Pilot program to be expanded

When Marilyn Tavenner met with Sen. Max Baucus earlier this year to solicit his support for her confirmation hearing in the U.S. Senate, Baucus gave her a photograph of a well-known man from Libby who died of asbestos-related cancer several years ago. The photo came with strict instructions to keep it on her desk as a constant reminder that the people who were exposed to asbestos in Libby need her help. 

Tavenner, who is now the top official in charge of the Centers for Medicare and Medicaid Services, said the photo of Les Skramstad means a lot more to her after standing next to his gravesite and meeting people whose family members died after inhaling toxic asbestos fibers that came from a now-closed W.R. Grace vermiculite mine. Tavenner accompanied Baucus on a visit to Libby on Wednesday that included a stop at the city cemetery and the Center for Asbestos Related Disease Clinic.

“He told me, ‘I will never forget Les, and I don’t want you to you to forget Les,’” Tavenner said. “The photo made all of this real for me. It’s in my office, behind my desk. It’s really important to me. Coming out here today and meeting people up close and personal - I can’t imagine losing children, grandchildren, your spouse. That picture will remind me of the senator, but also the people out here today.”

That’s exactly what Baucus was banking on.

Baucus said he wanted Tavenner to see the faces of the asbestos victims who rely on Medicare to cover their healthcare costs because she has authority to influence the way healthcare benefits are administered to people who became ill due to exposure to the deadly fiber. Specifically, Baucus was trying to convince Tavenner to expand a Medicare pilot program that provides additional healthcare benefits to residents of Lincoln and Flathead counties who were developed a disease after having contact with asbestos in Libby. 

The pilot program, which costs $1.5 million annually, provides benefits not normally covered by Medicare for things such as home healthcare services, medical equipment, medical travel, smoking cessation programs, nutritional supplements and medications. Baucus has been pushing Tavenner to expand the pilot program to include people who moved outside of the area after developing asbestos-related health problems.

“We’re here today to explain to (Tavenner) why it’s so important to change the administration of the law so that people, not only in Lincoln and Flathead counties who have asbestos-related disease get those benefits, but also people who live outside those counties get the same benefits,” Baucus said. 

Tavenner told The Western News that she will try to expand the program before the end of this year. 

“Yes, we do think by the end of the year. It will be short.” she said. 

Right now, about one-third of the people who have been diagnosed with an asbestos-related disease from exposure in Libby have enrolled in the pilot program, according to statistics compiled by the Center for Asbestos Related Disease Clinic. As of last week, 855 patients were enrolled in the pilot program, and at least 886 additional people who have been diagnosed with an asbestos-related disease would qualify for the program if the geographic boundaries were eliminated. 

The Center for Asbestos Related Disease Clinic diagnoses about 40 people per month with an asbestos-related disease. That number remains high because the disease has a long latency period, which means people who were exposed to asbestos years  or decades ago are just now developing symptoms of lung dysfunction. The clinic has a patient population of more than 5,540 people, and 2,780 of them have been diagnosed with an asbestos-related disease. 

While visiting the CARD, as the clinic has become known by its acronym, Baucus and Tavenner heard from several asbestos victims who do not qualify for the pilot program. One of those people was John Troyer, 43, who has been diagnosed with plural fibrosis. 

Troyer grew up in Libby and moved to Helena in 1995. His lung disease eventually cause him so much pain that he could no longer work regular hours as a dental hygienist. He said doctors on the other side of the state failed to accurately diagnose his condition, so he began making trips to Libby.

“Without the help of the CARD Clinic, I’d be in the grave,” Troyer said. “This (pilot program) really needs to be expanded to people who don’t live here.”

Theresa Ross said her father-in-law is a former Libby contractor who now lives in Sanders County, just eight miles from the Lincoln County border. She said it’s not fair that he is ineligible for the benefits of the pilot program even though he has an asbestos-related disease.

“My father-in-law is approaching needing care 24-7. He’s basically homebound,” Ross said, after explaining that she and her husband moved to Montana so they could care for their ailing family member. “It will come down to the point where he basically needs full-time care.”

Dr. Brad Black, who founded the CARD Clinic, underscored the disparity of the pilot program. “Just to travel seven miles across the county line, it’s unbelievable,” he said. 

Michelle Boltz, a CARD Clinic employee, said all four of her grandparents were diagnosed with an asbestos-related disease. She said one of her grandmothers qualified for the pilot program, and the other one didn’t because she lives out of state.

“All my grandparents are affected,” Boltz said. “They are crushing chest pains, and my grandfather wears a Life Alert pendant.”

Gayla Benefield, who, with Skramstad, blew the whistle on W.R. Grace for covering up decades of asbestos contamination in Libby, pointed out that Norita Skramstad, Les’ widow, remains ineligible for the pilot program because she now lives in Havre. 

“I thought that was important to bring up,” Benefield told Tavenner and Baucus. 

Benefield’s point wasn’t lost on Tavenner.  “We do want to make it complete,” Tavenner replied, referring to the pilot program. “We want to get it done right.”

Baucus said he believes the trip to Libby will lead to changes in the Medicare pilot program. 

“It’s been very positive,” he said. “She’s going to try. There’s no doubt, she’ll try hard to expand Medicare coverage to people with asbestos-related disease, not only in Lincoln and Flathead counties, but surrounding areas. She’s going to try hard.”

Baucus said he will keep tabs on Tavenner’s progress.

“And if things aren’t going well, I’ll just call Marilyn and say, ‘Marilyn, what about that photo on your desk? Remember when you were in Libby. You better be doing something about that now,’” Baucus said.