The federal Centers for Medicare and Medicaid Services (CMS) starting Tuesday will no longer reimburse the state for new patient care at the state’s only psychiatric hospital for adults. CMS sent a letter to the state on April 8 announcing the federal government's plan to pull the funding.
Inspectors with CMS in February warned the state it could lose funding after they found that the Montana State Hospital didn’t have measures in place to prevent COVID-19 infections and serious falls among patients, which led to four deaths. CMS inspectors returned at least three times, once after a violent attack by a male patient severely injured a female patient.
CMS again warned state health officials that the hospital could lose Medicare and Medicaid funding if it didn’t correct those problems. Inspectors found that the facility failed to do so.
Montana Department of Public Health and Human Services (DPHHS) spokesperson Jon Ebelt says the state hospital receives about $7 million worth of Medicaid and Medicare reimbursements annually and that the agency does not expect disruptions to care as a result of losing that funding. About 140 patients receive care at the hospital's main facilities in Warm Springs. The CMS letter does not indicate how many of those patients receive Medicaid or Medicare.
DPHHS Director Adam Meier said in a statement that the department is working with experts to resolve the patient safety issues. The department has attributed those to staffing shortages. In his statement Monday, Meier said that the problems at the hospital existed before the Gianforte administration took over and will take time to resolve.
Bernadette Franks-Ongoy is the executive director for Disability Rights Montana, the advocacy group for state hospital patients.
“It’s not helpful, in my opinion, that we keep on blaming past administrations. The state had an opportunity to fix it. They didn’t fix it,” Franks-Ongoy says.
Marla Lemons is a clinical psychologist who quit her work at the state hospital earlier this month after being there for 20 years. She says the hospital’s staffing woes are a result of a hostile relationship with administrators. Lemons says she hasn’t seen the state health department take action to improve working conditions.
"There’s no hope, and that’s why I left. And that’s why many, many people are now leaving, again. There’s another mass exodus right now,” Lemons says.
Other hospital workers expressed concerns over working conditions at arecent Children, Families, Health and Human Services Committee hearing.
State lawmakers on that committee in March decided to draft two bills aimed at reducing patient loads and making reports of abuse readily available to Disability Rights Montana. Those could be introduced during next year’s legislative session.
During that meeting, Democrats proposed that the committee immediately send a letter to the Gianforte administration asking that federal COVID funds be used to raise employee pay and that National Guard troops be called in to support hospital staff. The motion was voted down by Republicans.
Democrat Mary Caferro says the power to fix the problem is within the Gianforte administration’s authority.
"They need to do something before more people die. Losing the money is one thing, but you can’t put a price tag on people’s lives.”
Brooke Stroyke, a spokesperson for Gov. Gianforte, said in a statement that the hospital has faced long-standing challenges that have spanned multiple administrations.
A request for comment from Republican Vice Chair Dennis Lenz wasn’t returned by deadline.
CMS says the state hospital could regain federal funding, but would need to first demonstrate patient safety issues have been resolved and won’t occur again. The state could also appeal CMS’ decision to pull federal funding from the state hospital. It has until June 7 to do so.
