Near old Montana mine, special clinic for asbestos-related illness fights to survive

The Center for Asbestos Related Disease, aliases CARD Clinic, successful Libby, Montana, provides free lung screenings for breathing issues and cancers tied to asbestos exposure. CARD's doors were shuttered by a suit brought by BNSF Railway connected behalf of nan national government.
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Aaron Bolton/Montana Public Radio

Dozens of feet of tubing link Gayla Benefield to her oxygen instrumentality truthful she tin locomotion from room to room wrong her location connected nan picturesque Kootenai River, surrounded by nan Cabinet Mountains.

Like galore group who unrecorded successful this distant municipality astir 80 miles from nan U.S.-Canada border, nan 81-year-old Benefield has asbestosis, aliases scarring of nan lungs from asbestos exposure.

Her begetter worked astatine a now-closed excavation that supplied astir of nan world's vermiculite, a mineral pinch a wide assortment of uses successful insulation, fireproofing, and moreover gardening.

The excavation closed successful 1990, and successful 1999, a Seattle Post-Intelligencer investigation publically revealed nan relationship betwixt nan asbestos-contaminated mineral and nan expanding number of sick Libby residents.

Benefield remembered nan achromatic particulate that covered her father's apparel erstwhile he sewage location from work, and she learned later that nan full family had been exposed to asbestos, a mini fibre that lodges successful nan lining of nan lungs.

"Eventually, that scarring will afloat situation your lungs," Benefield said, "and slow strangle you."

The Environmental Protection Agency declared parts of Libby a Superfund site successful 2002.

Seven years later, nan agency declared a nationalist wellness emergency for nan municipality — a first successful U.S. history.

A study recovered that 694 Libby residents had died of an asbestos-related origin from 1979 to 2011. Additionally, wellness providers successful nan municipality of 3,200 estimate that 1 successful 10 residents person an asbestos-related illness.

That estimate is from the Center for Asbestos Related Disease, aliases CARD, a 501 (c)(3) nonprofit session that has provided free lung screenings for locals.

The clinic, which operates chiefly done U.S. authorities funding, has screened much than 8,900 people. Because asbestos-related illness symptoms tin return 30 years aliases longer to appear, astir a 3rd of nan clinic's screenings are for caller patients, according to a 2024 CARD report.

But now, Libby residents tin nary longer get that attraction because a judgement successful a suit brought by BNSF Railway closed nan CARD session successful May.

Gayla Benefield sits astatine her room array successful her location conscionable extracurricular of Libby, MT. Benefield struggles to respire because her lungs were scarred by asbestos. Benefield helped commencement nan Center for Asbestos Related Disease, aliases CARD Clinic, to thief group get diagnosed. She said erstwhile generations for illustration her parents died without knowing what was sidesplitting them.
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Aaron Bolton/Montana Public Radio

BNSF utilized a whistleblower rule to writer nan session connected behalf of nan national government. The railroad institution is seizing nan clinic's spot successful an effort to cod astir $2.9 million, its information of nan tribunal judgement and lawyer fees.

Clinic leaders are fighting nan tribunal bid and person vowed to reopen its doors, but nan suit isn't nan only threat to nan clinic's survival.

That's because nan national assistance that provides 80% of nan clinic's operating gross is connected a database of cuts nan Trump management is considering.

If nan $3 cardinal assistance is cut, nan session would apt adjacent for good, CARD executive head Tracy McNew said.

The assistance was stiff past unfrozen, aft nan Office of Management and Budget issued past rescinded a memo freezing grants having to do pinch nongovernmental organizations, programs focused connected diversity, equity and inclusion, and different issues.

But White House officials person said they will proceed reviewing those grants for imaginable cuts, leaving McNew uncertain of nan grant's position moreover arsenic session officials — and Department of Justice attorneys — conflict successful tribunal to retrieve nan CARD assets seized successful nan BNSF lawsuit.

The Office of Management and Budget, nan White House, and nan Department of Health and Human Services did not respond to NPR and KFF Health News' petition for remark connected nan position of nan clinic's grant.

