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March 1997



Mental Health
Managed Care Contract Protested

In November, the Department of Public Health and Human
Services (DPHHS) awarded a five-year contract with an
estimated total value of about $400,000,000 to Montana
Community Partners (MCP) to implement mental health
managed care in Montana. MCP is a non-profit joint venture
between CMG Health, a Maryland-based, for-profit corporation,
and the Care Coalition of Montana, a non-profit Montana
corporation comprised of over 30 Montana non-profit human
services organizations. Three unsuccessful proposers for the
Mental Health Access Plan contract have formally protested to
the Department of Administration (D of A), which handled the
project's request for proposals.

The protesting entities are: Vista Montana, a Montana non-
profit public benefit corporation, which is a wholly-owned
subsidiary of the Vista Hill Foundation, a non-profit
corporation based in California; Merit Behavioral Care of
Montana, a partnership between Merit Behavioral Care of
New Jersey and BlueCross BlueShield of Montana; and Big
Sky Health Partnership, an organization formed by OPTIONS
Health Care of Virginia and The Montana Plan, a non-profit
corporation comprised of Montana hospitals, community
mental health centers and other mental health providers.

The protests allege in part that MCP's response to the technical
proposal portion of the RFP was over the page limit allowed;
the evaluation team incorrectly scored portions of the various
proposals; non-state employee members of the advisory and
evaluation committees had conflicts of interest; the state should
have considered the over all costs of managed mental health
care in a different way than it did; and all proposers were not
treated fairly because the state chose to enter into negotiations
only with MCP.

DPHHS Director Laurie Ekanger said, "While we take these
allegations seriously, we believe the evaluation committee's
selection process was conducted correctly. DPHHS is
cooperating with D of A while they investigate the protests.
We are continuing to move ahead and work with MCP
toward the April 1 implementation date of mental health
managed care for Montana."

Dal Smilie, chief legal counsel for the D of A, noted, "With
a change in service delivery of this magnitude and a contract
of this size, we can expect the utmost interest by both the
mental health community and the offerors."

As of this writing, D of A was continuing its investigation, while
Montana Community Partners continued the extensive work
necessary to begin providing services under the Mental Health
Access Plan on April 1.



CALENDAR
OF EVENTS



MARCH
National Nutrition Month

March 7
March 14
March 21
March 28

Legislative updates via interactive video
At METNET sites in: Billings, Boulder,
Bozeman, Butte, Glasgow, CSIendive, Great
Falls, Helena, Kalispell, Miles City, Missoula
and Warm Springs
1:30 pm -2:30 pm
Contact: Anastasia Burton
(406) 444-2596

March 14

DPHHS Advisory Council meeting

Cogsw^ell Building/Room C-209

Helena

9:00 am - 4:00 pm i

Contact: Gary Curtis

(406) 444-9530

March 24

"Long-Term Care Town Forum"

Airs on your local MT Public TV channel

Topic: Legal Issues — When it's too late

to plan

7:00 pm - 8:00 pm

Contact: Brian LaMoure

(406) 444-7782

March 25

Diabetes Alert Day
Contact: Jane Smilie
(406) 444-0593

March 27

"Lunch with the Director"

Cogswell Building/C-209

Helena

Noon - 1:00 pm

Contact: Anastasia Burton

(406) 444-2596 •"

f

APRIL *•

April 1

Mental Health Access Plan implementation
begins

April 7 -13

National Public Health Week
Contact: Patrick Smith
(406) 444-2555



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GOVERNOR'S COUNCIL ON

FAMILIES TO PLAN

COMMUNITY EVENTS

At the last Governor's Council on Families
meeting, discussion centered on the council's plan
to sponsor public forums to gather information
about successful parenting practices, as well as
strengths and weaknesses of current family
related programs. The council learned it received
a warm response to the proposed "Family Days "
when DPHHS State/Local Relations Coordinator
Gary Curtis wrote to local DPHHS and Job Service
managers about helping sponsor town forums or
Family Days in their areas.

