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Montana state mental hospital loses federal money as well as oversight


Four patients at the state mental hospital in Montana died in a single week last year. Federal regulators concluded all the deaths were preventable. That led to the loss of millions of dollars in federal funding and the end of federal oversight of the hospital. Patient advocates say the result is a lot less transparency into a troubled institution. Montana Public Radio's Aaron Bolton reports.



MITCHELL: This is my husband's family's home.

BOLTON: Jennifer Mitchell is restoring her late husband's childhood home in the mountain town of Butte. It's helping her fill the time since he died a year and a half ago.

MITCHELL: Here's a picture of my husband. We did some cruises. We went to the Centennial Ball, Montana Centennial Ball, 1989.

BOLTON: When the pandemic hit, Bill who was 69, started to become paranoid and forgetful. He eventually crashed his car, winding up in the ER.

MITCHELL: And they thought he had the hallmarks of dementia.

BOLTON: Doctors legally committed bill to the Montana State Hospital as a danger to himself or others. After 60 days, he was discharged with meds for severe depression, but not his drugs for congestive heart failure. The hospital had taken him off those. A month later, he went into cardiac arrest. Jennifer blames the medication change.

MITCHELL: He turned 70 on July 29 and still lingered and lingered. And finally, his brother came to visit him. And he died the next morning. He was just waiting to see his brother.

BOLTON: The following winter, four patients died in one week at the state mental hospital. There was a serious assault shortly after that. And that's when the federal government pulled millions of dollars in Medicare and Medicaid funding. Losing that money is bad, Danny Tenenbaum says. But losing federal oversight is worse. Tenenbaum is a former state lawmaker and public defender who's represented state hospital patients.

DANNY TENENBAUM: Federal investigators are not able to go in there and report to the public as to what's going on there.

BOLTON: That means serious incidents could fall through the cracks, as state law allows administrators to keep details from the public.

TENENBAUM: It's a black hole.

BOLTON: A patient watchdog group says state law prevents releasing information that federal investigations used to make public. Mary Caferro, a Democratic lawmaker from Helena, wants to require the state to publicly disclose information about patient safety incidents at the state mental hospital.

MARY CAFERRO: The legislature, when we have good information, thorough information, we make better policy that's in the best interest of the people we represent.

BOLTON: Right now, lawmakers rely on people running the hospital to flag any problems. Charlie Brereton, head of the state health department, recently told them things are getting better.


CHARLIE BRERETON: We've stabilized MSH since that decertification with a change in leadership and with no significant increases in deaths, serious injuries or substantiated abuse or neglect allegations.

BOLTON: But Brereton, who declined an interview, didn't give any details about those incidents. A records request found 13 substantiated reports of abuse, neglect and severe patient injuries since the hospital lost federal funding. There were also six deaths. And the details are important, says David Hutt with the national patient advocacy group Disability Rights Network.

DAVID HUTT: Raw numbers aren't going to tell you that someone was forced into an illegal four-point restraint, was knocked down, that residents were allowed to fight each other because of lack of staffing.

BOLTON: Montana's Republican governor, Greg Gianforte, wants to spend 320 million of the state's $2.6 billion surplus reforming the state's mental health system. That includes bringing back federal oversight. Gianforte says previous Democratic administrations neglected the state hospital. And federal funding was at risk for violations on the watch of Montana's previous Democratic governor in 2017. But the state resolved the complaints. Democrats say more funding is sorely needed and patient advocates agree, so the state hospital can remain a fixture. But they also want more transparency about safety problems.

MITCHELL: This is my cat, Jamison (ph). Hey, Jamie (ph).

BOLTON: It's about a hundred miles from Montana's capitol, over the mountains, back to Butte, where Jennifer Mitchell is mourning her husband. She doesn't think the state hospital can be saved.

MITCHELL: This whole hospital needs to be completely just disbanded. And they need to start from scratch.

BOLTON: She fears only more patients will get severely injured or die at the state hospital so long as its doors remain open.

For NPR News, I'm Aaron Bolton in Butte, Mont. Transcript provided by NPR, Copyright NPR.

Aaron is Montana Public Radio's Flathead reporter.