St. Peter's Health hospital in Helena. Credit: John S. Adams / MTFP

HELENA — The findings of a legislative probe released late Monday into whether Attorney General Austin Knudsen and other public officials inappropriately interfered in health care directives and “harassed” health care workers at a Helena hospital last month have done nothing to subdue the uproar surrounding the incident. 

At the request of minority Democrats in the House and Senate, the top GOP leaders on Oct. 25 authorized legislative special counsel Abra Belke to review state government documents and interview witnesses to determine what happened between the state Department of Justice, hospital staff and a patient who was being treated for COVID-19 at St. Peter’s Health hospital. 

Belke delivered her report  — entitled “Summarizing the Examination of Records” —  to legislative leaders Monday, and a spokesman for Senate leaders sent it via email to members of the press just after 9:30 that evening. 

Republican and Democratic officials were quick to exchange barbs in public statements. GOP leaders said the report exonerated Republican officials of any wrongdoing and accused Democrats and members of the press of “defamation,” while Democrats said the report shows a “pattern of public officials using their power to intimidate people.” 

In response to the report, St. Peter’s hospital reasserted its allegations that medical providers had been threatened by public officials over patient care decisions.

Knudsen has said little about the report as of Tuesday afternoon, other than it confirms what his office has said about the event since it was first reported by Lee newspapers. 

“No one at the Montana Department of Justice threatened anyone while trying to get to the bottom of allegations reported to us,” DOJ spokesman Kyler Nerison said in a statement. 

SPECIAL COUNSEL INVESTIGATION

Belke’s investigation was prompted by media reports stemming from an Oct. 12 incident in which Knudsen’s office dispatched a Montana Highway Patrol officer to St. Peter’s to investigate claims made by family members of a woman hospitalized with COVID-19 that the 82-year-old patient was being mistreated by hospital staff. That patient has since died.

The family was reportedly upset that hospital staff refused to treat the patient with ivermectin and other “alternative medical treatments.” Other allegations included claims that the hospital denied family access to the patient, disrupted communication and denied the patient access to legal documents.

Hospital officials later released a statement to members of the media saying several hospital staffers treating the patient were “harassed and threatened by three public officials.”

A screen shot of a text exchange between Attorney General Austin Knudsen and Mark Taylor, a lobbyist and St. Peter’s Health board member, indicates Knudsen was frustrated with the hospital’s handling of a COVID-19 patient.

The incident also stirred up a longstanding debate among some law enforcement officials about the jurisdictional authority of the Montana Highway Patrol. Among those concerned was Lewis and Clark County Sheriff Leo Dutton, a Democrat, who said Knudsen overstepped his jurisdictional bounds by dispatching a patrol officer to the hospital rather than forwarding allegations to local law enforcement. St. Peter’s hospital falls under the jurisdiction of the Helena police and the county sheriff’s office, not the Montana Highway Patrol, he said.

Dutton confirmed Tuesday that he met with Knudsen to talk about his jurisdictional concerns, but referred questions about the meeting to the attorney general’s office.  

“We did have a meeting, and it was productive,” Dutton said. “For the content of the meeting, I would refer you to his office.”

In a response to an inquiry, spokesman Nerison said: “Attorney General Knudsen and Sheriff Dutton discussed future collaboration. It was a productive meeting.”

In an Oct. 21 interview with Montana Free Press, Knudsen denied all allegations of harassment and called questions of jurisdictional overreach “absolute, utter nonsense.” 

Knudsen’s office later confirmed that his chief deputy, Kris Hansen, a former Republican lawmaker, was involved in the incident with the hospital. The hospital did not publicly release the names of the officials it referenced in its previous statement alleging harassment. 

“PUBLIC OFFICIALS” REVEALED

Belke’s report confirmed that former Republican state senator and current Public Service Commissioner Jennifer Fielder and Hansen were among those public officials who contacted the hospital about the patient in question.

In a three-minute voicemail left with the hospital’s Risk Management Office, Fielder, who initially identified herself as a state senator and a close friend of the patient, stated that the hospitalized woman was of “sound mind” and had requested “Ivermectin and hydroxychloroquine,” but that the hospital refused to prescribe those treatments. 