Council members believed there would be even
greater interest in holding forums if its members
would go into their communities and initiate
discussions, but then allow the communities
decide on the dates and activities of Family Day.
Initial thoughts included tying Family Day into
other local events; holding activities at churches
and schools; and emphasizing successful
parenting strategies of local families. Family Days
will be held sometime between May 10- June 20.

The council is very interested in making successful
parenting practices the main focus of Family Days
so others may adapt the ideas for their own
homes. The council reviewed a brochure for a
'Parent Convention and Resource Fair" held in
Butte. Since this event appeared similar to what
the council has in mind for Family Days, member
Cathy Peoples and Gary Curtis will meet with the
fair's sponsors to gather more information.

The meeting's agenda also included guest
speakers. DPHHS Public Information Officer
Anastasia Burton presented strategies for building
public awareness about Family Days and town
forums. She suggested that members get to know
their local reporters, and presented the best ways
to get information out through various types of
media. Dr. Bailey Molineaux, a Helena-area family
counselor, followed with his presentation. The
Breakdown in the American Family". Then,
DPHHS Director Laurie Ekanger thanked the
council for its work and dedication, and reaffirmed
that Governor Racicot is committed to the Council
on Families and its budget.

The group's next meeting is planned for May 1 in
Butte to coordinate with the Family Support and
Child Abuse Prevention Conference being held
April 29- May 1. For more information, contact
Gary Curtis at (406) 444-9530.




PUBLIC HEALTH WEEK TO BE
CELEBRATED APRIL 7-13

During this century,
approximately 25 years
have been added to the
life span of the average
American. We all are
living longer, healthier
lives for many reasons-
children are getting
immunized, individuals
with chronic health
problems are learning
how to better manage
their conditions and
fewer adults smoke. All of these actions and
many more have made it possible for each of us
to lead improved lives. Why? Because our public
health system works!

To create greater awareness among Montanans
about what public health does for each of us,
DPHHS, along with its partners in public health, is
announcing the third annual National Public
Health Week celebration, April 7-13. The theme
for the 1997 observance is "Public Health: An
Investment in Your Future." This theme
emphasizes that investments in public health lead
to substantial future cost savings in medical
expenses and can add years of health and
productivity to our lives.

The department plans to provide a support
package to local public health partners to assist in
promotional efforts within communities. A
statewide media effort will be developed to
highlight public health activities and themes.
Program displays, as well as a series often-minute
workshops, will be provided in the Capitol rotunda
throughout the week of April 7-13.

Public Health Week 1997 is an opportunity for all
of us to come together and celebrate what we do
so well. Won't you join us in an effort to promote
the activities of public health across Montana
during this special week? This is your chance to
tell the public about what your program or service
does for them.

For more information, please contact Public Health
Week Chairman Patrick Smith at (406) 444-2555.
Local health departments and health clinics will
automatically receive information on this upcoming
celebration, so watch for it!



DEPARTMENT'S ADVISORY COUNCIL STRUCTURE
SLATED FOR REVISIONS



A consultant's review of DPHHS' advisory
council structure may result in changes to the
existing system. The report, which reviewed the
almost 45 advisory councils within the
department, recommends the consolidation of
several councils, the elimination of others, and
the appointment of a contractor to manage the
councils. Consolidation of councils would
eliminate duplication and overlap, which is also
identified in the report.

Restructuring department advisory councils is
the focus of Senate Bill 298, which is sponsored
by Senator Chuck Swysgood (R) of Dillon. The
bill was heard on February 12 by the Public
Health and Human Services jointsubcommittee.
As of this writing the bill has been passed out
of committee and is scheduled for second
reading on the Senate floor.

Advisory councils are volunteer citizen groups
assigned to provide information and guidance
to specific divisions or programs. Many of the
advisory groups currently in place in DPHHS are
mandated by law or grant provisions. The
report, completed by Rick Offner, Ph.D. of the
University of Montana, estimated that council
activities cost the department about $550,000
a year in staff time, participant travel and
operational expenses.

