During a Billings meeting that included several tours, members of the Children, Families, Health, and Human Services Interim Committee took an up close and personal look at many of the health and human services issues they deal with during and in between legislative sessions.

The committee's tours covered three of its assigned studies -- of prenatal drug use, senior and long-term care services, and child protective services -- and also touched on mental health, with visits to the Billings Clinic's inpatient psychiatric facilities and to the Billings Community Crisis Center, which provides outpatient stabilization services.

For the study of prenatal drug use, committee members heard from a panel of speakers about the work being done to connect pregnant women with alcohol, drug, and mental health treatment services during their pregnancy to improve outcomes for both the moms and babies. Two midwives at St. Vincent Healthcare also simulated the Screening, Brief Intervention, and Referral to Treatment (SBIRT) technique they use to identify and address drug or alcohol abuse in the pregnant women for whom they are providing care.

A panel of speakers representing nursing homes and assisted living facilities talked with the committee about the challenges the facilities face in finding and retaining direct care staff and with accepting Medicaid patients. They noted that the reimbursement they receive from the Medicaid program falls short of the costs of providing services, leaving providers to make difficult choices on whether to limit the number of Medicaid-funded residents they will serve.
The committee toured two facilities as part of the study.

For its child protective services study, the committee heard from a deputy county attorney, public defender, private attorney, and a representative of CASA of Yellowstone County about the issues they've experienced with child abuse and neglect cases -- particularly in recent years, as the number of cases has risen dramatically. The speakers discussed issues that can hinder the process of reunifying parents with children who have been removed from the home and also outlined a pilot project that the district courts in Yellowstone County will begin in January. The courts will hold an initial hearing within 72 hours of a child's removal from the home in hopes of improving several aspects of the cases.

The committee also talked with several women offenders at the Passages community corrections facility who were in an alcohol and drug treatment program and whose children are in the foster care system.

The committee also received updates from DPHHS on the use of suicide prevention funds approved by the 2019 Legislature, on the expected delay in implementation of work requirements for Medicaid expansion enrollees, and on proposed administrative rules that would, among other things, require schools to test for lead exposure. Members asked for an opportunity to review the final rules before they are adopted and also will receive more information in January on the public health reasons for the rules.

The committee will meet next on Jan. 16-17, 2020, in Room 137 of the Capitol in Helena.