State lawmakers on Friday reiterated calls for urgent reforms at Montana’s adult psychiatric hospital in Warm Springs, which has long struggled with insufficient staffing and resources — problems that have resulted in patient falls, deaths and loss of federal funding within the last year.
Some of the lawmakers serving on the Montana Legislature’s Children, Families, Health and Human Services interim committee pushed for rapid action in an effort to stabilize the hospital, including more robust staffing and services for particularly high-needs patients. Montana Department of Public Health and Human Services Director Adam Meier, in turn, doubled down on his calculated approach to remedying issues at the hospital. The exchanges Friday echoed debates from similar oversight hearings held in recent months.
“Step one is understanding how to fix the problem,” Meier said. “We have to work within our budget and we have to understand that this is a multifaceted issue.”
Rep. Ed Stafman, D-Bozeman, who chairs the committee made up of five Democrats and five Republicans, expressed frustration on Friday with the department’s vague timeline for immediate problems.
“I think I speak for most of this committee in that people actually died as a result of inadequate patient safety,” Stafman said. “I appreciate all of the efforts of the studies and the long term approach. And that’s needed. But I’m also concerned about patient safety today and tomorrow.”
The department has made significant adjustments to the hospital’s operations in recent months. The facility’s former administrator, Kyle Fouts, was removed and reassigned to head a state-run behavioral facility in Boulder in late April. Carter Anderson, the department’s inspector general in the Quality Assurance Division, was selected to serve as the interim administrator.
DPHHS also recently hired a New York-based consulting firm to oversee management of the state hospital. Alvarez and Marsal was awarded a $2.2 million contract to take over a wide range of responsibilities, including facility assessments and strategic planning, until summer of 2023. Meier said on Friday that the firm’s leading project managers have had several meetings with state health officials, hospital staff and other stakeholders since beginning their work on April 18.
“The assessment is in full swing and we’re already seeing some insights on the areas that we can improve, in addition to thinking about the big picture,” Meier said.
Meier’s appeal for gradual, procedural remedies was somewhat undercut by sharp questioning from some lawmakers who toured parts of the Warm Springs facilities earlier in the week. Representatives Danny Tenenbaum, D-Missoula; Jennifer Carlson, R-Manhattan; Mary Caferro, D-Helena; and Jane Gillette, R-Bozeman, had focused specifically on evaluating the Spratt Unit, which provides live-in care to roughly 35 elderly dementia patients. Tenenbaum said the lawmakers saw four patients being housed in one small room during their visit.
On Friday, Tenenbaum asked Meier whether that living arrangement would still be in place by the next time the committee tours the facility this summer.
“I’m talking about finding a set-up so that you don’t have four people with dementia living in one bedroom. I know the space is there,” Tenenbaum said. “It was disturbing and disgusting. And it’s unacceptable.”
Tenenbaum also noted that the roots of the hospital’s current problems pre-date the administration of Gov. Greg Gianforte, who took office at the beginning of 2021.
“I don’t want to turn this into a political thing,” he said. “I just want Montanans who live with dementia to not have to fear ending up in that place, in those conditions and the complete absence of rehabilitative services, being treated like cattle.”
Meier said he could not commit to a timeline for providing different living arrangements for patients, partially because of the difficulty of discharging patients to local facilities that can effectively care for them.
“We have to create places for them to go. And absent putting them on the street — I share your concern,” Meier said.
The committee is considering a bill draft, requested by Tenenbaum and Carlson after months of study, that would transfer state hospital residents with dementia to community placements. If backed by the majority of the interim committee, the bill will likely be introduced in the upcoming legislative session.
The committee is scheduled to meet again in late June.
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