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Alluvion Health

Implementation of an Innovative Alternative Payment Model for Direct Primary Care

Project Term: 12 months; 2019-2020
Grant Amount: $32,750

Alluvion Health will increase access to primary care, behavioral health, and dental care with a focus on preventive services, by collaborating with organizations who do not have the ability to offer health insurance benefits to their employees. This project will improve access to high quality health care with a simple, flat, affordable fee. Patients will have access to Alluvion Health providers with the ability to be referred to sliding fee specialty care. Funding will be used to support the program manager for project development and operation and legal fees to review and advise on employee contracts. Through this project, Alluvion Health will work to develop and foster strong partnerships with the local business community and will work with other organizations across the state who have implemented similar programs and can help provide technical assistance. The project’s goal is to design a program that creates access for patients currently in this unique health care gap, supports employers’ interests in caring for their employees’ health, and ensures a long-term viable solution for improving the overall health of the community.

Arlee Community Development Corporation

The Community Dining Project

Project Term: 24 months; 2018-2020
Grant Amount: $51,090

This project will develop a community dining program in Arlee, Montana. The model is based on a national program developed by Harvard University, that involves strengthening families, improving kinship support, and addressing healthy eating and nutrition. The project builds on current programming by the Arlee Community Development Corporation which includes hosting community dinners with youth tracks for 26 families; providing nutrition education, meal planning, and cooking classes; and developing garden boxes and a community farmers market. The project’s goal is to conduct community dinners that incorporate youth and adult cooking classes, include traditional native foods in meal planning, and facilitate dinner conversation and games. Partnerships include the Arlee School District who will be providing kitchen space, Hopa Mountain who will help train staff in developing community engagement techniques, and CSKT Tribal Health.

Barrett Hospital Foundation

Southwestern Montana Rural Accountable Care

Project Term: 24 months; Ended 2017
Grant Amount: $50,000

This goal of this project was to support Barrett Hospital’s participation in Montana’s first Rural Accountable Care Organization (RACO). The RACO consists of 12 critical access hospitals in Montana, Idaho, and Wyoming that collectively serve more than 9,000 Medicare patients. Barret Hospital’s project developed an evaluation and measurement process for key health outcomes and implemented case management and patient discharge care plans. Highlights include: more than 63 percent of Medicare patients received annual wellness visits (the Centers for Medicare and Medicaid’s goal is 50 percent); a multidisciplinary team was developed to do a monthly review of all patients (reducing the cost of sub-acute care by 15 percent over 6 months); several reports were designed and implemented, giving providers the ability to focus on and follow up with chronic disease patients. The hospital plans to continue working with the RACO workgroup and a consultant and will sustain this project through internal funds. 

 

Beaverhead County Public Health

Integrating Behavioral and Physical Health in Rural Southwest Montana

Project Term: 18 months; Ended 2017
Grant Amount: $22,100

For this project, Beaverhead County’s local advisory council on mental health oversaw a community-wide coalition which leads work plan development and implementation of integrated behavioral health in their county. Other coalition accomplishments include: establishing criminal justice, crisis response, ACE (project materials: ACE Task Force Mission and GoalsACE Task Force Pamphlet), universal screening, and mental health task forces; implementing universal screenings for depression at the University of Montana-Western Student Health Center; and successfully hosting a two-day behavioral health summit which was facilitated by the National Council for Behavioral Health and will continue as an annual event. 

Behavioral Health Alliance of Montana

Advocacy for Behavioral Health Prevention, Treatment, and Recovery

Project Term: 36 months; 2017-2020
Grant Amount: $150,000

The Behavioral Health Alliance of Montana (BHAM) is a newly formed consortium of substance use and mental health providers serving adults and children statewide. BHAM is the culmination of two years of intensive discussions led and facilitated by MHCF. The purpose of BHAM is to strengthen the behavioral health prevention and treatment system in Montana by coordinating the efforts of providers, and effectively guiding state policy, implementing new initiatives, and promoting and supporting the adoption of best practices. Grant funds will be used to build the organizations operational and programmatic base with the initial focus on strategic planning; the grant will also allow BHAM to broaden outreach efforts, cultivate membership, and secure ongoing financial, leadership and management resources.

Benefis Health System Foundation

Integrated Behavioral Health for Primary Care in Great Falls and North Central Montana

Project Term: 12 months; Ended 2017
Grant Amount: $35,000

This project’s initial goal was for the Benefis Medical Group to plan for the integration of behavioral health into their primary care practice and support the broader implementation of integrated behavioral health by regional partners in Cascade County and north-central Montana. However, the project experienced unexpected challenges which led to an adjustment in scope. Despite challenges, the project did succeed in implementing a pilot program with a provider in a primary care clinic to screen individuals for depression. More than 150 individuals were screened, 40 of whom reported high depression scores. Through this pilot project, Benefis was able to fine-tune an algorithm for identifying individuals with depression and/or suicidal ideation, develop plans for the ongoing integration of behavioral health in clinic operations, and identify ways to improve and consolidate their electronic health records system and incorporate behavioral health modules into primary care clinic workflows.

 

Benefis Health System Foundation

Addressing Perinatal Substance Use Disorders in Cascade County and Montana Northern Tribes

Grant Term: 24 months; 2018-2020
Grant Amount: $150,000

Benefis Hospital, together with community agencies, will work to reduce the adverse outcomes of perinatal drug and alcohol use for newborns and their families through supportive, team-based care and better coordination between health care providers and social service agencies. Benefis will implement SBIRT (screening, brief intervention, and referral to care) as a routine part of perinatal care and develop a system of care coordination for pregnant women who are identified through routine screening. The hospital will invite and engage outside providers to implement a similar model of team-based care throughout the community, and partnerships with outside social service agencies and neighboring tribes will be established throughout the course of the project. Grants funding will be used to support the project coordinator position.

Bighorn Valley Health Center

School-Based Health Center at St. Labre Indian School

Project Term: 24 months; Ended 2017
Grant Amount: $100,000

For this project, Bighorn Valley Health Center (BVHC) partnered with St. Labre Indian School to start a school-based health center for students, their families, and school staff members. Using a modular building provided by the school, BVHC configured the space to support the provision of medical, dental, and behavioral health services. In 2017, the clinic had over 1,300 visits and more than 70 percent of patients were screened for depression. Patients with positive depression screening results were referred to the care of a behavioral health provider who ensured that they received appropriate support – either directly or through a referral with a partner organization. In addition, this project developed a learning collaborative (consisting of BVHC behavioral health staff and select counselors and coordinators from St. Labre) to better support the school’s staff in their work to foster a trauma-informed approach to school discipline and culture. In the second year of the grant, the collaborative expanded to include staff from the Pretty Eagle School Campus in St. Xavier. While MHCF funding was utilized for the design and implementation of this project, a financial analysis indicates that the project will be entirely self-sustaining at the conclusion of the grant.

For more information about this grant and the partnership between BVHC and St. Labre, read our case study.

Bighorn Valley Health Center

Integrated Health Care Delivery through a Hub and Spoke Model

Project Term: 24 months; 2017-2019
Grant Amount: $150,000

This project will expand substance use disorder care with medication-assisted treatment to two towns in Southeastern Montana, and build curriculum to pilot a certification-granting program to train behavioral health care managers. Grant funds will be used to hire two behavioral health care managers for new sites in Ashland and Miles City, and a social worker who will work on curriculum development with the Chief Dull Knife College in Lame Deer.

Bighorn Valley Health Center

Feasibility Study for Itchik Diiawakaam Family Healing Center

Project Term: 12 months; 2018-2019
Grant Amount: $49,350

This project will support a feasibility study for establishing the Itchik Diiawakaam Family Healing Center within the Apsaalooke Nation. This center aims to provide a program and facility that allows individuals and families to heal together in their community while immersed in Crow cultural values and support. The center’s focus on relational justice, foster care alternatives, integrative approaches to mental and physical health, meaningful work, trauma resolution, and indigenous models of education will serve as a blueprint for the exploration process. The center will be piloted in Lodge Grass on the Crow Indian Reservation, and residents will be engaged in all facets of program creation and implementation. This grant will fund staff time to complete the feasibility study. Project partners include Lodge Grass City Government leadership and tribal community members.

Bighorn Valley Health Center

Establishing A Structured Framework to Improve Sustained Health and Well-Being

Project Term: 12 months; 2018-2019
Grant Amount: $25,000

Embedding Lean Six Sigma as an evidence-based quality performance improvement methodology will allow Bighorn Valley Health Center (BVHC) to make progress toward enhancing a systems approach toward value-based health care services. BVHC is expanding to increase access and services, merging with existing clinic sites to share expertise and resources, and extending outreach to develop community partnerships. In order to optimize clinical workflow, patient experience, and outcomes, the health center will engage various resources and expertise to train our teams to apply and practice Lean Six Sigma tools, to ensure projects and workflows are well defined, measured, analyzed, improved, and controlled. Grant funding will support the initial cost to integrate the Lean Six Sigma framework across the organization.

Billings Clinic

American Indian Health Care Advocate Program

Grant Amount: $46,829
Project Term: 12 months; Ended 2017

This project provided outreach, information, and health insurance enrollment assistance to American Indian people residing on the Crow and Northern Cheyenne Reservations and the urban American Indian population residing in Billings. Through the American Indian Healthcare Advocate Program, outreach events, presentations, and informational materials were distributed to over 700 individuals with questions about Montana’s Medicaid expansion and how obtaining health insurance could increase their access to quality health care. Twenty-six people were directly enrolled in a health insurance product for which they were eligible but not yet enrolled and 177 people were assisted in the enrollment process. Additionally, a qualitative research project was initiated to gain insight into American Indian perceptions of health insurance and health care.

Billings Clinic

Transforming Primary Care to Meet the Needs of Alzheimer’s Patients and Caregivers

Project Term: 24 months; Ended 2019
Grant Amount: $150,000

This project developed and implemented a clinical care pathway to screen for and improve outcomes among Alzheimer’s patients at Billings Clinic and two rural healthcare facilities: Glendive Medical Center and Lewistown’s Central Montana Medical Center. As part of the project, patients over the age of 65 were screened appropriately for Alzheimer’s dementia and related dementias (ADRD) and that those diagnosed with ADRD and their caregivers received high-quality care and support. A detailed clinical care pathway and set of tools that address clinical care, support services, operations, and billing issues, with the goal of transforming and standardizing dementia care were also put into place. The project produced a robust framework, and the sites will continue to work on implementing the clinical pathways and will collect data and outcome measures over the next 12 to 24 months. Billings Clinic is interested in sharing the success of this project and their specific approach with other clinics across the state.

Billings Clinic

Establishing a Montana Psychiatric Residency Training Track

Project Term: 24 months; Ended 2017
Grant Amount: $50,000

The goal of this planning grant was to create a blueprint for the establishment of a psychiatric residency training track at Billings Clinic. The University of Washington agreed to be the academic partner in the residency program’s design and launch. As part of the planning process, the project disseminated a survey that estimated costs of Montana’s psychiatry shortage at $3 million annually, which helped reinforce the need for psychiatric residency in the state. The project resulted in the Montana State Legislature allocating an increase of $400,000 annually to graduate medical education funding in the Office of the Commission of Higher Education’s budget. These funds will be crucial for the implementation of the psychiatric residency training track, will ensure the stability of Montana’s primary care and psychiatric physician workforce, and will enhance residency training overall in the state. With the inclusion of federal match dollars, this MHCF investment resulted in an increase of approximately $4.3 million annually for Montana’s residencies.

 

Billings Clinic

Integrated Behavioral Health Expansion

Project Term: 24 months; 2017-2019
Grant Amount: $150,000

The goal of this project is to build on an existing integrated behavioral health (IBH) pilot program and expand it to all of Billings Clinic’s primary care locations. In order to do this, the project will create an efficient and accessible patient registry to allow tracking and management of each patient’s clinical diagnoses, develop protocols for analysis of registry data, hire a program coordinator and mental health assistant for program support across multiple primary care practices, and create a scalable IBH model. The existing IBH pilot program follows primary care patients of four physicians at Billings Clinic West. This new project will allow for growth to other Billings Clinic family practices over the next two years, ultimately reaching patients of more than 20 primary care providers.

Billings Clinic

Regional Integrated Behavioral Health Expansion Program

Project Term: 24 months; 2018-2020
Grant Amount: $262,739

For this project, Billings Clinic will serve as a hub to support implementing integrated behavioral health in 10 affiliate hospitals. The grant will allow Billings Clinic to hire a project coordinator to oversee all implementation activities including universal screenings for depression and substance use disorders, expansion of the patient registry, care coordination, psychiatric consultation, and strengthening affiliate network training and support in rural sites. Additionally, Billings Clinic will utilize the tele-medicine network to link behavioral health clinicians to the affiliate sites. Expected outcomes include universal screening for behavioral health conditions in primary care, improvement in depression and substance use outcomes, decreased emergency room visits, improved support for treating behavioral health conditions for primary care teams, and enhanced coordination and collaboration between Billings Clinic affiliate facilities. Billings Clinic will also work with the regional mental health centers and Rimrock to develop business agreements to support specialty consultation for affiliate sites.  

Blackfeet Community College

Trauma Informed Planning Grant

Project Term: 18 months; 2017-2018
Grant Amount: $75,000

This two-part project will begin to create a trauma-informed campus on the Blackfeet Community College and disseminate a culturally-based, trauma-informed toolkit to other agencies on the reservation, and develop a feasibility and business plan for an integrated behavioral health student health center on campus. To create a trauma-informed campus, this project will train trainers in a culturally-based historical trauma curriculum, provide professional development in integrated care models, strengthen campus and community referral resources, create an action team, and provide support to students. The National Council for Behavioral Health will assist in creating a detailed strategic plan for implementing integrated behavioral health into the student health center. The goals for the student health center are for it to not only provide students with primary and behavioral healthcare screenings but also with space for behavioral health and nursing students to practice trauma-informed integrated health.

Blackfeet Tribal Health

School and Community-Based Health Services for Blackfeet Youth

Project Term: 24 months; Ended 2017
Grant Amount: $20,000

This grant allowed Blackfeet Tribal Health to plan for and establish a school-based clinic to serve students in Browning. During the grant, the tribe formed a successful collaboration with the school district, secured and renovated a building to house the clinic, and hired staff. In the fall of 2016, the new clinic (named the Southern Piegan School Health and Wellness Program) began seeing students. As of late 2017, the clinic had provided care to more than 1,500 students and was preparing to implement a new integrated behavioral health program. The clinic is fully self-sustaining through revenue from insurance billing and will not require grant support to maintain operations.

Blackfeet Tribal Health

Blackfeet Emergency Medical Services Program

Project Term: 24 months; 2017-2019
Grant Amount: $75,136

This project will train and certify six paramedics from Blackfeet Tribal Health’s current emergency medical technician staff. A consultant will provide classroom and skills training, and paramedic students will have the opportunity to do ride-alongs and work in the emergency departments of partner organizations. Trained paramedic staff will allow the tribe to address workforce challenges and provide much needed services for the community.

 

Blackfeet Tribal Health

Tribal Health Improvement Program

Project Term: 12 months; Ended 2019
Grant Amount: $42,000

This project provided funding for a project coordinator position to help design and implement the Blackfeet Tribal Health’s Tribal Health Improvement Program (T-HIP). T-HIP is Montana’s innovative new Medicaid waiver program that provides per capita funding for tribes to address factors that contribute to health disparities in the American Indian population residing on the reservation. Our grant funded the project coordinator position for six months and allowed the tribe to develop and execute a task order with the State of Montana to begin implementing Tier 1 of the T-HIP program. Tier 1 of the T-HIP program addresses high utilizers of health care on the Blackfeet reservation and provides care coordination and outreach to this population. The tribe is now providing care management, health education and transportation to the Blackfeet community, and the program is entirely self-sustaining; they are now planning for Tier 2 of the T-HIP program.

Blackfeet Tribal Health

T-HIP Tier 1 Daphne Software Support

Project Term: 12 months; 2018-2019
Grant Amount: $12,000

Daphne is computer software for recording and reporting care management information for the Montana Tribal Health Improvement Program and other care management initiatives. Daphne will provide Blackfeet T-HIP with electronic access to the software hosted and maintained by Daphne. Daphne makes the software available 24 hours a day, 7 days a week. Blackfeet T-HIP will upload data from the state’s Medicaid data system when required. This system will allow Blackfeet tribal health to track and report on T-HIP implementation as required by the state.

Blackfeet Tribal Health

The Perinatal Behavioral Health Project

Project Term: 24 months; 2019-2021
Grant Amount: $150,000

Blackfeet Tribal Health will partner with the Indian Health Service (IHS) Blackfeet Community Hospital to create a community-wide system of care to address substance use and mental illness for pregnant women and their families. Addressing perinatal substance use is a top community health priority for Blackfeet with a high fraction of babies born screening positive for substances. Grant funds will be used to hire a care coordinator and behavioral health specialist to work with the Blackfeet IHS OB Department and the Blackfeet Medication-Assistant Treatment Program to serve all perinatal patients. This project will bring together many of the tribal social service agencies together to collaborate and ensure services are provided to address social issues the families are facing.

Blackfeet Tribe

Centralized Third-Party Billing System

Project Term: 24 months; 2016-2018
Grant Amount: $100,000

This project will strengthen the Blackfeet tribal health system by creating a centralized third-party billing office. A centralized billing office will allow the tribe to maximize revenue from health services they currently provide and improve financial management of revenue from third-party billing. Funding will be used to create two staff positions: a benefits coordinator and a patient accounts coordinator. The new staff will identify risks and existing problems, and provide solutions for the billing and collection process, enroll uninsured tribal members in Medicaid or Affordable Care Act exchange insurance plans, and provide in-house training to tribal health program directors and staff. Once implemented, the centralized billing office with help the tribe improve and expand health services to better serve the needs of their community, and create a more fiscally stable and sustainable structure for existing health programs.

Blackfeet Tribe

Blackfeet Partnership for Food Sovereignty Strategic Plan

Project Tem: 12 months; 2018-2019
Grant Amount: $50,000

For this project, Blackfeet planners, in partnership with community-level organizations and the MSU Native Land Project, will engage in a facilitated strategic planning process to design a comprehensive food sovereignty strategic plan and begin implementation. The overarching goal of the project is to end food insecurity and the many of the problems implicit in disconnecting from traditional food sources. Objectives include coordination of food production and delivery systems on the Blackfeet Indian Reservation, the creation of a Blackfeet food code, and development of measurements tools to track potential health changes due to interventions in the food and health system. Funding will be used for a project manager and consultant to assist with the strategic planning process. Key partnerships include the Blackfeet Tribe, community partners, and the MSU Native Land Project.

Boys and Girls Club of Lewiston

Central Montana Mental Health Alliance

Grant Term: 12 months; 2018-2019
Grant Amount: $15,000

This project will help the Boys and Girls Club work towards providing behavioral health services to youth and their families in Lewistown and the surrounding rural communities. In partnership with Central Montana Head Start and the Lewistown School District #1, this project will either hire or contract with a mental health provider to provide services at each facility. Grant funding will support staff time and a consultant who will design an optimal service model and develop plans for funding and implementation.

