Lawmakers air frustrations facing Montana State Hospital following a Wednesday tour of the facility

When Missoula Rep. Danny Tenenbaum toured the Montana State Hospital on Wednesday, he was dismayed by how patients at the state’s psychiatric facility were housed and the lack of rehabilitative services offered to patients — and on Friday, Tenenbaum and other lawmakers pressed the state health department for answers about what is being done to help the struggling hospital.

“I just want Montanans who live with dementia to not have to fear ending up in that place. And I would really like a commitment that reflects the urgency of the situation,” Tenenbaum told Department of Public Health and Human Services Director Adam Meier on Friday. “You’re in the position to do better; you are in the position to make the decisions and to spend the money in order to provide better care for these people.”

A recent federal investigation found that the Montana State Hospital failed to protect patients against deadly falls and COVID-19 outbreaks, resulting in the hospital’s loss of federal funding. On Friday, Meier appeared before the Children, Families, Health and Human Services Interim Committee and stood behind his administration’s systematic approach to fixing the problems at the Warm Springs hospital.

“Step one is understanding how to fix the problem, and we have to still work within our budget,” Meier told the committee. “And we have to understand that this is a multifaceted issue, that there is no easy or quick solution.”

Part of the DPHHS plan to fix problems at the hospital is the hiring of New York based consulting firm Alvarez and Marsal, who recently signed a $2.2 million contract with the state to assess ongoing problems at the hospital and provide recommendations to the state. Meier also said the department is extending its contract with Mountain Pacific Quality Health, which is tasked with looking at specific issues found during the Centers for Medicare and Medicaid investigation of the hospital earlier this year.

Meier said Alvarez and Marsal began its work on April 18 and has met with a handful of stakeholders in the state and at the hospital, including staff, union representatives and disability rights advocacy groups. He also noted the removal the hospital’s administrator Kyle Fouts, perhaps the most concrete move by DPHHS so far.

Fouts was facing a slew of allegations by employees, including creating a hostile work environment, but has never publicly addressed the complaints.

The interim legislative committee also discussed Friday two pieces of draft legislation aiming to address the chronic problems at the Montana State Hospital. One would add additional oversight to the hospital by requiring it to submit complaints to the state as well as Disability Rights Montana, a nonprofit advocacy group in the state.

The second would begin the process of building out other care options for dementia and Alzheimer’s patients and eventually end the practice of involuntarily committing those patients to the hospital. But Matt Kuntz, executive director of the Montana chapter of the National Alliance on Mental Illness, warned lawmakers that moving too quickly may backfire.

“Please give us the beds before you change where you are going to send people. It does not work to change the commitment process first,” he told lawmakers on Friday. “We are fully in support of trying to get people with Alzheimer’s and dementia out of MSH, but please build the resources first.“

Rep. Jennifer Carlson, R-Manhattan, who has taken the lead in drafting the bill with Tenenbaum, a Democrat, proposed a three-year timeline for the legislation. “The first part of the bill is that by 2023 we have policy in place to find places for the people that are there, and by 2025 is when we stop admissions,” she said Friday.

The committee has until August to vote on the draft legislation.

In the meantime, Tenenbaum said he would like the hospital to disperse Alzheimer’s and dementia patients, who are housed in the hospital’s Spratt unit, to other areas of the hospital to prevent the overcrowding he said he witnessed during his tour.

“If we return for a tour of the state hospital before our next meeting, which is June 27, are we going to see that same four people in a room?” Tenenbaum said. “I’m talking about finding a setup so that you don’t have four people with dementia living in one bedroom.”

Jack Griswold, employee union president at the hospital, told the Daily Montanan on Friday that while there has been reduced admissions to other wings of the hospital, those wings are not designed to provide the level of care patients housed in the Spratt unit require.

“The logistics don’t work out; we would have to basically entirely revamp those units,” he said.

The committee will meet again in June.