It's time to stop warehousing people with dementia at the State Hospital

One of us is a Republican legislator representing rural Gallatin County. The other is a Democratic legislator representing the city of Missoula. Despite our political differences, we are committed to taking action to end the crisis at the Montana State Psychiatric Hospital at Warm Springs. The State Hospital’s problems are not new. For more than a decade, federal investigators and disability rights advocates have sounded the alarm about persistent human rights violations against the hospital’s residents. Avoidable falls, preventable deaths, untreated illnesses and broken bones, over-reliance on restraints both physical and chemical, chronic understaffing — this has long been the reality for the facility’s residents. As legislators tasked with oversight of Warm Springs, we frequently hear from families who are understandably terrified for the well-being of loved ones who end up there.

The first step is to stop warehousing people with neurocognitive disorders, like dementia and traumatic brain injuries, at the State Hospital. The most common source of violations is the wing being used to house people with neurocognitive disorders like Alzheimer’s disease and traumatic brain injuries. Although these residents often do not have a psychiatric diagnosis, under Montana law they can still be involuntarily committed to the state psychiatric hospital if a judge finds they are “unable to care for their basic needs.” This standard is low enough that virtually anyone living with dementia is at risk of being involuntarily committed. National experts who have testified before our legislative committee have expressed shock at how Montana’s outdated treatment model compares to other states. In legal filings, the state itself has referred to the placement of people with dementia at the State Hospital as “unfortunate.”

It’s time to stop kicking the can down the road. With input from medical professionals, disability advocates, families of residents, the department and community care providers, we are introducing bipartisan legislation to (1) end this misuse of the State Hospital and (2) fund medically-appropriate places for Montanans with neurocognitive disorders to receive quality, dignified care instead. Of course, quality care costs money. DPHHS is currently studying increases to Medicaid reimbursement rates. With these updated rates, long-term care facilities will no longer be forced to reject these Montanans for financial reasons. Furthermore, a major, soon-to-be-completed renovation of the Montana Mental Health Nursing Care Center in Lewistown will allow more people living with Alzheimer’s and related dementias to receive specialized care in a facility that’s designed to meet their unique needs.

We may be from opposing parties, but we are totally unwilling to engage in the usual political blame game. This is a problem that affects our entire state. Montanans deserve solutions, not partisan attacks. Once signed into law, our legislation will provide a dignified, medically-appropriate safety net for Montanans living with dementia and traumatic brain injuries.

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Rep. Danny Tenenbaum, D-Missoula, represents House District 95, Rep. Jennifer Carlson, R-Churchill, represents House District 69.