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Department mPublic Health & Human Services

August 1998

Incentive Grant Aims at Community Action

Don't be misled by the constant grin and faraway look in
Ken Taylor's eyes - he's not really floating on cloud nine.
He just looks that way because of a $9 million grant he
helped the department secure last month.

After months of waiting, Taylor learned in mid July that
DPHHS was one of 14 states this year to receive a
three-year, $3-million per-year federal grant from the
Substance Abuse and Mental Health Services
Administration, Department of Health and Human
Services. The money will be focused on helping
Montana communities develop effective, broad-based,
primary prevention programs for substance abuse among
Montana youth.

Taylor, of the Addictive and Mental Disorders Division
within DPHHS, said only 19 states have received these
research-oriented grants. Taylor wrote the grant
application along with Bruce Parsons, Ph.D., a Helena-
based psychologist and social science researcher. Dr.
Parsons will continue his involvement as principle
research investigator for the project.

The successful application was a collaborative effort
among four state government offices - DPHHS, the
Governor's Office, the Attorney General's Office and the
Office of Public Instruction.

"Our goal for this grant is to support and strengthen
community teams," Taylor said. "Grants have a limited
life span. Community teams will continue to support
their communities long after these grant funds run out."

The majority of the grant money, 85 percent, focuses on
communities, 20 to 30 of which will receive awards
ranging from $75,000 to $125,000 annually for three
years. Grants will be issued likely starting in mid-1999,
based on a competitive request for proposal (RFP)
process. Initially, the grant will be used to educate and
train community members on the types of local projects
that will be considered for funding.

In the next several months. Governor Marc Racicot will
seat a broad-based grant oversight committee that will
include the public and private sectors plus
one member of the federal agency that
awarded the grant.

For more information, call Taylor

Spinal Muscular Atrophy Awareness Month

August 14

DPHHS Golf Tournament
Fund-raiser for Hope Foundation
Fox Ridge Golf Course, 9 a.m.
Contact: Robert Rule (406) 444-6794

August 14

MT Statewide Independent Living Council
DPHHS Building, 111 Sanders, Helena
10:00 am -4:30 pm
Vicki Tumer — (406) 444-4175

August 14

Family Support Services Advisory Council
Family Outreach, Inc.
1212 Helena Ave., Helena, MT
Contact: Jan Spiegle Stinger

August 21

Alcohol Related Birth Defects Association

2500 Broadway, Helena

9 a.m. -4 p.m.

Contact: Janet Kraft, 1-888-866-3822

August 28-29

Overnight "Relay for Life" against cancer
Lewis and Clark Fairgrounds
Contact: 449-9300

September 10

Immunization Update Teleconference
Contact: Beth Cottingham 444-2969

September 11

Governor's Council on Families

Award Ceremony

1 p.m.. Capital Rotunda

September 25-26

Association of Diabetes Educators
Continuing Education Credit available
Radisson Hotel, Billings
Contact: Diabetes Project, 444-6677

Sept. 29-Oct. 1

30th Annual Governor's Conference on Aging
Heritage Inn, Great Falls
Contact: 444-7782

Sept. 30-Oct. 2

Conference on Service for Children and
Adolescents with Emotional Disorders
Colonial Park Hotel, Helena
Contact: 994-5240

Sept. 30-Oct. 2

1 998 Parents As Partners Conference
sponsored by the Developmental Disabilities
Planning and Advisory Council
Yogo Inn , Lewlstown, MT
Contact: Robin Homan (444-1338)

A Message From the Director: Summer Potpourri

Laurfe Ekanger
DPHHS Director


Remember the employee
survey from last year? Well,
it's survey time again.

This survey provides you an
opportunity to tell us,
individually, how you think
the DPHHS is doing and
how we can be better,
better, best. Honestly, this is
the most useful information
your management team receives to guide us
in supporting you as best we can. We are
revamping the form somewhat based on
suggestions from last year, and we will be
diligent to make sure everyone gets it on time
this year! And remember - every survey is
confidential and is sent directly to a
contractor, except for what you choose to
send directly to me.

