Montana commission recommends $30M+ in ARPA spending for health care initiatives

HELENA — A state advisory committee has finalized its recommendations on how to spend more than $30 million in the federal American Rescue Plan to fund health care initiatives.

At a meeting Friday, ARPA’s Health Advisory Committee endorsed six proposals from the Montana Department of Public Health and Human Services. DPHHS Principal Charlie Brereton said their focus is on “one time” funding opportunities.

One of the largest planned expenditures will be $15.5 million to support state and local public health workforce and data systems. That includes money to continue county and tribal public health positions created through ARPA funding set to expire next June — eight epidemiologists and about 13 disease intervention specialists, public health nurses and other positions. The funding will now extend them to November 2027.

The Montana Public Health Employees Association supported the proposal, saying public health departments have struggled with workforce capacity and the addition of ARPA funding has helped them restore that.

Some Republican lawmakers on the committee opposed the plan, saying they were concerned it essentially creates permanent positions that the state may eventually have to pay for.

“That was the whole narrative all along that the Legislature was worried about, planting a seed that we’re going to have to water later,” said Congressman Matt Regier, R-Kalispell.

Brereton said DPHHS has made it clear to local governments that this funding is for a limited period of time, but the federal government may provide continued funding in the future.

“There is no expectation, certainly under my leadership here at DPHHS, that the state will commit general fund dollars to continue these positions,” he said.

The commission also voted to authorize another $14.4 million for a program that provides COVID-19 testing resources to schools and child care facilities so they can remain open for in-person services.

Last year, the commission provided about $18 million for this initiative. So far, schools have used only about $5.2 million of that.

Brereton said federal rules severely limit what other options they have for spending that money. He said the CDC allowed it to be expanded to child care after it was originally only open to K-12 schools, but they rejected several other requests for more flexibility. He said DPHHS wants to be ready to spend the full amount available in the event of an unexpected need.

In one case, leaders were able to divert unused funds. The commission approved the transfer of $2.5 million to provide one-time payments of $1,250 to support about 2,000 children in temporary foster care. Leaders said carers involved in the Department of Children and Family Services had been particularly hard hit by inflation.

The money was originally earmarked for families receiving Supplemental Nutrition Assistance Program benefits to encourage people to find new or better jobs. DPHHS distributed just under $129,000 to 186 families through this program. Brereton said they have exhausted their efforts to connect eligible households with the benefit, including contacting all SNAP recipients and contacting directly those who appear to be eligible.

Rep. Mary Cafero, D-Helena, said she is grateful for the foster care assistance proposal and hopes the state will continue to look at raising foster care payments.

“It’s hard to put a dollar amount on the value of the investment in children who have been abused or neglected,” she said.

Other recommendations approved by the committee on Friday include:

  • $1.2 million for the State Public Health Laboratory to upgrade its testing equipment for COVID and other diseases and to conduct wastewater tests to monitor disease trends.
  • $866,000 to support Montana regional agencies on aging, create a strategic plan for senior centers and train health insurance counselors to work with Native Americans.
  • $121,000 to support the workforce at Montana’s four independent living centers that serve people with disabilities.

As with all ARPA advisory committee recommendations, Gov. Greg Gianforte must give final approval before the money is officially distributed.

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