The Child and Family Services Division has 16
advisory councils - the highest number of any
division. Several of these groups, such as the
Board of Public Assistance, are mandated by
statute. The report recommends that the
Montana Family Services Advisory Council be
expanded to include all division programs
including FAIM and the child care programs.
The council would form smaller subcommittees
who could focus on particular issues. If this
suggestion proves impossible, the report
recommends that the FAIM Advisory Council be
expanded to include employment and energy
advisory boards. Local family service advisory
boards would remain in place under the
proposal.



The consultant recommended the director's
office maintain the councils currently in place.
Those councils are: the DPHHS Advisory
Council, the Governor's Council on Families, the
Health Care Advisory Council, the Interagency
Coordinating Council/Family Support Services
and the Governor's Committee on
Telecommunication Access Services. In
addition, the consultant recommmended
continuing with the creation of the Native
American Advisory Council.

Consolidation of many of the 1 3 councils in the
Health Policy and Services Division was also
recommended in the report. Three new councils
combine many of the functions of the current
groups. One council would assume
responsibility for health policy and planning,
another for preventive health planning and the
third for maternal and child health. Other
councils, including the Governor's HIV/AIDS
Advisory Council would be restructured with
additional responsibilities.

The Disability Services and Senior and Long-
Term Care Divisions, with a total of six advisory
councils would not change. The consultant
acknowledged the Addictive and Mental
Disorders Division had already developed a plan
to reduce the number of advisory councils to
two.

People interested in additional information
about the report or Senate Bill 298 may contact
DPHHS State/Local Relations Coordinator Gary
Curtis at (406) 444-9530.



The mission of the Montana

Department of Public Health and

Human Services is to improve,

preserve, strengthen and protect

the health, well-being and

self-reliance of all Montanans.




IIStTROpUCTIONS

Ron Balas, Superintendent

Montana Mental Health Nursing Care Center

DPHHS Addictive and Mental Disorders Division

Location: 800 Casino Creek Drive, Lewistown

Telephone: (406) 538-7451
Fax: (406) 538-2863



Ron Balas has been superintendent of the Montana Mental Health Nursing Care Center for seven years.
Previously, he worked as a budget analyst for the Department of Corrections and Human Services in
Helena.

Ron is responsible for the long-term care and treatment of persons with mental disorders who require
nursing care and cannot be served appropriately in their communities. The facility has about 150

employees who make every effort to ensure residents are treated with respect, dignity and are provided
the opportunity to live in a healthy, home-like environment.

Ron commented, "Everyone at the nursing care center is anticipating significant change with the
inception of managed care. On April 1 , for the first time in the facility's history, it will operate solely
on its revenues. Facility costs are currently some of the lowest in the state."

In 1973, Ron graduated from the University of Montana with a B.A. degree in history/political science.
His wife Kathy is a registered nurse. They have three children.



PRIVATIZATION PLAN FAILS
EARLY IN SESSION

Senate Bill 78, entitled, "An Act Creating
Government Competition and Efficiency" was
unanimously voted down January 30 by the
Senate Business and Industry Committee. The
bill called for competition in the delivery of certain
state government programs and services. During
the 1999 biennium, specific services were
identified for potential competitive bidding
processes, including DPHHS public assistance
eligibility determination and the Montana Mental
Health Nursing Care center in Lewistown.

The legislation called for formation of a
competition council. Members on the council
would include the Governor"s budget director, the
commissioner of the Department of Labor and
Industry, several high-level state administrators,
two members of the House and two members of
the Senate, and the Legislative Auditor serving as
a non-voting, ex-officio member. The council was
to be administratively attached to the Office of
Budget and Program Planning and would have
assisted in identifying future opportunities to
engage in competitive processes for service
delivery; developing a competition plan for
submission to the legislature; evaluating bid
responses; recommending contract awards;



monitoring contracts; evaluating performance; and
reporting outcomes of the competitive process.

