This story is excerpted from the MT Lowdown, a weekly newsletter digest containing original reporting and analysis published every Friday
The state-contracted rehabilitation and monitoring program for doctors, nurses and other health care professionals struggling with addiction and mental health issues may be headed for an overhaul.
In light of a critical audit report written by nonpartisan legislative staff, recent reporting by Montana Free Press about a participant suicide and sharp questions last month from concerned lawmakers, the Gianforte administration’s Department of Labor and Industry in September launched an advisory council to recommend changes to the scope and purpose of the program designed and run by the current vendor, Virginia-based Maximus, Inc.
In their first meeting the evening of Oct. 2, members of the advisory council unanimously recommended that the labor department extend Maximus’ contract until the end of 2026 while the council works to reimagine the program and give input about what to require of future vendors.
Some members pushed for a shorter, six-month extension based on a range of concerns over what they’ve heard about Maximus’ program: that participants are overwhelmed and disillusioned by its punitive nature, are struggling with the financial costs of drug testing, and generally feel unsupported.
“It’s not working,” said Jean Branscum, an advisory council member and the president of the Montana Medical Association, an industry group that represents physicians. “Patients, meaning the individuals that are participating in the program, aren’t getting better.”
Like other states, Montana is required by law to provide an addiction monitoring program that helps many types of medical providers safely continue to practice. As of Oct. 1, the program is paid for by licensees of six professional boards: The Board of Medical Providers, the Board of Nursing, the Board of Pharmacy, the Board of Dentistry, the Board of Chiropractors and the Board of Veterinary Medicine, bringing the total number of covered licensees to more than 62,000.
The state selected Maximus to run the program beginning in 2023, after the former longtime nonprofit vendor, the Montana Professional Assistance Program, lost the contract under a cloud of allegations from employees about harassment and a hostile work environment.
The transition — which also included a monthlong attempt to have state employees from the labor department operate the program — shook many licensees. Former MPAP participants interviewed by Montana Free Press often endorsed the nonprofit’s model of monitoring, saying it was based on strong networks of peer support, compassionate understanding about addiction, and firm accountability about sobriety and workplace safety. When Maximus took over, many recounted, they felt punished and judged.
Advisory council members on Oct. 2 generally acknowledged the dissatisfaction with Maximus’ style of program and the need to transition to a different type of contract. But many members also said they did not want another tumultuous program upheaval.
“I really think it’s in our best interest and our licensees’ best interest to not rush it,” said Russ Motschenbacher, a member of the Board of Nursing. “I think it is best to at least do a six-month to a year extension, so we can have that time to do some thoughtful evaluation of what we want to go into the next contract.”
Several endorsed the advisory council drawing on the expertise of addiction medicine specialists, mental health providers and others with experience rehabilitating health care workers.
In an apparent reference to recent reporting about the death of Amy Young, the nurse in Maximus’ program who died by suicide this year, one council member suggested that future contracts could do more to make participants feel supported, as many said they were under the prior program run by MPAP.
“There’s been press about a failure,” said Jim Guyer, a member of the Board of Medical Examiners. “There was perhaps something that could have been done to prevent that. But I think if we go back and look at what we had before, what was good about that, what impact that had, and compare that to where we are now — Maximus is not much of a counseling service, they’re a compliance service. And it’s not been working very well for us here in Montana.”
Several council members expressed the desire to collect more testimony and data from participants about their experiences. Although many have spoken publicly about their experiences and urged reform through media interviews, there is not an advisory council position set aside for past members of the monitoring program. No one spoke during the public comment portion of Thursday’s virtual meeting held via Zoom.
The council did not set a date for its next meeting before adjourning.
