Illustration by PXhere (Creative Commons)
Three former employees of a medical non-profit that contracts with the state filed complaints with a government investigator alleging a years-long pattern of gender-based harassment, discrimination and retaliation by the organization’s director, behavior the complainants say has seeped into the program’s treatment of its participants.
The complaints, filed March 17 with the Montana Department of Labor and Industry’s civil rights bureau, claim the harassment by the clinical director of the Montana Professional Assistance Program spanned more than two years and ranged from sexist remarks about women to allowing a recently hired male employee to receive mileage reimbursements to boost his take-home pay.
All three of the women eventually resigned or were fired.
MPAP, a private non-profit organization, is currently under contract with the Montana Department of Labor and Industry to administer assistance programs for Montana’s Boards of Dentistry, Medical Examiners, Pharmacy and Nursing. The organization seeks to help “the distressed healthcare professional whose ability to practice is diminished due to chemical dependency or substance abuse, psychiatric illness, disruptive behavior, sexual misconduct or problems associated with the process of aging,” according to MPAP’s website.
But a series of former employees said in complaints currently under investigation by a state agency that the clinic’s director, Michael J. Ramirez of Billings, made sexist remarks, was threatening and demeaning, denied the women in the office opportunities for advancement, made light of a suicide attempt by a program participant and then retaliated when the complaints began mounting.
The former employees said they suffered lost wages, humiliation and discrimination, and that they believe Ramirez violated Title VII of the Civil Rights Act and the Montana Human Rights Act “by engaging in disparate treatment, discrimination, sexual harassment, and retaliation.”
Annah Howard, a staff member with the state Human Rights Bureau, confirmed that the bureau had received the three complaints and was investigating them but could provide no further information on the status of the probe.
Ramirez did not return requests for comment left at his office. The Daily Montanan reached out to several board members for comment, but calls went unreturned.
“This program is essential for the services it provides to the profession,” said one of the complainants, Amber Roane, who worked as an administrative assistant for Ramirez until this February. “It’s essential to people that need help, and it’s really disheartening that a program like this that is so important to the community is being led by someone like him.”
Allegations of misbehavior
Ramirez, who holds a master’s degree in rehabilitation counseling, has been with MPAP since the 1990s. Former clinical coordinator Meghan McGauley joined in 2017, followed the next year by Cecilia Zinnikas, while Roane started work in 2019.
State statute allows the Board of Medical Examiners to “establish a program to assist and rehabilitate licensed physicians who are found to be physically or mentally impaired” by substance abuse issues, depression and so on.
That program is MPAP, which has an office in Billings. According to tax paperwork filed for the 2019 fiscal year, a substantial portion of the program’s funding comes from the state and other public sources. It reported a total revenue of $667,000 that year, of which the vast majority came from contributions and grants. Ramirez posted an annual compensation of $108,000.
The complaints cover a variety of behaviors — for example, they say Ramirez often made sexist jokes about women, saying that “you either want to f**k ‘em or fight ‘em,” or that a woman who was participating in the program had “daddy issues” and needed to be referred to either McGauler or Zinnikas instead of a male clinician.
Roane told the Daily Montanan that attempts at encouraging more effective, appropriate communication were met with derision, gaslighting and accusations that the three women in the office were planning some kind of hostile takeover.
McGauley said Ramirez would give more leeway to male participants who slipped up in their recoveries than he would to women.
“It didn’t really matter how these guys were doing in the program. It mattered if Mike liked you and if you would do what he said with no questions asked,” she said, adding that males had a better chance of success in the program.
Over time — especially as the women became more vocal about their treatment — Ramirez’s behavior became more aggressive, the complaints say.
In November of 2020, by which time Zinnikas and McGauley had reached out to the program’s board of directors to alert them to this behavior, the complaints say Ramirez approached Roane and McGauley and slammed his fists on a desk where they were seated, yelling in McGauley’s face “Good morning, Meg!”
“During COVID there would be two people in the office at the time and if I was in there with Mike I would lock my door,” McGauley said in a phone interview.
Another allegation concerns a suicide attempt by a female patient.
In a meeting with the participant and clinic staff, the complaints say Ramirez dismissed the attempt as a “cry for help” and then went on to roll up his sleeve and illustrate how to properly commit suicide.
When McGauley tried to intervene, Ramirez said she was simply “uncomfortable with suicide,” according to the complaint.
Zinnikas, McGauley and Roane said that conditions started to deteriorate with the hiring of Mikhail Joutovsky, a retired surgeon now serving as the clinic’s medical director.
