- Associated Press - Thursday, January 11, 2018

Billings Gazette, Jan. 8, on funding for the 2020 census:

Montana has a huge stake in having every one of its residents counted in the 2020 census.

Our state is the largest of 435 U.S. House districts by population. Montana came up just slightly short of enough people to have two districts in the 1990, 2000 and 2010 counts. Election Data Services recently reported that it’s possible for Montana to regain the second seat, which it lost in the 1990 census. That political consulting firm projects that Montana could gain a seat now allocated to Rhode Island.

Not all assessments of 2020 population agree that Montana may gain a seat, and even Election Data Services says it would be close, with probably no more than 2,400 residents to spare.

So it is vitally important that every Montanan be counted in the next decennial census. That’s why the U.S. Census Bureau budget controversy in Washington is a local issue for Montana. The Trump administration proposed a 2018 census budget far below what the Census Bureau said it needed to keep preparations on track for the big 2020 count. Congress has yet to send an annual federal appropriations bill to the president’s desk. The latest short-term spending bill expires this month.



Meanwhile, the testing of new technology for the census has been delayed. Tests of how that technology would work in rural areas, including Indian reservations, has been cancelled.

The 2020 census will be the first conducted primarily online. The federal government expects to hire less than half as many employees to conduct the 2020 count as were hired for the 2010 count. To encourage U.S. residents to respond to the census, the Census Bureau had extensive plans for outreach in areas that are hard to count. Those plans are in limbo, awaiting funding.

Guess what? Hard-to-count areas include rural America - isolated homes and towns where a lot of people get their mail at a post office box rather than a city address.

Then there’s the leap in technology. Much of rural America lacks the access to the internet that urban Americans have enjoyed for years. The Census Bureau needs resources to reach out to those people and count them.

“Hard-to-count communities are not confined to urban areas,” Vanita Gupta, president of the Leadership Conference on Civil and Human Rights, told a U.S. House oversight committee in October. “It may be less well known, but rural and remote communities, including American Indian tribal lands and reservations, are also vulnerable to disproportionate undercounting in the decennial census, with lower income households especially at risk. Eighty-seven percent of the hardest-to-count counties in the 2010 Census were rural counties.”

In Montana, prominent Democrats and Republicans interviewed by The Gazette’s Tom Lutey last week agreed on the tremendous value of regaining the House seat lost 30 years ago. Having two representatives for our great, big state would provide better, more equal representation to Montana’s 1 million-plus residents.

We’re not going to get that representation unless all of us get counted. We call on Montana’s congressional delegation - Sens. Jon Tester and Steve Daines and Rep. Greg Gianforte - to be Census champions. Fight for adequate funding that will assure the Census Bureau has the resources to fulfill its constitutional duty. Give Montana a fair chance for equitable representation in the U.S. House.

Editorial: http://bit.ly/2EuiHVp

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Missoulian, Jan. 7, on treatment for pregnant addicts:

The birth of a child can be a powerful motivator to kick unhealthy habits. Even before giving birth, pregnant women know that any substances they put into their body will be shared with their developing baby.

It’s an especially critical time for parents struggling to overcome a drug addiction who, feeling the immense responsibility of raising a child, may be inspired to finally get the help they need to fight their addiction and learn how to make better choices.

Montana should do its utmost to support these parents in their efforts. At the very least, we should not leave them to fight their addictions alone.

Yet it’s clear that amid Montana’s unfolding opioid crisis, most pregnant women who use drugs are not getting the support they need to build a better future - and all of Montana is paying the price. The steps that must be taken to brighten this bleak future need more attention and more public backing.

A series of recent stories, “Addicted and expecting,” the result of a partnership between the Missoulian and the University of Montana School of Journalism, brought much-needed attention to the issue and highlighted some of the life-changing work being done.

The path Montana is on now is not sustainable. Consider that:

- The rate of infants experiencing opioid withdrawal after birth grew by a factor of four over the seven-year period between 2008 and 2015, and neonatal abstinence syndrome is now diagnosed in nearly 9 out of every 1,000 births in Montana.

- The costs for these births tend to be higher due to complications, and of babies born with this syndrome, Montana Medicaid covers the bills for more than half of them.

- The situation is even worse on Montana’s reservations. According to the most recent assessment, 44 percent of pregnant women tested positive for opioid use in the Blackfeet Indian Reservation’s Browning. Nearly half the infants born in Lake County, which includes the Flathead Indian Reservation, were deemed at risk for neonatal abstinence syndrome.

Unfortunately, many drug-addicted women who become pregnant avoid doctors and hospitals as much as possible, fearing that they might be forced to either give up their drugs or give up their kids. Years of throwing drug users in jail has led to overcrowding in Montana’s prisons and an overburdened foster care system, and has done nothing to fix the problem.

