Demand overhaul of regulatory system for teen treatment programs
Infrastructure. Aquatic invasive species. Education. Criminal justice reform. The 66th session of the Montana Legislature is currently riding the crest of an unprecedented wave of bill draft requests on a mind-boggling array of topics.
In fact, the Legislative Services Division crunched the numbers, and found that a whopping 699 more bill draft requests were submitted in the first 19 days of the current legislative session than in the previous session. More bills — at least 80 — also have made it past committee hurdles for a vote on the chamber floors.
Among the pressing legislation being considered in this session are two bills seeking to tighten oversight of alternative residential programs for youth. As shown in the Missoulian’s recent investigative series, “Troubled Kids, Troubled System,” there are some serious lapses in Montana’s regulatory system.
If legislative leaders fail to demand improvements now, it could well be another two years before urgent reforms are finally addressed. In the meantime, hundreds of youth — mostly teenagers — will continue to be put at risk through programs that are allowed to operate with very little meaningful regulation.
Most of these youth come from out of state, making it difficult for parents to monitor their children’s progress in person. Some programs also strictly limit their students’ ability to contact or communicate with their parents directly. And the state’s astonishing lack of transparency makes it unduly difficult for parents to thoroughly research the various programs operating in Montana, which offer widely differing levels of care.
Yet these programs are all lumped together under the same regulatory system that was created by the 2004 Legislature — thanks to a bill written and sponsored by owners of the very programs that would be regulated by the new system — after these businesses spent $34,000 lobbying legislators.
This system, still in place today, tasks a Private Alternative Adolescent Resident or Outdoor Program (PAARP) board with overseeing inspections, complaints and licensing. The board operates under the Montana Department of Labor and Industry, rather than a state agency that deals with child care or education. Three of the board’s five members run the same programs they are charged with regulating. And programs claiming a religious affiliation are exempted even from these generous requirements.
Given these realities, it comes as little surprise that inspections take place rarely or that schools are given a week’s notice beforehand. What’s more surprising is that the PAARP board has no transparency and no teeth when it comes to handling complaints. It has received some 58 complaints in the past dozen years, but according to PAARP rules, these complaints are not released to the public unless the board takes disciplinary action — and it has never taken such action. The board is severely limited in its ability to require programs to follow best practices, let alone adhere to basic standards.
Therefore it is disappointing that, so far, there is only one bill in the Legislature aimed at addressing one important aspect of the state’s regulatory failure. House Bill 222, by Hungry Horse Democrat Rep. Zac Perry, would finally bring religious programs under the state regulatory system. Legislators have sought to do the same in past legislative sessions but were unsuccessful, despite strong support for this legislation from the PAARP board itself, which has provided public, written testimony in past legislative sessions at every opportunity.
Passing this bill would be a solid step in the right direction. But Montana must take strides on at least two other aspects of this issue.
First, the PAARP board should be expanded from its current five members to seven, and the majority of public members should consist of experts in child psychology, therapy and adolescent mental health — who are not also owners with a stake in the very programs they are charged with overseeing.
It is worth noting here that the PAARP board chair, speaking only as an individual and not on behalf of the board, also supports changing the board makeup to include more members who are not affiliated with treatment programs. John Santa, a licensed clinical psychologist, is a co-director of Montana Academy, a therapeutic school for struggling youth he co-founded in 1997, along with his wife and fellow psychologist Carol Santa, Medical Director John McKinnon and his wife, Rosemary McKinnon, a licensed clinical social worker.
Last week, Santa told the Missoulian Editorial Board that he also is personally open to the idea of moving PAARP from the Department of Labor and Industry to the Department of Public Health and Human Services, although he would of course want to see specific ideas on how the board would work under DPHHS before fully supporting this change. He added that he would also want those who have experience running youth treatment programs in Montana to have a chance to provide input and help negotiate how the board would work under DPHHS, ideally in a way that would recognize the different kinds of care offered by different programs.
That’s the second item still missing from the current legislative agenda. The Department of Labor and Industry is clearly a poor fit for a board that deals with alternative treatment programs for troubled youth. PAARP should operate under the DPHHS umbrella so that problems that fall outside the board’s scope can be dealt with by qualified agencies, such as Child Protective Services. Inspections should take place regularly and without advance notice, so that inspectors get an unpolished view of a program’s daily operations, and the entire system should be as transparent to the public as possible.
The deadline to introduce general non-appropriation bills in the present legislature is Feb. 23, which means time is quickly running out for legislators to take action. Critical lapses in Montana’s regulatory system have been ignored for too long already. It’s time for legislative leadership to give this their immediate attention.