Montana Commission recommends $30 million+ in ARPA spending for healthcare initiatives

Helena – A state advisory committee has finalized its recommendations on how to spend more than $30 million in funding for the US Federal Rescue Plan for Health Care Initiatives Act.

At Friday’s meeting, the Health Advisory Committee supported ARPA Six proposals from the Montana Department of Public Health and Human Services. Charlie Brereton, director of DPHHS, said their focus was on “one-time-only” funding opportunities.

One of the largest planned expenditures will be $15.5 million to support the workforce and data systems in public health at the state and local levels. That includes money to continue the county and tribal public health jobs created through ARPA funding that was due to end next June — eight epidemiologists, about 13 disease intervention specialists, public health nurses and other positions. Funding will now be extended through November 2027.

The Montana Association of Public Health Officials supported the proposal, saying that public health departments struggled with workforce capacity, and that adding ARPA funding helped them rebuild that.

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

“That was the whole narrative all along the legislature was worried about, planting a seed we’ll have to water later,” said Rep. Matt Regier, Republican of Kalispell.

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

“There would be no expectation, certainly under my leadership here at DPHHS, that the state would provide public funds from funds to continue these positions,” he said.

The committee also voted to authorize another $14.4 million for a program that provides COVID-19 testing resources to schools and childcare facilities to remain open for in-person services.

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

Brereton said federal rules severely limited their other options for spending this money. He said the CDC allowed its expansion to include child care after it was initially open only to K-12 schools, but they have denied many other requests for more flexibility. He said the 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 redirect unused funds. The committee agreed to transfer $2.5 million to provide a one-time payment of $1,250 to support approximately 2,000 children in temporary foster care settings. Leaders said that people who care for children involved in the Department of Child and Family Services have been particularly affected by the inflation.

The funds were originally intended for families receiving Supplemental Nutrition Assistance Program benefits, to encourage individuals to obtain new or improved jobs. DPHHS distributed just under $129,000 to 186 families through this program. Brereton said they have exhausted their efforts to connect eligible families with benefits, including contacting all SNAP recipients and following up directly with those who appear to be eligible.

Representative Marie Cafiero, D-Helena, expressed gratitude for the foster care proposal and hoped that the state would continue to consider the possibility of increasing foster care payments.

“It is difficult to set aside a dollar amount for the value of investing in children who have been abused or neglected,” she said.

Among the other recommendations approved by the commission on Friday are:

  • $1.2 million for the state’s public health laboratory to upgrade its equipment to test for COVID and other diseases, and conduct wastewater testing to monitor disease trends.
  • $866,000 to support Montana area agencies on aging, develop a strategic plan for senior centers and train health insurance advisors to work with Native Americans.
  • $121,000 to support workforces at four centers for independent living in Montana, which serve people with disabilities.

As with all ARPA advisory committee recommendations, Governor Greg Gianforte must give final approval before the funds are formally allocated.

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