Through last year's survey, we developed a
Management Training Committee, which on
July 31 reviewed responses to our request for
training proposals. Also, we established our
Employee Training Committee, which
developed new-employee orientation packets
and training plans for all of us in
communications skills, teamwork, customer
service and sexual harassment\diversity
training. I also used the information in
constructive discussions with each Division
Administrator, which has led to performance
objectives and changes in policy and


We have now met with Governor Racicot and
described our budget priorities, after much
work with the Governor's Budget Office to fit
our request into overall budget parameters. I
am very proud of our DPHHS budget and
program staff for their unique combination of
advocacy for our programs and responsibility
to taxpayers. Good program initiatives and
management by all of you, together with a
good economy, have created efficiencies and
successes. For these reasons the DPHHS can
responsibly propose meeting some unmet
needs and waiting lists in the next biennium.
When the budget is finalized in the Fall we

will schedule a METNET meeting to describe
the DPHHS budget and legislative package
for you.



Where are we at with this? By the time you
read this, you may already know the
applicants' names for the new administrator
position for child protection programs.
Hopefully we will have selected a new
administrator in September (although these
things always take longer than you think!).
The new administrator. Hank Hudson and my
office will then set about working with those
of you affected to formally establish the two


Thanks to Juanita Mallo for organizing a
great day in Livingston on June 30, and to all
our DPHHS co-workers for being such
wonderful hosts. We had a fantastic turnout,
really great food, and learned a lot as well.
We were privileged to be able to attend the
grand opening of the impressive new
Livingston Community Health Clinic. Thanks
again to our friends in Livingston.

Juanita Mallo (third from right) and staff at the Park County
Office of Public Assistance.

Teamwork Turns a Potential Lemon into Lemonade

There's a lot of talk in offices
these days about "teamwork" and
/ ' "team building." Employees in

Mike Hanshew's Senior and Long
Term Care Division provided proof
recently that these are more than just buzzwords.
In mid-July, several Montana newspapers published
a story based on a Families USA survey. The survey
concluded that several million Americans with
limited income and receiving Social Security and
Medicare are not receiving full benefits entitled to
them, such as the Qualified Medicare Beneficiary
Programs (QMB) or the Specified Low Income
Medicare Beneficiary Program (SLMB).
To provide a contact for Montanans to garner more
information about the federal programs, the
newspapers published the toll-free telephone
number to the Citizens' Advocate Office in Helena.

The response from readers was overwhelming -
even a little chaotic, according to Citizens'
Advocate Myrna Omholt-Mason. "The weekly
average for Aging Services calls is 104," she said.
"From July 8-15, approximately 448 calls were
received and passed on to the Senior and Long
Term Care Division's Aging Services Bureau."

To help balance the workload, Hanshew shifted
one of his employees to the Citizens' Advocate

Office for part of the week to help field calls and
address questions.

"We had no idea the survey and story would create
such a huge public response," Hanshew said.
"Myrna and her staff did an incredible job keeping
up, and we felt we needed to pitch in as well."

Consequently, the calls created a backlog of
questions for DPHHS Aging Bureau staff to answer.

"On the flip side of the chaos coin, the article
was a great venue to disperse aging information,"
said Charlie Rehbein, Bureau Chief of SLTC Aging
Services. "Even if the callers didn't qualify for
certain low-income programs, they now have a
contact source to address long-term care needs.
We have responded to the calls as quickly as
possible, and informative literature about the
variety of programs has been mailed."
Hanshew, Rehbein and Insurance Counseling and
Assistance Coordinator Beverly Robinson extended
a special thank-you to Omholt-Mason and her staff
at the Citizens' Advocate Office. In fact, Hanshew
even sent them flowers. "The Aging Bureau staff
greatly appreciated her efficiency in handling the
massive amount of calls," Rehbein said.

For further information about aging services,
contact Rehbein at (406) 444-7788.

Social Security Recognizes Effort of Thibodeau, Helena Staff

The facts are impressive:

• For three years running, the
Social Security Disability
Determination Services
Bureau - part of the DPHHS
in Helena - has ranked sixth
nationally in terms of
efficiency, cost per case,
accuracy and public service.

