Budget Cuts Leave Montana Woman Without Trusted Case Worker

Helena Industries, founded in 1970, closed Friday citing financial challenges and the fact the state was cutting the pay for case management

By PHIL DRAKE, Great Falls Tribune

GREAT FALLS — Melissa Clark talks about once living in a parallel universe.

Clark, who goes by “Lissie,” describes it as a struggle between the world of “Here and Now” and the world of “Up Here,” she says, pointing to her head.

“The world in my head has something completely different than what reality has for me,” the 41-year-old Clark says.

Between the ages of 19 and 29, she struggled and bounced between the two worlds. Clark says she lives in the real world now.

In the alternate world, she says she “lives completely, contently, happily on my own.

“In my reality in here,” she says, again pointing to her head, “I have a house on my own, I know how to drive a car, and I know how to get myself around and survive it.”

But that is not the life she leads.

“The world out here is completely different,” she says gesturing around the room. “I don’t know how to survive on my own.”

She describes one attempt to live independently as “a complete failure.”

A sign that reads “Independence does not mean moving out” now hangs in the house. Clark was born with fetal alcohol syndrome, reportedly the first case recognized as such in Montana. It’s a condition caused by alcohol exposure during the mother’s pregnancy.

It causes irreversible brain damage and growth problems.

She has received help through the state of Montana in dealing with her condition.

Clark and her foster mother, Sister Johnelle Howanach, said they are navigating new waters since they lost their case manager this month due to the closure of Helena Industries.

The Helena-based facility, founded in 1970, closed Friday citing financial challenges and the fact the state was cutting the pay for case management workers.

Helena Industries provided case management services for several Great Falls organizations such as Quality Life Concepts, Easter Seals Goodwill Northern Rocky Mountain and others.

Case managers assess, develop plans of care and referral to other services.

The 83-year-old Howanach, an associate member of the Iowa-based Sisters of Humility, said this comes at a time that she had hoped to turn over more duties to the case management worker.

“It’s very sad,” she said. “It’s just heartbreaking, actually. She felt bad leaving us.”

“We lost one of the best case management workers we ever had,” Howanach said, adding that Lindsey had been with them for more than five years, checking in monthly.

Clark said she feels a void. And she says she lost her gym and computer classes as well.

“I feel like I lost one of my arms,” she said.

Jon Ebelt, public information officer with the Department of Public Health and Human Services, which oversees case management workers, said the state will take over case management duties for those who lost their help through Helena Industries.

That will continue until a new case management worker provider is in place, hopefully by the end of May.

While 650 people were affected by the closure of Helena Industries, not all of the people need immediate case management care, he said.

Ebelt said that services will continue for people who had those services set up by their previous case management worker.

He said DPHHS is working with providers to make sure the 84 people who had day and work activities through Helena Industries will have a safe place to go and a plan in place.

He said “providers are working as hard as they can to make transition as smooth as possible, and that is the goal.”

Clark said that in a typical visit the case manager would ask her how she was doing and what did she need.

“There’s things I know I need, but how do I tell you what I need?” Clark said. “I see it, but it may not be the way my mom sees it or it may be the same point but we are going at it at a whole different direction.”

“The case manager helps me find a voice for what I need,” she said.

Howanach said it could even include a ride to the grocery store or to a doctor appointments.

The closure of Helena Industries comes at a time of cuts to DPHHS due to a $227 million budget shortfall due to lower than expected revenues and a costly fire season. DPHHS is shaving $49 million from its general fund from the November legislative special session to address revenue shortfalls and to pay for a costly fire season.

Howanach calls the cutbacks “unacceptable.”

“This is a moral issue,” she said. “This is not political.”

Howanach calls for people to listen to their better angels.

“People say there is no problem, but where have they been?” she said. “The services we received I consider absolutely necessary.”

Howanach said the help was provided for free.

She said she has heard the arguments that people did not want to pay more taxes to keep these services.

“My dad always said ‘What’s wrong with paying taxes?'” Howanach, who grew up in Belt, said. “If you are paying taxes that must mean you are doing pretty darn good. So what is wrong with paying taxes?”

As children of God, if we are really Christians, we should want — not feel obliged — we should want to share our riches with our least-able brothers and sisters. As a Christian that is how I have to live. I don’t have a choice. Because as a Christian I have to follow the Boss.”

She fears the case managers will be replaced with a state case manager who makes a monthly phone call. A person can say they are doing well, even though may not be.

“You can’t manage with a phone call and my friend, that is what we lost,” Howanach said. “One (case manager) who I talked to this morning said ‘This hurts my heart.'”

She notes Clark’s brother, who also had fetal alcohol syndrome, and took his own life.

He did not have the support that his sister did.

“He is no longer with us, he chose to stop the suffering, and I will leave it at that,” Howanach said. “I don’t blame him at all.”

Howanach said she will keep working for a solution and will continue telling her story to anybody who will listen.

“I don’t know what is coming,” she said. “My next step is to find out what is coming and what we can do to make the situation better for people really being affected.

“I will fight for Lissie, but I will be watching and seeing what is happening with others.”

Howanach has been Clark’s foster mother since Clark was 5.

“I save the state of Montana a couple thousand a month for services I gladly provide to take care of Melissa,” Howanach said. She and Clark started a business, Lissie’s Luv Yums, which are dog biscuit treats and can be seen selling them at the Great Falls farmer’s market.

Fetal alcohol system prevents Clark from living independently, that’s why losing the case management worker’s monthly visit was devastating, Howanach said.

“My heart is broken,” she said. “I was taught to appreciate everything the government did. I was raised with the idea you share your goods. We are all children of God.”

Howanach, who is nursing an aching shoulder, said a friend told her to shout her message from the mountaintops.

“I told her if I could get there I would.”

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