Lawmakers urge DPHHS to actively pursue federal reaccreditation for Montana State Hospital

The state psychiatric hospital lost its federal funding in April

By: - August 23, 2022 7:41 pm

Montana State Hospital. Credit Keith Schubert

A handful of Democratic lawmakers are calling on the Montana State Hospital to reapply for federal accreditation, a move they say would improve care and clarify the state’s intentions with the psychiatric hospital.

Monday’s letter, addressed to Department of Public Health and Human Services Director Charlie Brereton, cites a Montana Free Press article from July in which former director Adam Meier and Brereton obfuscate their plans about trying to restore federal Medicaid and Medicare funding to the hospital in Warm Springs — the state’s only psychiatric hospital.

“We write to express our deep concern at your lack of commitment to recovering millions of dollars in federal funding for MSH, and urge you to immediately and publicly commit to pursuing CMS accreditation as soon as possible,” the letter reads.

As of August 15, the hospital was serving 218 patients, according to DPHHS.

The hospital lost $7 million in federal funding in early April after a Centers for Medicare and Medicaid investigation found an inability to prevent deaths, COVID-19 outbreaks and falls at the facility. The loss of funding was compounded by the fact the hospital was already $7 million over budget as of March, mainly due to its reliance on more expensive contracted workers rather than full-time staff. The hospital’s total budget for the fiscal year 2022 is $48.8 million.

More notably, according to reporting from Montana Free Press, the hospital is losing out on $70 million in Medicaid reimbursements over the next five years by not applying for re-accreditation. And the lawmakers said the state needs those dollars.

“The federal funds not only could help ensure that MSH is fully funded at a level sufficient to ensure the facility operates properly, but could free up state general fund dollars to invest through the continuum of mental health care, shoring up up community-based care in addition to MSH,” the letter reads.

Jon Ebelt, DPHHS spokesman, said the agency is reviewing the letter.

Earlier this year, DPHHS hired New York-based consulting firm Alvarez and Marsal on a $2.2 million contract to investigate all state-run hospitals, including Montana State Hospital.

A July report card from the firm found “significant deficiencies” at the hospital and showed the hospital was $17 million over its 2022 fiscal year budget.

While Monday’s letter expressed concern over the financial impacts, it also raised worries about the quality of care at the hospital.

“Beyond the financial implications, pursuing reaccreditation is an important step in demonstrating to the State Hospital’s patients, staff, and the community at large that the State is committed to correcting the serious wrongs that led to MSH losing its accreditation, to begin with,” the letter states.

The five lawmakers to sign the letter were Sen. Jessica Wicks, D-Anaconda; Rep. Sara Novak, D-Anaconda; Sen. Mary McNally, D-Billings; Rep. Mary Caferro, D-Helena and Sen. Jen Gross, D-Billings.

On Tuesday, Novak, who represents the hospital’s district, said she wants more clarity from the state about its plans for the hospital.

“I think it is important that they move towards recertification and the ability to access Medicaid funding and show they are making improvements to the status of the hospital,” she said.

She added that locking in the federal certification would indicate that the state is trying to make improvements to the hospital.

“I just think it’s important if you are going to comply with the federal regulations and provide safe facilities. I think that’s important, and if you want to wash your hands with it, what does that say about their intention of providing a safe environment?” she said.

Bernie Franks-Ongoy, director of Disability Rights Montana, a nonprofit that advocates for Montana’s disabled population, agreed with Novak and said securing federal funding would add an additional layer of oversight at the hospital.

“I think it is really important …  what comes with accreditation is a certain quality of services, and it also comes with money, so why is the state saying they’re not necessarily considering accreditation anymore?” she asked.

By not ensuring the hospital is abiding by the federal standards, Franks-Ongoy said the patients could lose access to quality care — and she said “the state should be willing to put the effort in for the quality of care following the standards of CMS.”

The Children, Family, Health and Human Services interim committee meets on Friday and is scheduled to receive an update from DPHHS and Alvarez and Marsal on the State Hospital.

Caferro, who sits on the committee, said she wished the state would be more transparent with the committee and expressed concerns about the patients at Warm Springs in the absence of CMS funding.

“I’m just so worried about the patients; it’s inconceivable they haven’t been pursuing reaccreditation … they got in trouble for a reason; patients died. When I heard they weren’t actively pursuing reaccreditation, I was shocked,” she said.

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Keith Schubert
Keith Schubert

Keith Schubert was born and raised in Wisconsin and graduated from the University of Minnesota in 2019. He has worked at the St.Paul Pioneer Press, Milwaukee Journal Sentinel and most recently, the Asbury Park Press, covering everything from local craft fairs to crime and courts to municipal government to the Minnesota state legislature. In his free time, he enjoys cheering on Wisconsin sports teams and exploring small businesses. Keith is no longer a reporter with the Daily Montanan.