Despite widespread confusion and concern expressed by local school officials last month, Montana’s Department of Public Health and Human Services reported to lawmakers Monday that recent changes to Medicaid reimbursements for student mental health services are “going relatively smoothly.”
That assessment came from DPHHS Children’s Mental Health Bureau Chief Meghan Peel, who gave members of the Legislature’s Education Interim Committee their first look at how the state’s Comprehensive School and Community Treatment (CSCT) program is faring. February marked the start of a new reimbursement model for the program, passed by the Legislature in 2021, that transfers some of DPHHS’ previous payment collection responsibilities to the Office of Public Instruction.
According to OPI’s portion of the update, 54 school districts have signed memos now required for program participation, and 47 of those districts submitted Medicaid reimbursement claims in February totalling roughly $1.4 million. The change also requires districts to self-fund the match payments necessary to receive Medicaid dollars, which they then use to pay third-party mental health providers for in-school services. The total for district matches statewide last month was $394,280. As of Monday, the state had released $992,352 for 29 of the February claims.
The brief update on the status of CSCT was one of a slate of pressing issues on the committee’s plate related to Montana’s K-12 education system. On Monday, lawmakers were also informed by DPHHS that it does not plan to pursue a third round of pandemic-era federal benefits aimed at bolstering K-12 student access to food outside school lunchrooms.
Gene Hermanson, administrator of the agency’s Human and Community Services Division, attributed the decision to a more than 50% decrease in demand since fall 2020 and to the administrative burden associated with the benefits. Known as Pandemic-EBT, the benefits were first made available in March 2020 to ensure that students who relied on free and reduced-price lunches were able to obtain food during COVID-induced school closures. Through summer 2021, the state distributed roughly $67 million in such benefits to Montana families.
Montana Food Bank Network Advocacy Coordinator Wren Greaney criticized DPHHS’ decision during public comment, estimating that the state was “poised to leave $36.6 million in federal food assistance on the table” for the coming summer. And Rep. Moffie Funk, D-Helena, pushed back on Hermanson’s analysis, saying that the number of children in Montana experiencing food insecurity hasn’t diminished. She acknowledged that some of those kids are back in school and once again able to access food through their school cafeteria, but questioned why DPHHS isn’t continuing to take advantage of a federally funded opportunity.
“What is your backup plan?” Funk asked. “If you’re not going to have this, what are you going to do for those food-insecure kids?”
Speaking to the broader challenges facing school food programs, OPI Student Support Services Senior Manager Jessie Counts assured lawmakers that her agency plans to continue utilizing child nutrition waivers developed by the U.S. Department of Agriculture during the pandemic. The waivers include increased federal reimbursement rates for lunchrooms and the ability for schools to offer free meals to all students, not just those from low-income families. A USDA report released this month showed that food programs using federal waivers were 8% less likely to operate at a deficit, and that more than three-quarters of the programs surveyed were relying on waivers to help cope with ongoing supply chain shortages.
But it’s unclear whether the federal waivers will still be available for OPI to make use of this fall. The USDA’s authority to grant the waivers expires on June 30, and according to national media reports, a political fight broke out in Congress last week over the question of extending that authority and funding another year.
Uncertainty over the waiver program’s continuity beyond June was not mentioned or discussed in the legislative committee this week. But in an email follow-up with Montana Free Press this week, state Superintendent Elsie Arntzen said that even if the waivers do expire, students can continue to access breakfasts and lunches through free and reduced-price meal benefits. Arntzen added that the Summer Meal Program in Montana has always been offered free to all students, meaning any return to a pre-pandemic “normal” for school food assistance will not occur until the fall semester.
“The waivers were put in place to ease the burden of the pandemic on schools and families,” Arntzen wrote. “The OPI will continue to provide resources like online free- and reduced-price meal applications, Montana pilot programs like the Montana Marinara project, and best practice training and resources to schools on preparing and serving nutritious meals.”
On Monday, Counts also mentioned that OPI is considering a change that would automatically qualify children on Medicaid for free and reduced-price meal benefits, eliminating the need for parents to submit separate applications.
The Education Interim Committee reconvened Tuesday alongside the Legislature’s Interim Education Budget Committee for a series of joint presentations, one of which touched off a discussion about early childhood education in Montana. OPI Budget Analyst Paul Taylor furnished members of both committees with data showing a dramatic increase over the past six years in the number of 3- and 4-years-olds accepted into school kindergarten programs. Montana law allows schools to enroll such students in kindergarten under “exceptional circumstances,” such as cases where a 4-year-old will turn 5 after the start of the fall semester. Schools can also count under-5 kindergarten students when conducting enrollment calculations for per-student state funding, but are restricted from including students in pre-K programs in those calculations.
According to Taylor’s figures, 23 public school districts in Montana reported a total of 76 under-5 kindergarten students in 2015. In 2022, that number has increased to 1,121 students across 88 districts statewide — a level of growth that the budget committee’s chair, Rep. David Bedey, R-Hamilton, described as “explosive.” Bedey said he found the data extremely concerning, speculating that there might be some confusion in school districts leading them to count pre-K students in their state funding calculations. He clarified that he was not questioning the worthiness of pre-K education, but is worried the state may be inappropriately, and inadvertently, appropriating school funds based on flawed data.
