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Roughly three years into a new initiative, 55 Montana providers have woven more mental health services into their regular care.

Montana Healthcare Foundation CEO Aaron Wernham announced the number Tuesday during the organization’s Integrated Behavioral Health Summit at Montana State University.

“That is a fantastic rate of transformation,” Wernham said.

The idea behind integrated care is doctors should spot symptoms of depression or anxiety and have a way to connect patients to ongoing support.

Wernham said the foundation began its initiative in 2016 and since, doled out $4.5 million toward integrated behavioral health planning and start-up costs throughout Montana.

That went toward all 16 of the state’s community health centers, 26 critical access hospitals, two tribal health departments and three urban Indian health centers. Eight of Montana’s largest hospitals also received grants.

Last year, Bozeman Health Deaconess Hospital announced it received $150,000 to add behavioral health to its internal medicine clinics over two years.

Livingston HealthCare — a critical access hospital — received two grants from the foundation beginning in 2015. That money led the hospital to hire its first psychiatrists and up its number of clinical social workers.

The effort is still new. Wernham said not every provider in the initiative has a full range of integrated care, but it’s a start.

More than 300 people attended the Bozeman summit.

The opening remarks began with the state of behavioral health in Montana, which Sheila Hogan, the director of the Montana Department of Public Health and Human Services, kicked off.

Hogan talked about reengineering a system “that works in Montana for all Montanans.”

She said that will take work across organizations.

Hogan touted a state collaboration with the Montana Healthcare Foundation that gets care to pregnant women or new mothers who face mental health issues.

She talked about the fact that Montana held onto a version of Medicaid expansion that covers some mental health treatment services. Lawmakers also approved Medicaid reimbursement for certified peer support specialists, professionals who work with people living with a mental health or substance use illness.

Hogan didn’t mention the state Medicaid cuts that providers across Montana felt beginning in 2018. In a state balancing act, the health department had to cut $49 million, some of which was restored.

Providers have said in past interviews those cuts led to three facilities closing in Bozeman and Livingston. That includes the Livingston Mental Health Center, a Bozeman case management office called Winds of Change and Bozeman’s sole recovery house for women under the area’s Alcohol and Drug Services.

Wernham said those cuts impacted speciality providers more than primary care. He said a major question Montana faces is what’s the ideal model to deliver behavioral health to primary clinics and how to pay for it.

Most of Tuesday’s audience were people weighing how to make that model work in their town.

That included Emily Hutchinson, a medical coder with Livingston HealthCare.

Hutchinson said while the hospital is a few years into its effort, they’re still learning about who and what to bill for the increased behavioral health services. Hutchinson said she also wants to understand how the hospital can reach home-based patients with the care.

Psychiatric physician Kayli Christophel joined Livingston HealthCare as part of its expanded behavioral health team. Christophel said part of what they’re still figuring out is how to work together without overloading a few workers.

“It’s about making as much as we can with limited resources,” Christophel said. “We’re still learning a lot in how you actually make this work.”

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Katheryn Houghton can be reached at or at 582-2628. Follow her on Twitter @K_Hought.

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