With longer and warmer days on the horizon, we have much to look forward to with the official start of spring on March 20. In this issue of Ink, AWARE’s Medical Director, Dr. Brogan, writes about the impacts of the seasons on our sleep cycles and mental health. In her column, she offers a friendly reminder to take care of yourself and empower yourself to make sleep a priority. I will take it one step further and encourage you to make it a priority to get outside and enjoy the fresh air and activity this spring. Spring in Montana is something special – take advantage of it!
Also in this issue of Ink, we will highlight AWARE’s fiscal and human resources teams. These people are often “behind the scenes,” yet are crucial to our success. With more than 800 employees serving 5,000 Montanans in all 56 counties, it is imperative that we have teams to support our frontline caregivers. Led by Francine Cooper (CFO), Leighann Knight (COO), and Trish Thompson (HR Director), our fiscal and HR teams do tremendous work. I hope you will take the time to read about their contributions and impact.
To fully understand the importance of those teams, it is important to provide some background information on how AWARE is funded, challenges we face, and how you can help.
Most of AWARE’s funding comes from Montana’s Medicaid program. Medicaid is a state-operated public health insurance program with significant federal funding participation.
It is hard not to recognize the behavioral health crises our communities are facing. The scenarios are real, they are serious, and they are personal. Our family, friends, neighbors may be dealing with an intellectual or developmental disability, autism, mental illness, or may rely on self-medication as coping mechanisms. Homelessness is not a new problem, kids have “couch surfed” due to lack of functional home or family, and people with mental illness have lived on the streets or in shelters. However, perhaps the perception of the problem is reaching crisis levels because now it is more prevalent and visible.
Truth be told, much of this behavioral health crisis was self-created:
It was only a few years ago (2017) when our state government decimated community-based behavioral health programs by slashing Medicaid (footnote 1) funding. For example, case management programs help connect people to necessary services, yet the provider rates for these programs were reduced 50-60% in 2017, and to this day, they have not recovered to the funding levels of eight years ago.
Behavioral health group homes exist as better alternatives than forcing people with disabilities to live in hospitals and institutions. Group homes not only offer less expensive alternatives to institutionalization, but they also allow people with disabilities to live with dignity and respect in communities across our state.
However, these home and community-based service options have historically been underfunded, with Medicaid behavioral health provider rates increasing on average 1.1% per year. Imagine making a wage of $10 per hour in 2007, and then making $11.78 per hour in 2022. One would probably seek supplemental income or find another job. It’s no wonder that the current workforce crisis disproportionately impacts behavioral health services and negatively impacts people with disabilities.
There is hope. We know what works and know what to do to prevent crises, support families to stay together, and assist people to re-enter our communities after hospitalization and institutionalization.
In 2023, our state legislature appropriated historic funding increases for behavioral health that helped close the expanse between adequate funding and the reasonable costs to deliver quality services. For this, we citizens and behavioral health providers are thankful and hopeful that we’ll soon experience improvements in the system of care and soon see access to services at the right time and place.
Our state and local governments, along with providers, advocacy organizations, foundations, and community stakeholders, are responding to this crisis with significant coordination and strategic planning efforts.
Many of us are advocating for continued investments in, and sustainable funding for, home and community-based behavioral health programs. You too can help by educating yourself and others via AWARE Ink, other media, and by participating in local government and legislative hearings regarding public health. You can also advocate for people with disabilities, advocate for our staff, and our services by communicating with our governor’s office and your legislators.
I have said it before, and I will say it again. It takes a team to help people live independent lives and we are so grateful to have you on ours.
Sincerely,
Matt Bugni – CEO
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