Boys and Girls Clubs of Yellowstone County

Joint-Service Behavioral Health Model Pilot for the Lockwood Clubhouse

Project Term: 12 months; 2018-2019
Grant Amount: $50,000

The Boys and Girls Clubs of Yellowstone County will partner with Billings-based organizations, Yellowstone Boys and Girls Ranch and Tumbleweed, to provide behavioral health services to the youth who participate in the Boys and Girls Club activities in Lockwood. While this is planning a grant, services for the youth will begin to be provided and sustainability will be determined through planning and evaluation of billing for services provided. The intent of the project is to provide long-term behavioral health services to youth living in Lockwood, a community with few behavioral health services. Grant funds will be used to cover start-up salary costs for program staff while billing for services is being established. Key partnerships include the Boys and Girls Clubs of Yellowstone County, the Yellowstone Boys and Girls Ranch, and Tumbleweed.

Bozeman Health Foundation

Integrating Behavioral Health into an Internal Medicine Team

Project Term: 12 months; Ended 2017
Grant Amount: $32,700

The goal of this project was to develop a plan to integrate behavioral health care into a Bozeman Health internal medicine team. The project resulted in the hiring of a psychiatrist who worked with the internal medicine team and a women’s specialist to establish the integrated behavioral health (IBH) program. The National Council for Behavioral Health met with providers and staff to provide guidance on implementing IBH workflows, policies, procedures, and protocols. Bozeman Health integrated IBH into one “pod” of providers and then expanded to the rest of the group once workflows were ironed out. The staggered roll-out allowed refinement and improvement of processes prior to full implementation. Because of this thorough planning process, Bozeman Health positioned themselves to fully implement IBH throughout their primary care and pediatric practices.

Bozeman Health Foundation

Behavioral Health Symposium, Work Groups, and Summit

Project Term: 12 months; Ended 2018
Grant Amount: $25,000

For this project, Bozeman Health partnered with leaders from the Gallatin City-County Health Department, the mental health Local Advisory Committee, Gallatin Mental Health Center, United Way of Gallatin County, and MSU’s Student Health Services to host a behavioral health planning symposium in the fall of 2017, working groups through the winter, and a behavioral health summit in the spring of 2018. The project’s goal was to bring together community partners to re-imagine a behavioral health vision and develop a behavioral health strategy for Bozeman Health. Elevating Behavioral Health (EBH) successfully brought a broad cross-section of community leaders together to understand challenges, identify early and long-term solutions and to form new and strengthened partnerships focused on a common behavioral health vision. The EBH steering committee continues to meet, to advance early solutions, and to rally collaborative efforts toward a now agreed upon set of key community outcomes in improving behavioral health. The effort also enabled Bozeman Health to identify how and where it can best support behavioral health throughout its service region. This new clarity informed a Bozeman Health board endorsed Behavioral Health Care System plan and a budget that passed in November 2018.

Bozeman Health Foundation

Integrated Behavioral Health Implementation

Grant Term: 24 months; 2018-2020
Grant Amount: $150,000

This project will build upon the work of a planning grant to fully implement integrated behavior health throughout Bozeman Health’s primary care system. Bozeman Health will also continue integrating its OB/GYN and pediatrics practices through psychiatric consultation, shared learning, and training by the National Council for Behavioral Health. Grant funding will be used to cover the initial costs of employing licensed clinical social workers in the respective practices.

Bozeman Health Foundation

The Perinatal Substance Abuse in Southwest Montana Project

Project Term: 24 months; 2019-2021
Grant Amount: $110,000

This project will allow Bozeman Health to develop and implement an effective model of care for OB/GYN patients who have behavioral health needs. Through this project, Bozeman Health will integrate behavioral health provides into their current care teams and expand the model of team-based care to partners in the community. Grant funds will be used to add additional behavioral health providers, who will be available for warm hand-offs and same day visits, into existing care teams who care for pregnant women. Partners include Gallatin County Health Department and Roots Family Cooperative who will assist in addressing social needs of women and families. The project’s overall goal is to improve timely access to effective evidenced based care to help serve women and families that are affected by drug and alcohol use or mental health issues during the most crucial time of development. 

Browning Alternative School

Using Blackfeet Cultural Values to Create a Trauma-Informed School Setting

Project Term: 18 months; Ended 2017
Grant Amount: $15,000

The goal of this project was to create a trauma-informed school program by training staff in trauma-informed approaches to school discipline using Blackfeet cultural values. The Browning Alternative School developed trauma-informed teams and implemented culturally-adapted critical incident stress management training so that the community could respond sustainably to crisis situations. Teams were equipped to quickly respond to crises and provide support for trauma and grief. The project also implemented restorative justice practices into the school system to elevate student voices and developed training units for cultural and historical trauma with accompanying resiliency strategies and resources. The trauma-informed program began in the Browning Alternative School and then extended to the entire school district.

Cabinet Peaks Medical Center Foundation

Enhanced Transition of Care for Residents of Lincoln County

Project Term: 12 months; Ended 2018
Grant Amount: $44,236

This project sought to develop a new approach to discharge planning for hospitalized patients that systematically identified and addressed the social factors that influence health outcomes (such as the ability to afford home heating, food, housing, and medications). The project’s overall goal was to reduce re-admissions related to socioeconomic barriers to health, increase the acuity of patients seen in the emergency departments, and encourage better utilization of local clinics for outpatient care. A discharge planning tool was successfully developed, and staff hired to work with patients during the admission process to determine after discharge needs. During this project, Cabinet Peaks Medical Center experienced a 23% decrease on average in re-admissions. Strong community partnerships were also developed which will help address the ongoing health and social needs within the community.

Cabinet Peaks Medical Center Foundation

Lincoln County Community Care Coordination

Project Term: 24 months; 2018-2020
Grant Amount: $100,000

This project will focus on patients and families who are emergency department high utilizers by developing a care team that includes primary care, substance abuse counseling, a county jail diversion team, and socioeconomic resources. Currently, the Lincoln County health system consists of four clinics that each have separate records and processes. This project will explore health care communication tools that will allow the clinics to exchange information among themselves and with social resources. Outcomes include enhanced communication and collaboration between the clinics and other resources, expanded care coordination with the ability to provide warm patient handoffs through patient care teams, improved population health, decreased readmissions, appropriate emergency department utilization, and lower health care costs.

Cascade County Community Care Center

Integrated Behavioral Health Program Development Project

Project Term: 12 months; Ended 2017
Grant Amount: $35,000

The goal of this project was to strengthen the existing integration of primary care and behavioral health services within the Cascade County Community Care Center. To achieve this goal, the health center hired a psychiatric nurse practitioner to join their team of medical providers, licensed clinical social workers, and care managers to help move their program from partial to full behavioral health integration. The National Council for Behavioral Health provided technical assistance, training, and learning communities for this project. Key project outcomes included: strengthening the continuum of care with Benefis Hospital by ensuring that patients discharged from the hospital’s behavioral health unit would receive appropriate and timely care from the health center’s behavioral health team; adjusting behavioral health therapist schedules to ensure availability for “warm handoffs” and consults with primary care providers; coordinating with a dedicated biller/coder to ensure sustainable third-party billing and collections. Through this grant, the health center determined that the addition of the psychiatric nurse practitioner provided a more comprehensive model of care for the center and that the position would be sustainable moving forward through third-party billing. 

Cascade County Community Health Center

Health Wealth Service Partnership Pilot Program

Project Term: 12 months; Ended 2019
Grant Amount: $50,000

This pilot program assessed, tracked, and analyzed the link between mental, physical, and financial health by working to establish a financial planning service for Cascade County Community Health Center clients with large receivables balances. The project made progress with the branding and establishing a workplan for their approach and began to engage patients with financial coaching. There was a delay in the project when the financial consulting partner, Rural Dynamics, was sold to a national firm. However, they did find a new partner: MOFI, a regional community development corporation that has a financial literacy component. As part of the project, four case managers were trained and began working with patients, they are also working with a bank system to establish short-term credit instrument for patients who are participating in the program. The goal of this project was to develop a health care model that included financial health and could definitively prove the impact of financial instability on physical and mental health. While this ambitious goal was not fully realized during the grant, the health center is committed to continuing the project and to tracking its outcomes.

Center for Restorative Youth Justice

Reducing School-Based Arrests for Youth with Behavioral Health Needs

Project Term: 24 months; Ended 2019
Grant Amount: $60,000

In partnership with Kalispell Public Schools, the Center for Restorative Youth Justice (CRYJ) worked to develop and implement an alternative model for out of school suspensions based on a trauma-informed and restorative approach. The approach focuses on constructive, supportive ways to addressing discipline, with the goal of limiting the transfer and over-representation of youth with school-based non-violent offenses and behavioral health needs in the juvenile justice system. The data reported that 32 youth were referred to the program resulting in 160 less days of off-campus suspension, increased school engagement and less recidivism suggests that this approach to addressing school discipline improves student outcomes and creates opportunities for increased connection for students who are at-risk of entering the juvenile justice system. The project successfully launched an alternative to off-campus suspension and justice system referrals and engaged in long-term planning and technical support for the school board and committees. This project was pivotal in creating a foundation for future development and revisions to disciplinary guidelines across the Kalispell Public School District. The school district has committed their own funds to training teachers and administrators in the use of restorative justice and restorative practices as alternatives to sanctions-based discipline before the upcoming school year and have committed to a full revision of disciplinary guidelines.

Center Pole

Oosha Itchik/Healthy Food System

Project Term: 24 months; Ended 2018
Grant Amount: $50,000

Through this grant, Center Pole successfully created a model for community-based food sovereignty and a traditional and healthy foods hub. They trained youth through community internships in food sovereignty, exposed hundreds of community members to growing and eating natural foods, completed a community food assessment survey, and used the survey findings to further development of the healthy foods hub. Center Pole was chosen as one of eight “changemaker” organizations in the Pacific Northwest by Philanthropy Northwest, and Center Pole’s Executive Director Peggy Wellknown Buffalo received an award for long-term excellence working in Indian Country from the Seventh Generation Fund for Indigenous Peoples.

Center Pole

Using All Parts of the Buffalo: Better Reservation Health through Food Rescue and Recovery

Project Term: 24 months; 2019-2021
Grant Amount: $100,000

Center Pole will collect fresh foods from Billings that are near expiration and distribute them to the Crow and Northern Cheyenne reservations. This collection and distribution will be done through a system created and implemented by the Center Pole’s community food interns. Funding will be used to pay the food interns and for transportation costs and storage as well as for Center Pole’s traditional food production. Partners for this project include Crow Abundance is Here, a local community collaboration whose member organizations include the National Center for Appropriate Technology, Plenty Doors, Messengers for Health, Crow Tribal Health, Little Big Horn College, the USDA, AmeriCorps, and Food Corps Montana. Other partners include the Crow and Northern Cheyenne elders and Billings Family Service. The goal of this project is to assist the Crow and Northern Cheyenne in healing themselves through food and creating a healthy sustainable food economy that is culturally relevant, reflects traditional values of reciprocity, self-sufficiency, team work, sharing, and zero waste and leads to better health and longer lives.

Child Bridge

Finding A Way Home Project

Project Term: 18 months; Ended 2019
Grant Amount: $75,000

Through this project, Child Bridge worked to improve placement outcomes for children who have experienced trauma and require well-equipped families for permanency placements. Through education and mentoring, Child Bridge educated families on types of common behaviors and helped them build support networks. Mentoring and support was provided to families throughout placement and adoption. Child Bridge was able to establish permanency arrangements for 16 children, many of whom had spent months or years in state custody and experienced multiple foster care and group home placements. While measuring the exact cost savings the project achieved for the state is difficult, a conservative estimate suggested that this project saved the state more than $500,000 for each child placed. Child Bridge will continue to work with the Montana Department of Public Health and Human Services Department of Child and Family Services and have become a resource for social workers who are trying to identify families for child placement. While Child Bridge has not secured permanent funding for the services they provide, through this project they were able to establish cost saving estimates that provide a basis for negotiations with the state.

City of Missoula: Office of Housing and Community Development

Missoula Supportive Housing Collaborative

Project Term: 12 months; 2018-2019
Grant Amount: $60,000

For this project, the Missoula Supportive Housing Collaborative with the guidance of the Corporation for Supportive Housing will develop a plan that uses data integration and hospital analysis along with community resources and program coordination to drive investments in supportive housing. Supportive housing will be designed to serve the population that is most likely to be homeless or near homeless, and who face health obstacles including mental illness and substance use disorders. The project’s goal is to give community service providers guidance in identifying cost-effective ways to improve outcomes for vulnerable people by providing supportive services and secure housing.

Clark Fork Valley Hospital

Sanders County Behavioral and Medical Health Delivery Integration

Project Term: 12 months; Ended 2019
Grant Amount: $50,000

This enhancement grant worked to develop a sustainable integrated behavioral health model at Clark Fork Valley Hospital (CFVH). CFVH had been providing co-located behavioral health services for several years, however, prior to this project, they did not have a clinically or financially viable model. Over the course of the grant, CFVH developed universal screening for patients and made a commitment to start substance use disorder and anxiety screening in the summer of 2019, with two providers obtaining their waivers for medication assisted treatment. Through this project, CFHV revamped their workflows, care pathways, and billing and coding for integrated care. CFHV successfully doubled the number of behavioral health visits as part of the redesign and were able to develop a financially sustainable model. CFVH has also taken the first steps to formalize care coordination as part of its integrated behavioral health model. CFHV will pursue additional steps to solidify care coordination, population health, and substance use disorder services in the coming year.

Community Health Partners

Park County Connect Program: A Community-Based Model to Reduce ER High-Utilization

Project Term: 24 months; Ended 2018
Grant Amount: $93,000

High utilizers of the emergency department drive up costs unnecessarily and are not entering the healthcare system at an access point that is prepared to address their underlying needs. To improve care and health outcomes while lowering unnecessary costs to the health care system, Community Health Partners, the Park County Health Department, Livingston Mental Health Center, and Livingston HealthCare partnered to create the Park County Connect Program. Grant funding supported a social worker, housed in the health department, who designed and implemented a community-based outreach program for people while frequent the emergency department on a regular basis. This pilot project successfully established relationships between the partnering agencies and facilitated the connection of emergency department high utilizers with primary care providers. The program continues to expand care coordination to other community agencies and hopes to eventually build a more comprehensive care coordination and data sharing platform into the community.

Community Health Partners

Promotoras de Salud: Bridging Latino Health Disparities

Project Term: 24 months; Ended 2017
Grant Amount: $20,000

This project’s goal was to develop a program to reach the growing and isolated members of the Latino communities in Belgrade and West Yellowstone with education on basic health care and disease prevention. The program trained six individuals to be “promotoras,” or “promoters of health.” Promotoras received basic training in nutrition, diabetes management and prevention, and STI prevention which they then shared with their friends and community members in informal settings. The project’s success in reaching and engaging the Latino community led the Gallatin City-County Health Department to move the program’s operations in-house thereby ensuring its sustainability. 

Community Hospital of Anaconda

Integrating Behavioral Health at the Community Hospital of Anaconda

Project Term: 12 months; Ended 2019
Grant Amount: $50,000

This planning grant with Community Hospital of Anaconda (CHA) solidified organization support, understanding, and commitment to integrated behavioral health implementation. CHA also successfully standardized screening for depression for all their patients and developed care pathways for depression treatment. Depression screening went from 0% at the start of the project to 40% by the end, with a commitment to fully systematize screening for depression. They began developing an understanding of substance use disorder screening and treatment which they plan to begin when they implement their integrated system. CHA has organizational commitment to fully implement integrated behavioral health in the primary care and perinatal programs and will be invited to apply for implementation grants through these MHCF initiatives.

Community Hospital of Anaconda

The Reducing Adverse Outcomes of Perinatal Substance Use Disorder Project

Project Term: 24 months; 2019-2021
Grant Amount: $150,000

This project will allow the Community Hospital of Anaconda (CHA) implement a comprehensive, team-based, family inclusive continuum of care for perinatal patients with substance use disorders and mental health issues. As part of the project, CHA will build on its existing infrastructure to integrate behavioral health services into prenatal care. It will also work with community partners to addresses the accompanying social needs, including transportation, food insecurity, housing, employment, and social support. Grant funds will be used primarily for staff support and to hire a licensed clinical social worker to help implement the program. Partnerships include associate primary care clinics and local behavioral health agencies. The project’s overall goal is to reduce barriers to treatment for pregnant women and their families struggling with substance use disorders and mental illness and increase access to social support.

Community Medical Center

Improving Screening and Treatment for Perinatal Drug Use in Missoula

Grant Term: 24 months; 2018-2020
Grant Amount: $150,000

For this project, Community Medical Center (CMC) will work to improve the quality of care for pregnant women and infants affected by substance use disorders in Missoula County. In collaboration with Partnership Health Center, Saint Patrick’s Hospital, and community groups serving pregnant women, this project’s goal is to reduce the stigma that prevents many women with substance use disorders from seeking help. As a part of the project, obstetric offices will standardize screening and care for women with substance use disorders and partner with community organizations to provide referrals to addiction support services. As a part of the project, CMC’s mother-baby unit will institute a program to engage parents as partners in the treatment of neonatal abstinence syndrome after birth. This approach will train parents to use evidence-based, non-pharmacologic methods to soothe withdrawal symptoms in babies. The goal of this approach is to improve mother-infant bonding, strengthen families, decrease pharmacologic treatment and long hospital stays, and decrease foster care placements in Missoula County. Grant funds will be used for personnel expenses, staff training, and communications and marketing materials.

CSKT Tribal Health Department

Understanding and Utilizing Health Care Resources on the Flathead Indian Reservation

Project Term: 24 months; Ended 2018
Grant Amount: $100,000

The Confederated Salish and Kootenai Tribal (CSKT) Health Department accomplished all objectives for this project. Through public law 638 they assumed the Indian Health Service budget for purchased and referred care and now manage the entirety of this program for the tribe. The grant funding allowed the CSKT Health Department to provide Medicaid and insurance outreach and enrollment services to clients of the Flathead reservations. Seven outreach events were held throughout the course of the project and enrollment in Medicaid and private insurance, employee plans, and marketplace plans continuously increased. Finally, CSKT trained providers and patients on the new coverage approach and on how to effectively use health care coverage.

CSKT Tribal Health Department

Integrated Behavioral Health Program

Project Term: 12 months; 2016-2017
Grant Amount: $35,000

The Confederated Salish and Kootenai (CSKT) Tribal Health Department will formulate a detailed strategic plan to integrate behavioral health into primary care and to train their current behavioral health staff and primary care providers on conducting motivational interviews and brief interventions. With established protocol, screening tools, and workflow plan, primary care and behavioral health providers will be able to consult with one another regarding behavioral change for preventable disease as well as for indications of behavioral health and substance abuse problems. Once implemented, this program will help improve patients’ health behaviors and enable behavioral health providers to provide brief interventions occurring the same day that patients are identified by primary care.

Daniels County Health Department

Improving Behavioral Health Awareness in Daniels County

Project Term: 12 months; Ended 2017
Grant Amount: $35,000

This project’s goal was to help the community gain a better understanding of available behavioral health resources and for the Daniels Memorial Health Center to develop a plan to begin integrating behavioral health services into their primary care. The project engaged a diverse coalition of community stakeholders and held several training sessions on the behavioral health resources available in the community and on how to recognize the signs and symptoms of crisis situations. The coalition also developed a resource guide of local behavioral health services which was made available in print and online. The Daniels Memorial Health Center also succeeded in developing a business plan for integrating behavioral health into their primary care services and began routinely screening patients for depression. Health center leadership expressed their commitment to continue working towards integrating behavioral health throughout their health system.

