[NFBMT] Problems in State Government

[Jim Marks]

FYI

 

Montana health department calls staffing levels ‘unsustainable’ with 420
jobs left open after budget cuts  406 Politics  hele

 

Montana health department calls staffing levels ‘unsustainable’ with 420
jobs 

left open after budget cuts  

 

  HOLLY K. MICHELS holly.michels at lee.net 

 

 

 

 

 

 

 

 

  Holly Michels 

       

       

    Jul 23, 2018 

People line up in September 2017 to testify before the Children, Families, 

Health and Human Services interim committee in opposition to plans by the
state 

health department to lower its budget.

Thom Bridge, thom.bridge at helenair.com 

 

The state health department has nearly 420 positions held open because of
budget 

cuts, up nearly 90 from last October, and is at a level department leaders
call 

“unsustainable.”

 

 

Budget cuts hit the Department of Public Health and Human Services at
several 

points during the past two years, first during the 2017 legislative session,


then during that summer from a bill passed during the session that called
for 

reductions if revenues came in lower than expected. Still more cuts were
imposed 

during a special session called when revenues looked like they’d be so low
the 

state wouldn’t be able to pay its bills.

 

 

The cuts have come through a combination of loss of state funds and federal 

matching funds, as well as lowering Medicaid rates that reimburse providers
for 

services. Some cuts made during the special session could be reduced if
revenues 

come in high enough, an amount that will be certified late this summer.

 

 

 

 

 

 

Last week, department Director Sheila Hogan said the cuts’ effects on 

organizations around Montana have received a lot of attention. For example, 

Helena Industries, a nonprofit that provided job opportunities and case 

management to people with disabilities, closed amid rate cuts.

 

 

But she said the lack of sufficient employees to perform basic department 

functions will catch up to the state at some point. Hogan pointed to a unit
that 

works to collect child support payments as another example. It’s down 19 

positions.

 

 

“Getting that support to families is extremely important,” Hogan said. The
unit 

has done “really well, but again I don't know how long it’s sustainable.”

 

 

Operations Services Branch Manager Erica Johnston said she’s seen other work
by 

the agency reduced to the point she’s worried about the safety of vulnerable


Montanans.

 

 

Johnston said the department is doing less certification and oversight work 

because of a lack of employees. The department does four tiers of
certification 

and oversight for nursing homes and state-run facilities, but only the first
two 

tiers are tied directly to funding. Because of that, the other two levels
are 

going unchecked.

 

 

“In times like this, we have to let the last two tiers, which are important 

survey and oversight work in terms of the safety of our citizens, we have to
let 

that slide,” Johnston said. “It weighs heavily on the people that do that
work. 

If you let the other tiers go for long periods of time, there’s a risk,
there’s 

always a risk it could develop into something that’s just not sustainable.”

 

 

Hogan said when she started at the department in January 2017, at the
beginning 

of the regular legislative session, she knew there were going to be budget 

issues, and started to rein in hiring. She approved every hire, weighing
whether 

positions were funded with state or federal money, and how critical they
were. 

Out-of-state travel was canceled and even in-state training and travel was 

scrutinized. Branch managers had to approve any expenses over $500.

 

 

Because 24/7 facilities, with the exception of Montana Developmental Center
in 

Boulder, were exempt from the hiring freeze, that meant cuts hit harder at
the 

management level. “My goal was the boots-on-the-ground group, we left those 

folks alone,” Hogan said.

 

 

Still, the shrunken agency has lost enough of those on-the-ground positions
that 

people who get services are struggling with the reductions, and department
staff 

won't be able to keep up with their workloads. In Helena, for example, a 

vocational rehab officer has 132 open cases and covers a territory from
Townsend 

to Augusta.

 

 

 

 

 

Even with the effort to target higher-level employees, there have been 22
office 

closures, 19 of them Offices of Public Assistance.

 

 

“My goal was that we’re able to provide services and not staff … although
staff 

often provide services,” Hogan said.

 

 

Johnston said branch managers tried to see how they could reduce at the top
and 

be able to fill front-line positions. The effort was to share workloads, so
as 

to be able to reduce supervisor positions.

 

 

“We just run really lean as an agency from an operations perspective,”
Johnston 

said. “I really see the work of my people, many of which are at levels where


they don’t make a lot of money. They’re not making $40,000-$50,000 a year
and 

we’re continuing to ask them to do more, to deliver services to their
friends 

and family with less, and it’s taxing and it’s wearing on them."

 

 

 

 

 

 

Later this summer, the state will determine whether revenues have come in
high 

enough to build back some money to the state budget, including funds that
would 

be directed toward the health department. Under a bill passed during the
special 

session, the department could get up to $30.5 million. It had its budget
reduced 

about $49 million during the special session.

 

 

“If some goes back, we’re going to have a process to ask, we’re going to ask


people in the field. We’re going to ask families and we’re going to ask
clients 

and we’re going to ask providers. We’re going to do it as a group,” Hogan
said.

 

 

Hogan said the specifics aren’t set for when and where the public could
provide 

feedback. An interim legislative committee that oversees the agency is
holding 

its own meeting Aug. 6 to take public input on where individuals and
providers 

would like to see money put back.

 

 

Hogan said as she’s traveled around the state meeting with providers, she's 

tried to explain the department didn't choose to make the cuts itself.

 

 

“A lot of people are angry, providers are angry,” Hogan said. “Sometimes
it’s 

hard. Oftentimes, I have to offer a civics lesson. I am not an appropriator.
The 

department, we are not appropriators. The budget is handed to us from the 

Legislature, and we have to work within those sideboards.”

 

 

The department and administration of Democratic Gov. Steve Bullock have said


Republicans in the Legislature who haven’t been willing to consider new
revenue 

sources helped create a situation that necessitated budget cuts.

 

 

State Sen. Fred Thomas, a Republican from Stevensville, said Monday the
governor 

had the option to take a deal that would have extended a contract with a
private 

prison in Shelby and generated roughly $15 million the governor could have
used 

to offset cuts. The governor said at the time he didn't support the idea
because 

of questions about operations at the prison and criminal justice reforms
meant 

to reduce the number of prisoners statewide.

 

 

“This is why we laid out ways for the governor to come up with the revenue
to 

mitigate these reductions that were his cuts,” Thomas said.

 

 

 

 

 

 

 

 

Jim Marks

Blind.grizzly at gmail.com <mailto:Blind.grizzly at gmail.com> 

(406) 438-1421