New DPHHS director provides update on public hospital

HELENA — Montana State Hospital was over budget by $17 million, and elderly patients with dementia and serious mental illnesses are still sometimes detained four to a room, according to Friday, Aug. 26, 2022 testimony from the new director of the Montana Department of Public Health and Social Services (DPHHS).

The Interim Committee on Children, Families, Health and Human Services met for the last time before the 2023 legislative session to vote on bills it would introduce next year. The hearing was also the first time the committee heard testimony from Charlie Brereton, the new director of DPHHS, about Montana State Hospital.

Lawmakers on both sides criticized Brereton’s lack of action to correct conditions at the Montana State Hospital. State Rep. Danny Tenenbaum, D-Missoula, confirmed the hospital still permits the practice of keeping multiple geriatric patients in one room in the Spratt Unit, where elderly patients with dementia and mental illness are placed. severe.

Getting those patients into single rooms should be the number one priority for improving patient care at the state hospital, Tenenbaum said.

“Four dementia patients, in one room, that’s unacceptable,” Tenenbaum said. “It’s dangerous.”

Lawmakers also criticized Brereton for refusing to increase provider reimbursement rates for state nursing homes. Brereton said the department does not have the authority to raise rates without the legislature.

Rep. Jennifer Carlson, R-Manhattan, said she disagreed with Brereton’s approach to the issue.

“Somehow we find a way to pay $855 a day in a public facility,” Carlson said. “And one of the reasons we were told we had to place a patient with dementia in the Spratt unit at the mental health facility is that he doesn’t have a nursing home placement. of his community.”

Montana State Hospital is the only public psychiatric hospital in the state. After failing to meet basic health and safety standards for patients, contributing to at least four patient deaths, the US Centers for Medicare and Medicaid Services withdrew the hospital’s federal accreditation this spring. .

Without accreditation, the hospital cannot receive federal reimbursement funds, which means the hospital will miss out on about $25 million in funding over the next two years, according to committee chair Rep. Ed Staffman, D. -Bozeman.

“Did I understand those numbers correctly,” Staffan asked Brereton during the hearing. “Are Montana taxpayers really going to be in the game for a minimum of another $25 million before seeking recertification, if we even do that?”

Brereton confirmed the accuracy of the numbers and made no commitment to seek recertification and, at a minimum, the hospital would not seek certification for at least two years. Brereton denied rumors that his department planned to privatize the hospital.

Hospital staffing was about 45%, according to a July report from Alvarez and Marsal, a DPHHS company contracted to conduct a comprehensive assessment of the seven state-run health facilities. However, Montana Federation of Public Employees deputy executive director Quint Nyman said morale was improving among Montana State Hospital employees. Unionized hospital employees fall under the Montana Federation of Public Employees.

Lawmakers also voted 6-4 to introduce a bill in next year’s session that would make significant changes to child abuse and neglect laws in Montana. Tenenbaum voted with Republican lawmakers to propose the bill in the next session.

If passed, the bill would require a warrant from a judge for most child removals and shorten initial court appearance times after removals. In response to opposition to the bill, Tenenbaum pointed to a 9e Circuit Court of Appeals case, which ruled that removing a child without a warrant violates the Fourth Amendment.


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