Daniels Memorial Healthcare Center

Developing Regional Behavioral Health Care Services Using Primary Care Resources

Project Term: 12 months; Ended 2018
Grant Amount: $50,000

This project was intended to plan for integrating behavioral health services throughout Daniel’s Memorial Healthcare Center’s hospital system. Grant funds were used to assist in planning and developing the scope of service for a self-sustainable clinic model in the rural region they serve (which includes the frontier Scoby community in Eastern Montana). The health center was able to successfully establish standard screening protocols for depression. However, as a result of the planning that took place, the focus of the project shifted, and Daniels Memorial decided to participate in an affiliate grant with Billings Clinic that will assist them in connecting to broader network of hospitals and integrated behavioral health work throughout the region. The Daniels Memorial Healthcare Center’s leadership is committed to implementing integrated behavioral health as part of Billings Clinic network.

Eagle Shield Center

Blackfeet Community Hospice Project

Project Term: 12 months; Ended 2018
Grant Amount: $26,262

This planning project supported the establishment of a partnership among tribal agencies on the Blackfeet reservation who will collaborate toward developing hospice services for the community and provided a one-day workshop to educate the Blackfeet community about hospice and end-of-life care. Since 2007, Blackfeet community members and a researcher from Montana State University have been collaborating on end-of-life experiences among Blackfeet people using a participatory approach. The partnership includes the Blackfeet Tribal Business Council, the Eagle Shield Center, the Blackfeet Tribal Health Department, Tribal Planning, Blackfeet Community College, Blackfeet Family and Child Services, Indian Health Service, and the Tribal Diabetes Clinic. At the conclusion of this project, solid partnerships had been established; the workshop on available hospice services in the Blackfeet community increased the community’s knowledge of end-of-life care needs and services. Eagle Shield Center will continue to work towards establishing hospice services through the new partnerships and advisory committee.

Eastern Montana Community Mental Health Center

Peer Support: Addressing Behavioral Health Crisis and Jail Diversion in Eastern Montana

Project Term: 24 months; 2017-2019
Grant Amount: $74,916

This project will develop and implement peer crisis support services to assist people who are struggling with mental illness, substance abuse disorders, and other co-occurring health disorders in eastern Montana. In turn, this will lead to a reduction in the number of mental health crises being treated in emergency rooms, the number of people transported and admitted to higher levels of care for behavioral health crisis, and the number of contacts individuals in behavioral health crises have with law enforcement agencies and detention centers. The Eastern Montana Community Mental Health Center will partner with Montana’s Peer Network and regional stakeholders (hospitals, law enforcement, and social service agencies) to implement this program.

Families First Children's Museum

Confederated Salish Kootenai Tribe Family Education Services

Project Term: 12 months; 2019-2020
Grant Amount: $26,118

The Families First Children’s Museum (FFCM) will provide family education classes and resources for the Confederated Salish and Kootenai Tribal (CSKT) community intended to foster healing and help develop resilient communities. The project will introduce new, relevant, and evidence-based curricula within three separate tracks: parents/caregivers, foster parents, and childcare providers. Funding will be used to hire native instructors and support curriculum development. Through current partnerships with CSKT, the Department of Human Resource Development, and Salish Kootenai College, as well as growth in collaboration with the Tribal Health Department, Tribal Education Department, local childcare providers, and organizations like the Montana Department of Public Health and Human Services, FFCM’s work will extend to reach more families and create connections between parent education skill development and a stronger family resource network.

Flathead City-County Health Department

Developing a Comprehensive Plan to Transform Behavioral Health and the Criminal Justice System

Project Term: 24 months; 2018-2020
Grant Amount: $47,565

Many individuals with behavioral health disorders find themselves involved in criminal justice due to barriers to adequate treatment and support. This project will identify resources in the Flathead community to support individuals who are unnecessarily involved in the criminal justice system due to a behavioral health disorder. Through the Sequential Intercept Model (SIM) mapping process, the Flathead County Health Department will identify current gaps in service and develop a community plan to improve outcomes. SIM will be utilized to organize behavioral health services to better meet the needs of individuals with behavioral health disorders who are involved in the criminal justice system. Through this project, the community will identify where crisis diversion activities can be developed or enhanced to meet treatment needs and assist with reentry from the justice system or inpatient setting back into the community. The grantee will include a team of stakeholders in this process that includes community experts in mental health, substance use, law enforcement, criminal justice, housing, health, tribal, social services, and individuals directly impacted by behavioral health disorders in Flathead County.

Flathead Community Health Center

FCHC/Intermountain Integrated Behavioral Health Collaboration

Project Term: 12 months; Ended 2017
Grant Amount: $35,000

For this project, Flathead Community Health Center received technical assistance and training from the National Council for Behavioral Health so that they could enhance their integrated behavioral health model and explore a partnership with Intermountain. The health center succeeded in refining their structure and protocol for defining when to treat, when to consult, and when to refer individuals for specialty behavioral health services. They also standardized their depression screening tool, developed protocols for a scope of care and referral, and purchased an EHR module for screening, brief intervention, and referral to treatment (SBIRT). The successful collaboration between the health center and Intermountain can be used as a model for further integration efforts across the community.

 

Florence Crittenton

Substance Abuse Treatment for Pregnant and Parenting Women

Project Term: 18 months; Ended 2018
Grant Amount: $75,000

This project allowed the grantee to plan and implement outpatient substance abuse services for Florence Crittenton’s clientele, and to explore residential treatment options for pregnant and parenting women and their children. Florence Crittenton received licensing as a Level 3.3 Recovery Home for Women and Children ages 18 to 35 and became a state approved provider for outpatient substance use disorder services for families of all ages. They also applied for and received a mental health center license, allowing them to provide services for co-occurring disorders. Finally, they developed a process for documenting and billing for services provided which will ensure the long-term financial viability of these new programs.

Fort Belknap Tribal Health

Centralized Billing Capacity Building Project

Project Term: 24 months; 2017-2019
Grant Amount: $65,000

This project will help establish Fort Belknap’s centralized billing department by expanding the range of billable services and establishing internal controls to ensure legal compliance. The revenue generated will support prevention programs and help the tribe assume management of their behavioral health services from the Indian Health Service. Funding will also be used to hire a consultant to assess the revenue cycle process, controls and operations, and recommend specific improvements.

Fort Belknap Tribal Health

Diabetes Care Clinic

Project Term: 18 months; 2017-2019
Grant Amount: $90,000

This project will expand Fort Belknap’s current diabetes program by establishing a Diabetes Care Clinic to provide consistent, comprehensive, and culturally appropriate primary care to patients diagnosed with diabetes or prediabetes. The project will also create an independent, tribally-run health board to administer the clinic and provide a stable governing body to oversee its functions. Grant funding will be used to contract with a health system administrator to assist in developing the tribal health board and oversee the Diabetes Care Clinic and its supportive components. Partners include the Indian Health Service, and the Fort Belknap Tribal Health and Centralized Billing Departments.

Fort Peck Health Promotion Disease Prevention

Staff Recruitment and Telemedicine Systems Project

Project Term: 24 months; Ended 2017
Grant Amount: $25,000

This project’s goal was to develop long-term, innovative solutions to the critical shortage of health providers on the Fort Peck Reservation. The project successfully developed formal agreements with Yale Children’s Psychiatric Center and Harvard to provided behavioral health services using telemedicine, and the MSU-Bozeman School of Nursing to send students as part of their curriculum to assist in school-based health centers. Recruiting relationships for health care professionals were also strengthened with Yale, Harvard, UM and Wala Wala. With the help of more effective recruitment and retention methods, Fort Peck HPDP is better equipped to bring quality health care to their community.

Fort Peck Tribal Health Department

Needle Exchange Program

Project Term: 24 months; Ended 2018
Grant Amount: $50,000

This project revived the Needle Exchange Program that operated on the Fort Peck Reservation from the summer of 2009 to January 2012 and expanded it to provide injection drug users with clean needles, education, sharps containers for safe disposal of needles, and referrals to addictions counseling if needed. As one of the first and only needle exchange programs operated in a rural reservation in the US, Fort Peck’s employed a unique and successful protocol. The project’s main goal is to reduce the transmission of blood-borne illnesses such as hepatitis C and HIV. This program successfully now serves more than 200 clients on the Fort Peck Reservation and will be sustained indefinitely through a HRSA grant.

Fort Peck Tribal Health Department

Rapid HIV and HCV Testing Services

Project Term: 24 months; Ended 2018
Grant Amount: $50,000

This project expanded Fort Peck’s current needle exchange program to provide testing services for HIV and hepatitis C (HCV). With 446 cases of HCV between 2011 and 2015, the HCV rates on Fort Peck are among the highest in the state and six times the national rate. HIV screenings were successfully provided at an annual community-wide screening (which was also available to non-Native community members), and the adult and juvenile correction facilities. In addition to providing screenings for injection drug users in the community, the project also successfully facilitated new collaborations with county and state health agencies including the tribal corrections facilities, the Roosevelt County Health Department, and Indian Health Services.

Fort Peck Tribal Health Department

Third-Party Billing Project

Project Term: 24 months; 2018-2020
Grant Amount: $149,572

This project will develop a plan and supporting documents, train key staff, and develop partnerships to maximize third-party revenue generation for the Fort Peck Tribal Health Department. The project will work across tribal health programs and in close coordination with tribal and non-tribal partners including MT DPHHS, Indian Health Services, North Eastern Montana Health Services, Spotted Bull Treatment Center, Red Bird Woman Center, Fort Peck Tribes Veteran Affairs Office, Fort Peck Tribal Supplemental Health Insurance Program, Fort Peck Health Promotion Disease Prevention Program, and Fort Peck Transportation Department. The project will generate revenue from tribal health services that will be used to strengthen current services and address health facility needs.

Fort Peck Tribes - Spotted Bull Recovery Resource Center

Substance Abuse Inpatient Treatment Center Development Project

Project Term: 12 months; Ended 2017
Grant Amount: $50,000

For this project, the Fort Peck Tribes developed business and strategic plans along with a detailed cost analysis to guide the establishment of a new inpatient chemical dependency treatment center to compliment Spotted Bull Recovery Center’s current outpatient facility on the Fort Peck Reservation. When built, the center will be able to provide inpatient treatment services to Native American patients from the Fort Peck region as well as non-Native patients and will eventually expand to include other tribes throughout the state. This planning project was successfully completed through a partnership that included the tribal action plan committee, the tribal executive board, the tribal health department, tribal courts, and the law enforcement agencies with jurisdiction on the reservation. The completed plans provided the Fort Peck Executive Committee with enough information to approve the next phase of the project.

Fort Peck Tribes - Spotted Bull Recovery Resource Center

Tatanka Gdes’ka Capacity Building Project

Project Term: 24 months; 2017-2019
Grant Amount: $150,000

This project will establish and begin operation of a methamphetamine in-patient treatment center on the Fort Peck Indian Reservation. The project has three main components. It will: build the capacity of Spotted Bull Recovery Resource Center to conduct third-party billing and generate continuous revenue to fund operations; support the upgrade of current substance use disorder infrastructure to meet in-patient treatment standards; and prioritize and implement integrated behavioral health principles and programming to ensure a strong inpatient and outpatient continuum of care. This will provide a continuity of care for patients and ensure that those with medical and mental illnesses complicating a methamphetamine addiction are able to receive comprehensive, effective treatment. Once up and running the facility will have the capacity to treat patients from northeastern Montana and potentially from other tribes.

Friendship House of Christian Service

Capacity Building Assessment for Sustainable Youth Counseling

Project Term: 12 months; Ended 2018
Grant Amount: $10,000

This project’s goal was to help Friendship House develop the operational capacity for providing trauma-informed counseling to youth struggling with adverse childhood experiences (ACEs), in hopes of preventing youth from adopting high-risk behaviors. Aune Associates Consulting provided an operational and market assessment, revenues and project projection, policy and procedures manual, necessary legal forms and paperwork, connection with third-party billing services, and training to implement the plan. Despite initial hiring delays, Friendship House is now successfully operating a fully functional and sustainable counseling program for children and families in South Billings.

Friendship House of Christian Service

Transforming South Billings Youth and Families by Addressing Community Counseling Needs

Project Term: 12 months; 2018-2019
Grant Amount: $40,000

Through this grant, Friendship House will hire a counselor-in-training to provide behavioral health services to children and their families in south Billings. Through a previous Social Service Non-Profit Capacity Building Initiative grant from MHCF, Friendship House was able to bring on a licensed counselor and decrease the wait times for youth to see counselors from approximately 6-12 months to the day of need. Despite these positive changes, Friendship House has not yet met the full demand for counseling services. Through this project, a counselor-in-training will be hired to provide additional counseling services, and after completing the training requirements, this newly hired person will be able to bill for services which will result in a sustainable position at Friendship House.

Gateway Recovery Services

Peer Support for Substance Abuse

Project Term: 18 months; 2017-2019
Grant Amount: $75,000

This project will implement peer support for substance abuse in Gateway and Cascade counties. Implementation will take place over three phases: 1) Providing peer support for clients who have been placed on a waiting list for an evaluation by a licensed addiction counselor. 2) Use of the peer support program to improve show-rates for current clients in order to increase their chances of successfully completing treatment. 3) Making peer support available to law enforcement and local emergency rooms. Studies have shown that peer supporters can reduce the number of law enforcement and emergency room contacts with targeted patients and improve attendance at treatment and treatment outcomes. The intent of this project is for peer supporters to reach people in home and community settings, quickly build rapport and help motivate individuals with substance use disorders to enter and remain engaged in care.

Glacier Community Health Center

Dental and Behavioral Health Integration

Project Term: 12 months; 2018-2019
Grant Amount: $49,729

To date, Glacier Community Health Center has successfully linked behavioral health with medical, providing bidirectional warm hand-offs of patients who need the alternate department’s services, and thus improving patient care and health outcomes. This project will focus on a similar integration between behavioral health and dental with the addition of medical, with the knowledge that dental, medical and behavioral health diagnoses are often linked, and common solutions can often be found. Funds for this project will be used for staff time to work through the needed policies, procedures, and workflow for the integration of dental and behavioral health services.

Glacier County Emergency Medical Services

Integrated Mobile Health

Project Term: 24 months; Ended 2017
Grant Amount: $50,000

For this project, Glacier County Emergency Medical Services (GCEMS) implemented the state’s first Integrated Mobile Health Program (IMH). IMH is a new and evolving health care delivery model that builds on the concepts of community paramedicine and adapts them to serve the specific needs of the local community. The project’s primary goal was to improve the health of the community and reduce the number or emergency room admissions and hospital readmission. GCEMS successfully developed and implemented the IMH program to work alongside local health care providers and develop individualized, in-home treatment plans for patients who visit the emergency department regularly or who are at-risk for being readmitted into the hospital. Throughout the course of the grant, the program completed 1,148 patient visits which consisted of chronic illness management, respite services, end-of-life care, wound care, and other treatments and services prescribed by health care providers based on individual patient needs. As a result of this program, the grantee reported a nearly 90 percent decrease in hospital visits among the enrolled patients (from 387 to 40 visits). At the close of the grant in 2017, the project was working towards sustainability, however, the program was ended by the county in 2018 due to ongoing GCEMS budget concerns.

Hays Lodgepole School District 50

Fort Belknap Indian Community Homeless Youth Feasibility Study

Project Term: 12 months; Ended 2018
Grant Amount: $49,000

For this project, the Hays-Lodgepole Public School and the Fort Belknap Indian Community Council assessed the feasibility of designing, constructing, operating, and facilitating housing and supportive services to improve health and education outcomes for homeless youth on the Fort Belknap Reservation. The project successfully created 15 new community partnerships bringing together tribal leadership, community members, and youth over the course of 10 planning meetings. The finalized feasibility study includes two site options for the youth shelter along with an overall floor and feasibility plan that will allow the tribal planners to seek funding for the second phase of the project which will involve the construction of the facility.

Healthy Mothers Healthy Babies

Montana Children’s Health Data Partnership Project

Project Term: 12 months; Ended 2018
Grant Amount: $50,000

The project sought to identify shared data measures of early childhood health to create a Montana Data Dashboard that can be used by various organizations, including local Early Childhood Coalitions, to work collectively to improve early childhood health outcomes. Additionally, as part of the shared data measures, this project focused on identifying HOPE (health outcomes from positive experiences) measures as well as resiliency factors that contribute to childhood health. Through a collaborative, process with 19 organizations 13 early childhood coalitions participating, 11 shared data measures were identified to be used to create the dashboard. A strategic plan for promoting and implementing the 11 shared data measures was also developed. At the conclusion of this project, Healthy Mothers Healthy Babies has received commitment to promoting and using the 11 shared data measures from Zero to Five (sponsored by Headwaters Health Foundation) and is partnering with the Department of Public Health and Human Services to identify ways to integrate the 11 shared measures in DPHHS’s early childhood work.

Healthy Mothers Healthy Babies

Building Bridges for Better Births

Project Term: 12 months; Ended 2018
Grant Amount: $25,000

The goal of this planning grant was to learn about what communities in Montana are doing to address substance use and mental illness in pregnancy and to explore the need for the formation of a statewide coalition to strengthen and improve services provided to pregnant women and their families. Healthy Mothers Healthy Babies successfully completed site visits to 12 communities and strong support for moving forward with a statewide coalition was demonstrated throughout the course of the project.

Healthy Mothers Healthy Babies

Building Bridges for Better Births

Project Term: 24 months; 2018-2020
Grant Amount: $68,000

For this project, Healthy Mothers Healthy Babies (HMHB) will work with statewide partners to coordinate community coalitions focused on implementing evidence-based integrated behavioral health models to treat perinatal substance use disorders. This work aligns closely with MHCF’s Solving Perinatal Drug and Alcohol Use Initiative, and, as part of this project, HMHB will partner with the foundation to plan for and convene two meetings that will allow for presentation and coordination of statewide efforts to successfully treating perinatal substance use disorders and decrease the number of infants born exposed to drugs in Montana.

Helena Indian Alliance

Master Plan

Project Term: 12 months; Ended 2017
Grant Amount: $25,000

This project resulted in the production of a preliminary architecture report that the organization will use as a guide for building renovations and for developing additional health services including dental and pharmacy. The report was also used it to seek funding for a Community Development Block Grant. Their project was not selected for block grant funding in 2018, however, they will continue looking for future opportunities.

Helena Indian Alliance

Development of Best Practices for Excellence in Opiate Dependence Treatment

Project Term: 18 months; Ended 2018
Grant Amount: $20,000

This project created a best practice manual for the treatment of opioid use disorders utilizing medication-assisted treatment (MAT). The project successfully designed and implemented a registry for capturing the treatment data of individuals suffering from opiate and methamphetamine use disorders. The purpose of the data collection is to correlate treatment approaches with long-term outcomes. While there has been a tremendous increase in MAT for opiate and other substance use disorders, there remain many important open questions about the details of treatment over an extended period and the outcomes associated with differences in treatment approach. Registries such as this can become an important tool in determining answers and molding evolving therapy.

