Sustainable Funding For Mental Health and Substance Abuse Programs Through Montana’s Recreation Marijuana Tax

Each Legislative Session is its own rollercoaster and the descriptions of how things went on that rollercoaster depends on your interests, beliefs, and where you were sitting in the rollercoaster cars.

Here is my personal take on the effort to achieve one of NAMI Montana’s goals for this Legislative Session. This is heavier than our usual updates, but I thought it was important to use the actual text of the bill (in italics) to make sure I didn’t over-interpret anything.

One of NAMI Montana’s primary goals for this Legislative Session was to work for more sustainable funding mental health programs. We focused specifically on sustainable funding for research-proven programs to reduce negative mental health outcomes and crisis services.

Our initial legislative targets for this effort were both bills by Rep. Mary Caferro of Helena.

• HB 369 — Support school-based prevention programs
• LC 1234 — Provide funding for mental health crisis services

HB 369 used funding from expanding alcohol tax revenues to pay for research-proven prevention programs. LC 1234 would have used funding from taxes on recreational marijuana.

To paraphrase Prussian Field Marshal Helmuth Karl Bernhard Graf von Moltke, “No plan survives enemy contact.” Former Heavyweight Champion Mike Tyson’s has a similar quote, “Everybody has a plan until they get punched in the mouth.”

The public policy advocacy version of that is every piece of legislation is the start of a conversation, not the end. That advocacy push will face legislative committees, state administrative leaders, other advocacy groups, etc. Many of those people and groups will change the focus of the effort, bring their own spin, or launch their own parallel effort.

The transitory nature of legislation is a feature of the system — not a bug. It’s the reason NAMI Montana runs multiple bills on issues that matter to us.

HB 369 cleared the House Health and Human Services Committee 17–2. The bill generated a lot of support, but died on a 51–49 floor vote of the Montana House of Representatives.

At about this time, Representative Mike Hopkins’ HB 701 was gaining momentum as the preferred legislation for the Montana Marijuana tax. Representative Caferro felt like her overall role in the state budgeting process and funding allocation for the American Recovery Plan Act put her in a difficult situation to push LC1234. So, we decided not to move forward with LC1234; hoping that our goal of sustainable funding for mental health programming would make it in HB 701.

Thankfully, Governor Greg Gianforte’s “Healing and Ending Addiction Through Recovery and Treatment Account’” (HEART Fund) in Section 100 of HB 701 was also changing from a purely substance abuse prevention program to reflect the need for mental health funding as well.

Here is the final language in that section.

Section 100. Healing and ending addiction through recovery and treatment account. (1) There is a healing and ending addiction through recovery and treatment account in the state special revenue fund. The account consists of money transferred to the account pursuant to 16–12–111.

(2) Revenue in the account must be used to provide statewide programs for:

(a) substance use disorder prevention;

(b) mental health promotion; and

© crisis, treatment, and recovery services for substance use and mental health disorders.

(3) The programs must be designed to:

(a) increase the number of individuals choosing treatment over incarceration;

(b) improve access to, utilization of, and engagement and retention in prevention, treatment, and recovery support services;

© expand the availability of community-based services that reflect best practices or are evidence-based;

(d) leverage additional federal funds when available for the healthy Montana kids plan provided for in Title 53, chapter 4, part 11, and the medicaid program provided for in Title 53, chapter 6, for the purposes of this section;

(e) provide funding for programs and services that are described in subsections (2)(a) through (2)© and provided on an Indian reservation located in this state; or

(f) provide funding for grants and services to tribes for use in accordance with this section.

(4) (a) An amount not to exceed $500,000, including eligible federal matching sources when applicable, must be used to provide funding for grants and services to tribes for tobacco prevention and cessation, substance use disorder prevention, mental health promotion, and substance use disorder and mental health crisis, treatment, and recovery services.

Section 108 in HB 701 describes the amount and timing of funding for the HEART Fund below.

Section 108. Appropriation. (1) There is appropriated from the marijuana state special revenue account provided for in 16–12–111 to the department of revenue:

(a)$6,930,492 for fiscal year 2022, which comprises 34 total FTE. 22 of the 34 FTE represent positions transferred from the department of public health and human services to the department of revenue.

(b) $4,136,011 for fiscal year 2023 and which comprises 34 total FTE. 22 of the 34 FTE represent positions transferred from the department of public health and human services to the department of revenue.

© The appropriations described in subsections (1)(a) and (1)(b) must be used by the department of revenue for the operating costs it incurs when administering the provisions of [this act].

(d) The appropriation provided for in this subsection (1) must be considered a part of the base budget for the 2025 biennium.

(2) (a) (i) The following amounts are appropriated for each year of the 2023 biennium to the department of public health and human services for eligible services and programs in accordance with the HEART fund that is set forth in 17–6–606 [section 100]:

(A) $6 million in state special revenue funds; and

(B) $19 million in federal special revenue funds.

(ii) It is the intent of the legislature that these appropriation amounts be included as part of the base budget for the department of public health and human services for the biennium beginning July 1, 2023.

The final version of Governor Gianforte’s HEART Fund achieves NAMI Montana’s goal of providing significant sustainable funding for mental health programs. This funding will be especially important for programs that have proven by research to be effective, but don’t fit perfectly into the fee-for-service Medicaid system.

We are incredibly grateful to the Governor, Rep. Mike Hopkins, the Legislative staff, and DPHHS employees who help craft and re-craft this critical legislation.

We are also grateful to Rep. Mary Caferro who carried our original legislation that helped build momentum for sustainable funding at this year’s Legislative Session.

NAMI Montana is excited about the HEART Fund, but we need your help in making sure it rolls out effectively. We want to make sure the State of Montana awards the Mental Health Promotion funding described in Sec. 100(2)(b) through a competitive grant process, rather than just chosen by the Department of Public Health and Human Services.

This would allow the funding to go to a variety of research-proven Mental Health Promotion programs (such as the PAX Good Behavior Game and Youth Aware of Mental Health) that are supported by communities. This is the same model that the Legislature approved for suicide prevention program grants in 2017 and it has been successful.

Please email Governor Greg Gianforte at governor@mt.gov and ask him to ensure that the State of Montana awards Mental Health Promotion programs in HB701 through a competitive grant process.

Thank you,

Matt

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The Treatment Scout website helps people find effective inpatient and residential care. It can also help you explore other intensive care options for mental health, addiction, etc. Find out more at http://www.treatmentscout.com/

NAMI Montana’s has a resource guide for every county in Montana. Check it out at https://namimt.org/montana-county-mental-health-resource-guides/