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Montana State Hospital staff say facility still struggling

The State Hospital in Warm Springs. (Wikimedia Commons)

WARM SPRINGS — About a week after the Montana State Hospital lost a projected $7 million in federal funding, employees say the state health department is not acting with any urgency to improve conditions at the facility.

The U.S. Centers for Medicare and Medicaid last week ended its provider agreement with the state hospital due to health and safety violations. The announcement came almost two months after federal inspectors found the hospital’s practices put patients at risk of serious illness and death. Tom Glovan, vice president of the hospital workers union, said leadership has not addresses employees as a whole about the announcement.

Glovan is a psychiatric technician who has worked at the hospital for more than 30 years. After he heard the hospital would no longer be a Medicare and Medicaid provider, Glovan said he asked the hospital’s Chief Operations Officer Christopher St. Jean if employees would lose their jobs. St. Jean told him the hospital was funded by the state and it would be “business as usual.”

Disability Rights Montana Executive Director Bernadette Franks-Ongoy said she found it interesting the state’s response was to talk about the $7 million lost in federal reimbursement, and not the underlying concerns of federal inspectors. Disability Rights Montana is the designated protection and advocacy organization in Montana.

The U.S. Centers for Medicare and Medicaid Services inspected the Montana State Hospital for two days in February. Deficient practices put patient health in “immediate jeopardy” and put patients at risk for serious injury and death. Staff did not provide adequate protection for patients against falls, which contributed to the death of one patient. Three other patients died from COVID-19 when the hospital failed to separate infected and non-infected patients.

People should be really upset about what is going on at the state hospital, Franks-Ongoy said. The health and safety standards are putting people at risk.

“Employees have really just been crying out for help saying, ‘Please, will state government please do something,’” Franks-Ongoy said.

Montana Department of Public Health and Human Services Spokesperson Jon Ebelt said it was inaccurate to say the state isn’t acting to correct the issues raised by inspectors. In mid-March, the health department signed a $500,000 contract with Mountain-Pacific Quality Healthcare, which is a “healthcare improvement organization.”

The organization began to put in place corrective action plans to address the issues raised by CMS. Mountain-Pacific’s work will continue through June. Another consultant, Alvarez & Marshal Public Sector Services, LLC, will also do a full assessment of all state health care facilities and create a plan to improve operations, Ebelt said.

Rep. Dennis Lenz, R-Billings, is the vice chair of the Children, Families, Health and Human Services Interim Committee, which provides oversight of the state hospital. Interim committees are limited to studying issues and giving advice to some agencies, but don’t have direct power to make changes until the Legislature is in session, Lenz said.

Lenz compared the Montana State Hospital to an old car. Maybe it was running for a while, but now the engine is busted, he said. Rather than replace the engine, it might be time to buy a new car altogether, he said. A lot of changes have happened in mental health treatment in the last 20 years, Lenz said.

“Even if it was running perfectly,” Lenz said. “I would think we would still need to have a really serious assessment about how the state hospital works for these folks.”

Lenz said he’d like to see some internal solutions brought forward by union healthcare workers. He’s heard a lot of complaints about the head of the department, but he didn’t know if those were valid. Montana State Department of Public Health and Human Services Director Adam Meier wants to take a measured approach to improving the hospital, Lenz said. The goal is to agree on what the state wants to accomplish in the state hospital, he said. The head of the state hospital may fit into that plan, he may not, Lenz said.

“That is someone else’s call,” Lenz said.

MTN reached out to DPHHS several times to speak with Director Meier on the record about the situation at the State Hospital. However, those requests were denied.

The leadership team killed employee morale, Glovan said. The hospital feels more like a correction setting than a medical facility. Group therapies are no longer happening, patients receive infrequent passes to go outside, and overall treatment is limited to pharmaceutical intervention, he said. Staff are going in every day and providing the best care they can, but the circumstances aren’t getting better.

For employees, training is scattered and disorganized, he said. Until recently, part of orientation for new employees included a tour of the hospital campus, Glovan said. That doesn’t happen anymore, he said.

“We’ve got brand new staff training brand new staff on what should be done,” Glovan said. “They’re doing nothing to retain employees.”

The Children, Families, Health and Human Services Interim Committee will meet again May 12 and 13. Interim Committee Chair Rep. Ed Stafman, D-Bozeman, said a portion of the second day will be dedicated to discussing the Montana State Hospital.