Montana health organizations say a state government backlog in paying its contractors has hindered their ability to provide care, and they worry the bottleneck\u2019s ripple effects will be felt long after the money comes through.<\/p>\n

Several organizations waiting for contracts to be approved and funding to arrive said that more than 200 private and public contractors across the state government were affected at one point. Montana Department of Public Health and Human Services officials acknowledged the delays but would not confirm the total number of contracts affected.<\/p>\n

\u201cI\u2019ve never seen it this dysfunctional,\u201d said Jim Hajny, executive director of Montana\u2019s Peer Network<\/a>, a state contractor affected by the delays. \u201cSomething just completely broke down, but there is nothing coming out. Not even a letter to say, \u2018Hey, sorry, we\u2019re not going to get the contracts out.\u2019\u201d<\/p>\n

The state health department contracts with more than 4,000 organizations, including crisis mental health care and other critical local services. Contractors have reported going months without pay; one said it had been nine months. Some have laid off employees, scaled back services, or stalled programs.<\/p>\n

By January, the health department had 31 contracts left to finalize out of more than 700 due for review from June through December, spokesperson Jon Ebelt said.<\/p>\n

Ebelt blamed the delays, in part, on a higher-than-usual contract load, staff turnover, and new legislative mandates.<\/p>\n

The department also has increased the scrutiny of contracts during the state\u2019s legal review process. That is due to a new emphasis by the state Department of Administration on \u201cthe importance of legal review of agency contracts,\u201d Ebelt said.<\/p>\n

The bureaucratic snafu comes amid an ongoing initiative by Republican Gov. Greg Gianforte to cut bureaucratic red tape<\/a> and strengthen the state\u2019s mental health system,<\/a> which has long been shaky.<\/p>\n

Health department officials wouldn\u2019t disclose how much money is owed to organizations with outstanding or finalized contracts. The health and administration departments \u201chave worked collaboratively and constructively to address delayed contracts,\u201d health department spokesperson Holly Matkin told KFF Health News by email. \u201cWe have no further comment.\u201d<\/p>\n

Both agencies assigned additional staffers to finalize the remaining contracts.<\/p>\n

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Marvin Colman, who runs a substance use disorder facility in Helena, Colman Community Services, said he hasn\u2019t received any of the $330,000 grant it was awarded last April. The federal grant, managed through the state health department, was supposed to cover people who can\u2019t afford insurance or don\u2019t qualify for Medicaid.<\/p>\n
Colman hired staff and opened a second clinic in anticipation of the funding. After going into debt to stay open for nine months, he laid off six employees and closed the new clinic. Now, due to the unpredictable funding, Colman said, they can no longer treat uninsured people.<\/p>\n
\u201cWe discharged 20 clients this last week, not because they didn\u2019t need services, but because we can\u2019t afford to do it anymore,\u201d Colman said.<\/p>\n
In Ronan, on the Flathead Indian Reservation, a drop-in center for people in addiction recovery run by Never Along Recovery Support Services is reducing hours. Executive Director Don Roberts said staffers, including himself, had to take part-time jobs after the company dwindled its reserve funds waiting months for a finalized contract.<\/p>\n
\u201cI\u2019m worried about keeping people alive,\u201d said Roberts, a licensed addiction counselor. \u201cIf a person is like, \u2018I need help right now,\u2019 and they show up at the recovery home and we\u2019re not here, what happens to that person? They go and relapse.\u201d<\/p>\n
He worries those who survive a crisis won\u2019t come back the next time they need help.<\/p>\n
After three months without state funding that covers payroll, Roberts still doesn\u2019t understand what caused the delay. He said state employees trying to finalize the contract are helpful, but even they seem confused about the cause of the holdup.<\/p>\n
Once the money comes in, the inconsistent hours will remain for the foreseeable future due to workers\u2019 new part-time jobs, Roberts said.<\/p>\n
Montana\u2019s Peer Network, which trains mental health workers statewide, delayed holding its courses and laid off employees in October due to a lapse in multiple state contracts, Hajny said. Neither the health nor administration department explained why there was a delay or when to expect payment as of early January, he said.<\/p>\n
One of the legislative mandates Ebelt cited as a factor in the delays is a new state law requiring state contractors to verify in writing that they won\u2019t discriminate against companies that make, distribute, or sell guns, or firearm associations.<\/p>\n
Hajny shared emails with KFF Health News that showed his organization waited at least a month for a state official to sign off on its firearm nondiscrimination declaration.<\/p>\n
Although some of the company\u2019s contracts were finalized in December, he\u2019s still waiting for backdated pay. In the meantime, one employee found a new job, and Hajny said he\u2019s gotten calls from agencies with new hires who need training.<\/p>\n
\u201cHow can I bring my employees who were laid off back on if I haven\u2019t been paid for three months?\u201d Hajny said. \u201cIt\u2019s because the department can\u2019t get a contract out.\u201d<\/p>\n
The impact of the delayed funding varies based on how large an organization is and how much cash it has on hand.<\/p>\n
Gallatin County Commissioner Zach Brown said the state hasn\u2019t paid the county for its mobile crisis response services for six months. Officials found temporary funding to fill the gap, something smaller governments likely can\u2019t afford to do.<\/p>\n
Brown said he trusts the state will eventually pay up, but he doesn\u2019t know how much the county will be reimbursed for what it\u2019s spending now. He also worries that the unpredictability risks scaring off contractors that helped launch its mobile crisis team.<\/p>\n
\u201cIt\u2019s a big deal for our community to sort of organize its crisis system around having this service available,\u201d Brown said. \u201cIt\u2019s not like we\u2019ve got other folks champing at the bit to try and stand something like this up. It\u2019s not a moneymaker. It\u2019s really a difficult service to provide.\u201d<\/p>\n
Matt Furlong is a board member of the Montana Mental Health Central Service Area Authority, which advocates for and supports mental health services. The health department historically runs a little late in paying contracts, Furlong said. But this time, the gap has lasted long enough to risk contractors\u2019 operations.<\/p>\n
He said organizations are hesitant to speak publicly for fear the state will withhold future contracts. Living in uncertainty can create lasting trust issues between already stretched-thin health workers and the state.<\/p>\n
\u201cIt just breaks everybody down,\u201d Furlong said.<\/p>\n
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