• The office has a 97-percent
acceptance rating on
determinations, processes 85
percent of all requests within
60 days and has taken on
federal pilot projects to help
redesign disability programs.

Such work doesn't come without
dedicated staff and effective
leadership, both of which were
recognized June 30 by regional
Social Security officials in Denver.

DDS Bureau Chief Michelle
Thibodeau received the Regional
Commissioner's Citation during a
ceremony in Denver hosted by
Horace L. Dickerson, Jr., Regional
Commissioner. The citation is for
'Continued Excellence in

Leadership of the Montana
Disability Determination Services
in Their Delivery of Outstanding
Public Service," and Thibodeau
was able to share the honor with
her staff during a July 16
celebration in Helena.
DPHHS Director Laurie Ekanger
attended the Helena celebration
and told those in attendance, "In
case you aren't aware, you have
a wonderful reputation in state
government and our department.
This has been a particularly
challenging year for you with
program and law changes, yet in
every single case you excel."
In the letter notifying Thibodeau
of the award. Commissioner
Dickerson stated, "Your caring
and conscientious work ethic is
reflected in the extraordinary
service you provide to our
customers. Your dedication to
meeting agency goals, especially
during challenging times, has
been noticed and is
tremendously appreciated."

Thibodeau oversees a staff of
about 40 employees who review
requests for Social Security
Disability benefits. The state
works in conjunction with the
federal program to establish
medical eligibility.
- Division Administrator Joe
Mathews said, "Michelle
continually demonstrates
leadership and commitment to
running a nationally recognized
Disability Determination Program.
It is only fitting that she would
be recognized for her

Division Administrator Joe Mathiews.
award recipient Michelle Thibodeau and
DPHHS Director Laurie Ekanger dunng a
celebration honoring Thibodeau.

Susie Zanto:
Mailing Address:


Laboratory Technical Supervisor
PO Box 6489, Helena, MT 59604
(406) 444-2839
[email protected]

When a respiratory illness turned deadly for a Malta-area farmer last month, it was Susanne Zanto
and the 11-person staff in the Public Health Lab who confirmed the presence of hantavirus antibodies
in the victim's blood.

Although the small group of employees in white lab coats don't receive much public attention, their
work can dictate the course of breaking news in Montana.

"We've worked nights, weekends - whatever it takes to get the work done," Zanto said recently,
detailing the lab's seven-day work schedule. "It's necessary because it's in support of our public
health programs. We have cultures and samples that need to be maintained daily.

"Basically, the whole state of Montana is our patient. We're trying to prevent that patient from
getting sick."

The lab conducts some of its own research, but mainly receives samples from hospitals and clinics
throughout the state in need of test outcomes. Zanto, a specialist microbiologist and licensed Clinical
Laboratory Scientist, assures that all tests and quality control aspects are up to standards for safety,
accuracy and timeliness.

Frequent testing includes detecting the presence of tuberculosis (only definitive lab in Montana), e-coli
bacteria, HIV, influenza and genetic disorders in newborns to name a few. Some of the notable
equipment used includes fluorescent microscopes, a DNA replication machine, two biological safety
cabinets and three freezers that store samples at minus 70C.

"If we can identify a problem early on, we can help get people into treatment for intervention," Zanto
said. "We are on the ground floor of the prevention network."

While much of the lab's work involves routine testing, they are occasionally called upon for creative
solutions. For example, Zanto tells a story about a medical provider who noticed a trend of similar
symptoms in several children he was treating. He called the laboratory and state epidemiology
section for ideas on how to detect and identify the cause, and the outcome was successful in
preventing widespread problems.

"Those things are exciting, when we get to brainstorm and be creative and help in the field," Zanto
said. "It gives us a chance to make a difference."

Golfers Gearing up for DPHHS Charity Tourney

For the second time in a year, DPHHS
employees have shown caring creativity by
helping terminally and critically ill Montana
children via the Montana Hope Project.

On August 14, golfers will hit the links at
the Fox Ridge course east of Helena in a
charity scramble tournament to raise money for
the Project. Businesses and individuals have
contributed prizes and sponsorships, with
proceeds going to help the Hope Project fulfill a
dream wish for a Montana child.

