Montana House Approves Bills Aimed at Supporting Children and Families
Supporters tout cost savings, more support for children and families
By Keila Szpaller for the Daily Montanan
When Erin Hoch’s son was diagnosed with a rare disease, she was sent home with a car full of new medical equipment and the challenges of living a medically complex life.
It took five years for her to find support, to find a group of people who had similar experiences.
“It didn’t have to be this way,” Hoch said. “ … Caregiver burnout is a very real thing, and it trickles down to the care of the child and the quality of life of everyone involved.”
“We weren’t meant to navigate things like this alone.”
Earlier this month, Hoch shared her story with the House Human Services Committee in support of House Bill (HB) 76, to certify family peer support specialists.
Family peer support specialists are caregivers of children and youth with significant physical, developmental or behavioral needs who gain certification to provide guidance to caregivers in a similar situation.
The bill is one of a couple of pieces of legislation sponsored by Representative SJ Howell, D-Missoula, designed to strengthen families in Montana.
Both HB 76 and HB 77, which aims to provide consistency across jurisdictions in child abuse and neglect cases and transparency for families, passed the House last week after sailing through committee.
If HB 76 passes the Senate and becomes law, Hoch said it would allow her to help people struggling in the same way she did.
“I could be who I needed back then to someone else now,” Hoch said.
At a committee hearing, supporters of the program argued it would give organizations confidence to bring peer support specialists on board as part of, for example, a medical care team at a hospital.
They said certification, through the Board of Behavioral Health, will yield better outcomes for children, alleviate workforce shortages, and save money in medical care.
Howell, who said the idea came out of an interim committee, said peer support is working in 28 other states as of 2020, and the money up front, which has been paid from grants, “really shows a big return on investment over the long haul.”
“These kids are getting improved quality of care, improved health outcomes, improved family life,” Howell said. “We are having healthier kids who are able to stay in the family home, stay in school, and really be set up for success in adulthood.”
To help children and youth, peer supporters may work in hospitals, emergency rooms, pediatric clinics, residential and foster care settings, juvenile courts, and other areas, Howell said.
In response to a question from Representative Ed Buttrey, R-Great Falls, Howell said certification is one step toward Medicaid reimbursement, but reimbursement is not part of HB 76, nor is a mandate for private insurance.
“We could come back next session and talk about Medicaid reimbursement if we wanted to,” Howell said. “But as of right now, there are no changes to reimbursement structures in the bill as written.”
The 2023 Montana Legislature approved $300 million for behavioral health and developmental disabilities, and last summer, Governor Greg Gianforte announced $700,000 out of that fund toward grants for peer support services, as recommended by the Behavioral Health System for Future Generations Commission.
At the hearing, Beth Ayers, with Montana’s Peer Network and a family peer supporter under an earlier grant, said the Centers for Medicare and Medicaid Services deemed family peer support an evidence-based practice in 2007.
In Montana, a survey of families who received help from peer supporters showed 92% felt the quality of their family life had improved, and 86% believed the quality of their child’s care had improved, Ayers said.
Part of the idea is that peer supporters receive training in things like patient privacy and suicide prevention.
Ayers said every peer support interaction with a family saves $132.60, and every full-time peer supporter working with families translates into a savings for Medicaid of $92,902.12 annually.
“Parents don’t have to turn to the emergency rooms or call the police as their only plan in event of a crisis,” Ayers said.
Representative Zooey Zephyr, D-Missoula, wanted to know how the cost savings were estimated.
Ayers said surveys asked family members who they would talk to or which services they would use had they not had a peer supporter, and the savings represent the difference in cost. Also, Ayers said, of the families served, 81% were on Medicaid.
Patrick Yawakie, representing the Blackfeet Nation and Rocky Boy’s Indian Reservation, said the program will provide a greater chance of success for Native American children, who sometimes turn to drugs and alcohol instead.
In support of the bill, Matt Kuntz, with the National Alliance on Mental Illness in Montana, said sometimes, a family member can help another family member “because they’ve seen it all before.”
“We don’t have very many licensed clinicians, so it’s really important for us to not have licensed clinicians doing things that somebody else can do,” Kuntz said.
Representatives from the Montana Primary Care Association and Behavioral Health Alliance of Montana also expressed support for the program.
(At the hearing, just one opponent spoke, but appeared to be expressing disapproval of a different piece of legislation, and the chair redirected him.)
The committee also heard HB 77, to ensure consistency in child abuse and neglect investigations by the Department of Public Health and Human Services (DPHHS). An administrator for DPHHS spoke in support of the bill.
Friday on the House floor, HB 76 passed with 69-29, and HB 77 passed 98-0 on third and final reading.
We need more legislators like Howell. Solving problems, not obsessing about telling people how to live.