Montana public health advocacy groups support increased federal funding for maternal home visiting programs and are urging Biden administration officials to continue funding the services for Montanans who are pregnant or raising young children.
Health Resources and Services Administration Director Carol Johnson appeared in Bozeman on Tuesday to tout the $5.4 million in home visiting grant funding available to Montana next fiscal year, an increase of about $400,000 over the current allocation. Johnson said annual grant funding to the state will continue to increase for the next few years, based on the Legislature’s reauthorization of the program in 2022.
Johnson positioned Tuesday’s roundtable as an opportunity to hear from local stakeholders about what needs are currently being addressed with federal funding in Montana and what issues health officials need to pay more attention to.
“[We want to understand] “How do we use the work that we’re doing to ensure that every dollar and every policy that we propose, everything that we’re supporting as a state, everything that the counties are supporting, is moving toward the same goal, which is the health and safety and well-being of mothers and babies across the state,” Johnson said.
Montana is one of 11 states Johnson and other HRSA officials are visiting as part of the Biden administration’s Maternal and Child Health Initiative tour. HRSA representatives are meeting with state and local officials to discuss maternal and child mortality rates and health disparities, particularly among Native American and Black mothers.
“This is an issue that cuts across all sectors,” Johnson said. “When the Biden-Harris administration took office and we looked at the numbers, we said, ‘We’ve got to do more for families.’
According to data compiled by the Centers for Disease Control and Prevention from 2018 to 2022, Montana’s maternal mortality rate was 30.5 deaths per 100,000 live births, roughly the same as the national average for that same period.
A CDC analysis of 2020 pregnancy-related mortality data collected from 38 states, including Montana, found that 47% of deaths occurred between seven days and one year after delivery. Overall, about 84% of the deaths studied were determined to have been preventable. Mental illness, including substance use disorder, was the underlying cause in more than 22% of deaths.
In 19 Montana counties with home visiting programs supported by federal HRSA grant funding, 97% of participants enrolled in 2022 were screened for depression within three months of joining the program.
County public health officials and parents told Johnson and other HRSA officials Tuesday how Montana’s home visiting program is helping new mothers navigate the challenges of pregnancy and caring for their infants and toddlers in the days, months and years after birth.
“It felt like I was surviving the whole 10 months,” said Belgrade resident Claireen Kors, who gave birth to her first child at 29 weeks, nearly two months before her due date. “Giving birth prematurely, especially at seven and a half months, is a very isolating experience. [took] It’s taking a huge toll on my mental health.”
Colls recalled feeling lonely and anxious as she began caring for her premature baby at home after a stressful eight weeks in the hospital. One day, she says, her phone rang. The Gallatin County Health Department told her she had been referred to a home visiting program, where trained nurses answered all her parenting questions, including how to breastfeed a premature baby, important developmental milestones and how to deal with her own anxiety.
“They reached out to me and came to see me,” Kors said, and since then, her visiting nurses have provided “an ongoing line of communication.”
“More than anyone in my family, my mother has seen my son grow up and she’s seen me grow up as a mother,” Kors said.
Other local health officials said the HRSA grant money helped expand existing services: Amy Gutterdam, who oversees Gallatin County’s parent engagement program, said the health department is preparing to offer universal home visits to all residents who give birth in the county.
“We truly believe that everyone who has a baby needs a little extra help,” Gatterdam said.
Montana speakers pointed to other programs they said are essential to supporting maternal health and early childhood health, including peer support specialists, doulas specially trained to help parents navigate substance use disorders, and a workforce strategy to train and hire more midwives and other health care workers across the state.
Montana’s state medical officer, Dr. Doug Harrington, also noted the importance of Medicaid expansion to cover health care services for pregnant and parenting Montanans. The state’s expanded Medicaid program is set to expire in 2025, but Republican Gov. Greg Gianforte has said he supports reauthorizing a version of the program during the upcoming legislative session. Harrington reiterated the state’s position at the event on Tuesday.
“Everybody here wants to expand Medicaid,” Harrington said. “It’s clearly on the agenda.”
