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Much of this week’s profile of Charlie Brereton, the young and ambitious reformer at the helm of the Montana state health department, came together at the Lewis and Clark Public Library in downtown Helena, my unofficial office away from the office. It’s a great place, and one I found conducive to writing a thinky, long-form feature about this key player in the Gianforte administration — a guy apparently bent on fixing the state’s beleaguered mental health, addiction, and developmental disabilities services.
I was far from the library’s only regular throughout August and September. My schedule overlapped with the daily visits of many people who seemed to gravitate to the building’s relative quiet. Alongside the families, children and college students, I frequently watched a taller man in a flat-billed baseball cap loop around the building’s first and second floors, generally in deep conversation with himself and gesturing at people and things I couldn’t see. More than once, I wondered if he’d ever been to the Montana State Hospital in Warm Springs, if anyone at the library knew his name, and what we, library patrons and staff, would do if he ever needed help.
Also in early September, I heard back from another man — a source I hadn’t spoken with in months. Last I checked, he was in treatment for alcohol addiction in Missoula and interviewing for jobs. We had talked about stories I could write that might shed light on his experience in and out of recovery programs, a saga that likely resonates with so many Montanans. Now, he told me, he wasn’t doing so well.
“I just came out of the hospital because I tried to stop drinking and had a seizure,” he texted. “I’m suffering alone in a hotel room until Tuesday. If you think a collection of stories could help, I’m tired of dying and I’m tired of seeing my friends and family die as well.”
I texted him back days later, and another time after that, but heard no response.
In the last few weeks, my phone started pinging with emails and calls from parents processing a different kind of hardship. Intermountain Residential, a campus of therapeutic group homes in Helena for children and adolescents from Montana and across the country with severe behavioral issues, had announced its temporary closure, citing short staffing. For families, that meant scrambling to find other placements for kids who would still pose a safety risk to themselves or others if they were to return home.
“There’s is just no one to help,” one Montana mother told me. Getting a placement at Intermountain months ago for her 10-year-old son, she said, had felt like “a miracle.”
Multiply these stories — by 50, 100, 500 or more — and you might begin to understand the scale of the problem that Charlie Brereton and others in the Gianforte administration are trying to solve. The systems to serving so many of Montana’s most vulnerable residents are knotted, myopic and tremendously difficult to pull apart. It’s the layered nature of the problem, and the complexity of the possible solutions, that have seasoned health care professionals, lawmakers and policymakers looking at Brereton with raised eyebrows. To paraphrase our headline, can a 28-year-old from D.C. really pull this off?
To be fully transparent, I certainly don’t know. Neither do my sources. And, frankly, neither does the Gianforte administration. Without the convenience of a crystal ball, my editors and I think we need to watch this reform effort all the closer to see how it might work, or might not, for the people who need it the most.
—Mara Silvers, Reporter
The Viz 📈
Even with the much-remarked-upon waves of new arrivals streaming into Montana in recent years, the state is still — for now — a place where the majority of residents were born here.
That’s according to newly released 2022 data from the U.S. Census Bureau’s American Community Survey, which supplements the bureau’s full decennial census counts with demographic information on a yearly basis.
In Montana’s western congressional district, for example, a minority of the populace, between about 44 and 46%, was born in the state. The same is true for some of the state’s fastest-growing urban areas around Bozeman, Missoula and Kalispell. In Bozeman’s Gallatin County, Montana-born residents now account for less than 40% of the population, the survey data indicates.
That dynamic is reversed, however, in Yellowstone and Cascade counties, which encompass Billings and Great Falls, respectively.
Native-born residents may also be a minority in Lewis and Clark County, which includes Helena. The survey says 48.7% of residents reported being born in-state, but the 50% majority threshold is within that figure’s 4.5% margin of error.
—Eric Dietrich, Deputy Editor
News of the News 📰
Our publication of contributor Max Savage Levenson’s “The Sit-Down” feature this week, where he interviewed Missoula journalists Erika Fredrickson and Matt Frank about their new local publication, The Pulp, necessitated what we believe is the longest disclosure note in MTFP history.
As Levenson learned, The Pulp, which aims to cover news, arts and culture in Missoula, arises in no small part from the ashes of the Missoula Independent, the long-running alt-weekly that ceased to exist in 2018 after Lee Enterprises — which owns the Missoulian, the Billings Gazette, the Montana Standard, the Ravalli Republic, and Helena’s Independent Record — purchased the Indy and eventually shut it down.