Last fall, employees of the Child Support
Enforcement Division coordinated a fund-raiser
during a conference, raising more than $5,000 -
- enough to send two children to Disney World.

Golf tourney organizers have the same type of
goals in sight, but players need to get their
registrations in soon to Susan Haran (3907),
according to Robert Rule, Quality Assurance

The tourney has room for 120 golfers, or 24
teams of five people each. Tee time is 9 a.m.
Cost is $35 per person, which includes green
fees, lunch and the chance to win prizes.
Lunch is available for $5 for those who wish to
attend but not golf.

For more information about the golf
tournament, contact Robert Rule at 444-6794,
Terry Krantz at 444-4747, Brett Williams at
444-2528 or Susan Haran at 444-3907.




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A Vacation of Global Proportions

We don't normally highlight employee vacations, but because Randy and
Dorothy Poulsen's trip was research related and generated much interest
throughout the department, we asked them to share their experiences.

Vacation, to Randy and Dorothy Poulsen, means leaving work behind
them. Way behind. Try flying eight time zones east, turn south in
Switzerland and head straight for the African Equator.

In June, Randy (Managed Care Bureau Chief, AMDD) and Dorothy

(Medicaid Program Officer, HPSD) traded their DPHHS cubicles for

three weeks of research and adventure in the west African rain forest

of Cameroon. They haven't checked their frequent flier miles yet, but

here's the gist of the journey: a 16-hour flight from Chicago to Zurich, then to Yaounde,

capital of Cameroon.

Next came an 18-mile, eight-hour hike to the Project Calao research camp in the Dja
Reserve, where the Poulsens camped for 12 days with their son, John, his fiancee, Connie,
three research assistants and six guides.

John and Connie manage the Project Calao research camp for San Francisco State
University and are graduate students in tropical ecology/conservation biology. Research at
the camp focuses on seed dispersal by various species, including hornbills and monkeys.
Dorothy explained that a high proportion of the trees in tropical forests depend on
vertebrate species to disperse seeds. Knowing the roles different species play and the
effects of fluctuations in population densities is critical to understanding the function of this
ecosystem, she said. John's thesis research focuses on seed dispersal by gray-cheeked
mangabeys, one of the seven monkey species in the Dja Reserve. Connie studies seed
germination differences among vertebrate-dispersed and wind-dispersed seeds.

"Each day we followed our guide, David, through rain forest and up and down roches
(volcanic-created hills) to find monkeys (six species), birds (91 species), chimps, gorillas,
forest elephants, buffalo, ants ... whatever we came to," Dorothy said.

Among the highlights: tracking chimps through the bush; hiking to a colony of bare-headed
rock fowl, a bird species observed by fewer than 100 Westerners; watching six species of
monkeys eat, play, groom and move through the forest canopy; and a fete (festival) with
the Baka guides.

'This wasn't a catered safari - the hike in was hot, humid, and long," Dorothy said. We
helped with camp duties - cooking meals, washing dishes and laundry, and hauling water.
But we thoroughly relaxed and revitalized our minds, bodies and spirits exploring one of the
world's natural heritage sites."

Dorothy Poulsen offers this photo as proof of who

did all the heavy lifting during their three-week stay
in Cameroon.

The Poulsens relied on native guides to help them in their
research trips.

Child Support Collections Set Monthly, Annual Records

Congratulations to the Child Support Enforcement Division, whose employees collected a record $4,575,653
during June, surpassing the $4-million mark for only the fourth time in 23 years. In addition, the 1998 fiscal
year total of $42,501,846 set an annual collection record.

The CSED achieved the marks despite having 5.1 percent fewer employees from the previous year and steady
caseload demands. Two regions, Butte and Billings, each exceeded $1 million in collections for June.

The previous monthly record for collections was $4,567,921 in May 1997. To put
the records in perspective, it once took the Division five years - from 1975 to
1980 - to collect the same amount that was collected in June. And just eight
years ago, the annual collection record was $9,607,502 - about one-quarter of
the 1998 total.

