Montana State Legislature

HJR 35: Children's Mental Health Study

hjr 35: Children's Mental Health System
study materials (by meeting)

House Joint Resolution 35 requested a study of the children's mental health system. The committee began its study in September by learning about how children become eligible for services in the publicly funded system, the types of services that are available to them, and how changes in the state budget in recent years have affected those services. The committee also received required reports about the out-of-state placement of high-risk children and about outcomes for the children being served in the system.

In November 2021, the committee heard from providers of residential treatment services about the reasons they are unable to serve all Montana children. Members also learned about some prevention efforts in the school and some programs administered by the Department of Public Health and Human Services (DPHHS) that are focused on prevention and early intervention.

In January 2022, committee members heard more about the use of universal depression screening in the school setting and about the system of care statutes that govern services provided to high-risk children who receive services from multiple state agencies. They also learned about the use of Medicaid provider taxes to bolster Medicaid funding for some services.

At their March meeting, members asked for the drafting of bills to:

provide enhanced Medicaid reimbursement rates for psychiatric residential treatment facilities and therapeutic group homes that increase the number of children they serve in future years;
institute an assessment on PRTFs and therapeutic group homes; and
strengthen statutory requirements for qualified provider pools.

In May, the committee reviewed and took public comment on the bill drafts. Members decided against pursuing the bill to levy an assessment on PRTFs and group homes and asked for changes to the other two bill drafts. At their June 2022 meeting, members reviewed the changes and agreed to introduce the revised bills in the 2023 legislative session. As revised, those bills would:

allow for an enhanced reimbursement rate when PRTFs or group homes serve children who meet age or acuity levels established by DPHHS; and
require providers who receive the higher rates to participate in the qualified provider pool and submit -- within 2 working days of a request from DPHHS -- a plan of care for children with complex needs who are at risk of being placed out of state.

A final report for the 2021-2022 interim summarizes the committee's work on this study, as well as studies of the adult mental health system and of the involuntary commitment of people with dementia.

Meeting Materials: June 27, 2022