Helena Indian Alliance

Sheridan Hall Structural Assessment

Project Term: 12 months; 2018-2019
Grant Amount: $26,000

This grant will allow Helena Indian Alliance to hire an architect and professional engineering team to review and structurally assess Helena Indian Alliance’s building for the purposes of expanding and adding new programs. Helena Indian Alliance has seen a significant increase in demand for services such as general health care, case management, mental health services, substance use, and various other programs. The project will produce a finalized structural assessment that can be combined with their existing preliminary architectural report (also funded by MHCF) and used to secure financing a renovation and expansion project. For this project, the Helena Indian Alliance is partnering with Montana Business Assistance Connection and Montana Facility Finance Authority.

Helena OB/GYN and Associates

Go Mom Go

Project Term: 24 months; 2018-2020
Grant Amount: $150,000

Helena OB/GYN and Associates and community partners organizations will collectively develop a program that supports mothers and mothers-to-be in Lewis and Clark County. The genesis of the program is to provide a proactive, integrated behavioral health and community-based care delivery model for pregnant women and those exposed to perinatal drug use. Community outreach and a marketing plan will also be developed throughout the course of this project. Key partnerships include Saint Peter’s Hospital, Florence Crittendon Home, and Helena Indian Alliance.

Help Center

Building Billing Capacity for Behavioral Health Services

Grant Term: 12 months; Ended 2019
Project Amount: $15,000

This capacity building project allowed the Help Center to develop a plan to become an Employee Assistance Program (EAP). An EAP offers assessments, counseling, referrals, and follow-up services to employers and employees who are experiencing behavioral health needs, either personal or work-related. The Help Center explored several options for creating new, sustainable, needed health services and decided that becoming at EAP was the most viable option and would fulfill a local need for their clients and the greater Bozeman community. Through this project, the Help Center used consultation with Dan Aune and engagement with their community partners to reach their decision. The Help Center began this project with strong community relationships which will contribute to the success of their EAP services once those have been established. The Help Center is dedicated implementing the new EAP program and are confident they can provide sustainable employee behavioral health services once they are established.

Holy Rosary Healthcare Foundation

Eastern Montana Integrated Behavioral Health Collaborative

Project Term: 12 months; Ended 2016
Grant Amount: $25,000

This project focused on integrating primary and behavioral health care for patients in eastern Montana. The primary care team at Holy Rosary Healthcare and behavioral health experts from Eastern Montana Community Mental Health Center sought to provide seamless integrated behavioral health (IBH) services for patients with a full spectrum of mental health issues, addiction, and primary care medical conditions. Outcomes included: a stronger partnership between Eastern Montana Mental Health Center and Holy Rosary Healthcare, implementation of universal depression screenings for adult patients in primary care practice, and a detailed IBH implementation plan that maps out a model for the new services and addresses specific business operations questions. The partners plan to expand a full IBH model for all primary care physicians and providers (including youth) in the Holy Rosary Healthcare primary care clinic.

Horses Spirits Healing

Equine Assisted Activities and Therapy for Veterans and Returning Military

Project Term: 12 months; Ended 2017
Grant Amount: $20,000

Horses Spirits Healing, Inc. offers equine assisted activities and therapy for returning military personnel in southeastern Montana. This project formulated a sustainability plan and experienced steady growth in Veteran referrals and community support. Program growth over the duration of the grant led to the hiring of a program director, equine instructors, and contracted grant writers as well as technology and development personnel. Other accomplishments included program accreditation through the Professional Association of Therapeutic Horsemanship and the receipt of a large renewable grant through the Veterans Administration Adaptive Sports Program to cover Veteran session costs and planning for the implementation of a standardized research project through the MSU Center for Research and Recovery to determine the program’s effectiveness. Horses Spirits Healing also successfully entered into formal agreements with key partners which will support the long-term sustainability of the program.

Human Resources Development Council of District IX

Assessment of Chronic Homelessness Community Costs

Project Term: 12 months; Ended 2017
Grant Amount: $20,000

The Human Resource Development Council (HRDC) is a leader in community efforts improving lives for low-income people and those struggling with homelessness. This project produced a study that analyzed the costs expended each year by community stakeholders which could be impacted by housing. The report also gave recommendations for alternative models like the Housing First Model which connects homeless persons with stable housing and supportive services and costs approximately $11,860 per household annually. Importantly, the report has been shared with statewide providers and has been used as part of our Housing and Healthcare Initiative.

Human Resources Development Council of District IX

Partnership for Permanent Supportive Housing

Project Term: 12 months; 2018-2019
Grant Amount: $60,000

For this project, HRDC and Bozeman Health will partner with community service providers to build a cohort of organizations that will work together to address the need for permanent supportive housing for high-risk members of the community. With technical assistance from the Corporation for Supportive Housing, they will assess the community’s current housing and health care resources and create a plan to incorporate supportive housing systems to improve health care outcomes for chronically homeless populations. A key focus of this project will be on programs that help the people served successfully integrate into the larger community through association with others to foster strong connections to the rights, responsibilities, roles, resources, and relationships that a society offers to its members. This will help residents maintain housing stability and achieve a greater degree of self-sufficiency. This project’s goal is to help create the framework to bring stable, transformative housing to some of the community’s most vulnerable members.

Intermountain Deaconess Children's Services

Services for At-Risk Helena Youth in Alternative High Schools

Project Term: 18 months; Ended 2017
Grant Amount: $45,000

For this project, Intermountain collaborated with an alternative learning school to provide behavioral health services to students. The collaboration resulted in a 63 percent increase in screenings for substance use disorders and an increase in referrals to higher levels of care, substance use disorder assessments, and other community-based support. Unfortunately, the project struggled with the turnover of key staff and did not see as much of a decrease in reported or suspected substance or alcohol use as anticipated. However, the project did strengthen the relationship between the school and Intermountain and laid the foundation for future collaborations.

Intermountain Deaconess Children's Services

Intermountain/PureView Integrated Behavioral Health Collaboration

Project Term: 12 months; Ended 2017
Grant Amount: $35,000

This project’s goal was to prepare an integrated behavioral health business and operations plan to serve as a blueprint for building an economically sustainable, patient-centered, team-based collaboration between Intermountain and PureView. The project resulted in an MOU for placement of a part-time Intermountain psychotherapist at PureView, and a formal agreement for carrying forward a focused and informed approach for implementing integrated care at the East Helena Schools Clinic. This planning grant provided an opportunity for both partners to examine their existing and potential relationships with behavioral and primary care providers, and to explore new and promising opportunities for integrated health.

Jefferson County Mental Health Local Advisory Council

Support Our Youth Through Positive Parenting

Project Term: 12 months; 2019-2020
Grant Amount: $11,642

Through this project, the Jefferson County Mental Health Local Advisory Council will partner with the Jefferson County Health Department to deliver positive parenting classes to the residents of Jefferson County. This project stems from the identification of behavioral health as a top health concern in Jefferson County’s community health assessment. To take an upstream approach to improving behavioral health in the county, the health department and school nurse will use the state health department’s online parenting program, Parenting Montana, and a parenting curriculum known as “positive parenting” to encourage parenting practices that support the healthy child development. Grant funds will be used to purchase training materials and support program staff time to deliver the training and to work with community partners to identify good venues for program delivery. Partners involved in this project include the local advisory committee, county health department, local library, school nurse, elementary school, and Head Start. The overarching goal of this project is to establish healthy parenting practices that will support both parents and children and prevent behavioral health issues.

Kalispell Regional Healthcare

Post-Delivery Support for Neonatal Abstinence Syndrome Infants and Their Parents

Project Term: 24 months; Ended 2018
Grant Amount: $50,000

Through this grant, Kalispell Regional Healthcare’s (KRH) neonatal intensive care unit staff worked with Montana hospitals to develop and implement a standardized protocol to screen for and manage drug withdrawal in newborns. The grant resulted in several important accomplishments: 1) The grantee developed an educational video for staff using the Modified Finnegan Scoring Tool to assess infants exposed to opiates in utero. 2) The implementation of a new “incentivized parenting program” that fostered a cultural shift away from blaming mothers for their addiction and toward a sympathetic, supportive attitude that encouraged parents to participate in care of their infants and to engage in education and treatment activities; 3) The NICU improved cooperation with state agencies to support families. An independent evaluation of the program suggested that these accomplishments helped reduce foster care placement of infants with Neonatal Abstinence Syndrome (NAS). The prevalence of foster care placement for babies with NAS decreased from 75% (N = 12) in 2015 to 11.1% (N = 9) in 2017 (partial). Continuing an earlier trend, the average length of hospital stays for NAS-affected babies went from 23.5 days (average 2014-2015) to 14.9 days (N = 9) in 2017 (partial).

Kalispell Regional Medical Center: Pathways Treatment Center

Integrated Behavioral Healthcare for High Risk Pregnant Women

Project Term: 24 months; 2017-2019
Grant Amount: $150,000

With consultation from the National Council for Behavioral Health, this project will integrate behavioral health services into obstetrics (OB) care at Kalispell Regional Medical Center. Once implemented, behavioral health screening, diagnosis, and treatment will be fully integrated into the OB clinical care, and provided to mothers as part of standard prenatal care practice. Grant funding will be used to hire a OB behavioral health care coordinator who will offer behavioral health and substance use disorder screenings and treatment to at-risk mothers, develop and implement a fully integrated system of care in the OB clinic, and make necessary referrals to community based care after birth.

 

Kalispell Regional Medical Center: Pathways Treatment Center

Integrated Behavioral Health Implementation

Grant Term: 24 months; 2018-2020
Grant Amount: $150,000

This project will integrate behavioral health into Kalispell Regional Medical Center’s nine primary care clinics through hiring and embedding five social workers in those practices. With consultation from the National Council for Behavioral Health, this project will provide screenings, evidence-based treatment, and tracking for effective care management transforming the culture of delivering mental health services from the inception of the program. The project will also allow for care coordination between the primary care clinics, psychiatric outpatient clinics, emergency department, and inpatient psychiatric unit within the health center system, as well as a standardized system of communication and referral to community partners.

Lewis and Clark County

Creating a Community Justice and Mental Health System with Risk Reduction Services

Project Term: 24 months; 2017-2019
Grant Amount: $97,350

This project will create a director position for Lewis & Clark County’s Risk Reduction Program. The proposal is driven by community advocacy organizations including the Criminal Justice Coordinating Council (CJCC), Citizen’s Advisory Council (CAC), and Mental Health Local Advisory Council. The project seeks funding for two basic infrastructure components needed to build more effective systems: a county risk reduction director, and a consultant to assist with county data integration. The risk reduction director will function as the executive director for the CJCC and CAC. The risk reduction director will be responsible for implementing a new county Risk Reduction Department with a mission to reduce community risks of reoffending, inequity in bail system, lawsuits and injuries, ineffective behavioral health services and transitions, and victims of crime. The director will also oversee the second critical component of the proposal, data integration. Data is required to effectively assess, diagnose and classify offenders, as they move between county and health systems. Accurate data can be used to drive decision making on needed changes, measuring outcomes, and evaluating and establishing accountability.

Lewis and Clark County

Mental Health Strategic Plan

Project Term: 24 months; Ended 2017
Grant Amount: $20,000

This project convened a group of key stakeholders to develop a strategy addressing how people with mental illness and/or substance use disorders encounter and flow through the criminal justice system. The strategy included sequential intercept mapping which has three main components: 1) it reflects how individuals move through the local criminal justice system, 2) it indicates points for intervention or diversion of people with mental illness and/or substance use disorders, and 3) it provides a visual depiction of the ways in which treatment systems interact with the local criminal justice system. Stakeholders also identified priorities for change, developed an action plan, and helped create a new sustainable county department to address restorative justice and court services.

Lincoln County Health Department

Mental Health Coalition

Project Term: 12 months; Ended 2018
Grant Amount: $25,000

This project established a community coalition (led by the county health department and including mental health and medical providers, law enforcement, and schools) and the grantee developed a behavioral health strategic plan that assessed behavioral health needs and available services. The coalition became an affiliate of the statewide Elevate Montana Program, which will assist with working toward established care coordination and mental health services for schools. The coalition now has a trained mental health first aid instructor and training, education, and information will occur systematically throughout the community.

Lincoln County Health Department

Lincoln County Substance Use Disorder Follow-Up and Referral

Grant Term: 12 months; 2018-2019
Grant Amount: $19,955

This project will help the county health department work with a community coalition to implement a new diversion program that will operate in the hospital emergency department and the county detention center and route people with substance use disorders to treatment rather than the criminal justice system.

Little Shell Tribe of Chippewa Indians of Montana

Montana Native American Girl Empowerment Project

Project Term: 12 months; Ended 2019
Grant Amount: $15,000

The Little Shell Tribe assisted tribes and urban Indian health centers across the state to plan and implement girl-centered, protective asset programs, and to train mentors in each tribal community in Montana. The project focused on building ‘protective assets’ which are strengths and skills that can help young women stay safer, conquer crisis, and better plan for the future. The project hosted two well attended camps and several workshops and held group calls with representation from each tribe and urban Indian health center and trained mentors. The mentors will continue to work across the state through the Tribal Tobacco Prevention Program. The protective asset program expects to improve the self-confidence of Native American girls and provide skill building training that could lower the chances of experiencing adverse childhood experiences and improve school performance.

Livingston HealthCare Foundation

Behavioral Health Crisis Management

Project Term: 24 months; 2017-2019
Grant Amount: $75,000

This grant will enable Livingston HealthCare to develop a comprehensive primary-care-based behavioral health care system across its inpatient and outpatient services; and foster community-wide integration through partnerships with Community Health Partners, Western Montana Community Mental Health Center, and local law enforcement. The project seeks to improve the continuity of care and patient outcomes through facilitating a coordinated transition for people in behavioral health crisis from emergency departments or inpatient services to stable, outpatient care. To accomplish this, the project will add a licensed clinical social worker to serve the emergency department and inpatient units. Desired outcomes include yearly improvement in behavioral health care quality indices, declining suicide rate, declining rate of substance abuse in Park County and surrounding rural communities, and reduced rate of incarceration for behavioral health issues.

Livingston HealthCare Foundation

Integrating Behavioral Health into Primary Care Services in Park County

Project Term: 24 months; Ended 2018
Grant Amount: $126,717

For this project, Livingston HealthCare successfully integrated behavioral health services into their primary care clinic by creating a collaborative primary and psychiatric care team. They also began implementing universal behavioral health screenings and developed a streamlined system to provide care for patients with physical and mental health concerns at the same visit. Throughout the course of the grant, screening rates for depression increased from 17% to 65%, emergency behavioral health evaluations decreased by 43%, and depression scores improved by 76%.

Livingston HealthCare Foundation

Sweet Park Smiles

Project Term: 12 months; 2018-2019
Grant Amount: $20,803

This project will enable Park and Sweet Grass primary care providers to adopt and engage in the state’s Oral Health Framework in order to address the region’s oral health needs, actively support referrals to dentistry, and further facilitate partnerships with dentists. The heart of this project is training medical teams in oral health, including screening, risk assessment, fluoride varnish application, and referral. Sweet Park Smiles is a collaboration effort by Community Health Partners, Livingston HealthCare, and Livingston Food Resource Center.

Livingston HealthCare Foundation

The Perinatal Behavioral Health and Substance Use Treatment Pathway Project

Project Term: 24 months; 2019-2021
Grant Amount: $81,265

This project will allow Livingston Healthcare (LHC) to reduce the adverse outcomes of perinatal behavioral health conditions for mothers, newborns, and their families in the Park County region. The project will do this by developing team-based, early intervention and coordinated care between LHC providers and local resources and agencies. Grant funds will be primarily used to develop care pathways to address substance use and mental health referrals, staff training, and marketing and outreach services. Partnerships include the Park County Health Department and Community Health Partners. The project’s overall goal is to increase the number of women in the community who receive appropriate prenatal care, increase the number of perinatal patients who receive behavioral health and substance use disorder treatment, decrease crisis encounters for this population, and decrease incidences of children removed from families due to guardian substance abuse.

Lockwood School District

Lockwood Mobile School Based Health Center

Project Term: 12 months; Ended 2018
Grant Amount: $75,000

Through this project, the Lockwood School District worked with St. Vincent Healthcare to plan for and begin delivering health services to the community of Lockwood through the establishment of a mobile clinic. This mobile clinic, donated by the Ronald McDonald Foundation, began providing primary care services to students and the community members of Lockwood in July 2018. This is the first primary health care facility in the unincorporated city of approximately 8,000 residents. The Lockwood School District is continuing to partner with St. Vincent and will expand their scope of services to include behavioral health services in the next 24 months. The construction of a permanent clinic, operated by St. Vincent, is being included in the construction plans for the construction of the Lockwood High School.

Madison County

Integrating Behavioral and Physical Health in Madison County

Project Term: 12 months; Ended 2017
Grant Amount: $28,398

The Madison County Local Advisory Council for Mental Health oversaw a community-wide process for behavioral health integration. The National Council for Behavioral Health provided technical assistance and training throughout the process. The advisory council utilized integration of behavioral health as a lens to convene key community leaders and both Madison Valley Medical Center and Ruby Valley Hospital. Throughout the course of the project, primary care providers became more aware of the mental health and addiction counselors who practice in Madison County and learned how to contact them. Crisis response procedures between the two hospitals and Western Montana Mental Health Center were clarified and telehealth for crisis response evaluations was launched at both hospitals and their clinics. Universal screening for depression, referral forms, and protocols were developed for hospitals, and materials were distributed to all local primary care providers and licensed counselors. A local crisis counseling pilot project was designed and implemented by utilizing existing clinicians in Madison County, and transfer agreements with Barrett Hospital in Dillon were clarified to enable Madison County’s two local hospitals to transfer patients to the Barrett Hospital emergency room’s crisis stabilization/detox room on an as-available basis. Finally, a searchable database of local resources related to physical health, behavioral health, and social services was developed and is now available on the Madison County website with a list of priority projects.

Madison Valley Hospital Association

Madison Valley Medical Center Integrated Behavioral Health

Project Term: 24 months; 2018-2020
Grant Amount: $93,900

This project will support the integration of behavioral health into primary care at Madison Valley Medical Center in Ennis, Montana. The project builds upon a successful integrated behavioral health planning grant that was driven by the local advisory council on mental health. The grantee will continue to work with the local advisory council to ensure community, family, and consumer engagement in the project. The grantee will also work with Western Montana Mental Health Center (which is the regional mental health center providing crisis services) to strengthen the continuum of behavioral health in the community. Expected outcomes include early identification and more effective treatment of depression and substance use disorders, increased revenue from integrated care, and reduction in emergency visits related to behavioral health conditions. 

Messengers for Health

Traditional Relationships Improve Contemporary Health

Project Term: 24 months; Ended 2017
Grant Amount: $50,000

For this project, Messengers for Health worked to broaden their cancer screening outreach program (which previously focused on women) to include colon cancer screening for men and implemented a culturally-based chronic illness self-management program. Messengers for Health is a non-profit organization on the Crow Indian Reservation and has been working in cancer screening since 1996, in partnership with Professor Suzanne Christopher at Montana State University, using a community-based participatory research framework. For the cancer screening outreach project, several Crow Indian men were successfully recruited and trained to serve as health advisors for their communities. These men helped spread the word about colorectal cancer awareness and the importance of early screening to prevent colon cancer. In addition, the chronic illness self-management project successfully began facilitating an intervention with their first group of participants. Participants attended sessions on topics including gaining a better understanding of chronic illness, promoting self-advocacy, and improving personal self-care. Antidotally, participants expressed benefits to their overall health due to the support group intervention activities. Both programs represent new areas of outreach and intervention for the Crow community.