• $4,575,653

—collected in June

• $42,501,846

-FY98 Total

"These figures are encouraging because they involve a human element both inside and outside this office," said
Division Administrator Mary Ann Wellbank. "The caseworkers are diligent, caring and have accomplished more
with less, which ultimately means we are able to provide more assistance on behalf of children. The Legislature
has also helped greatly by providing us with improved collection technology and laws."

Billings caseworker Deb Spomer said improved technology has increased caseworker efficiency. "One of the
best tools we have is the New Hire Reporting Program," she said. "This program has been very effective and
allows the caseworkers to receive employment information in a more timely manner." Lori Fleming, also a
caseworker in the Billings child support office, agreed and added, "I really appreciate the cooperation of the
Montana employers."

Of note, fiscal year 1998 collections were 9.4 percent higher than one year ago, yet during that period the
number of TANF (Temporary Assistance for Needy Families) cases - the main source of CSED revenue -
decreased by 3,016, or 21.3 percent. However, TANF collections only decreased by 10.8 percent, from
$10,933,373 in fiscal 1997 to $9,750,799 in fiscal 1998. This means the average collection per TANF case
increased by $103.57, or 13.4 percent.

Money collected for non-TANF families is passed directly to those families - about $30 million in fiscal 1998.

Big Timber Business Awarded Child Access, Visitation Contract

Development of a program that will offer noncustodial
parents better opportunities to maintain meaningful
relationships with their children is in the hands of a
Big Timber company. The Settlement Center.

A work group of representatives from three different
state entities selected the Settlement Center in June
to complete a statewide planning process and develop
and distribute an Access and Visitation brochure. The
work group involved the DPHHS Child Support
Enforcement Division, the DPHHS Child and Family
Services Division and the Montana Supreme Court.

"The Settlement Center was particularly strong in its
ability as a team to approach this project from both a
legal and consensus-building background," the group
concluded. "Collectively, the Settlement Center brings
five years of direct experience with custody and
visitation issues." This expertise was a key element to
the selection group because Montana has no Access
and Visitation Program.

Funding for the project was awarded in September
1997 to the Child and Family Services Division. The
U.S. Department of Health & Human Services issued
the $50,000 grant to create an Access and Visitation
Program. Grants are being made to all 50 states to
establish and administer programs that will support
and facilitate noncustodial parents' access to and

visitation of their children. This will be done, for
example, through mediation, counseling, education,
development of parenting plans, visitation
enforcement, and development of guidelines for
visitation and alternative custody arrangements.

The Settlement Center and the work group will
meet this month to plan the statewide forums.
Forums will take place between Aug. 31 and Oct.
31 in the five DPHHS regions. The division expects
to receive final recommendations for a pilot project
and have brochures distributed by December 1998.

Funding for fiscal 1999 is

expected to be distributed this

fall. The state is scheduled to

receive $55,000 in the

second round of funding,

with the money

going to support


made by the



PERS Benefit Changes Recommended: Two Options Discussed

Your retirement benefit is one of the most
important benefits you receive from your
employer. Tine Legislature is considering
major changes to the state's Public Employee
Retirement System (PERS). Changes are
based on recommendations from several
employee focus groups and a private
consultant, according to Sheri Heffelfinger of
Legislative Services.

Two Options are:

• Defined Benefit plan

•Defined Contribution plan

The 1997 Legislature directed the Committee
on Public Employee Retirement Systems
(CPERS) to "modify or replace" PERS. Plans
have taken shape, and more information will
be available in the coming months. In short,
CPERS received the following guidelines:

• Increase portability of contributions.

• Increase flexibility to allow plan
members choices in selecting the
amount of the contribution, directing
investments, and benefit payout form.

• Offer a retirement plan that also
provides a specified benefit.

CPERS - comprised of four Senators and four
House members - accepted bids for a benefit
consultant and hired Actuarial Sciences
Associations, Inc. (ASA), to develop options
and provide recommendations.

Last winter, ASA coordinated meetings of 12
employee focus groups and six employer focus
groups in 10 Montana locations. CPERS also
held video conferences at 19 sites to inform
PERS members and solicit comments.
Feedback from those sessions resulted in ASA
presenting three plan options and
recommendations, which ultimately became
the Modified PERS plan (MPERS).

At this stage as CPERS continues to refine its


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