‘Concerned’ labor department to review addiction recovery program for medical providers

After a slew of public critiques, Montana’s labor department announced it will review the state’s process for monitoring medical providers struggling with addiction and mental health issues. 

In a Friday meeting with state lawmakers on the Legislative Audit Committee, labor commissioner Sarah Swanson said she was “very concerned” by the issues raised in a recent legislative report and news articles about the program’s current contractor, Maximus, Inc., including expensive fees, strict work limitations for participants and the January suicide of an enrollee, publicly reported for the first time this week by Montana Free Press.   

That reporting found that the death of Billings nurse Amy Young had not been acknowledged in standard reports presented to the members of the medical boards who license the more than 60,000 doctors, nurses, pharmacists and dentists who could be directed to go through the monitoring program. 

Rep. Mary Caferro and Sen. Laura Smith, both Democrats from Helena, cited MTFP’s recent reporting about Young’s death when questioning Swanson about how participant deaths, including suicides and overdoses, are tracked by the Virginia-based vendor and the state Department of Labor and Industry.

“What is very upsetting to me is the fact that nobody’s talking about the woman who died by suicide,” Caferro said. “This is pretty disturbing to me, and I would like to know what your thoughts are on why we’re not talking about it and why Maximus, the company that y’all contract with, is not talking about this situation or not reporting it.”

Swanson acknowledged that the contract with Maximus, signed in late 2022, does not require such disclosures. That three-year contract, which costs roughly $1.6 million, is up for consideration and possible renewal at the end of December. The program is paid for through annual licensing fees gathered from nurses, doctors and other covered professionals.

“I do not disagree that there is a better reporting mechanism that needs to be in future contracts. It is not in the contract that the department signed. … Yes, I’ve read the article,” Swanson said. “I, too, representative, am very concerned.”

In response to a series of July questions from MTFP about Young’s death, a spokesperson for the labor department said in an email that participant suicides are not included in routine reports from Maximus because of the “potentially inflammatory” nature of the information. While the department said Young’s death had been reported to a state employee in January, the agency did not say that the death was shared with appointed members of state licensing boards.

related

An addiction program was supposed to help nurses. Then one took her own life.

National health researcher say health care workers suicides are often wrongly downplayed and ignored by state and national regulators, missing valuable lessons that could prevent future tragedies.

by Mara Silvers 09.18.202501.30.2026

The department’s decision to form the advisory council was also prompted by the findings of a recent audit about the program written by nonpartisan legislative staff, Swanson said. That report, which did not mention a participant suicide, highlighted the tumultuous transition between vendors, disruption for enrollees and a sharp decline in how supported medical providers felt in the current program. 

Responding to the Friday meeting with lawmakers and the creation of a new advisory council, Eileen Rivera, a spokesperson for Maximus, said in an emailed statement that its program fulfills the current contract. 

“Maximus has been a reliable partner to the Montana Department of Labor and Industry (DLI) to provide monitoring services in support of the Recovery Program over the last two years. We have worked collaboratively with DLI so that the program is executed consistent with existing contractual requirements,” Rivera wrote.

Swanson, who did not lead the labor department when Gov. Greg Gianforte’s administration picked Maximus as a vendor, said she was also concerned about the lack of input from medical boards about the current contract and the type of monitoring, accountability and support their licensees need. 

The advisory council Swanson established will include representatives from the four boards covered by the program and the boards that license chiropractors and veterinarians, which are set to be included in the contract going forward.

Lawmakers questioned why the council does not include a position for former participants of the Montana Recovery Program, suggesting that their input could be valuable. Swanson responded by saying that adding former participants could give certain types of medical providers unequal representation, but said she aimed for the process to be open and accessible for participant testimony.

“We intend to operate this council very transparently with public meetings, public comment, and we do intend to invite [program] participants to provide either testimony written, in person, through their attorneys, however they feel comfortable,” Swanson said.

Some medical industry groups will also be represented on the council, Swanson said. One of those organizations, the Montana Medical Association, an industry lobbying group that represents physicians and physician assistants, had previously submitted a bid to take over the assistance program in 2022, after the state notified the prior vendor that it would end its contract.

Speaking to lawmakers during the public testimony, Montana Medical Association executive director Jean Branscum said that medical providers currently involved in the monitoring program have experienced “this kind of punishing, kind of beating down by the vendor when they should be supported and lifted up to be in recovery.” 

“People have had to write papers in regards to why they didn’t show up for an [Alcoholics Anonymous] meeting, for example. They’ve had to be faced with high costs to see a certain provider when they aren’t working and they don’t have that extra money to spend,” Branscum said. “So certainly additional action is needed.”

Swanson said the labor department has not decided whether to extend Maximus’ contract or request new bids from other vendors. That ultimate decision, she said, would be informed by input from the advisory committee. 

Another member of the Legislative Audit Committee, Rep. Jane Gillette, R-Three Forks, expressed support for Montana Medical Association re-bidding to operate the program in the future, even though the industry group represents the same providers it would be monitoring. 

“It would be kind of like the fox watching the henhouse,” Gillette acknowledged. “The flip argument for that is they might be a more compassionate vendor that would be able to relate to these individuals in a better way and help them get to the finish line and get across the finish line.”

In response to Gillette’s question about whether participating on the council would preclude the MMA from bidding on a future contract, Swanson noted that vendor bids are overseen and awarded by a different state agency, the Department of Administration, and reiterated that the agency had not yet decided to seek a new contractor.