A bill that would move oversight of private residential programs for troubled teens away from a board that has been equated to the "fox guarding the henhouse" passed a second House reading on Monday — but not before a Thompson Falls lawmaker added an amendment eliminating the requirement for programs to adopt minimum standards of care.
The amendment follows another one last week to remove the requirement that all program employees must be trained, certified and qualified.
Senate Bill 267, carried by Denley Loge, R-St. Regis, would eliminate the state board that currently oversees the private residential programs. The board’s majority comprises those who operate the programs, therefore allowing them to regulate themselves — hence the fox and henhouse analogy.
The bill would shift state oversight of private residential treatment programs from the Department of Labor and Industry to the Department of Public Health and Human Services (DPHHS), which regulates health care and similar programs.
In doing so, it would establish minimum standards of care, and increase transparency surrounding program oversight by making more complaints against programs public.
However, the new amendment approved Monday eliminates all language from the bill mandating minimum standards of care for licensed programs.
Rep. Bob Brown, R-Thompson Falls, said he proposed the amendment after meeting with program owners Sunday night.
“I met with some folks last night, you know, owners of these programs and they said there's a reason these programs don’t exist in California anymore and they don’t exist in Washington anymore,” Brown said Monday.
“It’s because of the way they get structured down within the rule-making authority of the different departments that doesn’t allow them to be personalized.
“So basically, what they said would happen would be they would either wind up closing down or they would move to another state that has more favorable regulations,” Brown said.
Brown didn’t specify which program owners he met with and did not immediately respond to the Missoulian’s request for comment.
Tucked in the mountains of northwest Montana, Thompson Falls is in Sanders County, where a number of the programs are located. The town of slightly more than a thousand residents has welcomed an influx of students and their visiting parents, benefiting the local economy.
Brown’s amendment removes the requirement for licensed programs to develop “minimum standards” for a variety of things, including policies “to ensure the health, safety, safety in transportation, development, education, and well-being of program participants,” “adequacy of admission policies,” “adequacy and appropriateness of behavior management practices and policies,” adequate facilities and minimum staffing requirements.
The amendment eliminates all of the “minimum standards” and instead adds language that says the department may adopt rules that pertain to “ensuring the health and safety of program participants.”
The change adds onto the amendment made last week removing the requirement for "suitability, credentials, training, experience and other qualifications" for all program employees, which was proposed by Rep. Ed Buttrey, R-Great Falls.
Although the recent amendments reduce the bill’s capacity to bolster standards of care at programs, the bill would still eliminate the Private Alternative Adolescent Residential or Outdoor Program board.
By law, that five-member board comprises three people from the programs it is supposed to regulate.
Brown said he expects that “some kind of an advisory council” of program owners will help create specific regulations by giving DPHHS “some guidance on how these programs really work.”
Brown said his meeting with program owners the night before the reading made him think about the differences among programs and the services they offer.
He noted that some provide on-site education to students while others (including a number of schools in Thompson Falls) use public high schools where students from programs bring state funds with them.
Brown said there was a fear among stakeholders that going under DPHHS would limit the freedom programs have to be “personalized.”
However, these differences are exactly how private alternative residential programs have avoided meaningful oversight in Montana and continue to do so in other states. By defining themselves as “therapeutic boarding schools,” “behavior modification” programs, or “emotional growth” schools, programs are able to operate outside traditional health care facilities, although they still advertise as therapeutic programs.
Nearly all of the programs are for-profit enterprises, with some charging more than $100,000 per year.
Brown’s amendment passed 59-41, and the bill passed the second House reading 80-20.
Loge said he didn’t speak on the amendment because he thinks getting the bill passed is paramount.
“I just really think this bill needs to move forward because we do need to put those schools in the right category,” Loge said. “They aren't under Department of Labor and they’re not work schools. They are counseling schools.”