About three weeks into the school year, roughly $420,000 in stopgap funding for in-school behavioral health treatment for Montana students with serious emotional disturbances has been spent by school districts.
The Legislature put $2.2 million toward the temporary funding, and the deputy superintendent of Public Instruction said the goal is to have that last until October. Schools could start using the funding July 1.
The Comprehensive School and Community Treatment program connects licensed or supervised in-training practitioners from a mental health center and behavioral health aides with children who can get services at school, in their homes or in the community. Parents have said services provided in schools are a huge help compared to having to take time off work to get children health care and teachers have cited the program as keeping kids in classes learning.
Districts have always been obligated to pick up a third of the cost of the program that’s a part of Montana Medicaid. But historically they did it through in-kind matches like providing physical space for treatment or laptops — not cash. After first raising concerns about that in-kind approach in 2013, the federal government finally stopped allowing it last year.
The state health department stepped in to cover the cost, arguing it didn't want mental health care taken away from students in the middle of the coronavirus pandemic. But earlier this year the state Legislature objected to the health department’s spending without lawmakers' approval and put a halt to that approach.
Lawmakers told the state Office of Public Instruction, which was not involved in the program before this year, and Department of Public Health and Human Services to hammer out a solution for when the bridge funding runs out. During an interim legislative meeting earlier this week, Megan Peel, head of the Children's Mental Health Bureau within the health department, said the state has submitted its proposals for informal review to the federal Centers for Medicare and Medicaid. That process allows the state to address concerns from the federal government before submitting a final plan for approval.
Schools won’t know what type of financial obligation they might be required to pay for the program until that proposal is approved, but Jay Phillips, the Centralized Services Senior Manager for the Office of Public Instruction, estimated schools would likely be obligated to put up about a third of the cost of providing services, with Medicaid paying for the rest.
While state officials said this week the goal is to not reduce services to Montana students, at least one district already has because of changes to the funding model.
Rob Watson, the superintendent for Missoula County Public Schools, said the district has cut back from having 31 teams helping students to 10 this school year. The district plans to submit its costs for providing services to be reimbursed by the bridge funding, but had to plan for that funding’s expiration and being on the hook for some of the obligations going forward.
“We committed to start the year with 10 CSCT teams. Then we would wait and see what the actual match was going to be. If it’s 35% we couldn’t afford more than 10,” Watson said. “ … We won’t be able to serve the same number of students. We won’t even be able to serve all our schools. … It’s greatly reduced in terms of what we’ve had in the past.”
Watson said districts were told they couldn't use the federal money that’s come to schools in various aid packages to offset the fallout from the pandemic, a massive pot of money some GOP legislators pointed to this week as a solution.
Missoula has used some of its federal COVID-19 aid to hire social workers directly for its school, which has consumed a “big chunk” of that money and won’t be sustainable, Watson said. He added the third-party provider of CSCT services already has the experience.
State Rep. Mary Caferro, a Democrat from Helena, also raised concerns about using federal money to try to fill the hole, saying that it was not an ongoing source of funding. She also said Gov. Greg Gianforte's administration has urged lawmakers to not create ongoing funding obligations with the one-time federal aid.
Deputy Superintendent of Public Instruction Sharyl Allen said earlier in the week the change has been hard for districts.
“This is new territory for our districts because prior to these changes in legislation, they really never had cash out of hand for this program,” Allen said.
At least one other district, Belgrade, has also used federal COVID-19 aid to hire behavioral health specialists, OPI leaders said this week.