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Department of Public Health & Human Services





u -1 151S E. eth iAf'E.

In June, forty states and the tobacco industry reached JCLENa, imontai^/| 59e20OF EVENTS

landmark tentative settlement that provides for unprecedented

restrictions on tobacco products and sales and on tobacco

makers' liability in lawsuits. Department of Public Health and

Human Services (DPHHS) Director Laurie Ekanger stated, "This

settlement will result in lives saved, reduced youth access to

tobacco, and funding for prevention and cessation programs

at the state level. We applaud the hard work of the state

attorneys general throughout these negotiations."

The tobacco companies would pay more than $360 billion
over 25 years ($15 billion per year after that), most of it for
anti-smoking campaigns and to repay states for tax dollars
spent to treat Medicaid patients for smoking-related illnesses.
The companies will also pay $50 billion over 25 years in
punitive damages for past violations of the law. The unused
money will fund children's health programs. Several national
public health officials and legislators have criticized the outlined
Food and Drug Administration (FDA) restrictions as being too
inflexible. The settlement must still be accepted by President
Clinton and will require action by Congress with possible
modifications before becoming final.

Included with the monetary conditions is a comprehensive
plan outlining allowable conduct for the tobacco industry.
Most noticeable will be the banning of cigarette vending
machines, outdoor tobacco advertisements, human and cartoon
figures from all advertising and packaging, as well as tobacco-
related "paraphernalia" and giveaways. Retailers would have
to be licensed to sell tobacco products and most workplace
smoking would be banned.

The tobacco industry will also pay $500 million in anti-tobacco

education, and will face a $2 billion penalty if youth smoking

rates do not decline by 30% in five years, 50% in seven years,

and 60% in 10 years. The industry, in turn, would be exempt || Great Falls

from any "class action" suits, although individual lawsuits would ii Contact: Gary Curtis

still be allowed. Also as part of the agreement, the FDA || (406)444-9530

could order changes in cigarette ingredients but could not ban |i August 24

nicotine until at least 2009. ■ Family Fun Day

i| Sponsored by the Governor's Council on

As part of the lawsuit, and as part of the proposed distribution Families

formula, Montana would receive $2.8 million per billion awarded. 11 Gibson Park— Great Falls

-. • , • rf-nr,^ ■,,■ ,, ^r. ,- , •„■ > r si| Contacti Gafy Cuftis

This amount translates into $18.2 million (from $6.5 billion) for m (406)444-9530

the first year, with projected annual increases. The actual amounts

and how much flexibility states will have will depend on action || J^f^ JJ;^|ness Week

by the President and Congress. The other tobacco moneys,

including individual punitive damages, would be separate.

{Continued on Page 3h- . ,v ^»<^ , ...,

w<** SkM* * at * - <*' JU_


August 1-7

World Breastfeeding Week
Contact: Pat Hennessey
(406) 444-2841

August 8

DPHHS Advisory Council Meeting

Cogswell Building/Room C-209


8:30 am - 3:30 pm

Contact: Gary Curtis

(406) 444-9530

August 12 - 14

County Directors' Meeting



Contact: Roger La Voie


August 13

Groundbreaking Ceremony
Montana State Hospital
Warm Springs
Contact: Don Anderson
(406) 444-3969

August 14

Community Day

DPHHS Offices


Contact: Anastasia Burton

(406) 444-2596

August 15-23

National Rehabilitation Week

August 23

Governor's Council on Families Meeting
Cambridge Court

A Message From the Director

New Ways to Communicate

Laurie Ekanger
DPHHS Director

Community Days : On August
14, seyeral members of the
DPHHS Management Team will
be traveling to Sidney for
"Community Day." This is our
opportunity to yisit local program
sites, meet with our coworkers
and providers, talk with local
elected officials, and generally
listen and learn. Last month,
we visited Great Falls and had
the additional honor of
recognizing Pat Casteel of the Cascade County
Office of Public Assistance for 40 years of service
to the state. Congratulations, Pat!

For Community Day, we have prepared a brief
summary of DPHHS services in Richland County
and neighboring counties to distribute. We hope to
develop profiles of our services for each Montana
county. We also have a fairly ambitious plan to
visit communities all over the state during the next
year. If you have a particular event that you believe
a DPHHS Community Day would complement, please
let Anastasia Burton or me know.

