End of state hospital funding could affect all communities


Last month, the Center for Medicare and Medicaid Services (CMS) sent a letter to Montana State Hospital (MSH) in Warm Springs announcing the termination of their provider agreement due to non-compliance by the hospital health and safety standards, after four patients died in what investigators called “preventable” deaths. That means the state hospital will lose $7 million a year in critical funding.

In many ways, it’s personal. My mother worked in the lab as a medical technologist at the public hospital. She was proud of the work she did, caring for some of the most vulnerable people in our state. She was a single mother and was able to support my brothers on union pay and benefits.

Thirty years later, as director of the Department of Public Health and Human Services DPHHS, I led the department and state hospital through the first year of a global pandemic that pushed our public health system at its limits – I know, better than almost anyone, how hard a job that is.

But it is precisely for this reason that I am so bitterly angry that the current administration and the current director of DPHHS have let us down. I know better than anyone that this crisis was preventable.

CMS performs routine reviews of health and safety standards at the state hospital, issuing warnings when something does not meet those standards. It is the responsibility of the leadership of DPHHS and MSH to deal with this. During my tenure, CMS discovered that some of the mirrors that had been hanging in the public hospital for decades posed a threat to our patients and staff, they issued a warning, and we replaced each one.

Because we responded to CMS warnings, we never lost funding and, more importantly, patients remained safe. This is how the process should work.

I know the politics of it all may seem frustrating, but it is a tragedy. Four people died. Our most vulnerable patients and their families are not getting the care and support they deserve. Staff are not getting the pay or security protocols they deserve. We have to meet this moment. We won’t stop talking about it because the lives and livelihoods of our fellow citizens are at stake.

So I have a few questions for Governor Gianforte and Director Meier:

Under your leadership, the state hospital ignored Covid-19 protocols established during the outbreak, withdrew differential Covid funding that had previously been successful in retaining staff, and refused to use the National Guard to perform work. support so that trained staff can meet the medical and emotional needs of patients, leading to a “rapid exodus of staff”. You had money and solutions at your disposal to address these staffing shortages and you took no action to address them. Why haven’t you taken any concrete action to remedy the shortage of personnel?

You had full control for 15 months and it counts now. Why do you always blame the last administration instead of owning your mistakes?

If the state hospital is closed, what will you say to the Montanese who will lose good-paying jobs and to the Montanese who rely on MSH as their mental health care provider of last resort?

When county prosecutors doubt a defendant’s ability to participate and pursue his own defense, they send him to the public hospital for treatment. If MSH can no longer take these patients, county prosecutors could be forced to drop these cases, putting the safety of our communities at risk. What do you intend to do to respond to this serious public safety problem?

You awarded a $2.2 million contract to a private out-of-state consulting firm. Is this an attempt to finance our public facilities?

This goes far beyond politics – it really is a crisis of leadership

The people of Montana deserve well-funded facilities that everyone can access, regardless of income; workers deserve well-paying jobs; our families deserve a public hospital that can provide mental health care during crises; our communities deserve peace of mind knowing that our criminal justice system is dealing with mental health.

The current administration has spent the past week blaming the public hospital’s problems on its predecessors. They seem to forget that neither Democratic administration has lost federal funding.

This is a serious crisis that will affect almost every corner of our state – it is irresponsible for the Gianforte administration to try to dodge blame. Take ownership of the problem. Work towards a solution that puts the Montanans first.

It takes diligence to run the state hospital. It’s hard work, but you got away – you asked Montanans to trust you to run our public facilities. So far, you have betrayed that trust. It’s time to step up and do your job.

Sheila Hogan is the executive director of the Democratic Party of Montana


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