Bill would create residential treatment center license to keep more youth in Montana

Senator Mike Cuff opened a hearing on Senate Bill 191, saying the bill would create a new residential treatment center health‑care license for lower‑acuity youth mental‑health residential care so more Montana children can stay in‑state and qualify for private insurance coverage. Cuff said a facility in his district already operates at that level and that the new license ‘‘lands right in the middle’’ between high‑acuity psychiatric residential treatment facilities and the state’s private alternative adolescent residential programs (PARP).

Supporters, including Julie Fink, a former residential care program manager in state licensure, told the House Health and Human Services Committee that Montana currently lacks a step‑down residential option covered by most private insurers and that families often must send children out of state or pay privately. Charles Denow, representing Turning Winds in Lincoln County, said the bill defines residential treatment centers for youth under 19 and would allow insurers to recognize an in‑state licensure type so Montana youth can remain in the state for care.

Opponents warned SB 191 could undermine statutory protections developed in recent sessions. Jennifer Shaw, a former educator and long‑time advocate who has testified on these issues previously, said Montana has become a national leader in oversight of the ‘‘troubled teen’’ industry after years of work to add statutory protections, parental‑notification rules and inspection requirements. Shaw and other critics told the committee that the bill delegates important standards to future administrative rulemaking rather than embedding them in statute, creating a risk that the measures adopted by rule would be weaker or omit protections such as 24‑hour parent phone access or guaranteed periodic inspections.

Department of Public Health and Human Services officials testified informally that they do not intend to adopt rules that are less restrictive than current PARP rules and that, if the law passes, rulemaking would likely reference existing therapeutic group‑home and PARP standards. Megan Peel, division administrator for Behavioral Health and Developmental Disabilities, emphasized the department’s intent to make rules ‘‘as prescriptive as the current PARP rules’’ but noted that exact rule language would follow the administrative‑rulemaking process and depend on the final statutory text. Peel also said the bill would not by itself add residential treatment centers as a Medicaid benefit.

Committee members asked about the number of similar facilities in Montana, rulemaking safeguards, and whether practitioner certifications would change. In answers during the hearing, Ms. Shaw said ‘‘last time I looked, I think there were seven’’ comparable programs in the state. DPHHS witnesses said they would aim to replicate the safety and oversight measures in existing statutes and rules during rulemaking, and that the administrative process includes a public comment period.

The hearing closed without a recorded committee vote. The bill sponsor urged the committee to consider amendments and expressed confidence that the licensure standards to be developed by DPHHS would protect children while expanding in‑state treatment options.