Coming Soon to a MetNet Near You : We've
received a lot of comments about how informative
and helpful the weekly MetNet sessions were

that we held during the last Legislative Session.
We've heard many suggestions that we should
continue these MetNet teleconferences. So, we
have scheduled a statewide staff conference via
MetNet on September 29 from 10:30 am - noon.
We plan to provide brief updates on major
department issues and provide an opportunity
for questions, just like we did during the last
Legislative Session. Keep us posted on whether
this is something we should continue periodically
during the year as an effective way to
communicate among ourselves.

And, it's hard to believe, but this fall we will be
launching our budget development process for
the 2000/01 biennium budget. Right now, we
are developing a timeline and some ideas for
having as much public input as possible. We
hope to launch this process via MetNet some
time in early November. By then we should also
have some idea about the parameters, constraints
and priorities that will direct our budgeting
process. Anyone interested in this budget process
is encouraged attend. More specifics about
times/locations will follow in future issues of
this newsletter.

Photo: Anastasia Burton
Pat Casteel receives a pin to commemorate 40 years of state service from DPIHHS
Cliild and Family Sen/ices Division Administrator Hank Hudson. Pat was employed
each of those 40 years at the Cascade County Office of Public Assistance, and continues
to work there as an Eligibility Assistant. Pat's co-workers hosted a lunch in honor of
this special occasion.

(Tobacco Settlement .... Continued from front)

Bob Moon, bureau chief of the Health Systems
Bureau of the DPHHS Health Policy and Services
Division said, "The impact of this suit stems from
the education being accomplished with the
attorneys general. As our chief lawmakers, they
realized tobacco has been a burden that states
bear." Bob added that he believed the tobacco
companies would pass along the cost of the suit
to smokers. If this is the case, the suit would
reduce consumption in yet another way. Bob said,
"since there's a direct correlation between a
tobacco price increase and a decrease in

DPHHS will be working with advisory groups to
formulate some broad-based recommendations as
to how the moneys from the settlement could be
used in Montana.



•^- fh

The Governor's Council on
Families is sponsoring a • Ipil

"Montana Family Friendly Day" "f[

in Great Falls on Sunday, August ^4,* iL II
24 at Gibson Park from 1:00
pm - 5:00 pm. This day is intended to draw
attention to the start of a year of various
educational activities related to families. The
program and activities will be open free of charge
to any family group from Great Falls and the
surrounding areas. The day will provide
opportunities for families to gather and participate
in many different activities, as well as provide
opportunities for families to interact with
community service personnel in a more social

The family-oriented entertainment will include:*
storytellers, bands, jugglers, magicians, dancers
and face painting for children. Attendees can
also participate in games like: sack races, a tug
of war, balloon toss and a watermelon eating
contest. An ice cream social will also be held.
The day's finale will include music, a presentation
by Governor Marc Racicot and the release of
balloons carrying the wishes of Montana families.

Throughout the year, educational presentations will
be available to families in the Great Falls area. The
Council on Families will work in conjunction with
local agencies and schools to increase the awareness
of good family practices. For more information, call
DPHHS State/Local Relations Coordinator Gary Curtis
at (406) 444-9530.

Begins At MSH

On August 13, a groundbreaking ceremony will
take place for a project to substantially redesign
the campus of Montana State Hospital (MSH) at
Warm Springs. Financing from the Montana Board
of Investments and the Montana Health Facility
Authority has enabled DPHHS to proceed with
the campus reconstruction project originally
authorized by the 1995 Legislature.

The new hospital will consolidate services that
are currently provided at several buildings on the
campus. The project will include construction of
a new 101 -bed general hospital facility, remodeling
of the multi-purpose building to better meet
education, recreation and rehabilitation needs of
patients, and conversion of the Medical Treatment
Unit building into a support service facility for
staff development, human resources, and business
functions. The Spratt Building, home to the
Geriatric Program, will continue to be used for
patient services. The newly designed Montana
State Hospital will have a total campus capacity
of 166 beds, a decrease from its current 248 bed

The new facility was designed with input by MSH
staff and patients. New construction will provide
for increased patient comfort, safety and privacy.
In addition, the new campus will be much less
expensive to operate than the current facilities,
many of which are antiquated and are being torn

Loan and bond repayments will be made through
patient revenues paid to MSH. The general
contractor for the project is Pro Builders of
Missoula. It is anticipated that construction will
be completed by September of 1999.