The bill would have allowed state agency
managers and employees who are delivering
services slated for a competitive process to
organize teams to bid on continuing their work.
In addition, state agencies wishing to compete
could have done so separately or as part of
consortia with other state agencies, public or
private organizations. Any bid process which did
not have at least two viable bidders would have
been abandoned.

During the hearing, some legislators expressed
concern thatthe council would have the final say
about what services would undergo a
competitive process.

Commenting on the bill. Child and Family
Services Division Administrator Hank Hudson
said, "While our division was concerned about
the timing and effect of this legislation on the
implementation of welfare reform, we recognize
the need for a public assistance delivery system
that is in tune with the 21st century. We are
open to innovation and working with public/
private sector initiatives to design the best
system for clients."



STATE AGENCIES ENCOURAGE CONTRACTORS TO HIRE
WELFARE RECIPIENTS



The Department of Public Health and Human
Services (DPHHS) is asking other state agencies
to encourage their contractors to hire welfare
recipients for their projects. As part of the
"Families Achieving Independence in Montana"
(FAIM) program, DPHHS, in conjunction with
the Department of Administration, is offering
assistance to agencies who will encourage the
employment of FAIM participants.

One suggested incentive from DPHHS is to give
extra points to vendors who can demonstrate a
plan to employ welfare recipients. This idea
was first used in the DPHHS Request for
Proposal (RFP) for a temporary services
contract. Susan Ramsey, Project Manager in
the DPHHS Child Support Enforcement Division,
wrote the language that was included in the
contract and also served on its evaluation panel.
Susan said the successful proposal included a
procedure to recruit FAIM participants. This
contract was awarded to Express Personnel
Services.

Express Personnel Services has effectively been
recruiting and placing individuals who are
receiving public assistance. Lynne Johnson,
Branch Manager at Express Personnel Services
in Helena, said her agency has successfully
placed nearly 65 individuals who were receiving
public assistance. Lynne receives referrals from
the local Career Training Institute, Adult
Learning Center, and Job Service. The Billings
and Kalispell branches also receive referrals and
recruit and hire public assistance recipients.



The Department of Administration Purchasing
Bureau has been instrumental in implementing
this language in all relevant state contracts.
Nyla Johnson, bureau contracts manager, said,
"The Purchasing Bureau has requested that
agencies include language in their bids,
proposals and contracts to encourage
contractors to participate in the FAIM program
by hiring these participants. We have also
attempted to educate state agencies about this
program through newsletters and training visits
around the state. We will continue to help
agencies identify appropriate contracts where
FAIM participants may receive employment
opportunities."'

Nyla added that FAIM participant language has
been added to the temporary services contract
that involves Fish Wildlife and Parks, and the
Departments of Administration, Revenue, Labor
and Industry, Commerce, Justice, Natural
Resources, and Military Affairs. This contract
was jointly awarded to Express Personnel
Services, Western Staff Services, and
Manpower Temporary Services. Nyla also said
this language will be added to banking and
janitorial contracts where applicable. The
Montana Lottery has already incorporated the
concept into its advertising contract.

For more information, contact Susan Ramsey at
(406) 444-0924, Nyla Johnson at (406) 444-
3314, or Lynne Johnson at (406) 442-7501.




Members of the DPHHS Child and Family Services
Division met last month with Governor Marc Racicot
to brief him on the one-year anniversary of Montana's
welfare reform program, FAIM
Seated at the table from left to right are: Child and
Family Services Division Administrator Hank Hudson,
FAIM participant Dalena Baker and her daughter
Amanda, and Governor Racicot.
Dalena descnbed her experiences with the old welfare
system. She is now working as a secretary, and
receives only medical assistance benefits. Dalena
credits her success to FAIM and the classes she took
at Career Training Institute in Helena.

Photo: Randy Bowsher



A REVIEW OF THE
LEGISLATIVE PROCESS

Donald Coburn, Senate Staff

Have you ever wondered how 100 state
representatives and 50 state senators read and
comprehend the more than 1,000 proposed bills
offered each legislative session? Many legislative
sessions ago, the leaders of the Legislature
established what has come to be known as the
"committee system" in response to an increasingly
larger and complex government.

