When Missoula’s mobile support team starts work at 10 a.m., they begin by discussing what happened when they were off the clock the previous night.
Mark Wayne, the team’s behavioral health clinical manager, often leads the 10-minute daily meeting to highlight people who may need further help and review any referrals from law enforcement or other emergency responders.
On any given day, the team of therapists and EMTs might respond to a call at the Poverello Center homeless shelter to help someone experiencing psychosis after losing access to their medication before heading up to a house in the Rattlesnake to work with an older person with dementia or to a school to help out a student struggling with intense feelings, Wayne told Montana Free Press.
“There’s nowhere mental health issues don’t touch,” he said.
The number of calls the team responds to annually has increased about 140% from 2021 to 2025, from 1,300 to 3,130, with the team responding to an average of about eight or nine calls per day. On most days, the team works past 8 p.m.
Law enforcement, emergency medical services and community organizations, particularly those with facilities open overnight, often ask when the team will expand its hours, Wayne said.
“Crisis definitely doesn’t wait for a specific window to occur,” he said. “That need is going to be there. It just really comes down to what we can do that’s sustainable.”
Despite the program receiving stable funding from a recent public safety levy, Missoula’s mobile support team lacks the resources to provide 24/7 services, program leaders said. The team recently received a four-year federal grant of about $726,650 annually, which will allow it to explore expansion. But program leaders cautioned that the funding does not guarantee expansion to 24/7 coverage, given the challenges of funding crisis services.
“We’re increasing call volume throughout the system, so expansion does need to occur at some point,” said John LaRocque, the team’s operations manager. “We don’t want to build something and see it fall away. We want to build smartly and ensure the resource is available for those we serve.”
So what would it take for Missoula to have a 24/7 crisis response?
Mobile crisis teams in Montana have been started or operated by hospitals or other healthcare organizations. The programs have generally been funded by federal and state grants and, in recent years, have begun billing Medicaid. Private insurance and Medicare do not reimburse for mobile crisis services, leaving the programs unable to bill for many clients.
The financial hurdles of funding crisis services have hampered other efforts, with Great Falls and Billings ending their mobile crisis programs in recent years. But plans are in the works to restart those services, and teams in Helena and Kalispell have recently expanded or plan to with new funding.
The city of Missoula, Missoula County and Partnership Health Center started the mobile support team in October 2020 to better serve people in crisis and reduce jail and hospital costs.
The team now includes five full-time EMTs, six clinicians and about five on-call staff members who respond to behavioral-health-related 911 calls, LaRocque said. Two case facilitators work five days a week following up with clients to help them navigate resources and next steps.
The number of calls the team responds to has increased dramatically since it first began in 2020, LaRocque said. In the first eight months of this year, the team responded to 2,074 calls, an average of 259 calls per month, said John Petroff, assistant fire chief, in a presentation to Missoula City Council in late September.
The team is also responding to more calls without police officers or firefighters, up to 67% in 2025 from 53% the previous year and about 10% in the early days of the program.
“That means that the dispatch system is working better,” Petroff said. “We’re getting people on calls without having to call for other people and doing it safely. That’s very unique to a mobile crisis team and doing a lot of what was asked for in the beginning of the program.”
In addition to alleviating strain on the city’s emergency response system, the team can spend more time connecting people in crisis with treatment or other services that are difficult to access.
“The simple fact is that we have the time, training, dedication and experience … to spend with somebody to really make them feel heard … without having to go to the hospital, without that person ending up in jail,” Wayne said.
Kate Wiltfong, St. Patrick Hospital’s behavioral health manager, told MTFP that “unnecessary” emergency department admissions for behavioral health care at the Missoula hospital increase after 8 p.m.
“We want people to come to the emergency department if they need to be there,” Wiltfong said. “But [the mobile support team] has narrowed down the number of patients that are coming in. That’s a positive thing for patients. No one wants to come to the emergency room if they don’t need to be there.”
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Financial support for mobile support teams is often inadequate and inconsistent, leaving many communities struggling to keep the teams operating. Two programs — one in Great Falls and one in Billings — recently shut down. Six units remain in Montana.
St. Patrick Hospital’s youth mobile crisis team has been partnering more with the mobile support team and aims to be a resource for them, Wiltfong said. As with other crisis services, securing long-term funding for the program, currently funded by a federal grant, is a concern, she said.
“The million-dollar question is how to support these programs,” Wiltfong said. “It would be nice to have more support from the state and federal government to fund these things permanently.”
The city and Missoula County used a state grant and federal COVID relief funds to start the mobile support team in 2020. In 2023, the fire department pitched an emergency services levy to the public as a stable funding source for the team, among other things. The Missoula City Council pulled that levy off the November ballot because of uncertainty around state property tax bills, but in early 2024 voted unanimously to put it back on the ballot. The levy passed with 58% of the vote, according to final results.
“The fact that that levy was overwhelmingly passed shows not only the commitment that this community has to mobile support but to the fire department in general,” Missoula Council Member Stacie Anderson said during the September meeting.