When the project is finished, one of the campus'
existing buildings, the Xanthopoulis Treatment
Facility, will be turned over to the Department of
Corrections for use as a correctional facility.
Fencing and other security measures will separate
the correctional and psychiatric programs at Warm


Dr. Michael Spence, State Medical Officer
DPHHS Health Policy and Services Division

Location: Cogswell Building, Helena, MT 59620
Phone: (406) 444-1286

E-Mail: [email protected]

Photo: Valinda Holmes

Dr. Michael Spence joined DPHHS in May when he began serving as the new state medical officer
for Montana. His role is to address the areas of health assessment, policy development, quality
assurance, and disease prevention as well as to provide the department with a physician's perspective
on how policies and procedures will impact practitioners and patients.

In addition. Dr. Spence will work to ensure that legislators, policy developers and health care
providers have access to adequate information and education on health care issues so the decisions
they make are based on the best available data.

Dr. Spence attended college at New Mexico State University and medical school at the University of
New Mexico. He then completed an internship at Gorgas Hospital in the Panama Canal Zone. Upon
completion of his internship. Dr. Spence entered the military. His first assignment was an Obstetrics-
Gynecology residency at Walter Reed Army Hospital in Washington, DC. He stayed at Walter Reed
an extra year to do a fellowship focusing on infectious diseases, and was then assigned to southeast
Asia for the next two years.

In 1975, Dr. Spence left the military arvd joined the Ob-Gyn faculty at the Johns Hopkins University
School of Medicine in Baltimore. While at John Hopkins, he obtained his master's degree in public
health with an emphasis in epidemiology. Meanwhile, Dr. Spence maintained an active Ob-Gyn
practice and directed the Baltimore City Health Department Clinics for Sexually Transmitted Diseases.

Dr. Spence was named chairman in 1984 of Obstetrics and Gynecology at Hahnemann University in
Philadelphia, while continuing to practice his medical specialty. In 1989, he established a primary
care clinic for HIV infected women and their families. This resulted in his becoming more actively
involved in the public health issues of the area.

In 1992, Dr. Spence received funding for an AIDS Education Training Center, a day treatment center
for pregnant and postpartum drug abusers, and a program addressing the needs of these women and
their families. During this same time, he helped establish a public health program for the University.

Dr. Spence said, "Although I have a public health background, I am new to the area and have much
to learn about Montana and our public health needs. I would like to start a dialogue about these
issues and how we can work together to address them. I am hopeful that people will take time from
their busy schedules to contact me and tell me about their concerns." He concluded by saying, "I
want to thank everyone once again for welcoming me so cordially to Montana! I look forward to
working with you."

"New Hire Reporting"
Begins Soon

The DPHHS Child Support Enforcement Division
is in the process of gearing up for the
implementation of "new hire reporting." This new
requirement goes into effect October 1. New hire
reporting is mandatory under federal welfare reform
legislation that was passed last August. New
hire reporting will allow the division to collect
money more quickly and efficiently. This, in turn,
will help families achieve and maintain self-
sufficiency, which is the main objective of welfare

Employers across the nation will now be required
to report the hiring or rehiring of an employee by
providing the worker's name, date of hire, social
security number, and residential and mailing
addresses. The report also includes the employer's
name, federal identification number, and address.
This information is to be reported within 20 days
of the date of hire. The report can be a copy of
the employee's completed W-4 form or any other
method that contains the required data. The
Department of Revenue will administer the program
in Montana. This information is provided to the
Department of Revenue already in quarterly
unemployment insurance reports which have been
matched against child support files for years. New

hire reporting makes this information available for
child support purposes much sooner.

Prior to the passage of this legislation, new hire
reporting had been in effect in over half the country.
In many cases, new hire reporting has proven to
be an effective tool in starting child support
collections several months sooner. When child
support staff receive employment information on
an obligated parent, an income withholding order
is sent to the employer. This order requires
businesses to withhold an ordered amount from
the parent's wages. The money is then sent to
the Child Support Enforcement Division, where
payments for the families are processed.