As it turns out, MTFP also shares much heritage with the Indy. Thus the disclosure:
Montana Free Press founder John S. Adams, editor Brad Tyer, reporter Alex Sakariassen, and board member Skylar Browning have previously worked at the Missoula Independent. The Pulp co-founder Erika Fredrickson has contributed freelance work to MTFP. MTFP contributor and “The Sit-Down” writer Max Savage Levenson has been commissioned to write an article for The Pulp.
Montana journalism is a small world, though, in encouraging news, it has lately shown signs of growth as well. We’re awfully glad to see it. We share with Fredrickson and Frank a fundamental belief that journalism contributes value to the communities it both covers and helps define. So we’re happy to give our friends at The Pulp a warm squeeze of welcome. We’re looking forward to their take on Missoula.
—Brad Tyer, Editor
Glad You Asked 🙋🏻
Many readers reached out, expressing varying degrees of shock, in response to the story we published last week about the high-dollar contractors Montana recently hired to oversee overlapping initiatives aimed at fixing the state’s behavioral health and developmental disabilities services. Some asked whether the two-year contract with Alvarez & Marsal Public Sector Services LLC indicated favoritism or some type of quid pro quo between the consultant and the Gianforte administration. Others asked MTFP to look into similar reform work the company has been hired for in other states.
Here’s some of what we dug up:
While we certainly don’t know everything, nothing we’ve seen so far indicates that a conflict of interest, personal benefits or kickbacks were involved the state’s hiring of Alvarez & Marsal, or A&M. It’s a privately held company still owned by its co-founders, not a publicly traded business, so no one from the Gianforte administration has a shareholder interest in the company’s financial performance. Additionally, A&M was not listed in any form he state business disclosures Gianforte has filed as a political candidate and public official.
Furthermore, none of the governor’s children work for the company, and it hasn’t reported lobbying activity in Montana to the state Commissioner of Political Practices that we could find. We did find one record of a campaign finance contribution from “Alvarez & Marsal PAC” in the COPP’s database — a $650 donation to former Democratic Gov. Steve Bullock in 2014.
None of the current governor’s top advisers, staff or appointees — including state health department Director Charlie Brereton — were on the selection committee that picked A&M for the contract. Members of that group did include some of Brereton’s direct reports: Medicaid Director Mike Randol, the health department’s Behavioral Health and Developmental Disabilities Division head Rebecca de Camara, health department Chief Information Officer Carrie Albro, the agency’s Chief Innovation Officer Marie Matthews, and Medicaid Reform Initiative Specialist Traci Clark.
In terms of the group’s previous work and outcomes in other states? The list is long and more complicated. A&M has done health care and disabilities services work in Rhode Island, Maryland, New Hampshire, New York, North Dakota, South Dakota, Oklahoma, Georgia and Oregon, to name a few. And, of course, the company currently holds a contract to oversee improvement efforts at Montana’s state-run health facilities, including the Montana State Hospital in Warm Springs.
Many of these contracts involve creating reports about how states could improve mental health, correctional and crisis services, or decrease costs and burden on state facilities serving people with developmental and intellectual disabilities. The sequence of events in Rhode Island may be most relevant to the work the firm is doing in Montana. In its application for Montana’s latest contract, A&M said it had been hired for a few months in 2020 to “propose a plan and budget for the redesign and rightsizing of state operated group homes” for people with intellectual and developmental disabilities and Rhode Island’s long-term care hospital. News reports describe a difficult process resulting in a downsizing of that facility, with critics raising concerns about how high-needs patients were being discharged.
Another point of interest: Some of the contracts A&M won in other states were “no-bid” awards, meaning there wasn’t a competitive application and vetting process. In Montana, state reviewers hired A&M over other bidders for both of the company’s current contracts. Most recently, as we noted in our original story, A&M was the highest-scoring competitor and also the most expensive.
That story if you missed it: Montana to pay behavioral health consultants hundreds of dollars per hour.
—Mara Silvers, Reporter
Closeup 📸
Kit O’Connor, a research ecologist for the Rocky Mountain Research Station, looks at the station’s fire risk management dashboard on his computer. Among other things, the public map breaks the western United States down into what researchers call Potential Operational Delineations, or PODs, geographic “containers” on the landscape that help fire managers assess where fires can reliably be controlled and where allowing them to burn can reduce risk and benefit the ecosystem.
O’Connor was part of the RMRS team that developed the current PODs framework, which seeks to improve firefighter safety, support fire-adapted communities, and get more of the right fire in the right place at the right time. Read the full story here.
—Bowman Leigh, Fire Reporting Intern
Fire Lookout 🔥
Cool, wet and even snowy weather conditions have dampened fire activity across much of the state this week. However, one new wildfire was reported in the Lolo National Forest southwest of Alberton on Sept. 9. The Lupine Fire has since burned 152 acres and is 20% contained as of Friday, Sept. 22. No pre-evacuation warnings have been issued and, according to the National Interagency Fire Center, officials estimate that the fire will be contained by Oct. 11.
