The Public’s Health: Six-tier strategy targets substance abuse

KAREN SULLIVAN for The Montana Standard

Substance abuse is the No. 1 health issue in Butte-Silver Bow, and collaborators in the community are working to develop a plan to address the problem.

Substance abuse in the state as a whole is a reigning health issue, ranking among the top concerns in most Montana communities.

Locally, a substance abuse task force, created last year by Butte-Silver Bow Chief Executive Dave Palmer, is at work to develop local strategies to address substance abuse and substance use disorders. The task force is ably facilitated by local therapist Laura Cross, president of Butte Cares, an organization that focuses on substance abuse prevention.

Statewide, a strategic plan has been developed to address substance use disorders. The plan will define statewide strategies through 2019.

“More than 100 people die every year from drug overdose in Montana, and almost 22,000 hospital or ER visits annually are attributable to alcohol and drug use,” says the introduction to the document, titled “Addressing Substance Use Disorder in Montana.” “The impacts of substance use span every generation and cut across socioeconomic lines, from children in our foster care system to seniors prescribed opioids for chronic pain.”

At the local task force’s first meeting a few months back, Mike Thatcher, chief executive officer of Butte’s Community, Counseling, and Correctional Services, Inc., underscored how substance abuse crosses every spectrum. Thatcher said CCCS officials are contacted weekly by Butte people worried about themselves or a family member and looking for assistance.

The state plan says rural states such as Montana are limited in ability to provide access to “robust, evidence-based systems to prevent, treat and manage” substance use disorders. However, with that reality in mind, the Montana plan — developed after five meetings were held statewide, with 114 people participating and 82 agencies represented — forwarded six areas for targeted strategy. They are partnerships; prevention and education; enforcement; monitoring; treatment; and family and community resources.

At the beginning of the state plan, Montana Gov. Steve Bullock wrote a letter saying that “we are in the midst of a significant public health crisis.” Bullock added, “drug overdose deaths have been on the rise nationally, and although alcohol abuse is more prevalent in Montana, opioid and methamphetamine use are a significant cause for concern as well. Drug overdoses are the third leading cause of injury-related death in Montana, accounting for 1,334 deaths between 2003 and 2014.”

Here’s what is going on in Montana — an estimated 64,000 residents have a substance use disorder; 90 percent of those with these disorders are not receiving treatment. Annually in the state, 390 deaths can be attributed to alcohol, with 34 percent of all traffic fatalities in the state being alcohol-related. Twenty percent of Montana adults report binge drinking in the last year, compared to 16 percent of adults in the United States, and seven percent of Montanans ages 12 and over are dependent on abusing alcohol.

In regard to methamphetamine, Montana has seen a 427 percent increase in meth violations from 2010 through 2015; 46 percent of all open Child and Family Services placements involve meth.

Regarding marijuana, 122,000 Montanans ages 12 and over are estimated to have used in the last year. Of drug violations in the state, 57 percent involve marijuana. Thirteen percent of high school students report using marijuana in the past month, even though 62 percent of youths believe smoking marijuana regularly is harmful.

And illicit drugs — in 2015, 116 heroin arrests were made in the state, up from four 10 years prior. Three percent of Montanans ages 12 and up — 18,000 people — say they are dependent on or abusing illicit drugs. Five percent of adults ages 18 to 25 report using cocaine in the past year.

“This challenge strains our families, our hospitals and healthcare providers, our health and our public safety,” Bullock wrote in his letter, adding that the plan “focuses not only on preventing deaths, but finding treatment and support for those struggling with substance use disorders so that our communities may heal.”

Please watch for future columns that will illustrate the contents of the state plan, and strategies being developed by the local task force.

I’m with Bullock — this is a straining challenge. But I very much look forward to working with local task force members to develop partnerships and prevention and education strategies, to beef up enforcement measures, to build monitoring strategies, to facilitate best-in-class treatment options, and to further develop family and community resources. It will take a village.

Karen Sullivan is Butte-Silver Bow Health Officer and Director of the Health Department. Her column, The Public’s Health, appears weekly on The Montana Standard’s health page.

Read the story on the Montana Standard

Rally sparks support for tobacco tax on ballot

HELENA – A rally was held Thursday to spark support for a ballot initiative that would increase the cost of a pack of cigarettes by $2 and add fees to other tobacco products to be used for Medicaid expansion and other health programs.

Kristin Page-Nei, American Cancer Society Cancer Action Network Montana Government Relations director, said a “major ground game” was planned for the tobacco tax proposal that is expected to be on the Nov. 6 ballot.

Dozens of people gathered at the amphitheater in the Great Northern Town Center, in the shadow of the carousel.

Read the whole story

By Phil Drake,

Published 2:25 p.m. MT April 19, 2018 at

Report: Medicaid expansion pays for itself

Report: Medicaid expansion pays for itself; future economic impact seen as bright

Apr 10, 2018

In the first two years after Montana expanded Medicaid, the savings to the state have eclipsed the costs. Though that could flip by 2020, increased activity in Montana’s economy because of the expansion will more than make up the difference.

That’s according to a report commissioned by the Montana Healthcare Foundation and Headwaters Foundation.

The full report will be released broadly later this week. A preliminary version was discussed at a state legislative interim hearing earlier this year. It was produced by the University of Montana’s Bureau of Business and Economic Research.