Belke did not release the audio of the voicemail message, stating that the message contained personal and health information about the patient. But according to Belke’s account of Fielder’s message, Fielder said a doctor in Havre would prescribe the two medications. 

Fielder argued that under “Montana law,” the patient has “a right to try” these “alternative medications” in search of “lifesaving care.”

According to the report, Fielder then advised the recipient that her voicemail is “a record” that she suggested the hospital employee not “erase” because “if this doesn’t turn out well there will be a suit.” 

“I don’t think it was a threat or harassment. It was to let them know that if they weren’t behaving themselves, there would be people in positions to closely scrutinize what went on there and investigate.”

Former State Senator and Public Service Commissioner Jennifer Fielder, R-Thompson Falls

Fielder also reportedly stated that the patient has an “awful lot of friends who care about her” and that the Commissioner doesn’t “think the Senators will be too happy to hear about what’s going on with [the patient’s] case at St. Pete’s right now.”

In an interview with Montana Free Press Tuesday, Fielder said she would not characterize the intent behind her phone call as “threatening” or “harassing.”

“I wanted the hospital to be aware that this was a near and dear senate staffer and that there would be many concerned public officials if she wasn’t treated well. I would add that there now are,” Fielder said. “I don’t think it was a threat or harassment. It was to let them know that if they weren’t behaving themselves, there would be people in positions to closely scrutinize what went on there and investigate.” 

According to Belke’s report, Hansen “was the only public official who ‘spoke with a provider,’ during a single speakerphone call where multiple providers were in the room.”

Belke attributed that fact to the attorney general’s office, and that Hansen had been on the phone with a patient advocate when the advocate made an “unprompted decision to put [Hansen] on speakerphone with providers.”

“No government records reference the specific content of this call; however, the hospital’s counsel stated that [Hansen] discussed the potential ‘legal ramifications’ of withholding legal documents and preferred treatment from the patient,” Belke stated in the report. Belke did not cite Hansen’s mention of possible legal action as a threat.  “No specific examples of threatening language were provided,” she wrote.

A request to interview Knudsen and Hansen went unanswered as of publication deadline. 

HOSPITAL RESPONDS

The hospital issued a statement Wednesday morning doubling down on the original characterization that health care workers were mistreated by public officials. 

“As shared in our previous statement and consistent with the Special Counsel’s investigative report, St. Peter’s Health maintains that our providers and care team members were threatened and harassed when they refused to administer treatments for COVID-19 that are not authorized, clinically approved, or within the guidelines established by the FDA and the CDC. When public officials became involved, a law enforcement response and a lawsuit were threatened.  In addition, there were phone calls, phone messages and/or social media posts to or about our providers that we believe constitute harassment.” 

“We stand by our assertion that the involvement of public officials in clinical care is inappropriate; that individuals leveraged their official positions in an attempt to influence clinical care; and that some of the exchanges that took place were threatening or harassing.”

St. Peter’s Hospital

The statement also indicated that the hospital responded only to specific questions by the special counsel and chose not to “elaborate on any of the conversations or events that took place during the care of the patient” out of “respect for the Office of the Attorney General and the genuine effort being made by both parties to address the concerns brought forward.”

“We stand by our assertion that the involvement of public officials in clinical care is inappropriate; that individuals leveraged their official positions in an attempt to influence clinical care; and that some of the exchanges that took place were threatening or harassing,” the statement said, calling the situation “incredibly unfortunate.”

“St. Peter’s Health has no other agenda than to provide the very best care for members of our community when they need us.”

PARTISAN ATTACKS CONTINUE

In the Monday evening email releasing Belke’s report to members of the press, Senate President Mark Blasdel and House Speaker Wylie Galt, both Republicans, issued a joint statement accusing House and Senate Democrats and members of the news media of “misleading and outright false political attacks on Montana’s attorney general.” 

“The special counsel’s examination did not produce any evidence to support allegations that the attorney general ‘harassed,’ ‘threatened,’ or ‘intimidated’ health care workers, as has been reported in the media,” the GOP leaders said in a joint email statement. “To the contrary, St. Peter’s CEO explicitly said he did not feel threatened by the attorney general, and the hospital confirmed that Austin Knudsen never spoke to any medical providers.”

