Health service cuts menace Missoula Co. agencies, commissioners


Missoula County Commissioners heard messages of disappointment and frustration Wednesday as state budget cuts continue to slash local services.

The information that was presented resonated around the daunting expectations that the cuts — specifically to preventative and case management services — will play out down the road in very harmful and expensive ways, according to Heather O’Loughlin, Montana Budget and Policy Center director.

To maintain the level of services offered now in places like the jail and through case management support of foster care families, the burden could fall on local property taxpayers to backfill where state funding cuts have left a looming gap, even as the caseloads of many local agencies are projected to increase, O’Loughlin said.

The Montana Budget and Policy Center estimates that $200 million was cut from health services in Montana through legislative actions in 2017.

In light of these cuts, Missoula County groups gathered to discuss how losing state money that supplemented local services already affects many agencies, from law enforcement to social work to case management services for kids and aging adults.

“The county partially funds some of these programs. When the state cuts out their portion or makes it so it’s not even viable to provide that, it is going to hit the county. What we want people to know is the only way the county increases revenue to provide this service is on your property tax. That is not a good way to do things,” said Missoula County Commissioner Jean Curtiss.

Many of these agencies are linked by their clients, even though they serve very different functions. One particular graph presented at the meeting visualizes how cutting preventative services can send people off a cliff.

“It just shows that so much of the costs and the suffering that can occur and are occurring in our community are preventable or at least can be mitigated earlier in life when people are young when families are young or earlier when they begin to occur,” said Missoula City-County Health Department director Ellen Leahy.

“When the types of funding losses occur that have happened, they take away–they squander that opportunity to prevent or to intervene early, people fall off the cliff, and so does the budget,” Leahy added.

She said her department has already eliminated three of their nurses and has lost additional dollars for services. “They’re preventative dollars, particularly for infants and young children,” Leahy said.

The Missoula City-County Health Department is facing a 77% cut to a preventative Medicaid targeted case management program for children with special health needs, she said.

According to Leahy, Missoula public health nurses and social workers served 533 children and their families through about 4,000 visits last year. Due to the 77% funding loss, they expect to serve 130 kids — and Missoula County isn’t alone with this difficulty.

“What we are seeing in Missoula County is not unique. Communities across the state are experiencing similar devastating impacts of the budget cuts that we have seen on a state level,” O’Loughlin said.

“I would say loss of services are being felt most significantly in our rural communities, but that, in turn, is putting more pressure on our larger communities to try to cover those services,” added O’Loughlin.

“What we do here is amazing, and we work together, but we need people to just see that we’re not just making this stuff up, its affecting people and families,” said Curtiss who became emotional during the presentations.

“There are people that are hurting because there is a lack of dollars or lack of management of those dollars…so, yeah. It matters when its people,” she said.

Although policy experts and agencies say it is hard to quantify at this point exactly how cutting these preventative measures will actually impact budgets, Curtiss says they are going to have to make some hard decisions as they figure out the next fiscal year Curtiss said.

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