So, how do we fix the problem? With full support from their communities, Montana’s obstetricians and hospitals that provide maternal care can lead the way by encouraging a less judgmental attitude toward addicts.

One hospital in northwestern Montana is demonstrating how it works. Kalispell Regional launched a new program in 2014 to rethink the way it treats pregnant drug addicts. It has integrated maternal care with addiction treatment and social services, and urged its staff to empathize with addicted patients.

These no-cost changes have resulted in measureable success: Foster care placements have dropped by almost 70 percent, the length of an intensive-care stay for drug-exposed newborns has been cut by more than half, and the bills covered by Medicaid have similarly been reduced.

Further, Montana’s medical community must work on increasing the number of doctors certified to prescribe buprenorphine, a medication used to treat opioid addiction. When combined with counseling, the prescription drug can more than triple the rate of successful recovery. Yet the “Addicted and expecting” series revealed that Montana has few certified physicians, and in fact, only one such doctor in the entire 120-mile stretch between Missoula and Kalispell.

On the bright side, the state is already on solid footing to make progress on this point, having recently secured a $4 million Substance Abuse and Mental Health Services Administration grant aimed at improving medication-assisted treatment. Montana should track this progress carefully to ensure this treatment is made available where it is needed most.

Next, Montana must push to expand the number and type of treatment beds available to pregnant women who want to kick their addiction. At the moment, only one inpatient center in Missoula and another in Billings regularly admit drug-addicted pregnant women. Other options in the state tend to be located long distances away, or have long waiting lists.

However, women who already have children are not able to take them to inpatient centers and are unlikely to leave their families for treatment. Residential programs like the Carole Graham Home in Missoula do accept women who have children, but are limited by federal rules that do not extend Medicaid to facilities with more than 16 beds. Montana could apply for an exemption, as five other states have, but has yet to do so. It should do so without additional delay.

Also at the federal level, Montanans must demand more funding for treatment centers, another area in which the state lags behind national averages. Difficult as it is for addicts to gain admittance to one of very few treatment programs accepting new patients, it is even more difficult for pregnant women. Only 7 percent of Montana’s treatment providers offer programs for pregnant women or new mothers; the national average is 21 percent.

Montana’s state leaders, including Gov. Steve Bullock and Attorney General Tim Fox, should be at the forefront of efforts to encourage the efforts that are working, and to make the necessary changes to those that are not. Montanans from every corner of the state can encourage our legislative leaders to study the problem and prepare to propose focused legislation in the 2019 session.

As House Majority Leader Ron Ehli, a Republican state representative from Hamilton, noted, “There’s nothing more important. Doing something now is going to reap huge benefits down the road.”

Doing nothing, on the other hand, is sure to result in more tragedy.

Editorial: http://bit.ly/2D1ujSz

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The Livingston Enterprise, Jan. 5, on efforts to combat chronic wasting disease:

It was welcome news to learn that recent testing for chronic wasting disease in Park County found no positive samples. Yet wildlife officials point out there’s no guarantee the disease doesn’t exist here.

“The conclusion we draw from (the testing) is not that any hunting district that didn’t have a positive is now free of CWD,” Greg Lemon, an administrator with the Montana Department of Fish, Wildlife and Parks, told The Livingston Enterprise earlier this week.

FWP wasn’t able to reach its surveillance goal and officials said that with the data that was collected, the agency had a 66 percent probability of detecting CWD if the prevalence within the sampled population was 1 percent or greater.

If you visited your doctor for a problem and were told the medical staff would have only a 66 percent probability of detecting a disease, you would likely consider getting a second opinion.

Or in FWP’s case, you continue monitoring, gathering data and working with hunters to get an early jump on CWD after it was detected last year for the first time in wild herds in Montana. Thankfully, that’s exactly what the agency did. Park County was included in a larger sampling area during the general hunting season. The area stretched across south-central Montana from the Livingston area to east of Billings. The presence of CWD in Montana should be a concern to all hunters in the Treasure State. CWD is an untreatable, contagious neurological disease that kills elk, deer and moose. There is no evidence that CWD can be transferred to humans, but the disease can wreak havoc on wildlife populations.

FWP says it will continue an aggressive monitoring program in its effort to determine the prevalence and geographic distribution of CWD in Montana. Once those questions are answered, the agency must have an open and transparent discussion with the public about what steps should be taken moving forward.

Currently, the agency sends samples it gathers at game check stations, from road kill and during special hunts to Colorado State University and results are returned in a week or two. Perhaps future discussions should include whether Montana should conduct its own testing - possibly at a regional FWP headquarters or one of our universities, as wildlife diseases are an increasing issue.

Editorial: http://bit.ly/2CZ18zv

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