When Zinnikas and McGauley joined MPAP in 2018 and 2017, respectively, they were both told by Ramirez they would take over his position as director when he retired — the complaints allege that Ramirez had made similar claims to other previous employees.
But at a September 2020 board meeting, Ramirez introduced Joutovsky and said he would take over for him in the next three to five years, the complaints say. When a board member asked if he had references, Ramirez said he was Joutovsky’s reference.
When reached by phone, Joutovsky would not comment on the complaints.
Joutovsky was hired as a clinical coordinator, like Zinnikas and McGauley, but made $3,000 more a year than McGauley even though neither of them had clinical experience, the complaints say.
Roane alleges in the complaint she overheard Ramirez tell Joutovsky after the meeting that he stopped considering Zinnikas and McGauley because “they are too emotional and could not handle the political pressure of the job.”
Both McGauley and Zinnikas say Ramirez hired them under false pretenses — that they would take over for Ramirez when he retired. McGauley said she learned from talking to former female employees that Ramirez had made the promise before.
McGauley said her job started with a lie and got perpetually worse as time went on.20210317160826123
“It was traumatic, and I am still trying to recover from it. I don’t know if I’ll ever be able to get another job and trust the employer, and that is something I worry about it,” she said.
Joutovsky’s hiring emboldened Ramirez’s behavior, McGualey said. Ramirez would grant Joustovsky luxuries like traveling to work events around the state, letting him boost his mileage to increase his take-home pay and allowing him to clock in while commuting to Billings from Whitehall.
“It got worse because then he had someone to give preferential treatment to … it was very obvious that he wanted to get back at us,” McGualey said.
There was also a disparity in caseload, Roane said. She noticed that even long-time patients of McGauley and Zinnikas would get reassigned to Joutovksy, especially those that were considered “easy” — meaning they were responsive, participatory, paid on time, and so on.
During their time at MPAP McGauley and Zinnikas were expected to handle a caseload of about 50 patients each who required more consistent monitoring compared to Ramirez’s smaller caseload with about 70 percent of who were on “senior monitoring” meaning they required very little oversight.
Meanwhile, the two female clinicians were left with more difficult cases, she said.
McGauley added that she and Zinnikas had 50 participants
“The grey area just kept on getting bigger and bigger and bigger,” Roane said.
Seeking a remedy
The complaints say that the former employees attempted to notify the organization’s board of directors about Ramirez’s behavior, leading to an investigation from an outside human relations firm. However, the alleged conduct didn’t change, they said, and the board eventually grew flippant and dismissive of the trio’s repeated attempts to flag Ramirez’s behavior.
McGauley said multiple complaints to the board went unheard. Despite telling her things like “There’s no way Mike’s going to be sticking around” and to just “hang on,” McGauley said she never felt like the board took the complaints seriously given their communications with Ramirez during investigations into his behavior.
Roane said that one board member spoke of a “plan,” which seemed to include an investigation from an outside HR firm. The women spoke with an investigator, who said the final report would only be made available to the board.
She also said she was never clear on how board members were appointed — seemingly, Ramirez had a great deal of control.
Attorneys for McGauley and Zinnikas provided to the Daily Montanan copies of letters the two women sent to the board flagging Ramirez’s alleged behavior throughout 2020.
When the women started making noise about the alleged hostile work environment, Ramirez accused them of plotting a “hostile takeover.” According to the complaint, he would go on to issue multiple write-ups against the women, who, before voicing their concerns, had received no disciplinary action.
In January, the complaint says McGauley was written up after sending a report to the state Nursing Board without clearing it with Ramirez first. She said she was told his signature wasn’t necessary on every document.
“This write-up is explicitly retaliatory, with Ramirez writing ‘in the face of office disruption, I am acting to preserve all that I have worked diligently to build up over the past 25 years’,” the complaint says.
The same month, the complaint says Zinnikas met with the board president.
“She was essentially informed that Ramirez had won and that the board viewed the complaints as from seventh graders,” the complaint says.
McGauley and Roane were fired in early 2021. Zinnikas resigned on Feb. 2, 2021, according to the complaints.
Roane said the alleged behavior was concerning not just for the impact it had on the clinic’s staff — which she said had been subject to significant turnover in recent years — but also because it distracted from MPAP’s valuable mission.
“Overall it’s just poor management, and it’s slowly bleeding into how the program is mishandling participants, both male and female, but generally female,” Roane said.
“Once we were all fired or quit, we started reaching out because we wanted to do something,” she added. “We tried to fight for ourselves and the participants to make sure that this doesn’t happen again. It’s for the program’s survival.”
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