Missoula voters’ decision on an emergency services levy in November will not only affect the fire department’s response times but the future of the team responding to residents suffering a mental health crisis, department officials said this week.
Since launching nearly three years ago, the mobile support team, a Missoula Fire Department and Partnership Health Center collaboration, has been funded by grants and federal pandemic relief money no longer available, according to information provided by the city.
“We would continue to look at other options, but I don’t know where the funding would come from otherwise,” said John Petroff, mobile support team operations manager with the Missoula Fire Department.
In early August, the Missoula City Council voted unanimously to put the 34-mill levy on the general election ballot on Nov. 7. The levy would raise $7 million in the first year, with about $930,000 allocated for the mobile support team.
At current rates, the 34 mills would cost approximately $46 each year per $100,000 of assessed value, according to the city. If passed, the owner of a $413,000 home — Missoula’s median assessed value — would pay about $190 per year.
The revenue would pay for 20 new firefighters to help improve response times that have worsened over the last few years, according to the fire department. In the last 15 years, Missoula’s population has increased by about 11.5%, driving up calls by 78%, but the number of firefighters has stalled at 80 since 2008, according to the city.
Much of the increased volume of calls stems from newer residential developments in the area north of the Clark Fork River and west of Reserve Street, said Fire Chief Gordy Hughes. Crews responding to that area from other stations are being “hammered” by high call volumes, he said.
The levy-funded firefighter positions would form a new engine company to respond to the growing neighborhoods from the nearby stations until a new facility is eventually built in the area, Hughes said.
The revenue would also help keep firefighter wages competitive as departments across the state look to expand, Hughes said.
“After COVID, and actually leading into COVID, a lot of cities in Montana have experienced this large growth uptick and uptick in call volumes and responses for emergencies driving the need across the state,” he said.
Fire departments statewide are looking at levies to increase staffing, including Great Falls, Hughes said. If approved in November, Great Falls’ $10.7 million public safety levy would pay for 32 new firefighters, a fire prevention staff member, equipment and training, as well as increased police officers, 911 dispatchers and court staff, according to the city.
While the Missoula department hasn’t struggled to recruit staff, the number of applicants to the Montana Firefighter Testing Consortium that Missoula and more than a dozen other departments use has decreased from 400 to 450 per year to 140 to 180, Hughes said.
“I don’t know if the interest in a firefighting career is waning or if it’s just a natural trend around the country,” he said. “We will be competing with other departments if we’re successful in this levy.”
The revenue would also help replace aging fire engines, ladder trucks and other equipment, Hughes said.
A DIFFERENT KIND OF CARE
The levy would provide permanent funding for the mobile support team, which responds with law enforcement to behavioral health-related 911 calls.
A licensed mental health clinician and an emergency medical technician (EMT) respond to calls and the team’s case manager follows up with clients to help them navigate resources and next steps, according to the program’s website.
The city and county used a state grant and federal pandemic relief funds to start the program in October 2020 to help better serve those in crisis and cut down on jail and hospital costs. The number of clients has increased over the last two years, with the team responding to about 2,200 initial calls and 1,700 follow-ups in the last 12 months, said Petroff, the support team operations manager.
“We’re able to connect people with the right resources to help them with continuum of care, rather than just dropping them off at the emergency department,” he said.
The team operates from 10 a.m. to 8 p.m., seven days a week, and is working toward having two units available during those hours, Petroff said. When fully staffed, the program includes five clinicians, a behavioral health manager, a case manager — hired through Partnership Health — and six EMTs employed by the fire department.
A state crisis diversion grant funds most of the program, and the fire department pays for the team’s vans and Petroff’s salary. Altogether, the program’s annual expenses are nearly $1.4 million, Petroff said.
About $930,000 of the $7 million raised by the November levy would go to the mobile support team, as officials anticipate receiving some reimbursement from Medicaid. The state is still working to finalize rates for behavioral health crisis response and follow-up case management, which was not covered by Medicaid in the past, Petroff said.
Petroff, though, said he’d be surprised if the program gets back that much from Medicaid, as it’s difficult to collect insurance information from clients in crisis. The program doesn’t bill private insurance for that reason and to avoid dissuading people from accepting help, he said.
“We’re working with them in that moment to say, ‘Hey, is there anything you can do right now to help you that you want to be a part of?’” Petroff said. “We’re bringing it back to having conversations with those clients and making sure they agree with what’s happening with their care.”
While the support team’s limited hours create some challenges, program staff collaborate with multiple community partners to connect people with resources around the clock, Petroff said. Adjusting how police, fire and other emergency responders approach behavioral health has made a “significant change,” he said.
“We know the program is successful and know we’re not able to fix everything for people,” Petroff said. “Responding differently, trying hard to be part of the system and, at some point, expanding to be available more often would be beneficial to [the] community because it would take other responders off calls that are not as much in their wheelhouse as having a clinician or EMT.”
Petroff said he doesn’t know of any plans to expand the team’s hours or staffing levels beyond what the city has budgeted.
“We offer a better response, but finding the workforce and funding for that is something the community has to get behind if that’s what they want,” he said.
If this levy fails, permanently funding the support team is in question, Petroff said. Grants allowed the city to hold off on spending federal American Rescue Plan Act (ARPA) money set aside for the program, but there’s only enough to continue the team through July 2024, he said.
Missoula officials planned to use revenue from the November 2022 crisis services levy to permanently fund the team, but the measure failed. Hughes, the fire chief, said the county-wide levy passed within the city limits, and despite “tax bill anxiety,” he said he is hopeful Missoulians will understand the need for this year’s levy.
“I’m hopeful that we can move our master fire plan forward and provide these services that will help our community,” Hughes said.
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