The State doubles the payment of the management contract for health establishments | 406 Politics

The state health department has more than doubled funding and extended the deadline for a contract proposal to secure new leadership to run its health facilities.

While the department acknowledged last year that the contract was partly motivated by someone’s desire to address problematic staffing shortages at facilities such as the state mental hospital, it also said the contract was to find someone to oversee the consolidation of all its health facilities into one. division within the department.

The Montana Department of Public Health and Human Services originally issued a tender in late November, offering a third party a $1 million contract. Now that’s up to $2.2 million, with an extended deadline to apply until January 26. The ministry posted the increased amount online two days after the initial proposal period closed.

The contracted leadership would be in place for 16 months, from Feb. 15 to June 30, 2023, when the department plans to hire someone full-time for the new position.

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Spokesman Jon Ebelt said the department extended the deadline “due to multiple rounds of questions from vendors.” The ministry increased the funding, he said, to allow the bidder additional flexibility to bring in human resources and support staff.

Since the submission period is still open, Ebelt declined to provide any further information about the applicants, or whether they applied.

The entrance to the Montana State Hospital campus in Warm Springs.

Meagan Thompson, The Montana Standard

Montana State Hospital is one of the hardest-hit facilities in the department, with 40% of its 524 employees currently vacant. A potential contractor asked the department Dec. 6 via the state contract procurement website if the 210 vacancies were, in fact, fully funded. However, “many of these functions are performed by contract staff at a higher rate,” the ministry responded.

In December, staff told the Montana State News Bureau that the exodus from the state hospital was due to an unresponsive and insufficiently trained administration. Staffing shortages, they said, put employees and patients at risk.

Ebelt previously told the Montana State News Bureau that the state hospital was deemed compliant after an investigation in September and that no remediation plan was required from the facility. But the September investigation, made public last week, found four shortcomings, one of which the report said could have been linked to the death of a patient in August.

The September inspection of the facility revealed:

  • An internal investigation could not determine whether negligence played a role in the death of a patient in August. The internal investigator, identified as ‘staff B’, failed to interview staff about the death, did not keep records of the investigation and video footage of the building on the date of the patient’s death were no longer available because they had been “accidentally recorded by other video footage.”
  • Staffing was below levels needed to prevent patients from falling. A review of the facility’s logbook showed patients fell 113 times between June and August. Staff failed to notify a health care provider that a patient had fallen; a doctor later discovered that he had broken his hip.
  • Employees reported that staffing documentation was “not accurate” and did not list patients whose needs required individual attention from staff. This alleged change in records “made the calendar look pretty”, one employee told inspectors.
  • A patient’s family or representative had not been informed of several incidents in which the patient had fallen.
  • Staff failed to review care plans for a patient who had suffered multiple falls.

Sen. Mark Sweeney, a Democrat whose district includes the state hospital, has been hearing hospital staff talk about deteriorating working conditions there for months. He said the report released last week was not surprising.

Sen. Mark Sweeney, D-Philipsburg

Sen. Mark Sweeney, D-Philipsburg

“Everything that was in that report was expressed to me,” he said in a phone interview on Friday. He also dismissed any notion that labor issues are a symptom of the pandemic era in health care facilities.

“The issues were there long before COVID,” Sweeney said. “And I believe it’s management-related and it’s been exacerbated by COVID. … It’s more than a shame, it’s a travesty that we’ve lost so many long-term employees.”

Ebelt has yet to respond to questions about how the hospital could both be in compliance and have shortcomings in the CMS report, but the survey does not list any remedial plans for the shortcomings found by inspectors. The Montana State News Bureau emailed the Centers for Medicare and Medicaid Services asking why such shortcomings would be allowed without a plan to fix them; a return email said responses would not be available until next week.

The state Legislative Committee on Health and Human Services set aside time at its January 21 hearing to hear from Sweeney, as well as Jeremy Hoscheid, executive director of the Mental Disabilities Board of Visitors, which represents patients at the state hospital; and Robin Haux, labor program director at the Montana Nurses Association, the state’s largest nurses’ union. Following the panel on “staffing and patient care concerns” at the state hospital, the committee will interview DPHHS Director Adam Meier. The committee oversees the department. Rep. Ed Staffman, who chairs the committee, previously told the Montana State News Bureau that he asked Meier to look into the concerns of staff brought up to the committee by Sweeney.

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