By: John Madsen MSW
Admissions Director
Alternative Youth Adventures
Boulder, Montana
406-439-4524 KCGJJM1@aol.com
March 15, 2005
With assistance from Larry Stednitz IECA and Lon Woodbury IECA
In November of 2003, the State of Montana produced a white paper intended to provide awareness, background information and research regarding the alternative youth residential care programs in Montana. Montana is probably the only western state that currently has no regulating requirements for private behavioral healthcare organizations. The State of Montana had issues with safety and not being able to respond appropriately to inquiries concerning these programs.
The white paper resulted in meetings in different cities in Montana to discuss this matter. According to the white paper, the State has minimal knowledge or oversight of these alternative private programs, and current estimates indicate that between 800 and 1,200 students are being cared for in 29 private programs in Montana. As a result of the information presented during the hearings, the director of the state child welfare agency, Gail Gray, initiated research on the programs, resulting in the white paper report that defined the issues surrounding the alternative programs operating in Montana. This paper resulted in Director Gray's decision to hold meetings in the State with interested people. A number of providers throughout the State responded negatively with their perception that the report was inaccurate, inflammatory and reflected unfairly on the private programs. Their views were expressed at the meetings and hearings as well as in writing to Ms. Gray.
Director Gray's decision after those meetings was that legislation needed to be proposed that would require registration of all unlicensed alternative adolescent residential and treatment programs including programs such as boarding schools, outdoor/wilderness programs, vocational schools, faith-based and residential treatment programs. It was also decided that an interim committee would be necessary to study the issue. The committee would engage providers of alternative programs, interested persons and the Department of Public Health & Human services to decide on the best licensing and regulatory standards. The hoped for result would be a drafted bill to be written for the 2007 legislature resulting in state-mandated oversight/licensing regulation of some or all of the programs.
During the 2005 Legislature, a bill was written and introduced at the request of the Department of Public Health and Human services. The private alternative schools and programs collaborated to create their own bill sponsored by Representative Clark. This alternative bill would allow for self-regulation through a newly-formed board operating under the auspices of the Department of Labor and Industry. The providers proposed forming a board that would draft regulations and rules of self-regulation similar to those of physicians, nurses, social workers and professional counselors.
During both hearings, the provider groups cited a significant distrust of a large unwieldy organization that would squash their individuality and enforce a medical model upon them. They cited NATSAP as a model with guidelines and principles that would guide the provider group's efforts to provide oversight of its members (for online copies of current NATSAP Best Practices guidelines see Woodbury Reports Breaking News index at www.strugglingteens.com/news/news.html). The State agency, DPHHS, cited a need for state oversight of children in out-of-home care and a need for Montana to follow other states in licensing these types of programs because some programs were reportedly coming to Montana to avoid licensing in other states. Reportedly, the programs migrating to Montana were avoiding regulation in states such as Wyoming, Idaho, Colorado & Utah. DPHHS reasoned that while the licensing regulations may require additional staff and money to regulate the programs, if a serious incident occurs at one of the programs, they may be vulnerable to legal actions.
Both sides agreed that there was a need for oversight and both agreed that most programs and outcomes were generally very successful. It was thought that only a few programs are possibly problematic.
The actions of the Montana Legislature will be closely watched. The state's DPHHS's point of view is that while registering and licensing would be expensive for Montana, possible legal action from private parties are a real threat and potentially more costly. They believe that they have the responsibility to protect children being cared for within the state. Their thinking is that if the state does not provide oversight of programs within the state, the potential for injuries, abuse, accidents, and other serious incidents perhaps are more likely to occur.
The provider group, on the other hand, opposes being licensed by a large state entity, believing that their creativity and uniqueness will be lost. Furthermore, they believe that the information contained in the white paper is slanted in a manner that does not recognize and understand the private pay industry.
Montana and providers within the state are now in the middle of a very interesting and difficult struggle. It needs to be remembered that Montana has some of the most effective and well thought out programs in the country. Montana Academy, Explorations, Chrysalis, Mission Mountain, Wilderness Treatment Center, Intermountain Children's Home, and Monarch are known to be some of the best in the country. This is indicated by them consistently receiving high positive marks and comments from the most successful and highly trained independent educational consultants throughout the country in the annual survey conducted by Woodbury Reports. Others, like Summit Preparatory have not been in existence long enough to establish a national presence, but show great promise. Still others like Galena Ridge and Building Bridges remain small, but provide excellent services for the youth of this country.
As difficult as this struggle is, Montana has the opportunity to thoroughly study the issue, and hopefully arrive at a level of understanding and enlightenment that will provide protection to children and at the same time lead the country in appreciating and respecting the private sector's ability to develop creative and effective programs for youth. Private sector programs operate under different dynamics than public sector programs. We do not want to lose programs of this caliber in an attempt to impose the same processes as have been developed for Montana children in public programs. We encourage the State of Montana to study this issue and show leadership throughout the country in developing an enlightened process that will both protect the public and encourage new ideas and approaches to helping youth.
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