Providing addiction treatment services for people in need has been a challenge for largely rural states in the U.S. where treatment centers are few and far between. But treatment will become more accessible in the state of Montana, which may come close to doubling its number of state-approved chemical dependency treatment centers, by the end of this year.
Last year, Montana legislators repealed part of a 40-year-old state law that limited the number of state-approved treatment centers to one per county. When it was put in place, the law was intended to encourage geographic variety in treatment centers. However, the state’s growing population made the law outdated as a way to ensure people who need treatment have access.
An estimated 64,000 residents of Montana have a substance use disorder, according to the 2014 National Survey on Drug Use and Health.
New treatment programs, some brand-new clinics, and other expansions by existing providers have been approved or are in the process in the Montana cities of Helena, Missoula, Polson, Billings, Shelby, Butte, St. Ignatius, Kalispell, Livingston, Browning, Eureka, Wolf Point and Plentywood.
“When this bill went through, we had 32 state-approved providers, and now we have a total of 25 that we think are going to be state-approved by the end of the year,” said Zoe Barnard, administrator of the Addictive and Mental Disorders Division of the state Department of Public Health and Human Services. State approval makes treatment centers eligible to bill Medicaid for services they provide, Barnard told the Independent Record, but providers need to provide evidence the services are needed.
To obtain state approval, centers are required to complete an application and spell out their policies and procedures. Substance use disorder services that can be state-approved include day treatment, detox, inpatient treatment, recovery homes, intensive outpatient treatment, outpatient treatment and educational courses for DUIs and minors in possession.
So far no applications have been denied, Bobbi Perkins, chemical dependency bureau chief for the state Department of Public Health and Human Services, told the Independent Record.
As part of the expansion of services, the state is also inviting providers to apply for approval of new types of programs than may already exist in a given area. For example, the Recovery Center in Missoula indicated in its application that it wants to open treatment homes for pregnant women in St. Ignatius, Perkins said.
In eastern Montana, Brenda Kneeland, chief executive officer of Eastern Montana Community Mental Health Center, said her organization sought state approval in five counties where it already had mental health services to be able to add the option of chemical dependency treatment.
“Many clients we serve have co-occurring disorders, so to have one provider who can treat both their mental health and substance abuse treatment needs makes sense,” Kneeland told the Independent Record. “Continuity of care allows for improved clinical outcomes.”
As of last week, seven providers were still working with the state on their applications, 11 have gotten temporary approval, and seven have been fully approved, according to the state. Barnard said though the duplication language was removed from state law, providers still must demonstrate a need for the services they propose to provide.
Ironically, as treatment options are expanding for Montana residents, budget cuts being proposed by the state health department could limit the number of counseling sessions the state’s Medicaid program will cover for each recipient.
Montanans with substance addictions could be limited on how many counseling sessions they get a year as the state health department continues to make budget cuts. Patients and providers gathered in the state capitol to demonstrate against the cuts, which they say would lead to more crises, hospitalizations and suicide attempts statewide.
The proposed rules, set to begin April 1, would move Montana’s addiction counseling system from a needs-based assessment to a cap on services, according to the Bozeman Daily Chronicle. Clients who request more than 12 individual and 12 group sessions a year would need a professional evaluation and state approval to continue therapy.