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AWARE Ink Newsletter

  • AWARE

Gaps in Montana Service Limit Access to Crucial Care

This is as much a story about one individual as it is a story about a group of individuals. The details are accurate, but names have been changed to maintain anonymity. This story depicts the impact of funding constraints and staffing shortages. After years of inadequate rates, this system is beginning to buckle for clients, families and providers.

Ava is a 16-year-old who currently lives with her grandparents. She is a person with developmental disability and qualifies for residential services but is unable to find a placement with a care provider in the state of Montana despite numerous attempts and an approved funding plan.


Ava enjoys living with her grandparents, but they are both in their 80s and have their own health needs. Their ability to provide the care that Ava needs on a daily basis is limited because of this.


Ava has nowhere else to go. Her grandparents are her only support, and they don’t know how much longer they can do it.


As time goes on, Ava shows an increase in behavioral episodes that are just as traumatic for her as they are for her grandparents. They’re trying to help, but they don’t have the ability or tools to know how to provide adequate and consistent care for Ava.


Even with approved emergency funding, residential care providers have turned Ava down on repeated attempts. They have open beds in their homes, but they can’t find enough staff to operate at full capacity.


Providers are unable to meet the demands of crucial care because of staffing shortages. They’re trying to hire qualified employees as fast as they can, but they are unable to provide competitive wages with service rates that have fallen behind year after year.


The system is not sustainable. Some providers have already made the difficult decision to close their doors, not because they want to, but because they felt they could no longer maintain the health and safety of their clients.


Families are frustrated. They’ve moved from one waiting list to another without any progress for months and years at time.


Case managers have exhausted all options. They’re the link to care for individuals and families as they navigate funding, placements and treatment plans.


Everyone is just waiting.


Needs are at an all-time high, but care cannot be delivered without an improved rate structure. A study of our behavioral health system commissioned by the 2021 legislature shows an urgent need for enhanced funding.


The solution is to fully implement the Medicaid rate study, including an annual cost of living adjustment, to keep our community-based behavioral health system of care intact.

Please call and/or email the governor and your representatives and ask them to support this investment in mental health.

Without adequate funding, our system of care will collapse and ultimately cost the state more. We need your advocacy now more than ever.

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