State Hospital’s funding termination could affect every community

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 the failure of the hospital to meet health and safety standards, after four patients died in what investigators said were “preventable” deaths. This means that the State Hospital will lose $7 million annually in critical funding.

In many ways, this is personal. My mother worked in the lab as a medical technologist at the State Hospital. She was proud of the work she did, taking care of some of our state’s most vulnerable people. She was a single mom, and was able to support my brothers on the union salary and benefits.

Thirty years later, serving as the Director of the Department of Public Health and Human Services DPHHS, I steered the department and the State Hospital through the first year of a global pandemic that pushed our public health care system to its limits — I know, better than almost anyone, how difficult a job it 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 failed us. I know, better than almost anyone, that this crisis was avoidable.

CMS conducts routine reviews of health and safety standards at the State Hospital, issuing warnings when something falls short of those standards. It’s the responsibility of leadership at DPHHS and MSH to address. During my tenure, CMS discovered that some of the mirrors that had hung in the State Hospital for decades posed a threat to our patients and staff, they issued a warning and we replaced every single one.

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

I know the politics of it all can feel frustrating, but this is a tragedy. Four people died. Our most vulnerable patients and their families aren’t getting the care and the support they deserve. The staff aren’t getting the pay or the safety protocols they deserve. We must meet this moment. We won’t stop talking about this because our constituents’ lives and livelihoods are at stake.

So I have some questions for Governor Gianforte and Director Meier:

Under your leadership, the State Hospital ignored established Covid-19 protocols during the outbreak, pulled back the Covid differential funding that had previously succeeded at retaining staff, and refused to use the National Guard to do support work so the trained staff could deal with the medical and emotional needs of patients, leading to a “fast-moving staff exodus.” You had money and solutions at your disposal to address these staffing shortages and you took no steps to address them. Why did you take no substantive steps to fix the staffing shortage?

You’ve had complete control for 15 months and counting now. Why are you still blaming the last administration instead of taking ownership of your mistakes?

If the State Hospital gets shut down, what will you say to the Montanans who will lose good paying jobs and to the Montanans who count on MSH as a last-resort provider of mental health care?

When county attorneys doubt a defendant’s ability to participate and fitness to proceed” in their own defense, they send them to the State Hospital for treatment. If MSH can no longer take these patients, county attorneys might be forced to drop these cases, putting our communities’ safety at risk. What are you planning on doing to address this dire public safety concern?

You’ve handed a $2.2 million contract to a private out-of-state consulting firm. Is this an attempt to defund our public facilities?

This goes far beyond politics — this is truly a crisis of leadership

Montanans deserve well funded facilities that everyone can access regardless of income; workers deserve good paying jobs; our families deserve a State Hospital that can provide mental health care during crises; our communities deserve the peace of mind knowing that our criminal justice system is addressing mental health.

The current administration has spent the last week blaming the State Hospital problems on their predecessors. They seem to forget that neither of the two Democratic administrations lost federal funding.

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

It takes diligence to run the State Hospital. It is a hard job, but you ran for it — you asked Montanans to trust you to run our public facilities. So far, you have failed that trust. It’s time to step up and do your job.

Sheila Hogan is the executive director of the Montana Democratic Party