Missoula Aging Services

Care Transitions Achieving Better Health Outcomes

Project Term: 24 months; Ended 2018
Grant Amount: $135,250

This project supported a care coordination position to help older adults transition successfully from the hospital back into their homes. This group of patients tends to utilize high-cost services such as inpatient care more frequently than the general population, and social risk factors such as poor housing and social isolation often lead to poor clinical outcomes. The project used an established model that involves home visiting followed by frequent phone or in-person contacts during the month after a hospital stay. The program also identified social risks and helped coordinate appropriate referrals as needed. Missoula Aging Services successfully developed data sharing agreements with the local hospital and other partners to ensure the discharge needs of the patients were met. The program saw a dramatic decrease in readmissions for this senior population and an increase in discharge instructions and care recommendations among patients. Funding from local partners and potentially the local hospital will help continue these care transition efforts.

Missoula City-County Department of Grants and Community Programs

Missoula County Collaborative Care Planning Summit

Project Term: 12 months; Ended 2017
Grant Amount: $20,000

Missoula County successfully coordinated two stakeholder meetings with the National Council of Behavioral Health’s facilitator which resulted in a shared vision for moving forward and achievable action items. Through these two primary meetings, monthly phone calls, and occasional follow-up meetings, Missoula was able to increase communication among providers and secure commitment for expanding integrated care. Community partners successfully came together to celebrate successes, identify gaps, and create action items for the future. Through these meetings, communication and understanding of other agency roles have increased, resulting in a more unified approach to integrated care across Missoula County. At the conclusion of this project, Missoula committed to creating a community of wellness group to continue this work and to provide a platform for future communication and collaboration.

Missoula City-County Health Department

Missoula Foster Child Health Partnership: Model Practice for Montana Replication

Project Term: 24 months; 2018-2020
Grant Amount: $69,653

This project will evaluate the Foster Child Health Partnership, the home visiting model currently used in Missoula, to create a documented protocol for replication in preparation for piloting the program in one additional Montana county, in cooperation with DPHHS. The grant will support an independent program evaluation that uses local and DPHHS data to characterize impacts of support to foster parents, foster care medical providers and Child Protective Service caseworkers and to assess foster child health outcomes. The grantee is seeking model practice designation from the National Association of City and County Health Officials (NACCHO), which would be an important step toward broader replication of the model. The grantee will engage with Missoula’s federally qualified health center, Partnership Health Center and the Kindness, Elegance, Love Project (PHC-KELP) along with other agencies to coordinate services to biological parents after family reunification. This project’s goal is to demonstrate the improved health outcomes of the Foster Child Health Partnership and to replicate similar partnerships in other counties in Montana. Partners include Missoula City-County Health Department, MT DPHHS Child and Family Services Division and Providence Grant Creek Foster Care Clinic.

Missoula Food Bank and Community Center

Place-Based Health Care: Increasing Access Through Partnership

Project Term: 24 months; 2018-2020
Grant Amount: $66,350

For this project, the Missoula Food Bank and Community Center, in collaboration with Partnership Health Center, will increase access to family practice, behavioral health, and dental services for people experiencing food insecurity in Missoula County. The project will place a satellite health office in the food bank facility and co-design programming with health benefits. The grant funds will support site design and program implementation.

Missoula Urban Indian Health Center

Walking Well with Traditional Healing

Project Term: 24 months; Ended 2017
Grant Amount: $50,000

This project successfully increased the health center’s capacity to provide culturally adapted, evidence-based, and trauma-informed awareness to the over 500 active clients they see each year. Project accomplishments include providing historical trauma education sessions and Community Resiliency Model workshops to the Missoula community. Mending Broken Hearts, a grief support series, was provided to clients who reported a deeper understanding of historical and inter-generational trauma and were able to begin addressing the impact on their own lives. Finally, a trauma-informed organizational assessment was completed, and trauma-informed practices were incorporated into the diabetes prevention education series offered to teens and adults.

Missoula Urban Indian Health Center

Qua Qui Connection: The Circle of Good Medicine and Holistic Health

Project Term: 24 months; 2017-2019
Grant Amount: $150,000

This project will add primary care services to the current behavioral health and diabetes programming at Missoula Urban Indian Health Center (MUIHC). The addition of a primary care services will help MUIHC become a fully-functioning urban Indian health center that provides comprehensive, culturally appropriate care for one of the largest urban Indian populations in the state. Grant funding will be used to support a primary care provider to launch the medical clinic.

Montana Budget and Policy Center

Researching Effective Strategies to Help Enroll Low-Income Montanans in Health Care Coverage

Project Term: 12 months; Ended 2016
Grant Amount: $10,000

This project developed and disseminated (via an accompanying proposal from Montana Women Vote) two reports that helped guide efforts to enroll newly eligible people in Medicaid and help them use health care effectively.

  1. The Medicaid Expansion in Indian Country: Effective Strategies for Outreach and Enrollment report was released September 2016 and was presented to the HELP Oversight Committee, which resulted in the inclusion of a recommendation to the Governor and Legislative Finance Committee to develop and implement coordinated and expanded efforts to enroll American Indians in the Medicaid expansion.
  2. The Medicaid Expansion Outreach and Enrollment: Effective Strategies for Expanding Access to Coverage report was released March 2016.

Montana Budget and Policy Center

Report on the Impact of Medicaid Repeal on Montana’s Budget, Health Care Providers, and Individuals

Project Term: 12 months; Ended 2017
Grant Amount: $8,000

This project produced a report, 142,000 Montanans Face Uncertainty of Health Coverage with Threat of ACA Repeal, published in January 2017. The report generated two news stories and was mentioned in nine others.

Montana Budget and Policy Center

Medicaid Policy Analysis and General Operating Support

Project Term: 12 months; Ended 2018
Grant Amount: $50,000

This grant provided general operating support for the Montana Budget and Policy Center who will continue their work with Healthy Montana Coalition partners to disseminate information about Montana’s Medicaid expansion. During the grant period, the grantee helped to organize 15 events, conducted outreach to more than 18,000 Montanans, and produced 3 reports:

  1. Rural Montana Hit Harder Under House Passed Health Care Plan
  2. 142,000 Montanans Face Uncertainly of Health Coverage with Threat of ACA Repeal
  3. Montana Families Rely on Children’s Health Insurance Program

Montana Department of Public Health and Human Services

Improving the Health of Montanans through Local and Tribal Public Health

Project Term: 24 months; Ended 2018
Grant Amount: $1,344,740

This project supported county and tribal health department strategic planning and programming through a collaboration with the Montana Department of Public Health and Human Services (DPHHS). This grant made a major contribution to strengthening county and tribal public health departments in Montana and helped transform the relationship between the state and local health departments. The grant enabled local and tribal jurisdictions to complete community health planning that otherwise would not have happened on a statewide scale. From 2015 to 2018, the grant activities increased the number of completed community health assessments (CHA) by county and tribal health departments from 10 to 44; the number of community health improvement plans (CHIP) from 7 to 35; and the number of strategic plans from 7 to 26. In addition, some the funding was used by local health departments to implement programs that addressed priority areas identified in the CHIPs. For smaller health departments that lacked the resources to complete CHAs or CHIPs, the grant also allowed DPHHS to provide basic resources such as public health training for boards of health. The funding and collaboration between DPHHS and MHCF also facilitated the creation of a permanent public health system support unit that will provide ongoing support and technical assistance to local health departments beyond the term of the grant.

County Health Profiles are available to the public via the DPHHS portal for the county health departments and Community Health Assessments are available on our website.

Montana Department of Public Health and Human Services

Montana Oral Health Program

Project Term: 12 months; Ended 2018
Grant Amount: $100,000

This project helped develop and implement a framework for oral health improvement in Montana. The Montana Department of Public Health and Human Services began to develop a statewide framework to improve oral health, and in the fall of 2016, they held a Dental Action Summit which brought together 34 oral health stakeholders to establish strategic direction in addressing oral health disparities. Grant funding allowed the state to successfully make progress on priority areas that were identified including: improving community-level outreach and technical support for water fluoridation and dental sealants, developing a dental health workforce plan that includes in-depth examination of dental therapists to expand access to care, collecting and disseminating timely surveillance on oral health outcomes, and conducting a demonstration project that would provide case management through a “dental home” model for Medicaid-enrolled children to increase access to effective care.

Montana Department of Public Health and Human Services

Analyzing and Understanding the Impact of Medicaid Expansion on Montanans

Grant Term: 12 months; 2018-2019
Grant Amount: $90,500

This statewide project seeks to analyze available demographic and health data of the Montana Medicaid Expansion population in order to better understand the impact of expanded health coverage on Montanans.

Montana Free Press

In-Depth Health Care Reporting in Montana

Grant Term: 12 months; Ended 2019
Grant Amount: $10,000

This project allowed the Montana Free Press to research, investigate, report, and publish in-depth stories about health care and health care policy in Montana. The independent news site experienced tremendous growth in exposure and pick-up rate during the grant period, and many of their most popular stories and podcasts were directly related to health care and policy in Montana. Some of the key stories that were produced as part of this grant included:

  • Forgotten Communities” (Aug 2, 2018), which detailed how cuts to state-funded health services were disproportionately impacting rural communities. This article was the third most popular story on the website during the grant period.
  • Two Visions for Medicaid Expansion” (Feb 25, 2019), featured a discussion between Rep. Mary Caferro (D-Helena) and Rep. Ed Buttrey (R-Great Falls). This podcast provided an unfiltered debate between two key lawmakers on what was arguably the most significant issue of the 2019 legislative session. This was among the site’s highest performing podcasts with more than 550 unique downloads.
  • “The People of Medicaid” was a podcast series that went beyond the political debate and put a human face on a complex issue of Medicaid.

Montana Generational Justice Foundation

Estate Planning to Prevent Health Care Exploitation and Fraud

Project Term: 12 months; 2018-2019
Grant Amount: $30,000

This project will assist rural Montanans in addressing legal considerations related to incapacitating illnesses and end-of-life care. The project will help participants complete a durable power of attorney for health care, medical advanced directives, and living will which will provide directions to guide health care choices if they are unable to do so themselves. This project will also help individuals appropriately plan for and respond to immediate and long-term medical concerns, protect their assets from exploitation and fraud, assist in avoiding probate, and enable participants to minimize avoidable risk and confusion through assisting with estate planning. Services will be provided to one community as a pilot site and a business plan for sustainability will be developed through the course of the project. 

Montana Health Network

Eastern Montana Integrated Behavioral Health Program

Grant Term: 24 months; 2018-2020
Project Amount: $280,000

This project will support the integration of behavioral health into primary care for the health care facilities in eastern Montana that are not affiliated with a larger health system. The project will pull together rural clinics, hospitals, and partner organizations that provide behavioral health and substance abuse treatment services. Through this grant, the Frances Mahon Deaconess Hospital (Glasgow), McCone County Health Center (Circle), Prairie Community Hospital (Terry), Rosebud Health Center (Forsyth), Roosevelt Medical Center (Culbertson), and Sidney Health Center (Sidney) will implement integrated behavioral health (IBH) into their primary care practices. The Eastern Montana Community Mental Health Center is a close partner and will help meet the behavioral health needs for this project. Other facilities that are not directly involved with the grant but who will benefit from the results and training include Dahl Memorial Healthcare (Ekalaka), Fallon Medical Complex (Baker), Garfield County Health Center (Jordan), North East Montana Health Services (Wolf Point, Poplar), and Phillips County Hospital (Malta). Expected outcomes include decreased emergency room visits for patients in crisis, early and more frequent screening and identification of behavioral health and substance abuse issues, and increased patient coordination between treating facilities resulting in better care sooner for the patient.

Montana Health Research and Education Foundation

Montana Medicaid Expansion Impact Study

Project Term: 12 months; Ended 2019
Grant Amount: $54,100

This project allowed the Montana Hospital Association (MHA) to work with the nationally recognized consulting firm Navigant to develop an independent assessment of the financial impacts, fiscal performance, and health care impacts of Montana’s Medicaid expansion. The report was released during the legislative session during which reauthorization of the program was being debated. The report provided independent, rigorous analysis that informed stakeholders of the costs, cost-benefits, and overall objective, third-party analysis of the impact of Medicaid expansion on Montana’s health care system and economy. (The Montana Health Research and Education Foundation is the foundation arm of MHA.)

Montana Human Rights Network

General Operating Support

Project Term: 12 months; Ended 2018
Grant Amount: $30,000

This project was executed in collaboration with Montana Women Vote and the Montana Budget and Policy Center. The Network pursued two overarching strategies to protect access to health care for Montanans, particularly low-income and LGBT Montanans. First, they engaged in grassroots organizing to identify supporters and people who were directly affected by policy decisions related to the ACA and expanded Medicaid and then they worked to mobilize these supporters to take public action. Second, they worked to build a consistent narrative using primarily earned media that was supplemented with paid media at strategic times. The Network’s efforts identified hundreds of supportive Montanans through volunteer phone banks, online surveys, social media, and event canvasses. Through conversations with supporters, the Network identified individual stories of how the ACA and expanded Medicaid had created access to health care for themselves and their families. The Network also pushed honest, data-driven, and compelling research out through membership communications and social media.

Montana Legal Services Association

Montana Health Justice Partnership – Part 1

Project Term: 24 months; Ended 2017
Grant Amount: $100,000

The Montana Health Justice Partnership (MHJP) – a collaboration between the Montana Legal Services Association (MLSA), the Montana Primary Care Association, and four Federally Qualified Community Health Centers (CHCs) – provides legal assistance to patients in some of Montana’s most rural and isolated communities. MHJP’s model, a medical-legal partnership that explicitly engages both community health centers and the Primary Care Association, is the first of its kind in the United States and an emerging model for future medical-legal partnerships.

Through implementing this new partnership, the MLSA was able to provide legal services to rural and isolated communities addressing issues that impact health and well-being, and helping these rural patients live healthier lives. The grant allowed a strong, new partnership to form and enabled the partners to create systems that are integrated into the workflow of CHCs. The partnership has resulted in an increase of legal services in counties where partner CHCs are located: 168% increase in Cascade County, 177% increase in Hill County, and 184% increase in Lincoln County. The increase in Yellowstone County was minimal, largely because MLSA already had an office in Billings and since the migrant farmworker population served by the Billings CHC is much harder to reach and will require additional time to build trusting relationships.

The MHJP achieved national prominence over the course of this grant. In 2016 and 2017, partners were invited to present at the National Center for Medical-Legal Partnership (NCMLP) Annual Summit in Washington, D.C., and were included in a small cohort of national leaders under a Robert Wood Johnson Foundation research initiative to study medical-legal partnership operations and dynamics. In addition, MHJP was approached to be part of a collaboration between NCMLP and the Network for Public Health Law with a goal to provide expertise in public health law to partners working on medical-legal partnerships and be a conduit for best-practices. MHJP will also be featured in a case study series that NCMLP will develop and release over 2017-18. The MHJP team will continue to play a leadership role with other state organizations nationally to support the development and implementation of a statewide strategy to build sustainable medical-legal partnerships.

Project Materials:

MLSA Referral Process
MLSA and Montana Primary Care Association MOU
MHJP Health Harming Legal Needs and Social Determinants of Health Training
MHJP Authorization for Uses and Disclosures of Protected Health Information
MHJP Authorization to Release Case-Related Information
MHJP Screening Tool

Montana Legal Services Association

Montana Health Justice Partnership – Part 2

Project Term: 24 months; 2017-2019
Grant Amount: $100,000

Montana Legal Services and Montana Primary Care Association partnered in 2015 to create the Montana Health Justice Partnership (see Montana Health Justice Partnership – Part 1). The partnership provides legal assistance to low-income patients in several rural community health centers across the state on issues such as housing in disrepair, medical debt, family violence, denial of senior benefits, employment problems, health care access, and other issues that can have direct and indirect impacts on health. This project will expand the project’s service area to include two additional rural community health centers and will help sustain their activities while they finalize a sustainability plan. Grant funding will be used to add capacity through hiring a part-time paralegal which will allow the program to expand to two additional health care centers, increase capacity, and strengthen effectiveness.

Montana Medical Association Foundation

Montana Health Information Exchange Feasibility Development Plan

Project Term: 18 months; Ended 2018
Grant Amount: $50,000

This project’s goal was to explore the potential for creating a health information exchange (HIE) for Montana. The project successfully enabled over 100 individuals from 74 organizations to collaborate on a feasibility study. Partners included the Office of the Governor, the Montana Department of Public Health and Human Services, Montana Hospital Association, health insurance providers, and the Montana Primary Care Association. The launch event in December 2016 brought over 100 individuals from across the state together to share perspectives and concluded with support for the initiative. This diverse stakeholder group worked together over the following year to explore topics of privacy and security, business and finance, technology, clinical quality, and governance, and they offered recommendations in support of creating a state HIE. The project is summarized in the 2017 Montana HIE Planning Project Report, crafted by the consultant team from MyHealth Access Network. In addition, the project resulted in the establishment of a 501(c)3 organization, Big Sky Care Connect, and the appointment of a 12-member organizing board. Interest and support continue to grow for this private-public partnership.

Montana Medical Association Foundation

Prescription Drug Abuse Reduction Initiative

Project Term: 24 months; Ended 2017
Grant Amount: $25,000

This project developed a curriculum to present new and consistent information and to emphasize key points in the existing learning experience for residents (see training modules below). Presentations were completed in two programs and will continue to be available in future years. To assist the teaching faculty and residents, scholarships were provided to the Billings Clinic Internal Medicine Residency Program, the Family Medicine Residency of Western Montana Program, and the Montana Family Medicine Residency Program for teaching faculty and residents to attend the 2018 Montana Pain Conference: Evolving Science and Modalities. The conference was held in April 2018 at the University of Montana, and participants learned about best medical practices, shared experiences, and discussed challenges.

Training Modules:
An Ethical Approach to Current CDC Guidelines on Prescribing Opioids for Chronic Pain
Targets in the Pain Pathway to Manage Chronic Pain

Montana Medical Association Foundation

Optimization of Patient Care Through Health Information Exchange

Project Term: 12 months; 2018-2019
Grant Amount: $50,000

This project will build on a previous MHCF grant to explore the need and feasibility of a Montana health information exchange (HIE). This is part of a multi-stakeholder effort to establish a sustainable, statewide HIE that can serve as a patient’s data home and allow health care providers to access and share health-related information statewide. The stakeholders engaged include the Montana hospitals, physicians, behavioral health providers, primary care providers, Indian Health Services, insurance companies, patients, employers, Montana Veterans Affairs Health Care System, Montana Office of Rural Health, Mountain Pacific Quality Health, and the State of Montana. This grant will integrate a community pilot HIE in Billings into the statewide effort, support the formation and initial organizational development of a new nonprofit health information organization, and support activities related to the completion of a business plan, including communications and fundraising plans.

