used to install Wellness Kiosks throughout the state, which will dispense and distribute fentanyl testing strips and naloxone. The kiosks will be strategically placed at community-based programs such as Projects for Assistance in Transition to Homelessness and Drop-in Centers. Both programs are low barrier access points to behavioral health treatment and offer individualized supports.

• Recommendation for Access to Naloxone and Fentanyl Testing Strips
• Governor Gianforte Announces $400,000 Investment in Response to Fentanyl, Opioid Crisis

Funding to Launch Occupational Therapy Doctorate and Physician Assistant Programs

Funding for this initiative was awarded in January 2025 to the University of Montana (UM) and Carroll College. The initiative provides $4 million to support startup costs for UM and Carroll to launch Physician Assistant (PA) and Occupational Therapy (OT) doctorate programs. UM is in the process of launching both an OT doctorate and a PA program and Carroll plans to launch a PA program. The investment in start-up costs will support UM in launching programs that will graduate 30 OT students and 25 PA students each year starting in 2028. Carroll anticipates matriculating its first cohort of 34 students in May 2028, pending the program’s accreditation process. PAs and OTs fill critical roles in Montana’s BH and DD continuum of care. In rural areas with shortages of physicians and other behavioral health professionals, PAs often function in primary care roles and can be the only providers in the community. OTs provide an array of vital services, including prevention and treatment services. According to a 2022 Montana Department of Labor and Industry report, approximately 67 PAs and 33 OTs are needed to meet community demands.

• BSHFG Recommendation – OCHE NTI Updated with Amendment
• Governor Gianforte Announces $4 Million Investment to Increase the Number of Health Care Providers in Montana
• Governor Gianforte Announces $4 Million Investment to Increase the Number of Health Care Providers

Tribe Local Innovations Pilot Program Grant Application

County Local Innovations Pilot Program Grant Application

Funding to Pilot Local Innovations in Behavioral Health through Grants to Counties and Tribes

This initiative will provide $2.5 million to support rural counties and tribal communities as they design and implement targeted, locally developed solutions to behavioral health needs within their communities. The one-time, two-year grants of up to $250,000 each will be awarded to up to 10 tribal communities and rural counties throughout Montana. Through the program, tribes and counties can apply for either the System-Level Innovation or Local-based Community Health Workers track. Tribes and rural counties will be able to apply for funding later this fall on the DPHHS website.

• Local Innovation NTI
• Governor Gianforte Invests $2.5 Million To Meet Behavioral Health Needs in Rural Montana