“I think that we need to get a handle on this, and I would ask OPI to look into this,” Bedey said. “It looks to me that, should these numbers be misrepresented, we could be appropriating in the neighborhood of three to three-and-a-half million dollars a year, spending state funds, that is not permissible by current law.”
As Taylor continued, he sparked yet another concern related to state funding: that the same restriction may be preventing Montana from adequately funding special education for children under 5. His data showed that of the 1,102 under-5 children enrolled in pre-K programs statewide in 2021, 707 were special needs students. Federal law requires that Montana offer educational services to those students, Taylor said, and prior to 1993 the state reimbursed schools for those services. However, he continued, when the Legislature overhauled both its school and special education funding formulas, those students “became invisible.”
House Bill 16 sought to resolve the issue last session by allowing districts to count 3- and 4-year-olds with disabilities in their per-student calculations. But, as Rep. Linda Reksten, R-Polson, recalled Tuesday, the fiscal note prepared for the bill — which estimated the change would cost the state $5.9 million over the biennium — caused some lawmakers to “gasp.” The bill was tabled in the House Education Committee.
“We have to go back and look at this because this is a federal mandate that we are to take care of 3- and 4-year-olds in special education,” Reksten said. “It simply is a fact.”
Rep. Sara Novak, D-Anaconda, who works as a special education teacher, noted that the need for improvement goes beyond funding. Montana’s current process for identifying, evaluating and enrolling preschoolers with special needs can be a “nightmare” to navigate, she said. But she added that educational services for those students can be “super expensive,” and from what she’s seen on the ground, need is only increasing.
“We’re seeing just a big increase in the referrals in early childhood, and the needs of those kiddos is just going through the roof,” Novak said.
Characterizing the situation as an “unfunded mandate,” Bedey again turned to OPI, directing Taylor and the agency to reassess the fiscal note for HB 16 and report back to both committees.
Here’s a quick look at a few other notable points raised before the committees this week:
- During a lengthy discussion about teacher recruitment and retention strategies Monday, talk briefly turned to a state loan assistance program designed to attract teachers to rural schools with the promise of helping them pay off their student debt. Legislative research analyst Pad McCracken noted that the state historically spends only half of what it allocates for the program, and suggested that lawmakers consider removing some of the eligibility criteria — namely, the requirement that a qualifying applicant be hired to teach in a specific content area the school has identified as a critical shortage area.
- A separate presentation by Montana Health Care and Benefits Division Administrator Amy Jenks addressed the possibility of expanding the state’s employee health plan to include public school employees. Jenks speculated that the option would likely appeal only to smaller school districts, as larger ones such as Billings and Missoula already have established self-funded plans. She added that the issue, if brought forward during the 2023 Legislature, would potentially have implications for districts related to local control over benefits and bargaining with local union shops.
Diane Fladmo, public policy director for the Montana Federation of Public Employees, said the move could drastically lower health care payments for school employees her organization represents. Fladmo noted that some Montana teachers pay as much as $400 a month for health coverage, while the state plan costs $30 a month — an expense that can be erased if an employee participates in a wellness program.
- Zam Alidina, who’s heading up OPI’s effort to update teacher licensing software, informed lawmakers that the project is on track to hit its June 1 launch date. At that point, educators in the state will once again be able to apply for licensure or renew their existing licenses online. In the meantime, OPI is continuing to conduct those processes using paper applications.
- A presentation Tuesday by Jason Dougal, president and COO of the National Center on Education and the Economy, prompted considerable debate among lawmakers on the joint committees. Dougal was there to discuss ongoing student performance and equity issues in public education, describing how those issues have contributed to the U.S. boasting the “most inequitable distribution of income in the industrialized world.” Dougal asserted that Montana and other states should be working to modernize their education systems to better prepare students for today’s job market.
Rep. John Fuller, R-Kalispell, told Dougal he had a “distinct disagreement” with his presentation, stating that his concern wasn’t the distribution of income in America but whether education was “an impediment to movement” between income brackets. Fuller also said Dougal had failed to mention that the country’s education system was founded to “create good citizens of America,” sparking a broader debate among lawmakers about the core mission of public education in Montana. Rep. Llew Jones, R-Conrad, agreed with Fuller’s characterization of the origins of public education before taking the discussion a step further.
“I would make the argument today that citizenship by itself doesn’t answer keeping our students competitive on the world scale,” Jones said. “If you can’t begin with the end in mind that we agree on, it’s pretty hard to arrive at an end.”
Gianforte announces leadership change at Montana Fish, Wildlife and Parks
Dustin Temple, who’s been serving as the agency’s acting director, will take Worsech’s place overseeing the department. Worsech, who’d been on medical leave since February, is retiring from FWP for a second time. Prior to taking the director post, Worsech served as the agency’s license bureau chief.
As Medicaid purge begins, ‘staggering numbers’ of Americans lose coverage
The overwhelming majority of people who have lost coverage in most states were dropped because of technicalities, not because state officials determined they no longer meet Medicaid income limits. Four out of every five people dropped so far either never returned the paperwork or omitted required documents, according to a KFF Health News analysis of…
More states OK postpartum Medicaid coverage beyond two months
Montana Lawmakers in the recently ended legislative session voted for a state budget that contains $6.2 million in state and federal funds over the next two years to extend continuous postpartum eligibility from 60 days to 12 months after pregnancy.