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Meier out as head of state health department

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Adam Meier is resigning as the head of Montana’s Department of Public Health and Human Services due to "an ongoing family health issue," Gov. Greg Gianforte’s office announced Thursday, and will be succeeded by Meier’s chief of staff.

Charlie Brereton will take over as department director after Meier leaves office on Aug. 12, according to a Thursday morning press release from the governor’s office.

“I am grateful to Gov. Gianforte for the opportunity to lead an amazing team of dedicated public servants working to improve service to Montana’s most vulnerable populations,” Meier said in a press release Thursday morning. “Despite navigating many challenges, I am proud of what we’ve accomplished during the first 18 months of the Gianforte administration. DPHHS is well-positioned to continue addressing issues that have long plagued the health and human services ecosystem here in Montana. While this is an unexpected turn in my tenure as director, I have the utmost confidence that our progress will continue under Charlie’s leadership.”

Meier assumed the role of director in February 2021, and was confirmed by the state Legislature the following month. His annual salary is $165,000.

DPHHS is by far the largest department in state government, with an annual budget of more than $3 billion. It oversees the state’s Medicaid program as well as agencies and programs ranging from foster care and child protective services to nutrition services and the state hospital system. It also continues to manage the state’s response to the coronavirus pandemic.

Charlie Brereton

Brereton.

Meier, an attorney, came into the job with prior experience as the top health official in Kentucky. Brereton appears to have little administrative experience as he prepares to take the helm of a department with more than 2,700 full-time-equivalent staff positions, according to a recent audit report.

The George Washington University graduate was a health policy advisor to Gianforte before becoming the DPHHS chief of staff in December, according to his LinkedIn profile. Before that, he worked as a health policy advisor to Sen. Lamar Alexander, R-Tenn., who was then chair of the Senate Committee on Health, Education, Labor and Pensions.

Following internships from 2014 through 2016, he joined law firm Squire Patton Boggs as a public policy intern in 2017, then worked there for about two years as a policy associate and advisor. During his time there he was registered to lobby on behalf of clients that included hospitals, universities and pharmaceutical and biotechnology companies.

"Charlie will make an exceptional director of our state’s largest agency,” Gianforte said in the press release. “Charlie has a knack for leadership and a superior ability to develop relationships, building consensus on complex issues. I look forward to continuing to benefit from his expertise, counsel, and hard work in this new role.”

In an email, Gianforte spokesperson Brooke Stroyke added that the governor was "not at all" concerned about the incoming director's lack of administrative experience and that "he has full confidence in Charlie."

Meier’s departure comes after the recent hire of the new state Medicaid director, Mike Randol. Randol was questioned recently during an interim legislative hearing about his past work in states that have moved to managed care for their Medicaid programs, meaning a third-party contractor does the management of the program. Randol told lawmakers he wasn’t brought in to move toward managed care.

Montana has a troubled past with managed care for mental health services. In 1993 during a special legislative session, lawmakers passed a bill that allowed for the exploration of managed care and subsequent legislation in 1995 allowed for managed care to start in the state for mental health services.

Montana’s Medicaid also faces a major effort expected later this year to go through the process of determining the eligibility of everyone covered by many of its programs, a process put on hold during the pandemic. Some have said the effort will be one of the most significant changes to health care coverage in the U.S. since the Affordable Care Act first went into place.

Meier’s departure also comes as the Montana State Hospital in Warm Springs remains under intense scrutiny from federal officials and lawmakers. Last year the federal Centers for Medicare and Medicaid Services pulled reimbursement funding following repeated failures to meet health and safety standards. Those failures resulted in deaths that would have been otherwise preventable, according to a CMS report released in February.

In April, the department announced it was replacing the state hospital administrator, who had been identified as a key driver of a staff exodus at the hospital.

The governor’s office lauded Meier’s leadership since his appointment, noting that he oversaw “expanding substance use disorder and mental health treatment services, kicking off a long overdue assessment and overhaul of state-run facilities, comprehensively assessing provider rates to address significant gaps in Montana’s continuum of care, implementing reforms to better support DPHHS’ workforce, and bringing a culture of customer service to the agency.”

Gianforte’s office also praised his implementation of House Bill 702, Montana’s controversial law to prohibit “vaccine discrimination” by prohibiting both public and private workplaces from requiring vaccinations as a condition of employment.

Public health experts largely opposed the bill, but Republicans who supported the measure argue it’s a critical tool to protect the rights of Montanans who remain skeptical of the COVID-19. The law applies broadly to all vaccines, however, with some carve-outs for schools and nursing homes. It’s currently being challenged in court, and was partially blocked by a judge earlier this year.

Under Meier's tenure, the state also lost the $2 million annual federal grant for Title X, or family planning, services. For the first time, a nonprofit in Bozeman applied and got the funding, spurred by a law passed in 2021 that would have prohibited the department from entering into a contract with any organization that provided non-federally qualified abortions.

In a Thursday email sent to DPHHS staff, Meier elaborated on the reason for his departure, saying that an immediate member of his family "faced unexpected health issues that require specialty care unavailable in Montana."

He added that he will work from the office through July 22, and then work "intermittently to assist with the transition" through Aug. 12.

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Head of the Montana State News Bureau

State Bureau reporter for Lee Newspapers of Montana.

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