Mary Ann Wellbank, administrator of the
department's Child Support Enforcement Division,
said, "Although new hire reporting was a very
controversial issue with the last Legislature, I believe
it's the single most important improvement to
strengthen our state and national child support
enforcement systems. Montana employers deserve
our recognition and appreciation for the role they
play in ensuring regular support for children."

For more information, call the DPHHS Child Support
Enforcement Division's Customer Service Unit at
(406) 442-7278 from the Helena calling area or
out of state, or 1-800-346-5437 from other
Montana locations.




Photo: Valinda Holmes

Back row (L - R): Budget and Program Analysis Bureau Chief Scott Sim, Information Systems
Bureau Chief Art Pembroke, Laboratory Sen/ices Bureau Chief Doug Abbott (recently retired),
and Vital Statistics Bureau Chief Sam Sperry. Front row (L - R): Fiscal Bureau Chief Chuck
VIrag, Internal Support Systems Bureau Chief Marilyn Carlin, Network and Communications
Bureau Chief Teri Lundberg, and Internal Support Section Chief Mary Rude. Not pictured:
Division Administrator Mike Billings.

DPHHS Native American Advisory
Council Meets

The first meeting of the Native American Advisory Council
was well attended by representatives from the Blackfeet,
Rocky Boy, Fort Belknap, Fort Peck, Crow, and Northern
Cheyenne reservations as well as the Little Shell Tribe,
Bureau of Indian Affairs, and four Native American
organizations: Area VII Agency on Aging, In-Care Network,
IDEA, and Missoula Indian Center.

This initial meeting provided an opportunity for council
members to become acquainted with DPHHS and some
of the many programs it administers. DPHHS Director
Laurie Ekanger and DPHHS Child and Family Services
Division Administrator Hank Hudson served as
facilitators. Hank serves as the department's
representative to the council.

After introductions and an invocation by council member
George Snell, Hank discussed the importance of the
Native American Advisory Council and ways the
department can continue to build a positive relationship
to better serve Native American communities. He
suggested four goals for the council: 1) to improve
communication between DPHHS and Native Americans;
2) to serve as a forum for Native Americans to provide
advice on agency decisions; 3) to serve as a forum for
advocacy on Native American issues; and 4) to serve

as an exchange of ideas on best practices. He
emphasized that because of the department's size, it
is important to decide how the council can be used
strategically to address the many challenging issues
that will come before it in the future.

Laurie then gave an extensive overview of the last
Legislative Session, as well as the budget issues that
will impact services provided by DPHHS. The
remainder of the day was devoted to division
presentations by agency management, including: Mary
Ann Wellbank, Child Support Enforcement; Maxine
Ferguson, Health Policy and Services; Charlie Rehbein,
Senior and Long-Term Care; and Joe Mathews,
Disability Services.

In addition. Randy Poulsen of the DPHHS Addictive
and Mental Disorders Division was joined by Kelly
Moorse of Montana Community Partners to discuss
mental health managed care, and Jon Meredith of
the DPHHS Public Assistance Bureau provided an
update on Montana's welfare reform program, FAIM.
Connie Erickson of the Committee on Indian Affairs
gave council members more information about this
commission, which serves as a liaison between the
Legislature and tribes.

For more information, contact DPHHS Indian Child
Welfare Specialist Kathy Deserly at (406) 444-9748.

DPHHS Native American Advisory Council Members




Fort Belknap Comm. Co. R.R. 1, Box 66/Harlenri MT 59526

Gros Ventre & Assiniboine

Myron Littlebird Northern Cheyenne Tribe

George Snell

Francis Onstad Blackfeet Tribal Soc. Serv. PO Box 870/Browning MT 59417

Rosemary Lincoln Crow Tribal Social Services PO Box 159/Crow Agency MT 59022

Donna IVIurray

Ken Blatt

Northern Cheyenne/PO Box 128/Lame Deer MT 59043 (406) 477-6284

FAX: (406) 477-6210

(406) 353-2205
FAX: (406) 353-2797

(406) 338-3414
FAX: (406) 338-2243

(406) 638-2606
FAX; (406) 638-2448

Assiniboine & Sioux Tribes PO Box 1027/Fort Peck Reservation/Poplar MT 59255 (406) 768-5155

FAX: (406) 768-5478

Chippewa Cree Tribe

Confederated Salish &
Kootenai Tribes

Little Shell Tribe

In-Care Network, Inc.

