Montana Chapter of the AAP

Blue Print for Children

A State Child Health Policy Agenda 2023 and Beyond

Priorities and recommendations to foster child health and well-being, achieve health equity, eliminate health disparities, optimize lifespan outcomes, strengthen families, support our communities, and enhance the position of Montana as a leading state for children.

Policy Goals

Promote healthy children

All children must have access to the highest-quality health care, so they can thrive throughout their lifespan. Policymakers must ensure that all children, regardless of their immigration status:

have affordable and high-quality health care coverage,
have insurance with comprehensive, pediatric-appropriate benefits,
have access to needed primary and subspecialty pediatric care and mental health services, and
receive comprehensive, family-centered care in a medical home.

SUPPORT secure families

Together we can work to advance efforts to ensure that parents can give their children the best foundation for the future. Policymakers must ensure that all families have:

BUILD STRONG COMMUNITIES

Strong communities are the building blocks for secure families and healthy children. Policymakers must ensure that communities:

are safe from violence and environmental hazards,
provide high-quality early education programs,
support public health systems that protect children from infectious diseases and support maternal and child health, and
respond effectively when disasters and public health emergencies occur.

Ensure our state is a leader for children

Child health and well-being must be elevated and maintained as a priority in our state. Policymakers must develop and implement policy that:

funds and supports public health and health services to help children grow into healthy adults,
addresses environmental health and climate change issues that affect children, and
addresses factors that make some children more vulnerable than others, such as race, ethnicity, religion, immigration status, sexual orientation or gender identity, and disability.

2023 Advocacy Agenda

Access to care

Too many Montanans are uninsured. Children with special health care needs are particularly at risk of missing needed care. Supporting adults’ access to health insurance improves child health as well. As Montana’s pediatricians, we commit to work collaboratively with decision-makers to:

Support a robust health care work force to meet the mental and physical health needs of all Montanans,
Reduce unnecessary barriers to enrollment in insurance programs such as Medicaid and Healthy Montana Kids (CHIP) for those who qualify,
Continue Montana’s commitment to the Medicaid expansion program for all eligible residents,
Prevent delays and disruptions to care from insurance prior authorizations and denials, and
Actively work to find strategies to increase the availability of home nursing for children with special healthcare needs and technology dependent children

Early childhood education

An investment in high-quality, universal early childhood education is an investment in the future of our state.
As Montana’s pediatricians, we commit to work collaboratively with decision-makers to:

Increase state funding for Early Head Start and Head Start programs,
Collaborate to support access to other high quality child care programs throughout the state,
Improve schools’ and child care providers’ abilities to provide a safe learning environment and to respond to health emergencies,
Support high-quality public education for all children,
Provide evidence-based health education, including comprehensive and inclusive sexual education, for all,
Oppose the exclusion of books and class materials due to accurate historical content or diversitypositive messages,
Address food insecurity in school and child care settings by supporting healthy meals, and
Fully support children with special health and behavioral needs, so they can be successful in the school environment and in their transitions to adult life.

Mental and behavioral health

Montana leads the nation in suicide rate, and suicide is particularly high among the Native American population. As Montana’s pediatricians, we commit to work collaboratively with decision-makers to:

Support training for schools, community, clinical and behavioral health service providers on recognizing
warning signs and preventing suicide,
Fund a robust, coordinated system of first-line outpatient mental and behavioral health care, to include
school-based psychologists, social workers and counselors,
Encourage the implementation of strategies to reduce access to guns and other lethal means of suicide for
teens who are at risk, and
Develop and support programs for screening, brief intervention and referral to treatment for substance use
disorders, mental health issues and suicide.

Child poverty and food insecurity

Poverty affects many of Montana’s children, with 14.5% of children living in households with incomes under the Federal Poverty Level in 2020. 10.4% of Montana’s children live in food-insecure households. Living in poverty means children may not have access to food, secure housing, and health care. As Montana’s pediatricians, we commit to work collaboratively with decision-makers to: • Support aggressive action to reduce food insecurity among children, including increasing access to meals in childcare and school,

Increasing Montanans’ participation in the Supplemental Nutrition Assistance Program (SNAP) and the Women, Infants, and Children (WIC) program,
Raise the minimum wage, which has been shown to have a strong positive effect on working families,
Reduce the impact of significant household expenses on low-income families, with policies that support the affordability of housing, child care, and energy.

