Montana State Hospital Warm Springs
Credit: Montanabw via Wikipedia

Five Democratic lawmakers on Monday called on state health department leadership to clarify the agency’s intentions for the struggling Montana State Hospital (MSH) and urged the department to publicly support the hospital regaining accreditation from federal health authorities. 

The state’s only public psychiatric hospital, which provides short-term and residential treatment for Montanans with serious mental illnesses, lost its accreditation from the Centers for Medicare and Medicaid Services (CMS) in April after investigations by federal officials highlighted significant shortfalls in patient health and safety protocols that resulted in preventable patient injuries and deaths. 

In the letter addressed to Department of Public Health and Human Services Director Charlie Brereton, legislators cited a July Montana Free Press article in which Brereton and his predecessor, Adam Meier, said they had not decided on the “best use” of the facility or whether pursuing re-accreditation made sense. 

On Monday, Democratic state Sen. Jessica Wicks and Rep. Sarah Novak of Anaconda, Sens. Mary McNally and Jennifer Gross of Billings, and Rep. Mary Caferro of Helena called the health department’s noncommittal stance deeply concerning.

“[R]e-accreditation for the State Hospital could go a long way towards stabilizing MSH’s financial situation and secure its long term viability as an important component of our mental health care system,” the letter said. “It is irresponsible for the State to continue funding MSH completely out of the state budget when federal funds could be drawn down for this purpose.”

While the hospital’s roughly $49 million annual budget is primarily funded by state taxpayer dollars, the facility was receiving roughly $7 million a year in treatment reimbursements for its Medicare-eligible patients. Those funds dried up when federal authorities pulled the hospital’s accreditation, as did any opportunity for any additional Medicaid reimbursements in the future.

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In July, the federal government authorized Montana to use Medicaid coverage at large inpatient addiction treatment facilities. But health authorities also delivered a significant set-back for the state’s overall plan: they would not allow Medicaid to cover treatments at large hospitals that handle serious mental illnesses, including the problem-plagued Montana State Hospital in Warm Springs.

The letter’s signatories said finances are not the only reason to pursue re-accreditation, an industry-wide designation showing a hospital is in compliance with federal health and safety standards. When placed in “immediate jeopardy” status, as the Montana State Hospital was earlier this year, federal authorities have found that a hospital “has placed the health and safety of recipients in its care at risk for serious injury, serious harm, serious impairment or death,” according to the government’s operations manual for facilities covered by Medicaid or Medicare.

By not seeking re-accreditation, the letter said, the state has not made it clear that it is committed to “correcting the serious wrongs” that caused the hospital to lose its good standing with the federal government.

“Montanans deserve to know that patients committed to the State Hospital are being treated humanely and with a high standard of care. The staff of MSH deserves to know their workplace is safe and that they will be treated with respect and dignity,” the letter said. “With DPHHS unwilling to commit to re-accrediting MSH, it raises questions as to DPHHS’s commitment to the State Hospital as a whole.”

State health department spokesperson Jon Ebelt said Monday that the agency is reviewing the letter, which it received that afternoon, and had no immediate comment. 

Previously, Brereton and Meier told MTFP the state would consider the future of the hospital with input from the private consulting firm it hired earlier this year to oversee state-run health facilities. In a July report card, consultants from Alvarez & Marsal found that the state hospital showed “significant deficiencies,” the same as the month prior. The report also showed that the hospital has spent $17 million more than its allocated budget for the current fiscal year, largely because of hiring more expensive traveling staff to cover existing staff vacancies.

Brereton and the consultants from Alvarez & Marsal are scheduled to appear at a Friday meeting of the Children, Families, Health and Human Services Interim Committee, according to a draft agenda of the meeting posted on the committee’s website. A final agenda has not yet been released.

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Mara writes about health and human services stories happening in local communities, the Montana statehouse and the court system. She also produces the Shared State podcast in collaboration with MTPR and YPR. Before joining Montana Free Press, Mara worked in podcast and radio production at Slate and WNYC. She was born and raised in Helena, MT and graduated from Seattle University in 2016.