Last fiscal year was the first that the program was fully funded by the levy and Medicaid reimbursements after previous state and federal grant funding ran out, LaRocque said.
The levy covers about $940,000 of the mobile support team’s annual budget of about $1.4 million. The Medicaid reimbursements don’t quite cover the program’s funding gap but come close, LaRocque said. The amount the program receives from Medicaid varies, and the reimbursement rate and the rules surrounding it have changed frequently, he said.
“It’s always been a tricky number,” LaRocque said. “We’re always looking for opportunities to better fund the program and make sure they are sustainable.”
The new four-year federal grant of between $726,650 and $748,500 annually will allow the mobile support team to replace aging equipment, attend training, learn more from existing 24-hour programs and explore expansion, Petroff told the Missoula City Council during the September meeting.
“Our goal will be evaluating timeframes of when we’d be in service, using that data and performance to make sure we’re expanding smart and not just expanding because,” he said. “Testing when are we missing calls, when are people needing us more often.”
Any expansion would be phased and would likely begin with increasing hours but maintaining the same number of full-time employees, Petroff said. From there, the program would evaluate whether further expansion or a move to 24-hour service is sustainable, he said.
The team is also exploring partnerships with other organizations to help fund the long-term expansion of services, Petroff said. That includes statewide nonprofit Aware, which recently began operating in Missoula County as a Certified Community Behavioral Health Clinic, said Matt Bugni, Aware’s CEO. That program requires a 24/7 mobile crisis service in the community.
Other programs are all facing similar funding challenges as Missoula, with some using federal funding to expand, while others are figuring out how to maintain operations. One mobile crisis team in Montana has been operating 24/7, and only since this summer.
In July, Helena’s mobile crisis response team expanded to 24/7 operations after essentially starting from scratch, said Kayla Morris, manager of community-based services and crisis care delivery for St. Peter’s Health. The hospital started the program in 2020 with a therapist responding to behavioral health calls with law enforcement, Morris said. Staffing was sporadic, and after initially increasing, call volume fell over the last two years, she said.
When Morris took over the program earlier this year, it switched to a provider-led model, meaning a licensed therapist and another behavioral health worker will respond together with law enforcement backup if needed. The increased call volume from being available 24/7 was one reason the team could afford to expand its services, Morris said. The other was the increase in the Medicaid reimbursement rate for a two-person team operating 24/7 compared to a one-person team operating less than 24 hours a day, she said.
In Billings, plans to restart the mobile crisis team are underway after the Community Crisis Center received the same four-year federal grant as Missoula for $750,000 annually. The 24/7 center, which opened in 2006, provides assessments, stabilization services and case management to people in crisis.
MarCee Neary, the center’s program director, told MTFP the team will start with a 10-hour day before ramping up to 24/7 service by the end of the second year of the grant. Neary said she is aiming for the relatively quick transition to 24-hour operations because “the Billings community needs more than 10 hours.”
The grant funding and higher reimbursement rates for 24/7 coverage, along with plans to run only one team during each shift, allow for full-day service, Neary said. The center is no stranger to funding challenges, but Neary said the grant should allow the organization to create a sustainable plan for the mobile team.
“Sometimes you have to operate leaner than what you want, but we don’t want to have to do that with this mobile unit,” she said. “We’re hoping we can kick this off and provide a valuable service for the community and complement what we do at the crisis center.”
Though the crisis team run by Connections Bozeman has seen a huge increase in calls, it is essentially stuck at its current 10-hour daily service, said Ryan Mattson, director of social services. The organization took over the program, founded in 2019, in 2022. The program includes one two-person behavioral health team each day running from 10 a.m. to 10 p.m., or until the team wraps up its last call, Mattson said.
“We would love to be able to expand to 24/7; that is our eventual goal,” he said. “But until we figure out something with the funding, the increase you get from bumping to 24/7 doesn’t come close to covering the additional costs you’re going to incur.”
The program has gone through multiple funding iterations since it started in 2019 and is currently funded by opioid abatement funds through 2027, Mattson said. After that, the team’s future is uncertain, he said.
“Mobile will not make money; it’s not what we do,” Mattson said. “We don’t make money; we save money. Most people don’t look at the system and fund things by savings. It doesn’t matter that we’re keeping people out of hospitals, jails.”
While the state has endorsed a model to expand crisis services across all communities through the Certified Community Behavioral Health Clinic program, it’s still unclear how those services will be funded in the long term, Mattson said.
Morris in Helena said crisis response needs to be viewed and funded like fire departments or other emergency services.
“We don’t want people in crisis, and we want someone appropriate to respond, but the only way to sustain that is to have enough people in crisis,” she said. “It’s like saying we want a fire department, but the only way to do that is to have enough house fires. As a society, we need to work through this, and I believe we will head in that direction at some point, but today is not that day.”
This story was updated Oct. 26, 2026, to correct the percent increase in calls Missoula’s mobile crisis team has responded to annually from 2021 to 2025.
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