Vaping, Tobacco and Marijuana

According to the 2021 Montana Youth Risk Behavior Survey, 48% of high school students have tried ecigarettes or electronic vapor products, and 25.4% are current users. Montana must act now to keep nicotine addiction from overwhelming a new generation. Marijuana use causes neurodevelopmental effects on teenagers and on children whose mothers use it while pregnant or breastfeeding. However, many Montanans view it as safe. As Montana’s pediatricians, we commit to work collaboratively with decision-makers to:

Reduce the sales of flavored nicotine and THC products, including mint and menthol flavors,
Support strategies for preventing youth smoking exposure and initiation,
Prevent the use of THC products by teens and by pregnant women, or the accidental ingestion of THC products by young children,
Amend the Clean Indoor Air act to include vaping devices, to reduce secondhand exposure,
Provide resources to teens and young adults trying to recover from nicotine addiction, and
Appropriately fund and support enforcement activities.

LGBTQ + Youth

Montana’s LGBTQ+ youth deserve a right to live full lives without fear. They are at risk for discrimination, bullying and associated mental health issues. As Montana’s pediatricians, we commit to work collaboratively with decision-makers to:

Ensure sexual orientation and gender identity are protected classes against discrimination,
Prohibit conversion therapy for minors,
Provide all appropriate mental and physical health care for LGBTQ+ youth,
Allow youth to use appropriate bathroom and changing facilities for their gender,
Allow gender diverse youth to accurately list their gender on legal documents, and
Allow LGBTQ+ youth the right to participate fully in sports and other activities without discrimination based on gender or sexual orientation.

FOSTER CARE

As of April 2022, 2,883 Montana children are in foster or kinship care. The foster care system struggles with employee turnover, caseloads, and funding. According to a recent audit, in 47% of removals, parental substance abuse is a factor. As Montana’s pediatricians, we commit to work collaboratively with decisionmakers to:

Increase access to both outpatient and inpatient substance use disorder treatment for parents, and especially programs able to treat pregnant women,
Remove barriers to providing Medication Assisted Therapy for opioid use disorders,
Provide appropriate resources to protect children from experiencing physical, sexual or emotional abuse or neglect,
Align Montana child protective standards to national best practices, including recommendations that exist under the Family First Prevention Services Act,
Improve access to health services for children and teens in foster care, including bridging services for youth up to age 21, and
Advocate for fair and responsive child protective resources that can provide comprehensive support for families working towards reunification.

CHILDHOOD IMMUNIZATIONS

Montanans are susceptible to vaccine-preventable diseases when childhood immunization rates fall. Unfortunately, poor access to care, active disinformation and the ease of obtaining nonmedical exemptions is leading to low childhood immunization rates, which places children’s health and safety at risk. As Montana’s pediatricians, we commit to work collaboratively with decision-makers to:

Reinforce the importance of routine child immunization in order to increase statewide immunization rates,
Actively counter vaccine misinformation,
Increase ease of tracking vaccine status to ensure children can stay up to date, by encouraging participation in the state immunization registry and converting it to an “opt out” system,
Eliminate nonmedical exemptions to vaccination wherever feasible, and
Increase participation in the Vaccines for Children program, which serves over half of Montana children, including those at highest risk for not obtaining recommended care.

Climate Change

Children are uniquely vulnerable to environmental contaminants, from air pollution to the effects of climate change. In addition, children face disproportionate exposure to environmental factors that negatively affect health; they breathe faster than adults, spend more time outside and have lungs that are still developing. Montana pediatricians support the American Academy of Pediatrics’ belief that aggressively addressing climate is necessary, and that to do otherwise is an injustice to our children.

Reduce air pollution and mitigate its effects on Montana children,
Shift Montana towards renewable energy and increasing energy efficiency,
Make Montana a leader in reducing greenhouse gas production,
Protect children vulnerable to extreme weather and climate events by preparing for disasters,
Ensure that our children will benefit from a clean and healthy environment in perpetuity, and

Montana AAP: Annual Pediatric Roundup Conference - October 11-13th in HELENA