Democrats had a very different read of Belke’s report. 

Speaking at a Tuesday press conference via Zoom, House Minority Leader Kim Abbott, D-Helena, said Belke’s summary “clearly shows a pattern of public officials using their power to intimidate Montanans into doing what they want.”

“I think we saw four clear examples of that in what was included in the report,” Abbott said. “We saw the attorney general threaten to send law enforcement and file charges when, you know, I guess he lost his patience against hospital leadership. And we saw the deputy attorney general threaten legal ramifications. She was directly involved in dispatching Montana Highway Patrol.” 

Abbott was referencing a text message exchange contained in Belke’s report between Knudsen and a St. Peter’s board member in which Knudsen stated: “I’m about to send law enforcement in and file unlawful restraint charges.” 

Knudsen later added: “This has been going on since yesterday and I was hoping the hospital would do the right thing. But my patience is running out.” 

Abbott, and Senate Minority Leader Jill Cohenour, D-East Helena, both commended the responding patrol officer, who acted appropriately, they said. 

“I just want to keep saying that this is a problem with the chain of command,” Cohenour said. “This is not a problem with that law enforcement person, who responded appropriately when they were asked to do so, went and did what she was asked to do, and then took that through the appropriate jurisdiction with the county attorney. She understood her jurisdiction, and she applied her knowledge of the statute appropriately in this situation and with professionalism.”

Cohenour and Abbott said the patrol officer should never have been dispatched in the first place. They criticized the report for failing to investigate what policies Department of Justice officials relied on to decide to send that officer. 

“I think that we’re missing the policies and protocols that were used to decide to send law enforcement into a situation where they didn’t have jurisdiction,” Abbot said. 

Abbot and Cohenour added that the report doesn’t account for the “shifting nature” of the attorney general’s office’s explanation of why the agency engaged in the first place, and their justifications for doing so. 

“We want to make sure that those aren’t political decisions because Montanans, all Montanans, should feel the ability to access law enforcement when needed. It should not be a political decision,” Cohenour said. 

INQUIRIES NOT OVER

According to Belke’s report, St. Peter’s is conducting its own investigation into the treatment of the patient at the hospital. A request for more information about that investigation went unanswered as of press time. 

“For some reason, the special counsel felt that she couldn’t include what is, I think, one of the central questions, which was: how did this decision get made? And what was the process? What internal process was followed or not followed?”

House Minority Leader Kim Abbott, D-Helena

Belke indicated that the DOJ is also conducting an “ongoing investigation,” and that some documents related to the case will not be made public because they remain “confidential criminal justice information.” 

Fielder, in a letter to Belke and in an interview with MTFP, called for a “full investigation by the appropriate authorities.” 

“What happened at St. Pete’s needs to be fully exposed and corrected,” Fielder said. 

Cohenour and Abbott said they would continue to seek additional answers about the incident, specifically related to what policies and procedures, if any, the DOJ relied on when deciding to dispatch a patrol officer to investigate. 

“That is one of the things that’s most troubling about the summary,” Abbot said. “For some reason, the special counsel felt that she couldn’t include what is, I think, one of the central questions, which was: how did this decision get made? And what was the process? What internal process was followed or not followed?” 

Cohenour said Democratic lawmakers would also be looking for ways to strengthen the legislative branch’s ability to investigate and hold the executive branch accountable when the Legislature is not in session. 

“That’s the question that we’re going to be asking ourselves between now and the next session,” she said.

Reporter Mara Silvers contributed to this report. 

This story was updated on Wednesday, Nov. 24, to include the response from St. Peter’s Hospital.

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Montana Free Press was founded by veteran award-winning investigative and political reporter John S. Adams. John was formerly the Capital Bureau Chief of the Great Falls Tribune and a correspondent for USA TODAY. John is known as a dogged investigator and the host of the MT Lowdown podcast whose unbiased reporting has changed the shape of Montana politics. Contact John at jadams@montanafreepress.org, or follow him on Twitter.