It’s been nearly six months since the first waves of anxiety over state cuts to Medicaid swept through Missoula’s behavioral health community. Even after last week’s special session, however, case managers still have no clear picture of how Montana’s budget crisis will affect them. What they do have—at least at one regional not-for-profit—is a newly unified voice.
On Sept. 20, case managers at the Western Montana Mental Health Center voted to unionize, a development that shop steward and six-year WMMHC case manager Cheryl Nguyen-Wishneski attributes largely to fear over the impacts of state budget cuts. Nguyen-Wishneski says case managers first got together in a state of shared shock mid-summer to discuss their options, after they were informed of impending layoffs in their department. She adds that the new union also includes community rehabilitation aides, who frequently work in tandem with case managers for high-need clients.
“Pay was going to go down, workloads were going to go up, and that’s what was presented to us,” Nguyen-Wishneski says of the explanation she and other case managers were given for how WMMHC would absorb a 37-percent cut to Medicaid reimbursement for case management.
The union has yet to finalize a collective bargaining agreement with WMMHC. Nguyen-Wishneski says that on the advice of Missoula Area Central Labor Council President Mark Anderlik, union members opted to first proceed with negotiations focused narrowly on how layoffs are handled.
Jodi Daly, the center’s CEO, says she empathizes with the fears that prompted the union’s formation, though her account of the inciting events differs. Daly says there were no firm plans for widespread layoffs in case management, only talk of “innovative ideas” to repurpose staff.
“It was a possible RIF [reduction-in-force]. I think the communication came out wrong,” Daly says, adding that no cuts were actually presented to WMMHC administration for authorization.
Daly announced her impending resignation Oct. 13. A search committee has already whittled the applicant pool to two finalists, she says, and both will be in Missoula for interviews early next month. According to Nguyen-Wishneski, the union’s request to participate in the search was denied.
Nguyen-Wishneski hopes that the union, in addition to channeling anxiety over the affects of the budget crisis, can begin to tackle the issue of case manager retention—a longstanding problem she attributes to stagnant pay. WMMHC uses Medicaid dollars from case management to bolster budgets in other departments, and Nguyen-Wishneski says keeping a bigger piece of that pie in case management could fund pay increases and better benefits, encouraging new hires to view the position as more than an entry-level job, thereby creating more stability for clients.
“There should be awareness when you work in community mental health [that] you don’t do this to get rich,” Nguyen-Wishneski says. “But we can at least share the wealth a little more equitably.”