All but two large fires remaining in the state are at least 90% contained. The River Road East Fire southeast of Plains has burned 17,313 acres and is 62% contained, and the East Fork Fire south of Trego is 75% contained at 5,259 acres.
Following the Law ⚖️
A trio of new faces got permission this week from Lewis and Clark County District Court Judge Chris Abbott to enter the legal fracas over one of Montana’s new charter school laws. All three intervenors have joined the state in defending the currently enjoined House Bill 562 and its system of “community choice schools.”Their reasons for doing so add another layer to an already complex case.
One of those voices is Connie Filesteel, who has her eyes set on creating a choice school under the auspices of HB 562 geared specifically toward promoting culture and language education on the Fort Belknap Indian Reservation. Speaking with MTFP this week, Filesteel, a former Hays Lodgepole principal, said efforts to deliver such instruction in existing schools on or near the reservation haven’t done enough to strengthen tribal identity among Fort Belknap’s youth. She now intends to try through the nonprofit Aaniiih Nakoda Montessori Academy. While Filesteel said the academy will likely start as a private school, she sees the ability to transition to choice school status and secure state funding as its best shot for long-term growth and sustainability.
“What this community choice bill does is it allows for true autonomy of tribal nations and tribal peoples, like myself, who want to establish a school to really take control of the destiny of their children’s education,” Filesteel said.
Fellow intervenor Jonathan Windy Boy, a state representative, hails from the neighboring Rocky Boy’s Indian Reservation and was the only Democrat to support the bill as it was debated in the Legislature this year. He spoke in favor of the measure on the House floor this spring, raising many of the same arguments he outlined in his court declaration, among them a defense of choice schools as a pathway to ensuring students in reservation and bordertown communities “are not left behind.”
The third intervenor, Kasey Koehler, is a former elementary school principal in Miles City and recipient of a 2018 award from the National Association of Special Education Teachers. In her declaration to the court, Koehler argued that choice schools offer “much more flexibility” in class size, structure and governing authority than traditional public schools. She added that she intends to capitalize on those flexibilities to establish a Miles City-based choice school designed in part for students with special needs.
Filings from Koehler and Filesteel shed new light on the types of choice schools Montanans were envisioning before Abbott temporarily froze HB 562 last month, as well as the alleged challenges motivating that interest. Neither the state nor the plaintiffs opposed the intervenors’ entry into the case, though the latter did argue — in a statement from attorney Rylee Sommers-Flanagan — that such opportunities already exist outside of HB 562, including through a separate public charter school law also passed this year.
—Alex Sakariassen, Reporter
On Our Radar 
Amanda — This New York Times Daily podcast episode describing a proposal to build a desalination plant in Mexico and pipe potable water to an H2O-starved region of the southwest is pretty incredible. I also loved the title: “Arizona’s Pipe Dream.”
Alex — The nonprofit education news outlet The 74 published a fascinating article this week about a new trend within the school choice movement: microschools. The small, private learning spaces are serving as many as two million students nationwide, the outlet reports, but are running into regulatory growing pains and triggering concern among public school advocates.
Arren — I’ve been in Glendive this week for MTFP’s reporters-in-residence program. As it turns out, the city is in the midst of political crisis: The mayor, Teresea Olson, resigned earlier this month, per the Glendive Ranger Review, capping off a year of dramatic changes in city hall.
Nick — Comedian Hasan Minhaj, the former host of “Patriot Act,” has provided an important voice in America for his political and cultural commentary. Turns out, as The New Yorker recently reported, a lot of his heart-wrenching recounting of his life as an Asian American and as a Muslim in America isn’t true. Minhaj countered that his performances are based on “emotional truth.” So, I’ve been wondering: Do we ask too much of comedians? Is “almost true” good enough? What would George Carlin think?
Bowman — In digging into the intricacies of fire management over the past few weeks, I found “Can ‘Moneyball’ Fix How The West Manages Wildfire?” — a deep dive published by Oregon Public Broadcasting in 2018.
Mara — The Biden administration is pushing to prohibit unpaid medical debt from bogging down individuals’ credit scores through future rules developed by the Consumer Financial Protection Bureau. If successful, the move would potentially help millions of Americans struggling to pay back expensive medical bills while also renting apartments, securing jobs or getting a car loan, explains KFF Health News’ primary medical debt report Noam Levy.
Eric — Looking for some light bedtime reading about what the federal government could do to promote housing affordability? Search no further than this wonderfully dense report courtesy of the nonpartisan Congressional Research Service.
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