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HELENA, Mont. (AP) — After Montana spent hundreds of thousands of taxpayer dollars to treat his seriously ill son, John Wilkinson voiced support for both Republican and Democratic proposals this legislative session to prioritize early and local intervention in mental health care. He didn't know which measures would survive.
At the session's halfway point, the future of two legislative packages to augment mental health care is clearer.
Three Republican-sponsored bills to bolster short-term care have passed the House with unanimous support. But they cover only a fraction of the governor's sweeping proposal that partially survived initial budget hurdles.
House Bills 33, 34 and 35 spend $4.2 million over the next two years to facilitate local interventions in mental health crises. Republican Rep. Ron Ehli said the plans would send fewer patients and inmates, like Wilkinson's son, to the Montana State Hospital in Warm Springs.
"The model is really simple," the Hamilton representative said. "It's a model that pushes mental health care more toward community-based care versus institutional care."
The measures do not include long-term services covered in the $20 million mental health package that Democratic Gov. Steve Bullock recommended in his budget plan in January. About half of that proposal survived subcommittees.
Despite what is currently slotted to be a $3.7 million overlap between the two mental health packages, no one from the governor's office has supported or opposed the Republican measures.
"We can't very well go in and say, 'We support this, but it's not a complete package,'" Budget Director Dan Villa said. "It's sort of like saying you ran half a race, and you get a ribbon. No, you ran a part of the way. You've got a lot more to go."
House Bill 33 would help communities open local crisis centers. House Bill 34 would provide additional beds for overnight stays at those centers. House Bill 35 would allow people facing involuntary commitment at the state hospital to voluntarily undergo treatment closer to home and, if stabilized within two weeks, forego the state institution.
Ehli introduced each bill on behalf of the Children, Families, Health and Human Services Interim Committee, which conducted research on the state's mental health needs over the past two years.
In the Legislature's first 45 days, the measures flew through the House Appropriations Committee and House of Representatives on 20-0 and 100-0 votes after the sponsor successfully tacked on $3.7 million of his proposals to similar ones in the governor's plan.
Meanwhile, budget subcommittees dissected and passed $10.8 million of the governor's original $20 million proposal.
Apart from crisis funding merged with Ehli's bills, the surviving services in Bullock's plan include housing and re-entry procedures, peer support services, 72-hour crisis beds and a $7.6 million infrastructure expansion at the state hospital. But the subcommittees nixed the staff and hospital programs that the governor's office asked to fill those new halls.
Villa said the Republican bills ignore that some people can be treated only in a psychiatric hospital.
Both plans invest in short-term crisis beds.
"However, the governor's plan is still the only plan that addresses the entirety of the continuum of care," Villa said. "From community-based preventative services to community-based crisis services to state-wide acute care needs."
For John Wilkinson, any movement toward local treatment facilities is better than no change in the overcrowded and expensive detainment that his son and other mentally ill inmates experience in Warm Springs.
The Republican proposals will be heard Thursday in the Senate Finance and Claims Committee. The governor's proposal moves on to the House Appropriations Committee.
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