The saga over management of the State Psychiatric Hospital at Warm Springs continues. The Centers for Medicare and Medicaid Services (CMS), the federal government oversight agency and primary funder of the State Hospital, placed the State Hospital in immediate jeopardy after discovering four patient deaths that were likely preventable. In response, the legislative committee with oversight of the State Hospital called an emergency meeting. After six hours of discussion, the committee concluded that taking accountability means shutting down a portion of the State Hospital – the Spratt Unit – and returning those patients to their communities for placement at local nursing homes. This haphazard idea was proposed without any analysis of the need for the Spratt Unit; the legislators just presumed that the folks residing in the Spratt wing have readily available community resources for their care. The assumption that our communities have chosen to send patients to Warm Springs without trying community placement is, in a word, absurd. By law, a patient cannot be placed in Warm Springs without a court determination that there are no community resources available to care for the patient and involuntary commitment to Warm Springs is the least restrictive environment for the patient due to the nature and severity of their mental illness. The fact that neither the legislators on the committee nor Department Head Adam Meier were aware of these facts and the law concerning involuntary commitments reflects the ineptitude of the folks running our state. Worse, if this shutdown plan becomes a reality in Montana, our violent, demented patients will literally be left out in the cold.
Nursing homes cannot house violent, demented patients. These patients end up at the Spratt Unit because nursing homes rejected them as residents due to their violent tendencies. Local hospitals are not equipped to provide long-term psychiatric care. For our legislators to be willfully ignorant of these facts and choose to view the psychiatric needs of Montanans as solvable by simply forcing these patients back to private facilities in their home communities is extraordinarily naïve. If such a notion were viable, the Spratt Unit wouldn’t have come into existence in the first place. The legislative committee members clearly know nothing about psychiatric healthcare. They haven’t set foot inside the State Hospital they oversee, and they haven’t even bothered to consult with experts in in their home communities about how best to address the issues at Warm Springs. How we treat our most vulnerable is a reflection of our character as a state; the lackadaisical approach to problem-solving by this legislative committee forebodes a bleak future not just for patients housed at Warm Springs, but all of Montana. The easy stuff of government was done in 1776; our issues deserve far more deliberation than naive puppy-dogs-and-rainbows soundbite solutions that, in reality, solve nothing and make life worse for our most vulnerable Montanans.
Tammi Fisher is an attorney, former mayor of Kalispell and host of the Montana Values Podcast.