In general, here is how the committee system
works: legislators, their constituents, state
agencies, and the Governor's Office request
legislation regarding a myriad of subjects.
Through an elaborate process, the legislation is
drafted by the Legislative Council according to
established rules. Oncedrafted and signed by the
sponsoring legislator, the drafted legislation is
now referred to as a bill. The bill is then assigned
to a committee of senators or representatives.

Committee assignments are the responsibility of
the presiding officer in each house, i.e. the
Speaker of the House of Representatives and the
President of the Senate. Currently, there are 16
standing committees in each house. Standing
committees are committees in each house which
will be permanent in the legislative process and
which are assigned to hear the many bills based
on the subject of the bill. In addition to standing
committees, leaders in each house may form
select and special committees.

Standing committees are composed of members
of each political party based upon party division in
each house and special considerations. In the
House, these committees usually number 15-18
members; in the Senate seven - nine. House
Appropriations, Senate Finance and Claims and
Judiciary committees are usually larger in number.

Notice of the time and place for a bill's committee
hearing is given to the media and is posted on
official bulletin boards in the Capitol. In addition,
committee hearing information is posted
electronically on the state bulletin board system
and on the Internet at the "Montana On-Line"
home page. The information is also available on
the State of Montana mainframe status system
which is available to all state agencies and other
subscribers.

Any interested person may present written or
verbal testimony during a hearing on a bill.



Testimony may come from persons interested in
the proposed legislation, but most testimony is
from lobbyists who represent groups, industries or
professional organizations affected by the
legislation. Agency personnel testify as to the
extent their agency mission might be affected or
enhanced.

Committee members encourage the public to give
testimony and ask questions of those giving
testimony in order to be sure they clearly
understand the testimony given. If the committee
chair or other members recognize that the
proposed legislation is controversial and requires
additional time for interested parties to be heard,
they may schedule another hearing.

When a committee determines that a bill has
received sufficient exposure, the members discuss
the bill and the testimony and take action. This
process, called executive action, may result in
motions to pass, pass as amended, do not pass, or
table. If a bill is tabled, rules of both houses allow
for a motion on the floor of the house of origin to
bring the bill directly to the floor for debate of
second reading.

A tremendous amount of work is required by
legislators to thoroughly scrutinize proposed
legislation for probable consequence of actions
taken by them. Therefore, they rely heavily on
actions taken by the various committees.

Regardless of the action taken by the various
committees, most proposed legislation does come
to the floor and may be further debated on
second reading. The committee has done the
initial work by gathering testimony directly from
interested parties. They then pass their
recommendations on to the floor.

If you have questions about the legislative process,
contact Don Coburn at (406) 444-4883 or (406)
227-8629.



We welcome your story ideas

and newsletter comments.

Please contact any member

of the newsletter staff

with your suggestions.



Legislation to be Introduced for a
Health information Network

In 1995, the Montana Legislature directed the
DPHHS to work with the Montana Health Care
Advisory Council to design and develop a health
care database of resource, cost and quality
information to "...increase access to health care
services, promote cost containment and maintain
quality of care."

As a response, a Health Information Committee
was established to explore database options and
make recommendations. Committee members
include representatives of the private and public
sectors whose organizations maintain health-
related data and would be affected by sharing
data.

Early in its explorations, the Health Information
Committee determined the creation of a central
database would be cost prohibitive and
unnecessary. Numerous options were

considered for achieving the legislature's goal.

The House Human Services Committee
requested on February 5 that a bill be drafted for
a proposed Montana Health Information Network
to provide a system for data sharing. It would
access existing databases at a relatively low cost
and use that data to respond to inquiries about
health care. It would be operated by a private,
not-for-profit corporation with a Board of
Directors.

Through voluntary agreements with organizations
which collect and store health information, the
network would coordinate and integrate health
care data to produce specific reports and answer
specific questions. Protecting confidentiality
through a system of safeguards would be a top


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