Montana ranks among the top three states in the nation per capita for traumatic brain injuries, according to industry workers and advocacy groups. Traumatic brain injuries, or TBIs, include strokes, brain infections, or a hit to the head that causes brain damage.
Ann Geiger is the executive director and co-founder of Liberty Place in Whitehall, an organization founded more than two decades ago that provides homes and life training skills for people who live with brain injuries.
"We have high risk industries, high risk recreation. We have wide open spaces that people drive really crazy fast and may not be wearing their seat belt. If you get thrown from the vehicle you’re probably going to have a brain injury if you survive. So, that’s kind of the deal. Montana also being among the highest for volunteerism for the military service, TBI and PTSD [Post-Traumatic Stress Disorder], they’re kind of hand in hand."
Down the street from Liberty Place’s office in Whitehall there’s a townhouse where 9 people with traumatic brain injuries can live together in semi-independence. When I visited Wednesday there was a man sitting on a couch in the living room watching TV, sometimes rocking back and forth in his seat.
Another resident sitting in the kitchen asks me if I was told that a bunch of nuts lived in the house. A woman who works at Liberty Place defends her, saying it’s not that they’re nuts, they just have a brain injury, and that makes it harder them to make the right decisions or do some everyday things on their own.
Like many other healthcare facilities in Montana, there’s a shortage of trained, skilled workers here.
Executive Director Ann Geiger also says Liberty Place alone can’t meet all the needs people with brain injuries have Montana. When she got started, Geiger imagined that there could eventually be seven organizations like hers working in the state. Today, it’s still just them.
"The need, it’s huge," Gieger says.
On Wednesday, the Montana Department of Labor announced it’s using federal money to sponsor about half a dozen apprenticeships to train existing employees at Liberty Place. It’s unclear right now exactly how much that will cost.
Madeline Boehm, a health care program specialist for the labor department, says offering apprenticeships like this will help fill a gap in health care needs in the state and add opportunities for health care workers to earn higher wages.
"There is an impending — or it’s already here, depending on how you look at it — workforce shortage in health care in Montana. We need to add about 2,000 new health care employees every year,” Boehm says.
Sarah Murrish, a life skills trainer at Liberty Place, is going to take part in the new apprenticeship programs in behavioral and community health.
“It is a tough job. So anybody that wants to do it, I think the more training you can give those people who really have the heart to work with people with TBIs. Any kind of training when you’re in the medical field is good,” she says.
Ann Geiger of Liberty Place says about 95 percent of her organization’s funding comes from Medicaid, because her clients need government assistance to pay for their medical needs. She says low Medicaid reimbursement rates limit her ability to pay higher wages.
Geiger says the new training program sponsored by the state labor department can help her attract people to work at Liberty Place.
"You kind of have to grow your own workforce. And not everybody can afford to go to college. And this is a great way for someone that can’t afford a college, that wants to be in a healthcare field, to jump in. And they’ll end up with a nationally recognized accreditation afterwards, so they’ll be much more employable."
Although the new state apprenticeship programs are helpful, Geiger says not everything the state has been doing lately is improving the availability of health care services in the state.
"The only reason we end up turning people away that really need our services is a funding issue. The Montana Medicaid is struggling right now. As you know, they’ve done a major rate cut for all providers, not just us, so getting people into that system is much more complicated than it used to be and taking much longer. That’s really a bad story when we have to say ‘we would like to help you, but we can’t until you can get funding.”
To solve the state’s budget crisis last year, Governor Steve Bullock and lawmakers agreed to cut how much the state pays Medicaid providers by about 3 percent. Other Medicaid services are being cut as well.
But the administration is continuing programs aimed at filling the gap in available health care services in the state by retaining existing workers and bringing in new ones, like the new apprenticeships at Liberty Place that hold the possibility of higher wages that come with additional training and education.
Still, the state Labor Department’s Madeline Boehm says it doesn’t look like they’re going to hit their goal this year of adding 2000 workers to the health care sector.
"I don’t think we’re going to make it. I think that we have a really low unemployment rate and we’re probably going to have to find other ways as well as apprenticeship and education. But we’ll have to figure it out."
Boehm says the curriculum for the new apprentices in Whitehall should be ready in mid-March. Their on-the-job training will last one year.
Once complete, they will be the first health care workers in the state to receive nationally recognized credentials in their jobs of assisted living and transitional care for people with traumatic brain injuries.
This report was made possible, in part, by a grant from the Montana Healthcare Foundation.