Health department braces for impact of budget cuts

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At-risk children and families will be among those impacted by budget cuts passed during the Montana Legislature’s recent special session.

Local health department officials are bracing for a reduction in program materials, staff training and office supplies thanks to a 13 percent reduction in Targeted Case Management for Children and Youth with Special Health Care Needs funding.

The program got its start in the mid-1980s and provides home visits for low-income and high-risk children and families to improve their access to health care and parenting services. Participants range from financially at-risk families to babies with low birth rates, parents with addiction or developmental disorders and teen moms.

The Flathead City-County Health Department operates a trio of programs which are partially supported by Targeted Case Management dollars: Parents as Teachers, which focuses on developing parenting skills; SelfCare, a health and safety venture; and the Maternal Child Health Program which provides a range of parenting and pregnancy services such as infant weight checks, insurance assistance and developmental screenings.

Holly Jordt, a maternal child health services supervisor at the health department, said the home environment is also an important component of the success of Targeted Case Management programs.

“We prefer the services to be in the home because that’s where the child’s most comfortable, that’s where they learn, that’s where they play,” Jordt said.

The health department employs a team of seven social workers, registered nurses and paraprofessionals to conduct the home in-visits, which have shown in recent studies to reduce infant deaths by 48 percent, infant emergency room visits by 34 percent and to reduce child maltreatment by 33 percent.

Families and individuals often find their way to one of the department’s three programs by referral from hospitals, other health department programs, WIC or area schools.

In 2016, the department served more than 2,000 individuals in their Maternal Child Health Program, 82 families in Parents as Teachers and another 32 families in SelfCare.

Jordt said the department has grant funding that will cover staff, but will likely be unable to send those employees to further training and will have to cut back on both program and office supplies. Supplies for programming might include something like blocks, which home visiting staff give to families to help children develop fine-motor skills.

“The things that are going to be cut first are supplies, like blocks, not visits to parents … it’s hard to capture what we’re not preventing because our capacity is lessened, but the things were potentially not going to prevent are things like child death,” deputy health officer Kerry Nuckles added. “So that’s why we’re so concerned.”

As the department observes trends in injuries and deaths of children, they conduct preventative outreach to address those problems head on. For example, Nuckles said, they were hoping to distribute safe sleep kits to parents of infants to help reduce sleep-related fatalities, but will be unable to do so with the announced funding cuts.

“At some point, there will be staffing cuts, which allows us to reach fewer families,” Jordt added.

And the 13 percent reduction may not be the end of funding drawbacks for the health department’s home visiting programs.

“Thirteen percent is a very big deal for this program and what we can provide and the number of families we can give those added pieces to,” Nuckles said. “I think what’s really scary to us is the 13 percent is the only budget cut that has been announced — it doesn’t mean it’s the only budget cut. So we’re waiting for what the next round is … we’re all just sitting at the edges of our seats.”

Reporter Mackenzie Reiss may be reached at 758-4433 or

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