Editor's Note: A previous version of this story incorrectly stated that Sinopah House will be converted to a group home for adults with developmental disabilities. Fox Creek will serve adults with mental illness.
The only group home in the Flathead Valley that offered therapy specifically tailored to abused and traumatized girls shut its doors last Friday, the latest casualty of state-level budget cuts.
"It's a sad day, sad day," Paula Buckley said.
Buckley has been the therapeutic group home’s program manager since it opened 24 years ago.
"I keep thinking of all the girls that we won't be able to help, and what will they do next? That's the hardest part," she said.
Sinopah House, which means "kit fox" in Blackfoot, served as a community-based home for girls aged 11 to 17, who had serious emotional and behavioral disorders. The goal was to help them reunite with their families or a foster home, or prepare them to live independently.
"They've been the victims, so they get overlooked," says Sheila Smith, Sinopah House’s director.
We spoke at the home’s sending off party last Friday.
"I think a lot of kids will not be able to access the service and will end up in psychiatric facilities in Billings, Helena, Butte, or Utah, out of state. I think there will be a lot of kids that end up in out of state facilities, which is really, really, really, wrong," Smith said.
Sinopah House was a program of the Missoula-based non-profit Western Montana Mental Health. Girls lived at the home on Windward Way for nine to twelve months but stayed close to their families.
"With a program like Sinopah House, we could keep kids in the community. It's not a locked psychiatric facility, we could do family treatment with families because they’re here, and keep them in their communities," Smith said.
Sinopah House had eight beds and ran on an annual budget of about $600,000. Nearly all of its girls were covered by Medicaid, and more than half came without a referral from a state agency, so families were responsible for room and board.
Smith said Sinopah House always ran at a loss, but recent state budget cuts to Medicaid, paired with legislators axing a room and board fund from the state health department that covered what families couldn’t, proved too deep to overcome. The home said goodbye to its last client on Friday.
"For me it's like looking back at the 1980s. We're back to that. In my opinion, unless and until the citizens of Montana decide that things like this are worth paying for, they're not going to be able to happen," Smith said.
Not all youth home providers in Montana are feeling the pinch in the same way. That’s because the services they offer and the way people pay for them are different.
For example, Youth Dynamics, which is based in Billings and currently has 72 beds across its 9 therapeutic group homes, turned to donations to help cover the room and board fee, which averages $45 a night per client, that’s about $1,200 a month.
Missoula-based Youth Homes, which runs four therapeutic group homes in Missoula and Helena, has asked families to commit to at least four behavioral health appointments a week.
Executive Director Beth Cogswell said that commitment should make up for the loss in other Medicaid revenue. In addition, Youth Homes tends to serve kids who are placed in programs by state agencies, like Child Protective Services or Youth Court.
"So, often Child and Family Services will pay for the room and board costs, and once in a while the Department of Corrections will pay for room and board costs if it's an appropriate placement," Cogswell said.
Neither Missoula-based Youth Homes or Billings-Based Youth Dynamics plans to close any of its residential or outpatient programs. Youth Homes’ Cogswell adds that when any mental health service is lost in Montana, like Kalispell’s Sinopah House, other providers feel a ripple effect.
"That might mean we're seeing more kids come to the Flathead Youth Home in need of shelter. It might mean that there's a higher demand for therapeutic group care in our other communities. We certainly hope that we can serve all the kids and families that need us, but I can see getting to a point where maybe it's really difficult to, because the demand is so high,” Cogswell said.
Sheila Smith with Sinopah House agreed.
"They will end up somewhere, because they don't go away. Their problems do not go away. If you cut community-based services, people go to higher, more expensive levels of care," Smith said.
For girls whose families can’t afford other treatment facilities, that could mean they end up in the criminal justice system or a psychiatric facility at taxpayers’ expense. Smith says some girls will just run away.
Smith may have said goodbye to the last of Sinopah House’s girls last week, but the home’s beds will soon be full again. Western Montana Mental Health Center is converting the space to a group home for adults with mental illness, who are often more able to pay the same room and board fee that the state health department is no longer paying for girls at Sinopah House.
On Friday, she and her colleagues swapped out the home’s green sign that read Sinopah, for a new one that reads Fox Creek. Smith says she’ll add it to a growing stack in her office.
"I figure we need a museum. I've got the Stillwater sign from Eureka. I've got the case management sign from there. I’ve got the case management sign from adult services. Have a little sign museum," she said.
Sinopah is Western Montana Mental Health’s latest closure. Earlier this year, the non-profit laid off almost 50 case management workers and closed its offices in Eureka, Libby, Livingston and Dillon.