Missoula’s new mobile crisis unit set to roll, but crisis stabilization still lacking

Missoula Mayor John Engen said the city and county must find a way to provide operational funding for a crisis stabilization center as the mobile crisis unit begins operating. (Martin Kidston/Missoula Current file photo)

A new mobile crisis unit funded by a federal grant and the city and county of Missoula is expected to begin operating next week, and when it does, local officials will continue to look for gaps in the mental healthcare system and ways to close them.

Meeting this week, city and county officials said that could include fine tuning the mobile crisis unit while exploring ways to fund and operate a crisis stabilization center.

Expanding the role of a planned navigation center at Trinity – an affordable and supportive housing project under development off West Broadway and Mullan Road – may also come into play, according to Mayor John Engen.

“I continue to think this is an opportunity for us to sort out what we’re doing at Trinity, and I continue to think it would be a failure if we didn’t go beyond that simple housing navigation center to really that crisis stabilization, no-wrong-door model,” Engen said. “Those conversations will continue. I think it’s a critical gap and one we have an opportunity to close.”

Up until this year, that “gap” covered nearly all aspects of mental healthcare in Missoula, as it does across much of Montana given the state’s lack of investment in issues around behavioral health.

Seeing what’s been described as a systemic flaw, the city and county this year set out to begin making their own small investments in the effort. During budgeting, they both set aside funding to match a federal grant to launch a mobile crisis unit on a 10-month trial basis.

As designed, the mobile crisis team will address 911 calls and other service requests that include a mental or behavioral health issue, thus removing law enforcement from the situation when possible. The two teams will each include an EMT and a mental health professional, and they’ll work in tandem with other local services.

But getting the unit up and running hasn’t been easy, and it continues to undergo changes. The Missoula Fire Department won the initial contract and will work with Partnership Health Center.

“They were going to do a third-party agreement with Partnership Health Center to provide the mental health piece,” said Kristen Jordan. “Upon further review, it became critical and necessary for Partnership to have a separate contract with the county, to ensure they had better liability insurance and an ability to bill at an enhanced amount.”

Missoula County commissioners this week agreed to amend the fire department’s contract and write a new and separate contract with Partnership Health. With the contractual details now addressed, the mobile crisis unit is expected to begin operating as early as next week.

“The overall project scope hasn’t changed, the overall responsibility and services rendered aren’t going to change, and the budget amount hasn’t changed,” Jordan said. “We just needed to do a separate contract with PHC and amend the existing contract.”

With the mobile crisis unit set to begin operating, those at the table, including hospital staff and city and county officials, continue to place their focus on Missoula’s lack of a crisis stabilization center. Engen described it as a critical piece of the puzzle and one that’s needed to ensure the mobile crisis unit is successful.

But while stabilization beds may be available at the Dakota House, the operational coverage remains lacking. Engen said other cities that have established crisis stabilization generally set aside $1 million to $1.5 million for operational funding.

“One of the gaps we need to close behind mobile crisis is crisis stabilization,” Engen said. “There seems to be momentum with the right folks at the table to figure out the funding side.”

Engen and county commissioners agree that the stars are beginning to align behind solving mental health care in Missoula. They also agree the efforts are young and need to time to fine tune, including the full intent of the navigation center planned at Trinity.

“I agree that Trinity needs to be more expansive to address some more systemic issues rather than being narrowly focused, like it could end up being,” Commissioner Dave Strohmaier said.

With sweeping political changes coming to the state capitol in Helena, local officials expect the costs of providing such services will fall more heavily upon local governments and local taxpayers.

That will likely be a topic of political discussion as new budgets are drawn up, and as debates heat up over what local services will be funded and at what level.

“We’ve been seeing that for years, but I think the pace of that abdication from the state will pick up a little bit,” Engen said. “My working theory continues to be that the city and county will be in the social service business. We’re going to be the safety net.”

Strohmaier agreed that the state has and will continue to pass service costs on to local governments.

“As is more often than not the case, we’re going to have to figure this stuff out in spite of and not because of assistance from the state or federal government.”

Missoula mobile crisis unit nets startup funding; attention now shifts to outcomes