IDEA, Inc.

Arlene Templer

John Gilbert
William Snell

Ernie Bighorn

Toni Plummer

Bill Walls

Darrell LaMere

Louise Zokan
de los Reyes

Garfield Little Light Indian Health Service

PO Box 544/Box Elder MT 59521

PO Box 2808/St. Ignatius MT 59865

PO Box 1494/Chinook MT 59523

2906 2nd Ave. N *316/Billings MT 59101

PO Box 726/Miles City MT 59301

Cherish Our Indian
Children, Inc.

Missoula Indian Center

(406) 395-4282
FAX: (406) 395-4497

(406) 745-3525
FAX (406) 745-3536

(406) 357-3161

(406) 259-9616
FAX (406) 259-5129

(406) 232-6112
FAX (406) 232-3148

PO Box 2920/14 E 3rd St, Ste 19/Kalispell MT 59903 (406) 755-0302

FAX (406) 755-0315

2300 Regent, Ste. A/Missoula MT 59801

Area VII Agency on Aging 1445 Avenue B/PO Box 21838/Billings MT 59102
Bureau of Indian Affairs 316 N 26th Street/Billings MT 59101

2900 Fourth Ave, N. /Billings MT 59103

(406) 329-3373
FAX (406) 329-3398

(406) 252-4812

(406) 247-7988

(406) 247-7100

DPHHS Starts Project 2000

Lab Services Reorganized

You may have heard of the issues surrounding
the capacity of computer systems to handle the
changes associated with the approach of the
year 2000 and beyond. The "year 2000 problem"
is the result of computer software's inability to
handle dates outside the range of 1900 - 1999.

In the early years of the computer industry, unlike
today's environment, computer storage space was
both expensive and limited. Programmers were
encouraged to be creative in saving storage space,
resulting in the widely used convention of only
storing the last two digits of the year (for example,
97 instead of 1997). The problem this practice
presents as the 21st century approaches was not
anticipated when systems were developed over
the past 30 years. Many believed these systems
would be replaced long before the turn of the

DPHHS Operations and Technology Division
External Systems Bureau Chief Marilyn Carlin
said, "There is a common misconception that
the problem does not occur until January 1,
2000. in reality, programs will either fail or yield
incorrect results at the point they have to deal
with dates in the next millennium as they perform
arithmetic operations, comparisons, or sorts. For
systems that do forward projections, such as
financial or long-range planning, the problem will
occur before the year 2000."

An effort is underway at DPHHS to identify and
correct similar computer problems. Marilyn
emphasized that year 2000 compliance is a
priority of the department, with the goal of
bringing each of the agency's many computer
systems into year 2000 compliance. System
users are asked to cooperate with year 2000
efforts which, because of the importance and
priority of such changes, may compete with other
less urgent fixes or enhancements. For more
information, contact Marilyn at (406) 444-0012.


In July's issue, the 20- and 25-Year service
award recipients were inadvertently switched.
The people listed under 20 years were actually
25-year service award recipients; the people
listed under 25 years were realty 20-year service ,
award recipients. We apologize for any
inconvenience this may have caused.

The former Laboratory Services Bureau of the DPHHS
Operations and Technology Division (OTD) took on
a new profile last month. Kathleen Martin, bureau
chief of the Communicable Disease Control and
Prevention Bureau (CDCP) of the Health Policy and
Services Division (HPSD), said, "In order to more
closely align the clinical lab with the public health
programs it serves, the lab is being reorganized."

She explained that a Lab Transition Team was
established to advise the department regarding the
reorganization proceedings. This included evaluating
the possible overlap of services and responsibilities
between the two lab types, addressing lab safety
issues, and overseeing the implementation of the
new structure. Various personnel from OTD, HPSD,
the Director's Office, and the Legislative Auditor's
Office participated.

Although the clinical portion of the lab serves some
of HPSD's Maternal and Child Health Bureau, most
of its services are related to communicable disease
concerns. Because of this association, a portion of
the laboratory's personnel will be integrated into


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