Cutting nan assistance mightiness not beryllium easy, said Tim Bechtold, an lawyer who represented nan session successful nan BNSF case.

The Affordable Care Act gave Libby asbestos patients entree to Medicare and called connected nan national authorities to connection grants to money diagnostic services for them.

The CARD Clinic successful Libby closed aft a suit brought by BNSF Railway connected behalf of nan national government. After nan tribunal issued a astir $6 cardinal judgement, nan railway seized nan CARD clinic's spot to cod a information of nan judgement arsenic a whistleblower. The session is now fighting that move successful national court. hide caption

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In 2020, the Montana Supreme Court ruled that BNSF could beryllium held liable for spreading asbestos on its tracks erstwhile nan railroad shipped shipped vermiculite mined successful Libby crossed nan country.

The twelvemonth before, nan railroad sued nether nan False Claims Act, arguing that CARD defrauded nan authorities by erroneously diagnosing patients and helping them use for Medicare benefits.

The rule allows backstage parties to return connected fraud cases connected behalf of nan national authorities if national prosecutors diminution to return nan case. Money awarded successful those cases goes backmost to nan national government, but backstage parties support a information of nan winnings.

A jury sided pinch BNSF's claims that CARD falsified nan records of much than 300 patients who received national benefits.

CARD officials said those patients did not person a test of asbestos-related disease, but nan session wished them eligible for Medicare nether nan ACA based connected abnormal radiology readings.

In a connection to NPR and KFF Health News, BNSF denied nan suit was an effort to debar ineligible liability for asbestos contamination on its tracks.

In 2023, nan session revenge for bankruptcy, citing nan BNSF lawsuit. In May, BNSF persuaded a region tribunal to let nan institution to seize astir each of CARD's spot to cod its stock of nan astir $6 cardinal tribunal judgment. It took power of astir everything, from nan clinic's building to its section mower.

The national authorities is coming to CARD's defense. In a tribunal filing, nan agency of nan U.S. Attorney for Montana, Kurt Alme, said that because CARD spot was mostly purchased pinch national assistance funding, BNSF cannot prehend it.

The lawsuit has moved to national tribunal and nan judge is expected to norm connected whether BNSF tin prehend CARD assets to cod its information of nan judgment.

In nan meantime, CARD patients will person to look elsewhere for screening and treatment, services that could beryllium difficult to find.

Diagnosing diseases linked to asbestos

Diagnosing group pinch asbestos-related illness aliases showing that different conditions are tied to asbestos vulnerability requires expertise, said Robert Kratzke, an oncologist astatine nan University of Minnesota who studies cancers tied to asbestos.

"Most physicians would beryllium modestly clueless astir what to look for," he said.

Kratzke explained X-rays aliases CT scans request to beryllium done successful a circumstantial measurement and publication by specialized doctors, known as B readers, to diagnose patients.

Kratzke said rebuilding nan expertise of nan CARD session would beryllium difficult successful a mini municipality for illustration Libby.

"It would beryllium very, very difficult for nan physicians and hospitals successful Libby to travel these group arsenic they would request to beryllium followed for nan remainder of their lives," Kratzke said.

Jenan Swenson is nan only 1 of Gayla Benefield's 5 children who hasn't yet been diagnosed pinch an asbestos-related disease.

She received nan results of her past screening astatine nan CARD session nan time earlier it closed successful May. For now, nan 62-year-old is successful nan clear.

Swenson expects to yet create breathing problems from her asbestos vulnerability arsenic a child. Her mom, for whom she is simply a caregiver, besides needs ongoing screenings for lung cancer.

She worries they'll person to recreation retired of authorities to find that attraction if nan CARD session doesn't reopen, which Swenson said they can't afford.

She doesn't deliberation her family will beryllium nan only 1 incapable to entree care  elsewhere.

"There's going to astir apt beryllium a batch of group conscionable mislaid retired location pinch nary spot to go," Swenson said.

This article comes from NPR's reporting business with Montana Public Radio and KFF Health News.