Montana Primary Care Association

Documenting Patient Experiences with Montana’s Medicaid Expansion

Project Term: 3 months; Ended 2017
Grant Amount: $16,400

This project resulted in the publication of Montana Coverage Matters, a storybook that documents individual patient experiences related to the Medicaid expansion. This project was done in partnership with the Montana Human Rights Network (who received an additional $20,000 MHCF grant for this project).

Montana Primary Care Association

Behavioral Health and Substance Use Disorder Integration in Primary Care

Project Term: 24 months; 2018-2020
Grant Amount: $200,000

Through this project, the Montana Primary Care Association will hire a full-time integrated behavioral health (IBH) director to support system-wide IBH implementation in federally qualified health centers (FQHCs). The goal is that in the first year, 100% of FQHCs will complete the base assessment and will move at least one level each year on the implementation integration scale from their base data. The IBH director will coordinate all training and technical assistance which will be measured for key patient services and outcomes. Screening, brief intervention, and referral to treatment for substance use disorders will be a major focus of the project.

Montana Public Health Association

Montana Public Health 101: Improving the Health of Citizens by Training the Public Health Workforce

Project Term: 24 months; 2018-2020
Grant Amount: $75,000

This project will help orient and train new public health workers by creating an online learning platform in partnership with the Department of Public Health and Human Services, the Association of Montana Public Health Professionals, the Montana Environmental Health Association, Montana State University Area Health Education Center, the University of Montana, and the Rocky Mountain Public Health Training Center. This new training resource will provide no-cost orientation for new public health workers to the state system and create an additional local board of health training option. This project aims to increase the knowledge and skills of local public health officials, decrease the amount of staff turnover, and mitigate the negative effects of staff turnover when it does occur. Grant funds will be used to develop the content of the online training module and produce the training in an online format. The primary public health entities in the state will be engaged throughout this project and will help disseminate the training and encourage its use once it has been developed.

Montana State University Foundation

Developing an Assessment of Climate Change and Human Health for Montana

Project Term: 24 months; 2019-2020
Grant Amount: $94,500

This project will establish a collaboration of health and climate science experts to produce Montana’s first assessment of the impacts of climate change on human health. “Assessing Climate Change and Human Health in Montana” (C2H2 for short) will be released in 2020 as an online web resource and a printed document with associated outreach and educational materials and activities. C2H2 will present health-relevant climate information describing recent trends and future projections; explain how climate change affects aspects of human health; and offer practical recommendations to guide local, state, and tribal efforts to anticipate and adapt to climate-related health threats in Montana. The report will receive both public comment and scientific peer review before its release, and professional evaluation after release. The goal is to provide the best-available science and health-related data at a level that is easy to access and understand by communities, medical professionals, and policy makers in Montana. C2H2 will serve as a Special Report to the 2017 Montana Climate Assessment.

Montana Supreme Court

2018 Montana Statewide Drug Court Conference

Project Term: 12 months; 2018-2019
Grant Amount: $12,988

This grant will support a convening of the 34 drug courts across the state. This project allows for the courts to convene around four primary goals: 1) Native American cultural competency and best practices for treating American Indians with a substance use disorder; 2) knowledge and skill building in what it takes to become a trauma-informed drug court, thus improving drug court outcomes; 3) medication-assisted treatment (MAT) and implementation of MAT in drug courts; 4) motivational interviewing techniques and support in drug courts. Partners include the Center for Court Innovation, National Association of Drug Court Professionals, the Native American Addiction Technology Center, the Tribal Law and Policy Institute, DPHHS, Montana Department of Transportation, and the Judicial Branch of Montana.

Montana Women Vote

Implementing Effective Strategies to Enroll Low-Income Montanans in Health Care Coverage

Project Term: 12 months; Ended 2017
Grant Amount: $25,000

Montana Women Vote worked with 45 volunteers to successfully reach more than 26,000 uninsured low-income individuals with information on the Medicaid expansion and enrollment opportunities. Given the scope of this project, it was not possible to accurately measure how many of the people reached subsequently enrolled in Medicaid. However, anecdotally, the grantee reported multiple conversations with people who said that they enrolled as a result of the outreach.

Montana's Peer Network

Statewide Peer Support Outcomes Collection Project

Project Term: 12 months; 2018-2019
Grant Amount: $43,774

This project will develop and implement a universal peer support data collection platform that can provide real-time outcome data on peer programs statewide. Outcome-based data collection can be used to secure future funding and demonstrate cost savings for long-term sustainability of peer services. This data platform would be available to any entity utilizing peer services statewide with real-time data outcomes from all programs collectively. Funding will be used to develop and host the statewide data collection platform for peer support programs and will help build a stronger business infrastructure through hiring administrative support staff to support the growing use of peers throughout the state. This new staff will help oversee the data platform, collection, and analysis and assist with general administrative duties for the organization.

Mountain Home Montana

Substance Use Disorder Treatment for Pregnant and Parenting Teens

Project Term: 18 months; Ended 2018
Grant Amount: $73,754

This planning project worked to develop a strategy for integrating substance use disorder treatment into Mountain Home Montana’s wrap-around care for pregnant and parenting mothers. Over the course of the project, Mountain Home Montana expanded and deepened partnerships with providers and strengthened their referral network and processes to better serve young families struggling with substance abuse. They successfully provided robust staff training around substance use disorder issues and levels of treatment, clarified referral processes, and hired an in-house therapist who is also a licensed addictions counselor. Mountain Home also obtained a Medicaid youth endorsement, which allows billing for case management and therapeutic services for clients under age 18 and they adopted an evidence-based evaluation tool to measure their program’s successes and challenges. As a direct result of policy shifts for substance use disorder treatment, staff training, and capacity, Mountain Home was able to reduce evictions from their residential program due to substance abuse from 20% to 6%. Beyond these direct results, Mountain Home also leveraged this planning grant into a five-year award from the federal Family and Youth Services Bureau to support residential programs.

Mountain-Pacific Quality Health Foundation

Implementing Trauma-Informed Care

Project Term: 24 months; 2018-2020
Grant Amount: $98,284

For this project, Mountain-Pacific Quality Health will collaborate with the Billings Area Indian Health Service and service unit facilities in Montana to support the implementation of comprehensive approaches to trauma-informed care that effectively address trauma and its impact on American Indian and Alaska Native populations in Montana. Mountain-Pacific will also offer these services to tribal health departments and urban Indian centers at their specific request and as resources allow. Mountain-Pacific will provide project management services to facilitate the transformation to trauma-informed care, train staff on trauma-informed principles and approaches, design and track workflows for trauma screening, develop an emotionally safe environment, determine and ensure safeguards like compassion fatigue training to prevent secondary traumatic stress in staff, and foster partnerships for referral sources that can monitor and maintain the ongoing mental and emotional well-being of patients and staff.

Mountain-Pacific Quality Health Foundation

Comprehensive Medication Management Pharmacist Training and Pilot Program for Primary Care

Project Term: 12 months: 2018-2019
Grant Amount: $21,912

For this project, Mountain-Pacific will partner with a consultant to train five care management pharmacists on comprehensive medication management (CMM). CMM is an evidence-based approach to improve patient outcomes. It ensures practices individually assess patient medications to determine each medication is appropriate, effective, safe (considering comorbidities and other medications), and able to be taken by the patient as intended. Mountain-Pacific will partner with clinics and payers to define options for providing CMM services onsite, collaborating with community pharmacies, and remotely providing medication management to two primary care practices in the Comprehensive Primary Care Plus (CPC+) program. This project aims to improve medication-related therapy outcomes, decreases adverse drug events, and decreases utilization of health care services.

MSU - Center for American Indian and Rural Health Equity

Responding to Secondary Trauma among American Indian Victim Service Providers

Project Term: 24 months; Ended 2018
Grant Amount: $25,000

This project’s goal was to serve American Indian social service employees who support victims of domestic violence, elder abuse, child abuse and neglect, sexual assault, and other forms of trauma. As part of this project, a toolkit was successfully created to mitigate the effects of secondary trauma among social service providers. Secondary trauma is recognized as an occupational hazard that contributes to health problems and burnout among victim service providers. The community advisory board met two-dozen times over the course of the grant to evaluate project and ensure the toolkit’s cultural relevance. A training on how to use the toolkit, using a train-the-trainer model, was held with over 50 people in attendance. Following the initial training, the project team received six requests for additional trainings and those trainings are currently being planned. Quantitative data analysis showed that the training resulted in statistically significant increases in awareness, knowledge, and normalization of secondary trauma and a statistically significant increases in awareness of coping strategies to reduce the impacts of secondary trauma among American Indian service providers who were trained to use the toolkit. Organizations engaged in this project have expressed their desire to make organizational changes to reduce the impacts of secondary trauma.

MSU - Department of Health and Human Development

Increasing Mental Health Access in Gallatin County

Project Term: 24 months; 2018-2020
Grant Amount: $69,395

MSU’s Graduate Counseling Program faculty, Dr. Anna Elliott, and Dr. Rebecca Koltz will partner with the Gallatin City-County Health Department (GCCHD) to develop an integrative system to provide mental health services to low-income Gallatin County residents. First, participants in the GCCHD home visiting program will be offered mental health service access through the Human Development Clinic (HDC), a community mental health agency, affiliated with MSU’s Counseling Program. To attend to logistical barriers that prevent low-income residents from seeking out counseling services, the HDC will offer transportation and child programming on site. The second portion of this collaboration will involve the hiring of post-graduate, pre-licensure counselors who are able to see clients with higher acuity and are insured by Medicaid. In addition to serving a demographic of Gallatin County, who face multiple barriers in trying to receive mental health services, this collaboration will also create an opportunity to train new counselors to work with high-need populations, preparing them to provide quality mental health service to a diverse and challenging array of clients upon graduation.

MSU - Office of Rural Health

The Montana Graduate Medical Education Council’s Rural Residency Sustainability Initiative

Project Term: 12 months; Ended 2016
Grant Amount: $25,000

This project’s goal was to provide rural training opportunities in Montana for medical residents. The project successfully held two “meet the residents” events which were attended by individuals from over 30 health care facilities. This direct contact with potential residents resulted in many placements. The project also produced a “culture of learning” toolkit which included state reference materials, statistics, and self-assessment tools for potential recruitment efforts. Surveys indicated that rural hospitals found the toolkit to be relevant and helpful. Annual conferences and resident connection events will be continued through funding from the residency programs and other sources.

MSU - Office of Rural Health

Community Health Worker Stakeholder Project

Project Term: 24 months; Ended 2018
Grant Amount: $140,772

This project created a plan to support the broader use of community health workers (CHWs) in Montana. CHWs are frontline public health workers who are trusted members of the communities they serve. They are intended to serve as a liaison between community members and health and social service providers in order to facilitate access to care, transportation, appropriate follow-up, and continuity of services. Over the course of the grant, the project achieved several major accomplishments. 1) It created a Montana CHW curriculum which includes nationally recognized core competencies as well as a focus on issues of importance to Montana. 2) It developed a training program for CHWs. The curriculum is currently offered online through the AHEC system partners and will also be piloted as a classroom training program. 3) As a result of this project, the MT AHEC Program was able to apply for and receive funding for a Behavioral Health Workforce Education and Training Grant from HRSA which pays the cost of training CHWs in Montana.

MSU - Office of Rural Health

Montana-Regional Initiatives in Dental Education

Project Term: 12 months; 2018-2019
Grant Amount: $46,660

This one-year planning grant is a result of statewide gatherings convened by the Montana Oral Health Program in 2016 and 2017. Participants included health, human service and education professionals with a passion and history for improving Montanans’ oral health. The resulting Oral Health Strategic Framework states: “MSU, WWAMI and UW School of Dentistry will continue to develop a sustainable model of dental education in Montana with at least 50 UW SOD students completing rotations in rural, tribal, and underserved communities by 2023 to meet the oral care needs of rural residents, and to better understand the opportunities, challenges, and promise of serving in these settings.” This one-year planning project will put together a plan to reach that goal. Elements of the planning process are to 1) engage in collaborative planning with organizations across that state to increase the number of dental student rotation sites, 2) develop a plan to expand clinical training experiences for dental students, 3) deliver continuing development to oral health professionals, and 4) support collaboration among health professionals to support the delivery of dental care in rural and underserved areas.

MSU - Office of Sponsored Programs

Partnerships to Support Palliative Care in Montana Critical Access Hospitals

Project Term: 24 months; 2018-2020
Grant Amount: $79,785

This project will develop partnerships which enable Montana critical access hospitals to provide primary palliative care services. Many Montanans are living with serious and life-limiting illnesses in rural settings with limited access to palliative care services. Most critical access hospitals in Montana do not offer palliative care services and challenges associated with providing palliative care in rural areas are well documented. The goal of this project is to provide palliative care education to rural health care providers and improve access to palliative care for rural dwellers who are living with serious and life-limiting illnesses. Partners include the Family Medicine Residency program of Western Montana and four critical access hospitals in western Montana.

MSU Foundation

Promotion and Delivery of Thrive-Montana, an Internet-Delivered Cognitive Behavior Therapy Program

Project Term: 12 months; 2018-2019
Grant Amount: $26,904

This project will establish and strengthen state partnerships for effective promotion and delivery of Thrive-Montana, an evidence-based, internet-delivered cognitive behavior therapy program designed to assist adult Montanans experiencing anxiety, depression and/or suicidal thinking. To achieve this goal, MSU has built-in funding for effective marketing messages to reach vulnerable populations throughout the entire state. Funding will support staff FTE to outreach rural areas and assist with messaging and communication. Key outcomes for this project are to strengthen partnerships with MSU Extension system, One Montana, Montana National Alliance for Mental Illness, and Montana’s Department of Public Health and Human Services to identify state health care systems, community critical care hospitals, health departments, and other identified state and community organizations for implementing effective promotion and delivery of Thrive-Montana.

Native American Development Corporation

Billings Urban Indian Health and Wellness Center

Grant Term: 12 months; Ended 2019
Grant Amount: $75,000

This grant supported planning for and opening the Billings Urban Indian Health and Wellness Center. In December 2018, the new center began providing comprehensive primary care and behavioral health services to the American Indian community in Yellowstone County. They are continuing to expand the services they provide. They are now an approved provider for Medicaid, Medicare, and private insurers and have hired a state approved substance use provider. This structure will enable them to collect reimbursement for the services they provide and will ensure long term sustainability. As part of this project, they also successfully established meaningful partnerships with other health organizations in the community and will begin to implement an integrated behavioral health model of care within their primary care clinic.

NeighborWorks Great Falls

Home Matters: Linking Homes and Health Outcomes

Project Term: 18 months; Ended 2017
Grant Amount: $10,000

NeighborWorks Great Falls completed two surveys of health outcomes, one of the residents of new apartments and the other of homeowners in newer homes. The surveys indicated better self-reported health outcomes after residents moved to the new home or apartments. Focus groups were conducted with discharge planning professionals, and they indicated that housing is considered in discharge planning and that supportive housing is needed. This study and community engagement was the impetus for the grantee to engage in a MHCF Housing and Healthcare Initiative planning grant.

Neighborworks Great Falls

A Housing and Health Care Plan for Cascade County

Grant Term: 12 months; 2018-2019
Grant Amount: $60,000

For this project, Neighborworks Great Falls, in partnership with Benefits Health Systems and with the guidance of the Corporation for Supportive Housing, will develop a plan that uses data integration and hospital analysis along with community resources and program coordination to drive investments in supportive housing. Supportive housing will be designed to serve the population that is most likely to be homeless or near homeless, and who face health obstacles including mental illness and substance use disorders. The project’s goal is to give community service providers guidance in identifying cost-effective ways to improve outcomes for vulnerable people by providing supportive services and secure housing.

NeighborWorks Montana

Manufactured Housing Rehabilitation and Replacement Collaboration

Project Term: 18 months; Ended 2017
Grant Amount: $20,000

NeighborWorks Montana conducted surveys and community engagement in two manufactured home communities near Missoula. The survey found that residents do see links between their health and their housing, and many would like to make improvements to both. Grant support was used to build new relationships and partnerships to address various aspects of manufactured health and housing. These partnerships and the process involved to engage the health and housing sector led the community to pursue a MHCF Housing and Healthcare Initiative planning grant.

North American Indian Alliance

Strategic Planning Initiative

Project Term: 12 months; 2017-2018
Grant Amount: $50,000

For this project, North American Indian Alliance (NAIA) will complete a needs assessment and strategic plan. This initiative will take place in two stages: first, a consultant will work with organizational leadership to create an interim plan to stabilize the organization by fall 2017; and second, NAIA will work with partner organizations including the county health department, hospital, and behavioral health providers to conduct an in-depth needs assessment and develop a more comprehensive strategic plan. The strategic plan will reveal current and potential service provision gaps and formulate a plan that addresses programming, operations, and financing. The goal is to stabilize the organization internally and build on the strengths of their current work while looking for ways to extend their services to the community.

North American Indian Alliance

Electronic Health Record and Revenue Cycle Optimization Project

Project Term: 12 months; Ended 2017
Grant Amount: $15,000

This project helped optimize the North American Indian Alliance’s electronic health records and improved third-party revenue within the organization. The Helena Indian Alliance provided technical support in developing office procedures to ensure accountability, producing efficient managers capable of teaching staff, and building the correct measures to report progress. All of the clinical and behavioral health providers were successfully trained to use the new system and the organization is now able to successfully complete third-party billing.

North Valley Hospital Foundation

Virtual Access for Behavioral Health Care Services

Project Term: 24 months; Ended 2018
Grant Amount: $50,000

This project expanded behavioral health and tele-behavioral health throughout the North Valley Hospitals service area with targeted communities in Eureka, Whitefish, and Columbia Falls. In the Eureka school system, North Valley expanded tele-behavioral health services by putting the technology and services in place. In Columbia Falls and Whitefish, behavioral health services were expanded into the existing school-based health centers through onsite behavioral health staff. The project also resulted strengthening North Valley Hospital’s infrastructure for tele-health throughout the organizations service lines, which will allow for increased behavioral health access in the region moving forward.

North Valley Hospital Foundation

School Based Integrated Behavioral Health Care for Students

Project Term: 24 months; Ended 2018
Grant Amount: $150,000

This project helped North Valley work towards integrating behavioral health services into a school-based health center serving at-risk students in Columbia Falls and Whitefish. A previous grant from MHCF, helped North Valley establish telepsychiatry services at the school. This new grant was intended to help the hospital hire an on-site behavioral health provider who would offer mental health and substance use disorder screening and treatment to the high-risk student population and develop and implement a fully-integrated system of care in the hospital’s outpatient clinics. The project experienced some staff turnover, and they are currently recruiting for this position. Even so, during the grant North Valley realized a 23% improvement in depression screening rates for their primary care clinic and a 71% improvement in depression scores for the integrated behavioral health population during the time when the behavioral health position was filled.

Northern Cheyenne Tribal Board of Health

Revenue Enhancement Project

Project Term: 18 months; 2017-2018
Grant Amount: $75,000

This project will help increase revenue by billing third-party insurance and will strengthen tribal health services by improving the tribe’s revenue management system. Funding will be used to hire a new staff position to focus on insurance enrollment, and a consultant to help with revenue cycle management. Expected outcomes include educating the revenue enhancement staff in third-party insurance billing, increasing revenue by approximately 25 percent, and hiring a permanent patient registration staff.

