At the June 2026 GCMHLAC meeting, discussions covered the county’s Assisted Outpatient Treatment (AOT) program, the Fresh Start program at the Detention Center, and a major new federal opportunity for behavioral health clinics.
Assisted Outpatient Treatment Program Marks Progress in Year Two
Caitlyn Avey, Director of the Assisted Outpatient Treatment (AOT) Program, reported that the county is now in year two of its four-year SAMHSA-funded initiative. To date, the program has served 10 individuals through the commitment process.
Individuals become eligible for AOT when they meet commitment criteria, whether through discharge from a state hospital into a higher level of care or through direct court order. Once enrolled, participants work with an AOT manager for a 90-day period, supported by a broad network of partners including law enforcement, hospital staff, the county attorney’s office, and the office of the public defender, which provides legal representation.
A management team meets monthly to troubleshoot ongoing cases, and a quarterly steering committee is actively seeking new members, particularly individuals who are consumers or have lived experience with the system. Avey noted that many participants voluntarily choose to stay connected with the program through Connections, a service offered by Sally Browning, even after their formal commitment period ends.
Looking ahead: When asked what happens if someone needs support beyond the initial 90 days, Avey explained that individuals can continue working with a provider. On the question of measurable impact on crime reduction, she noted the program is still relatively new, and robust outcome data is still being developed.
Key barriers identified include:
- Difficulty engaging individuals who are not compliant, given the lengthy court-ordered process required
- The need for sustainable funding to support voluntary continuation of services and options for extending commitments
- Distinguishing between mental health, substance use, and co-occurring conditions
- Determining the right long-term setting for care — whether within the county, a clinic, or a crisis receiving center
- Reaching agreement between public defenders and the county attorney on commitment criteria
- The loss of certain rights under commitment and the associated stigma, which can create hesitancy to use AOT as a tool
Avey emphasized a broader goal of engaging individuals “further upstream,” before court involvement becomes necessary, as the ideal window for connecting people with AOT services.
Shawna Lockhart added that one of the biggest challenges facing AOT and commitment processes overall is a lack of available services for individuals once they are identified. She also highlighted the Wellness Recovery Action Program, calling it an extremely valuable resource for incarcerated individuals, with two people set to be trained in the program in Gallatin County.
From a law enforcement perspective, Erin Taylor noted that officers continue to encounter familiar faces — individuals with two or more prior contacts with law enforcement — underscoring the need for continued intervention and support.
Fresh Start Program Continues to Reduce Recidivism at the Detention Center
Julie Henry provided an update on the Fresh Start Program, which offers a series of classes and opportunities to individuals incarcerated at the Detention Center. The program has shown strong results, with participants experiencing a 14% recidivism rate — notably lower than the state average.
Despite this success, the program faces ongoing challenges connecting individuals with chemical dependency and addiction services after their release, as treatment costs can be prohibitively expensive for many. Meeting attendees noted that funding for services through Rimrock may shift as the organization moves toward a sliding scale fee structure.
In response to a question about available funding, it was noted that 189 funds can be used to support these services and do not require recipients to be enrolled in Medicaid. Caitlyn Avey offered to connect interested parties with more information.
Montana Selected for Certified Community Behavioral Health Clinic (CCBHC) Expansion
Malcolm Horn shared exciting news regarding the Certified Community Behavioral Health Clinic (CCBHC) model, which currently spans more than 500 clinics across 46 states. CCBHCs are required to provide crisis services 24/7, though how the state will fully implement round-the-clock mobile crisis services remains an open question.
Montana has been selected as one of only 10 states nationwide to participate in a four-year federal program beginning in October 2026. Participating organizations include Rimrock, Many Rivers, and clinics in Eastern Montana and Western Montana (Missoula), each serving their respective satellite areas. This designation represents a significant opportunity to expand access to community-based behavioral health crisis services across the region.