The report also found that in the time Montana has expanded Medicaid, workforce participation has increased among low-income earners. When Montana choose to expand Medicaid, it also added a program called Help-Link that connects those covered under expansion with employment assistance.

Read More:

Montana’s income inequality is growing faster


Montana is the state with the fastest growth of income inequality, according to a recent report based on U.S. Census Bureau data.

The report, from a website called Zippia that covers career issues, summarizes data from the American Community Survey from 2010-2016.

Montana’s income inequality increased 4.97 percent over those six years. The state ranks 30th in overall income inequality; New York tops that list.

“What we are seeing is not unique to Montana, but we have seen income inequality grow at a faster rate in Montana over the past five years,” said Heather O’Loughlin, co-director of the Montana Budget and Policy Center.

O’Loughlin said part of the reason Montana ranks at the top of the list is likely that non-wage income is making up a bigger share of the state’s economy. A vast majority of that kind of income, such as capital gains and real estate investments, goes to higher-income households, O’Loughlin said.

Read More

Billings Gazette Reports on Yellowstone County’s Top Health Issues

The Billings Gazette reported on February 6, 2017 that the “overall health and mental health of Yellowstone County residents is worse than it was a dozen years ago, even though they have access to more treatment and are seeking it out, a recent report shows.”

View the entire Billings Gazette Article

Montana Health Information Exchange Launch Stakeholder Meeting

Montana Medical Association hie-2016-theme-image


You are invited to join other top decision makers December 6-7 in Helena to jumpstart a sustainable Health Information Exchange Organization in Montana!
On December 6, key decision makers committed to the successful launch of this foundational component
of health care reform will engage in a straightforward conversation about unique legal, technical, and
governance challenges. Collaborative work groups will be formed to determine the feasibility of a Health
Information Exchange Organization in Montana.

Discussion continues on December 7 with targeted work groups diving deeper into areas critical to a
Health Information Exchange Organization’s success.
Works groups that will be formed are:
  • Clinical Use Cases
  • Finance / Business Model
  • Governance
  • Privacy & Security
  • Quality
  • Technology

To register for this important planning event click here.


Uninsured now accessing care with Medicaid Expansion

Uninsured now accessing care with Medicaid Expansion.  

Doctor Shortage Leads to Questions of Health Care Access

Flathead Community Health Center mentioned.


Sapphire Community Health Center Opens

Sapphire Community Health Center Opens: CEO Janet Woodburn quoted.

Montana Health Justice Partnership Forms after grant from Montana Healthcare Foundation

A Community Health Center – or CHC – is a not-for-profit, consumer-directed health care organization that provides access to high quality, affordable, and comprehensive primary and preventive medical, dental, and mental healthcare. Community Health Centers have a unique mission of ensuring access for underserved, underinsured and uninsured people. Since 1965, Community Health Centers have delivered comprehensive health and social support services to more than 22 million Americans, including many people who otherwise would not have access to quality care. Today in Montana, 17 Community Health Centers across the state serve approximately 100,000 Montanans.
In addition to Community Health Centers, Migrant Health Centers and Health Care for the Homeless programs help meet the health care needs of Montanans. All of these community-based providers are sometimes referred to as Federally Qualified Health Centers (FQHCs) because they must meet rigorous federal standards related to quality of care and services, as well as cost.

Can anyone seek healthcare services from a Community Health Center?

Yes, anyone can become a patient of a Community Health Center, regardless of his or her ability to pay. Insured or uninsured, low-income or high-income – all can receive primary and preventive healthcare from a Community Health Center.

How are Community Health Centers funded?

Community Health Centers are funded through a combination of federal and local grants and payments from patients and insurance companies. Health Centers must compete once every three years for federal grant funding. Health Centers use these federal grant dollars to assist patients who need help paying for a portion of their healthcare costs.

What are the benefits of going to a Community Health Center for care?

Patients of Community Health Centers experience a combination of quality care, affordability, and accessibility that is unique in our country’s health care system. From a sliding scale payment system to the ability to get in to see a doctor promptly, Health Centers ensure that all members of their community have meaningful access to primary care. In addition to primary care services, Health Centers provide “wraparound” services, such as transportation, translation, care coordination and more, to further enhance patients’ access to care.
Each Health Center is staffed by licensed and board certified physicians, dentists, nurses and nurse practitioners, dental hygienists, mental health specialists, physician assistants, and other professional healthcare staff. Community Health Centers are held accountable to numerous and rigorous state and national standards of clinical and financial excellence. All 17 of Montana’s Community Health Centers use sophisticated health information technology throughout the routine care of their patients and more than half are nationally certified as Patient Centered Medical Homes

Why are Community Health Centers important to all communities?

Poverty, homelessness, poor living conditions, geographical isolation, lack of doctors and lack of health insurance pose insurmountable access problems for many people at higher risk for serious and costly health conditions, including asthma, tuberculosis, diabetes and high-risk pregnancies. Health centers address these access problems through the delivery of comprehensive primary and preventive services – the type of services not typically offered by traditional private sector providers to at-risk people, including most managed care systems. A 2009 George Washington University report showed that the average patient receiving care at a health center had total annual medical expenditures $1,093 lower than an average patient who did not use health centers.
Each health center takes a tailored approach to meet the unique needs of the people in its surrounding community. That local approach to health care, combined with an emphasis on comprehensive preventative care, generates $24 billion in annual savings to the health care system – for the American taxpayer, local, state and federal governments and public and private payers alike.