Northern Cheyenne Tribal Board of Health

Injury Prevention Project

Project Term: 24 months; Ended 2018
Grant Amount: $99,453

The grant allowed the tribe to establish the Northern Cheyenne Injury Prevention Program. The grantee formed a strong coalition and provided multiple car seat safety clinics, safety checks, seat belt law awareness, and data sharing. In a major success, the coalition provided data and advocacy that ultimately supported a decision by the Tribal Council to rescind the Secondary Seat Belt Ordinance and implement a Primary Seatbelt Ordinance in September 2018. The tribe is assessing options to fund ongoing injury prevention activities, including seeking federal injury prevention funding and possibly including this program in T-HIP Tier 2.

Northern Rockies Medical Center

Integrating Behavioral Health in a Critical Access Hospital

Project Term: 12 months; Ended 2019
Grant Amount: $50,000

Through this planning grant, Northern Rockies Medical Center (NRMC) was able to increase the effectiveness of behavioral health referrals, overcome barriers to psychiatric care, and increase the capabilities of their clinic and hospital to address the behavioral health and substance abuse needs of the community. NRMC strengthened local and regional partnerships through formalizing referral pathways, care coordination, and tele-psychiatry services for one hospital and two community health centers. NRMC also implemented universal screening for depression, anxiety, and substance use disorders, and developed data tools and workflows for screening, referrals, treatment, and emergency department utilization for behavioral health. NRMC is actively working with regional partners to explore a feasible and sustainable approach to integrated behavioral health through partnerships versus individual expansion. Leadership is committed to continued expansion of behavioral health through a regional model to better utilize existing workforce and resources.

Open Aid Alliance

Licensed Chemical Dependency Treatment Center

Project Term: 12 months; Ended 2017
Grant Amount: $8,780

This project helped Open Aid Alliance apply for and receive licensure to become a state-approved substance use disorder treatment center. This new licensure will allow the organization to expand their services and create a harm reduction treatment center for individuals who experience stigma as they seek to improve their health; including people living with HIV, people using injection drugs, and people who have been homeless and/or incarcerated. The grantee successfully completed a consulting process, developed feasibility and business plans, and created policies and procedures needed to implement sustainable substance use disorder services. This expansion not only successfully strengthened partnerships in the community but also provided immediate access to treatment for clients and created a new diverse revenue stream for the organization.

Open Aid Alliance

Overdose Prevention and Naloxone Access Project

Project Term: 18 months; Ended 2017
Grant Amount: $15,000

This project helped Open Aid Alliance build strategic partnerships and create training opportunities for service providers and people who use injection drugs to improve prevention, recognition, and response to opiate overdose. Open Aid Alliance trained nearly 100 people to recognize an overdose and to respond and administer naloxone. The project fell short of their projected goal of training 360 people, however, they added overdose recognition and response to their website. This project also helped Open Aid expand their programming by exploring a substance use disorder treatment provider endorsement. This exploration led to increased partnerships in the community, strengthened business operations, and ultimately improved the continuum of substance use disorder care in Missoula County. The most profound and meaningful outcome of the project was the relationship building, strengthening partnerships, and positive legislative work to increase access and availability of naloxone throughout Montana.

Park County Health Department

Recovery Court Program Strategic Planning

Project Term: 12 months; 2017-2018
Grant Amount: $49,250

This project will bring together a group of community stakeholders to use sequential intercept mapping (SIM) to develop a strategic plan for reducing the number of adults with co-occurring behavioral health and substance use disorders in the local detention center. SIM focuses on helping communities rationally identify the criminal justice, social service, health contacts, and costs of serving people with mental illness and substance use disorders; and design a system that improves system efficiency and outcomes. The program will contract with an independent consultant to develop a court supervision program built on evidence-based strategies from other regional and state programs. Stakeholders include members of local and regional behavioral health, law enforcement, and the judiciary.

Partnership Health Center

Care Management for Super-Utilizers Program

Project Term: 24 months; Ended 2018
Grant Amount: $148,183

This project established an innovative pilot to serve “super-utilizers” – frequent utilizers of Partnership Health Center’s services and local emergency rooms. Super-utilizers are the approximately one percent of patients accounting for twenty-two percent of total health care expenditures, and they often suffer from multiple health conditions and socioeconomic barriers to care which contribute to multiple emergency room visits and hospital admissions. The project created a team consisting of a licensed clinical social worker, registered nurse, and primary care provider to coordinate care and conduct home visits and follow-up calls with select patients to address their medical, behavioral and social needs. The health center also successfully redesigned their care approach to prioritize patient needs and focus on interventions that lessened the cycle of hasty emergency department use and inpatient stay. Outcomes included reductions in the number of emergency department visits and inpatient stays and increased self-efficacy among patients. Recognizing the success of the program, Medicaid changed its reimbursement models for this super-utilizer approach to care.

 

Poverello Center

Medical Respite Shelter for Homeless Patients

Project Term: 24 months; Ended 2018
Grant Amount: $50,000

For this project, the Poverello Center partnered with St. Patrick’s Hospital to establish care coordination for homeless individuals recovering from a hospital stay to help them transition from the homeless shelter to transitional housing. The project expanded on Poverello’s existing medical respite program by supporting more robust care coordination, evaluating health outcomes, and strengthening and formalizing partnerships and funding agreements. In partnership with the VA, the Poverello Center successfully converted five of their beds to house veterans. In addition, the project was successful in reducing emergency department readmissions and inpatient stays among the homeless population participated in the program. Care coordination and transitional shelter services will be sustained moving forward through ongoing support from the VA and St. Patrick’s Hospital.

Poverello Center

Medical Respite Program Evaluation and Capacity Building

Project Term: 24 months, 2018-2019
Grant Amount: $25,470

This project will evaluate Poverello’s pilot respite care program which was previously funded by MHCF. The respite care program established care coordination for homeless individuals recovering from a hospital stay to help them transition from the homeless shelter to transitional housing. Providence Hospital is supporting the continuation of this program because of its success in reducing emergency department readmission and inpatient stays among the homeless population. Evaluation will be a key next step for demonstrating this program’s success and modeling it for replication in other organizations.

Powder River First Responders

Regional Training Opportunities

Project Term: $12 months; 2018-2019
Grant Amount: $13,500

This project will provide three training and outreach sessions that incorporate local and regional services focusing on all aspects of emergency care in the frontier setting. The training will not only cover the participants who attend but also will enable them to bring what they learn back to their facilities and train others. The goal of the project is to create a more seamless continuity of care and a better working relationship between services and facilities.

Providence Montana Health Foundation

The Bridge to Hope Project

Project Term: 12 months; Ended 2018
Grant Amount: $42,600

This project worked to support mothers and families with newborns experiencing Neonatal Abstinence Syndrome (NAS) on the Flathead Reservation. This project was designed to reduce the rate of maternal-infant separation in the hospital setting as a result of NAS treatment, engage addicted mothers in the care of their infant through support group sessions, and increase addicted mothers’ voluntary participation in area drug treatment programs by the time of their infants’ discharge. The project successfully achieved its objectives and developed a model that has garnered the interest of other providers around the state. The program supported 40 infants per year resulting in 85% of infants involved in the program getting discharged home from the hospital with a biological caregiver. Maternal prenatal and postnatal substance use support resulted in 30% of mothers no longer using at the time of delivery and 20% of mothers involved in drug treatment programs. The project built new collaborative partnerships with Confederated Salish & Kootenai Tribal Social Services, the Montana Department of Public Health and Human Services (MT DPHHS) Child and Family Services, the Montana Department of Justice Drug Endangered Children Task Force, and the Lake County Public Health Department, in addition to many non-profit organizations and community partners.

Providence Montana Health Foundation

The Wrapped in Hope Project

Project Term: 24 months; Ended 2017
Grant Amount: $100,000

The Wrapped in Hope Project was a collaboration between Providence Montana Health Foundation and Saint Joseph Hospital, with strong support from the Confederated Salish and Kootenai Tribal government, to implement a multi-disciplinary approach to drug use during pregnancy through both clinical and home-based services. Both hospitals implemented collaborative, team-based approaches that provide holistic, respectful, family-centered care. They also hired licensed clinical social workers with expertise in addictions to provide care and coordinate supportive services for pregnant women struggling with addiction. A second component of the program focused on community outreach encouraging women to seek care in early pregnancy and informing them of available supportive services (materials below). This project achieved significant accomplishments both on the programmatic and community change level, including:

  • Women struggling with substance abuse while pregnant can now go to any health care provider in the Mission Valley and receive non-judgmental, quality health care, recovery support, and referrals.
  • Because of the project’s partnership efforts, local health care professionals have an increased knowledge and awareness about neonatal abstinence syndrome, the importance of working with Child Protective Services, motivational interviewing, pain and opioids, and other relevant topics impacting pregnancy and addiction.
  • This project has created and sustained a model of community collaboration for addressing the public health crisis of women and their babies impacted by substance abuse during pregnancy.

Project Materials:

Providence Montana Health Foundation

Providence Medical Group Integrated Behavioral Health Initiative

Project Term: 24 months; Ended 2019
Grant Amount: $150,000

With this grant, Providence Medical Group integrated behavioral health into their Grant Creek Family Practice (a patient-centered medical home). Over the course of the project, Grant Creek established universal processes for depression and increased screening rates from 63% to 71%. They also established protocols and started universally screening for substance use disorders, anxiety, and suicide. By developing clinical workflows and applicable billing and coding procedures, Grant Creek was able to create a financially sustainable model for the future. Providence Medical Group leadership is committed to implementing the integrated behavioral health model throughout its remaining eight primary care clinics and will do so starting in 2019.

Providence Montana Health Foundation

A Collaborative Approach to Screening and Treatment of Perinatal Drug Use Disorders

Grant Term: 24 months; 2018-2020
Grant Amount: $150,000

For this project, Missoula’s Providence Saint Patrick Hospital (SPH) will implement a collaborative approach to screen for and treat perinatal drug use. The goal of this project is to provide holistic, non-judgmental care empowering women with skills and resources to successfully care for their newborns, especially those with neonatal abstinence syndrome. The hospital’s family maternity center and neurobehavioral health will partner with Western Montana Clinic’s obstetrics and gynecology providers to establish and implement a clinical care team that includes licensed behavioral health clinicians. At the community-level, partnerships will be established with the Missoula City-County Health Department, the neonatal abstinence syndrome workgroup, child protective services, and other appropriate agencies. Providence SPH and Community Medical Center will work collaboratively on educational and outreach efforts for staff and the community-at-large regarding the critical importance of addressing the impact of perinatal drug and alcohol use in Missoula. A central focus is provider education regarding the need for universal drug screening for all pregnant women in Missoula and the surrounding areas to improve health outcomes for mothers and their newborns. Grant funds will be primarily used for personnel including a behavioral health provider and childbirth educator.

Public Health System Improvement Office

Improving Health Through Collaborations

Grant Term: 24 months; 2018-2020
Grant Amount: $262,587

MHCF’s 2014 grant to the Montana Department of Public Health and Human Services (DPHHS) supported county and tribal health departments to complete 34 local board of health trainings, 17 community health assessments, 10 community health improvement plans, and 10 strategic plans. One of the most important findings from this work was the prevalence of behavioral health concerns in communities throughout Montana: 80 percent of health departments identified substance use disorders and at least half also identified suicide or mental illness as top health challenges. This new grant will accomplish two related goals. First, it will build on MHCF’s current collaboration with DPHHS to continue strengthening capacity among Montana’s local and tribal public health departments. Second, through a new partnership between the DPHHS Public Health and Safety and Addictive and Mental Disorders divisions, it will implement a new, statewide, coordinated, public health-led initiative to prevent substance use disorders and mental illness.

Public Health System Improvement Office, Public Health and Safety Division

Montana Public Health Workforce Assessment

Project Term: 12 months; 2018-2019
Grant Amount: $11,000

This project will support the strengthening of public health in Montana by developing a statewide public health workforce survey and administering the survey to all participating health departments across the state. Partners for this project include the Montana Public Health Workforce Development Group and the University of Montana’s Center for Children, Family, and Workforce Development. The survey will provide health departments and public health organizations a comprehensive look at Montana’s public health workforce interests and needs. Grant funds will be used to hire a contractor to review the current workforce data, develop and distribute the survey, and collect and analyze the results. To date, Montana has not had a comprehensive workforce survey, and it is an essential ingredient for developing a sound, statewide approach to building a public health workforce.

PureView Health Center

Universal Substance Use Disorder Screenings and Warm Handoffs

Project Term: 12 months; Ended 2018
Grant Amount: $13,440

For this project, PureView Health Center sought to implement universal substance use disorder screenings for all patients over 10-years old. Every patient 10-years old and older were screened for substance use disorders, and if necessary, they were referred and given a warm-handoff to the health center’s behavioral health team. Screening, brief intervention, and referral to treatment (SBIRT) was successfully implemented and integrated into integrated behavioral health workflows and processes and substance use disorder screenings went from 0% to 75% during project period. Additionally, three providers obtained waivers for medication assisted treatment (MAT) and MAT has been initiated as part of PureView’s integrated model. Universal screenings for social determinants of health have also been incorporated into the integrated model with this pilot for screening starting in January 2019.

PureView Health Center

Development of East Helena School-Based Health Center

Grant Term: 12 months; 2018-2019
Grant Amount: $48,527

This planning grant will allow PureView Health Center (PVHC) to plan for the opening of a school-based health center in East Helena. The school-based health center will be created through partnerships with Intermountain Children’s Services (a children’s mental health center), PVHC (a federally qualified health center), and the East Helena School District (a school district that serves 50 percent of children on free or reduced lunch). This grant will allow all three organizations to effectively plan for the construction and service delivery of the clinic including but not limited to: architectural professional services, a site visit to a successful integrated school-based health center, and the development of a business and operational plan. 

Richland County Health Department

Connecting Resources for Emotional Wellness

Project Term: 12 months; Ended 2018
Grant Amount: $28,328

This project used innovative strategy to address the upstream risk factors contributing to poor emotional health and the consequent occurrence of mental health crises. Using an Emergency Preparedness Tabletop Exercise Model, the Richland County Mental Health Local Advisory Council successfully brought together multiple agency stakeholders to identify resources and gaps in support services. The methodology and results of this project were documented and translated into a toolkit that can be widely distributed to others who may be interested in conducting a similar project. On a local level, emotional wellness resource cards were developed and distributed and a “no wrong door” policy was developed; the goal of the “no wrong door” policy is to create an environment among health and service providers in Richland county where community members can be linked to behavioral health services from any point of service through which a person enters. All the products created through this project are designed to divert people from behavioral health crisis by strengthening emotional wellness supports in the community and increasing the opportunity for early intervention and engagement with behavioral health services.

Rimrock Foundation

Residential Treatment for Pregnant American Indian Women

Project Term: 24 months; 2017-2019
Grant Amount: $63,135

This project will help create Elm House, a residential treatment home for pregnant women struggling with addiction that will incorporate perinatal care with addiction treatment throughout the duration of the pregnancy. In partnership with St. Vincent Healthcare’s Provider Network’s Midwives, this treatment modality will promote long-term recovery, while the women receive the necessary obstetric care to decrease the occurrence of perinatal drug exposure and neonatal abstinence syndrome. Priority admission will be given to Northern Cheyenne and Crow patients referred through the work of previous MHCF grants to St. Vincent’s. In addition to treatment, women will receive case management services to ease into the transition to a safe sober living environment with their baby after delivery.

RiverStone Health

Integrated Clinical Pharmacy Services Best Practices

Project Term: 12 months; Ended 2017
Grant Amount: $25,000

This project focused on supporting clinical pharmacist and primary care integration to improve health outcomes. Important achievements included working with DPHHS to develop administrative rules for Medicaid reimbursement for clinical pharmacist practitioners. The grantee will continue to work on establishing standard outcomes measures across the state that will be used to demonstrate the value of clinical pharmacy services. Ongoing planning and educational sessions will also occur to assist pharmacists who are interested in establishing clinical pharmacy services in a physician practice.

Project Materials: 

RiverStone Health

Good Behavior Games and Trauma Informed Schools

Project Term: 24 months; 2017-2019
Grant Amount: $75,000

This project will build on the work that Yellowstone County has been doing to prevent adverse childhood experiences and promote trauma-informed care by implementing the PAX: Good Behavior Games in three schools located on the south side of Billings. The Good Behavior Games helps students learn effective self-management skills that have been shown to increase student success through increasing graduation rates, decreasing costs of special education, and decreasing suicide rates, incarceration, and substance abuse. This project will help create a more equitable school culture which will enhance student success and create a healthy trajectory for children as they become adults. Over two years, this project will train all kindergarten through third-grade teachers from the participating schools to use the Good Behavior Games and enhance the trauma-informed culture at each school.

RiverStone Health

Expanding Integrated Behavioral Health Care and Training in Primary Care

Project Term: 12 months; Ended 2017
Grant Amount: $50,000

For this project, RiverStone Health successfully completed a business feasibility plan for expanding its scope of service to provide integrated psychiatric services. The feasibility plan also examined opportunities for RiverStone to serve as an integrated behavioral health rotation site for students in psychiatric nurse practitioner training programs, psychiatry residency programs, and Master of Social Worker students. As a result of the planning, the project was able to successfully formalize an integrated behavioral health training program. Additionally, a community coalition of behavioral health providers was established in Billings and continues to meet to network and share critical information among programs.

Rocky Boy Health Board

Centralized Coding, Billing, and Revenue Maximization Project

Project Term: 24 months; Ended 2017
Grant Amount: $99,608

The goal of this project was to develop a sound administration and stable revenue base, which would allow the tribe to design and run effective, tribally-led health programs. During the course of the project, eight tribal health employees completed a coding course through Stone Child College, one patient registration clerk and two benefits coordinators were hired, three staff completed Indian Health Service third-party billing and account management training, and two staff members attended the National Indian Health Service patient registration. One year after the completion of the grant, the grantee reported an overall increase of third-party revenue of over $2 million (52.74%). 

 

Rocky Mountain Development Council

Tri-County RSVP Keeping You Home Project

Project Term: 12 months; Ended 2016
Grant Amount: $25,000

This project’s goal was to reduce the risk of hospital re-admission for high-risk seniors and disabled individuals. This pilot project successfully recruited 13 RSVP (retired senior volunteer program) volunteers to work with 47 discharged patients from St. Peters Hospital in Helena and four other rural hospitals. A care coordination training toolkit was developed and agreements for accessing patients’ health records were secured. Only two of the patients who took part in the program were re-admitted to St. Peters (which was well below the 20 percent re-admission rate that the hospital had experienced prior). Local health care providers found the program to be useful in reducing hospital re-admissions and plan to support it moving forward. 

 

Rocky Mountain Tribal Epidemiology Center

Feasibility of Maintenance Therapy in Pregnancy among Opioid Users in Tribal Communities

Project Term: 12 months; Ended 2017
Grant Amount: $25,000

This planning grant investigated the feasibility of providing medication-assisted treatment for women on the Blackfeet Reservation who are using opioids during pregnancy. This treatment is recommended by the American College of Obstetricians and Gynecologists as an evidence-based standard of care because it can prevent maternal and fetal complications of opioid use and withdrawal, encourage prenatal care and drug treatment, and reduce social complications and criminal activity associated with addiction.

