Montana State Legislature

HB 422

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HB 422: Children’s Mental Health Outcomes

The 2015 Legislature approved House Bill 422, which -- among other things -- required the Children, Families, Health, and Human Services Interim Committee to review evidence-based outcomes for children's mental health services and performance-based pay for children's mental health providers. The study was to result in legislation for a pilot project on evidence-based outcomes.

HB 422 specifically directed the committee to take into consideration the following items as it shaped its recommendations and developed legislation:

  • the current array of children's mental health services and any available data on the effectiveness of the services;
  • the degree to which the array and effectiveness of services offered by a provider might factor into the reimbursement the provider receives under the pilot project;
  • potential incentives for and risks of the evidence-based outcomes model under review;
  • existing data that must be collected to evaluate the effectiveness of the model; and
  • the need for changes to the state's information technology systems in order to collect and analyze data.

At its June 3 meeting, the committee reviewed the draft plan for carrying out the HB 422 activities and approved the plan after deciding to hold a required out-of-town meeting in November 2015, rather than May 2016. The meeting was held in Billings.

Members in September received an overview of the children's mental health system. November study activities included presentations about the development, use, and measurement of evidence-based practices for mental health treatment. Several Montana mental health providers also offered their perspectives on the benefits and challenges related to using evidence-based practices.

In January 2016, the committee heard about the use of performance-based contracting in Minnesota, Tennessee, and Wyoming. Members concluded that they would not have time during the rest of the interim to adequately address the use of performance-based reimbursement in a pilot project. In addition, they decided to focus future study activities on reviewing ways to promote the outcomes of keeping children in school, at home, and out of trouble.

During the committee's March meeting, providers offered suggestions for the type of information that could be collected to see if children are meeting the outcomes identified by the committee in January. However, state officials told the committee that the Children's Mental Health Bureau doesn't have a database for collecting the type of information that was discussed. In May, members heard from several state agencies about the databases they use to to collect outcomes information. They also learned about the potential costs of developing a new state system or adapting an existing system, as well as the time required to do so. As a result, they asked for more information in June from private companies that collect and analyze data.

After hearing from two private vendors in June, some committee members offered to work on legislation for the August meeting. However, they subsequently determined that executive branch support may not exist for any proposal from the commtitee. With the support of providers who had worked on the study, the committee concluded the study without recommending legislation for the 2017 session.

Staff Reports

Related Links and Study Materials

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