The grantee organized a conference on Blackfeet that was attended by more than 90 people. Speakers included clinicians from the Blackfeet Community Hospital, members of the Lummi Tribe, and a neonatologist from Kalispell Regional Medical Center. The conference and feedback from participants were used to generate a final report: Addressing Opioid Use in Pregnancy: Conversations and Next Steps in Blackfeet.

Following the conference, members of the Blackfeet Tribe visited the Lummi Opioid Prevention and Treatment Center in WA and were inspired to consider creating a similar program on Blackfeet. They formed an opioid prevention task force which includes employees of the Blackfeet Community Hospital, Silent Warriors, Blackfeet Tribal Health, Blackfeet Community College, and other stakeholders. This task force and their opioid prevention work will continue in 2017 with new foundation funding.

Rocky Mountain Tribal Epidemiology Center

From Plan to Action: Prevention and Support for Pregnant Blackfeet Women Using Opioids

Project Term: 12 months; Ended 2018
Grant Amount: $75,000

In 2016, MHCF supported the Rocky Mountain Tribal Epidemiology Center and their Boston University-based partners to work with the Blackfeet Tribe and the Indian Health Service Blackfeet Community Hospital on early-stage planning work to address opioid use by pregnant women. The funds supported a conference hosted at the Blackfeet Community College, a detailed report and feedback, an inspirational Blackfeet visit to the Lummi tribe’s opioid maintenance program, and the formation of a new, multi-partner opioid prevention task force on Blackfeet.

This project continued this work through task force strengthening and capacity-building, focus groups/key informant interviews with clinicians and substance-using pregnant women, the production of a “gap analysis” to determine treatment shortfalls for substance-using pregnant women on Blackfeet, and the production of a feasibility analysis and business plan for developing services to address perinatal drug use. Ultimately, the project resulted in the coordination and development of a medication-assisted treatment (MAT) clinic for pregnant women and families on the Blackfeet Reservation. The grantee was also able to successfully secure additional funding to support further development of the project through the State of Montana STR grant and a Tribal Opioid Response grant which will supplement the services offered through the MAT clinic. A building on the Blackfeet Reservation was secured for the MAT clinic and a partnership was establish with Community Medical Services. Community Medical Services provides the induction and medication management services and Blackfeet Tribal Health provides the care coordination and behavioral health services for the women and families.

Saint James Healthcare Foundation

A Relational Model for Reducing Perinatal Substance Use Disorders in Southwest Montana

Grant Term: 24 months; 2018-2020
Grant Amount: $150,000

For this project, Saint James Healthcare (SJH), in partnership with a network of community partners, will work to prevent perinatal substance abuse and improve care and access for pregnant women struggling with substance use in Southwest Montana. The multidisciplinary community team includes SJH, Montana Chemical Dependency Center, Southwest Montana Community Health Center, the Butte-Silver Bow Health Department, the Southwest Region Child & Family Services, and the Butte Community Action Team. This program a relational model of care and education inclusive of behavioral health, consistent prenatal care, and care coordination to address social factors impeding treatment. As a key component, the program engages the father or significant partner within the sphere of care, treatment, and social support. The program seeks to reduce occurrences of substance use in pregnancy and specifically encourages a path to long-term recovery through early detection and intervention, accessible treatment, and increasing community awareness. SJH will create a clinical team consisting of a social worker/care coordinator, a licensed behavioral health provider and family medicine physicians and an obstetric provider. Grant funds will be used primarily to support personnel and facilitate travel.

Saint James Healthcare Foundation

Butte Supportive Housing Collaborative

Project Term: 12 months; Ended 2019
Grant Amount: $60,000

For this project, Saint James Healthcare, in partnership with Action, Inc. and with the guidance of the Corporation for Supportive Housing, developed a plan that uses data integration and hospital analysis along with community resources and program coordination to drive investments in supportive housing. Supportive housing was designed to serve the population that is most likely to be homeless or near homeless, and who face health obstacles including mental illness and substance use disorders. The project’s goal was to give community service providers guidance in identifying cost-effective ways to improve outcomes for vulnerable people by providing supportive services and secure housing. Throughout the course of the grant, the project accomplished several significant milestones including: 1) identifying and bringing together stakeholders to address chronic homelessness, 2) developing collaborative needs assessments among stakeholders to define the scope of the problem of chronic homelessness in Butte, 3) identifying 19 unique individuals in the Butte area who are frequent users of existing public safety resources and who could benefit most from the project’s supportive housing services, 4) compiling economic data on the costs of chronic homelessness and frequent systems utilizers in Butte, and 5) and partnering with the Corporation for Supportive Housing to finalize a plan to implement a new strategy to address chronic homelessness in Butte.

Saint James Healthcare Foundation

Increasing Access to Integrated Behavioral Health in Silver Bow County

Project Term: 24 months; 2018-2020
Grant Amount: $150,000

This project will allow the grantee to expand integrated behavioral health services into Saint James Medical Group’s primary care practice. This grant will help Saint James meet the tremendous need in the Butte community by developing streamlined strategies to provide the full continuum of care for identified patients with mental illness and substance use disorders and thoroughly train and integrate their clinical teams. Saint James will work with the Butte-Silver Bow County Health Department, Western Montana Mental Health Center, Montana Chemical Dependency Center, and others to define a consistent continuum of care plan to ensure smooth referral of patients from one level of care to another.

Saint Luke Community Healthcare Foundation

Integrated Behavioral Health for Lake and Sanders Counties

Project Term: 12 months; Ended 2018
Grant Amount: $50,000

This project developed a plan to enhance St. Luke’s current integrated behavioral health model so that they could provide more evidence-based and financially sustainable services throughout their health care system. St. Luke’s successfully optimized scheduling and stratification of patient needs and reduced no shows for behavioral health appointments by 50%. They also received approval for rural health clinic status so that they can now assist with the delivery of integrated care and ensure its financial sustainability. Finally, they added a second licensed clinical social worker so that they could offer more comprehensive behavioral health coverage throughout their health system.

Saint Peter's Health Foundation

Integrating Behavioral Health into Saint Peter’s Medical Group’s Primary Care Practice

Project Term: 12 months; Ended 2018
Grant Amount: $50,000

This planning project sought to establish clinical work flows, data analytics, and revenue cycle needed to develop a successful integrated behavioral health model in St. Peter’s two primary clinics. The project successfully created a multidisciplinary team of primary care and behavioral health professionals who worked together to create standardized screening assessments and clinical pathways for the medical groups. Care team education, standardized tools, and clinical pathways were all developed and implemented to support best practice clinical care and integrated behavioral health workflows. As a result of this project, St. Peter’s realized a 9.4% reduction in emergency room visits and a 5.1% reduction in inpatient stays for behavioral health patients. The behavioral health professionals continue to increase the number of warm hand-offs and follow-up patient appointments to help increase the access to behavioral health services in their community. With this robust planning process and beginning implementation steps, St. Peter’s is positioned to take the next steps to fully implement integrated behavioral health into their primary care clinics.

Saint Peter's Health Foundation

Integrating Behavioral Health into Saint Peter’s Health Medical Group

Project Term: 24 months; 2018-2020
Grant Amount: $150,000

This project will bring Saint Peter’s Health Medical Group’s medical and behavioral health services together within the primary care setting to better the overall health and well-being of their patients and community. The project will focus on the Behaviorist Model of Care that encompasses the nine core elements of integrated behavioral health: intentional level of integration, leadership support, team-based care, care coordination, data analytics, evidence-based models of care, defined care continuum, stepped care, and psychiatric consultations. In addition to the employment of the core elements, the health system will also focus on the development of a business and operational process to ensure program sustainability.

Saint Peter's Health Foundation

Helena Regional Housing and Health Care Initiative

Project Term: 12 months; 2018-2019
Grant Amount: $60,000

This project will develop a cross-systems data sharing between health care, homeless services, housing, criminal justice, child welfare, and emergency service systems to identify high-utilizers of these community service systems who are homeless or unstably housed. The data sharing effort will begin with an inclusive effort to include as many key stakeholders as possible and resolve barriers to data sharing to allow for meaningful system coordination. The grantee will identify people and families that demonstrate the greatest need and cost burden and examine root causes contributing to their homelessness and high utilization of system resources. The project will also utilize the data sharing efforts to study patterns of systems utilization related to existing affordable housing locations and resources particularly among vulnerable populations of seniors, persons with disabilities, and families with children. Through this process, broader system-wide solutions will be proposed in a Helena Regional Supportive Housing and Services Intervention Plan. The plan will identify possible funding sources to implement supportive housing and services, new housing and services partnerships, and improved cross-systems data sharing and coordination.

Saint Peter's Health Foundation

The Reducing Adverse Outcomes of Perinatal Mental Illness and Substance Use Disorders in the Greater Lewis and Clark County Area Project

Project Term: 24 months; 2019-2021
Grant Amount: $150,000

This project will help St. Peter’s Health (SPH) work to reduce the adverse outcomes of perinatal mental illness and substance use disorders. The project will do this through implementing screening, treatment, and referral protocols; expanding integrated behavioral health services within SPH OB provider clinics and the inpatient women and children’s unit; expanding nurse care coordination staff and support resources in the Helena community; and developing applicable data management and reporting capabilities. Grant funds will be used primarily for hiring a behavioral health specialist and a care coordinator to help implement and support the project. Partnerships include Helena OB/GYN who will work with SPH to develop a community wide approach including outreach and development of partnership with the Women’s Clinic of Helena and Helena pediatric clinics. The project’s overall goal is to reduce substance abuse and stabilize mental health disorders in the perinatal and postpartum populations and reduce the necessity of Child Protective Services intervention and foster care removals.

Saint Vincent Healthcare Foundation

Comprehensive Prenatal Care with Integrated Substance Abuse Treatment for American Indian Women

Project Term: 12 months; Ended 2016
Grant Amount: $25,000

This planning grant resulted in a collaboration between the Northern Cheyenne Tribe and Saint Vincent Healthcare to establish a collaborative program to provide and coordinate care for pregnant women with substance use disorders. This tribally-led pilot program worked to increase early entry into prenatal care by refining a trusted model of care for prenatal care and integrate supportive services and substance abuse treatment. This work will continue with support from a new MHCF implementation grant.

 

Saint Vincent Healthcare Foundation

Integrated Prenatal Care Model for Native American Women: Reducing Substance Abuse During Pregnancy

Project Term: 24 months; 2016-2018
Grant Amount: $150,000

This grant will provide case management and program coordination for pregnant Native American women struggling with addiction by developing a program that creates supportive, integrated access to perinatal care and addiction treatment. The program will support sobriety and provide evidence-based treatment during pregnancy to decrease the occurrence of neonatal abstinence syndrome and fetal alcohol syndrome, as well as to support a path to long-term recovery. The care coordinator position will be a part of the Northern Cheyenne Tribal Health Department. Key partners include the Northern Cheyenne Tribal Board of Health, Indian Health Service, and Rimrock Foundation. Expected outcomes include improved access to prenatal care and substance abuse services for pregnant Native women on and off the Northern Cheyenne Reservation, decreased substance abuse in pregnant women, and a reduction in negative birth outcomes and medical costs associated with drug use during pregnancy.

Saint Vincent Healthcare Foundation

Building out the Continuum of Care

Project Term: 24 months; 2017-2019
Grant Amount: $150,000

This project would contribute to Saint Vincent Healthcare’s implementation of integrated behavioral health in all their primary care clinics, both those in Billings and those in the rural communities that they serve. This grant would enable them to plan and implement a strong referral system that ensures that behavioral health specialists are used efficiently and effectively. The process for referrals on to behavioral health counselors, as well as other staff members in the specialty clinic will be defined, and developed to ensure an integrated workflow for a complete continuum of care; the project will include consideration of telehealth for rural patients that require a level of care beyond the scope of what the team can provide onsite at the primary care clinics.

Saint Vincent's Healthcare Foundation

Look Closer: Addressing Perinatal Behavioral Health in Eastern Montana

Project Term: 24 months; 2019-2020
Grant Amount: $150,000

This project will help St. Vincent Healthcare increase access to mental health and substance use disorder care for pregnant women in Eastern MontanaThe project will do this by developing an integrated prenatal care program and expanding it to four additional OB sites affiliated with St. Vincent Healthcare and Riverstone Health Center. Grant funds will primarily be used for hiring a prenatal services liaison who will provide coordination to women in all participating sites. Partners include Rimrock Treatment Center and associated prenatal care providers in Eastern Montana (Billings OB/GYN Associates, St. Vincent’s West Grand Family Medicine, St. Vincent Maternal Fetal Medicine, St. Vincent’s Midwifery and Women’s Health, and RiverStone Health). The project’s overall goals are to increase the rates of women who receive prenatal care and substance use disorder screening, intervention, and treatment, and to reduce the rate of infants who are substance-exposed before birth.  

Salish Kootenai College

Type 2 Diabetes Intervention for At-Risk Youth

Project Term: 24 months; 2017-2019
Grant Amount: $75,000

This project will develop a screening and exercise-based intervention project for teens who are at-risk for type 2 diabetes on the Flathead Indian Reservation. Salish Kootenai College nursing students will work with the CSKT Health Department to identify at-risk teens based on family history and other risk factors. Quarterly, for two years, identified teens will be screened for diabetes as part of a “field day” that will provide intensive education on diet and exercise. Field day activities will include completing physical parameters, education on nutrition and the need for regular checkups, physical activity sessions with a fitness trainer, and screening for hypertension and diabetes. Students who screen positive for diabetes will be referred immediately to CSKT primary care or their private primary care provider.

Salish Kootenai College

Four-Year Bachelor of Science in Nursing Degree to Increase Native American Nurses in Montana

Project Term: 24 months; 2019-2021
Grant Amount: $100,000

This project will develop a four-year Bachelor of Science Degree in Nursing (BSN) at Salish Kootenai College (SKC). SKC’s mission is to provide quality education for Native American students so they can improve the lives of their families and the communities in which they live. The Indian Health Service (which only hires only BSN graduates), has hospitals and clinics on every reservation in Montana which means that BSN graduates will have a much better chance of finding employment opportunities in their own communities. Funding will be used to fund the staff time needed for development and implementation of the BSN program. The goal of this project is to graduate BSN students, particularly Native Americans, who can return to their home communities and reservations to decrease health disparities through the provision of culturally congruent care.

Shodair Children's Hospital

Integrated Behavioral Health Planning Project

Project Term: 12 months; Ended 2018
Grant Amount: $50,000

This project helped enhance Shodair’s current services by allowing them to develop a plan to integrate primary care and substance use disorder treatment to their current inpatient services and develop a plan to provide pediatric psychiatric consultation in their primary care clinics. In addition, Shodair opened an outpatient behavioral health program, which helps expand the continuum of care that was limited to inpatient. They also integrated substance use disorder treatment as part of their care by hiring and incorporating a licensed addiction counselor into their programming. Finally, they developed a psychiatric consultation service that is available to pediatricians throughout the state; this helps ensure access to remote areas and helps prevent unnecessary admissions and facilitates successful discharges back to the community.

Sidney Health Center

Bakken Behavioral Health Project

Project Term: 18 months; Ended 2017
Grant Amount: $20,414

The project enhanced integration of behavioral health into Sydney’s rural health clinic. The National Council for Behavioral Health provided technical assistance and training for the project. The project developed universal depression screening and referral procedures, provided support for the licensed clinical social worker working within the clinic to become credentialed, and ultimately enabled the clinic to implement a more sustainable business model by establishing reimbursable services. By the end of the grant, the project was functioning in a sustainable model where revenues exceeded expenses.

Smiles Across Montana

Expanding Smiles Across Montana Services

Project Term: 24 months; 2019-2021
Grant Amount: $100,000

Smiles Across Montana will expand the reach of their mobile dental clinic to serve rural and tribal communities across the state. The program will focus on providing dental hygiene services and oral hygiene education to children and Medicaid recipients. Funds will be used to support networking, planning, and implementing the mobile dental clinic’s services into new facilities and communities. As part of the project, Smiles Across Montana will prioritize developing strong partnerships which will help them increase access to preventative oral health services in rural Montana and make referrals to higher level of dental care as needed. The project’s goal is to bring equitable oral health to all Montanans and to work together with other programs to improve the overall health of Montana’s most vulnerable populations.

Southern Peigan School Health

Behavioral Health Services for At-Risk Youth

Grant Amount: $75,000
Project Term: 12 months; 2017-2018

This project will create a financially stable and evidence-based integrated behavioral health program in the Southern Peigan School-Based Health Center. This grant will be used to hire a licensed therapist to provide behavioral health treatment and develop an integrated behavioral health program within the existing school-based health center. Training and technical assistance will be provided by the National Council for Behavioral Health.

Special Olympics Montana

Insurance Enrollment, Health Screenings, and Follow-Up Care for Special Olympics Athletes

Project Term: 24 months; Ended 2018
Grant Amount: $20,000

For this project, Special Olympics Montana (SOMT) partnered with the Confederated Salish and Kootenai Tribal (CSKT) Health Department, and the Montana Department of Public Health and Human Services to work towards improving health for those with intellectual disability on the Flathead Reservation. Grant funds allowed for outreach, enrollment, and engagement by SOMT with the CSKT Health Department and other tribal communities. A SOMT tribal outreach director worked in the CSKT Health Department to identify potential CSKT Special Olympics athletes, involve them in SOMT, and facilitate participation in SOMT-required health screenings. CSKT Health Department staff will assisted with insurance enrollment, billed insurance for care received, and ensured robust coordination of care among all each individual’s health providers. The project successfully established relationships among the partners, and outreach and events to identify and engage potential Special Olympic athletes will continue as a result of this project.

Sprout Oral Health

School Nurse Fluoride Varnish Programs

Project Term: 24 months; 2016-2018
Grant Amount: $50,000

This project will develop and make sustainable statewide School Nurse Fluoride Varnish Programs in elementary schools across Montana to address oral health disparities in vulnerable child populations. The project will recruit school nurses in underserved and frontier areas of Montana to apply tooth-decay preventing fluoride varnish to eligible children’s teeth under standing orders of a physician or dentist as appropriate. Additional program components will include coordination of care for children with treatment needs and assistance to families in enrolling in Medicaid/CHIP. The project would also produce a reimbursement toolkit to allow school-based programs to become sustainable. Partners include the Montana State University College of Nursing and the Montana Association of School Nurses.

Sweet Medical Center/Bighorn Valley Health Center

Integrated Behavioral Health Planning and Development

Project Term: 12 months; Ended 2018
Grant Amount: $48,215

Through this project, Sweet Medical Center (SMC) sought to address behavioral health needs that were identified as a top concern in the 2016 Community Health Needs Assessment through an integrated behavioral health planning grant. Over the course or the grant, however, SMC merged with Bighorn Valley Health Center and grant funds were used to advance the provision of behavioral health services in the merger. While the merger caused some early delays, ultimately the grantee implemented a fully functional and sustainable integrated behavioral health model. At the conclusion of the grant, the grantee was working to expand this model to include substance use disorder screening and treatment. SMC has also implemented universal screening of patients for depression and anxiety, as well as SBIRT (screening, brief intervention, and referral to treatment) for all patients (over age 12) presenting at the sites. In addition, due to this planning grant, SMC was able to hire two additional behavioral health care staff, including a psychologist and licensed clinical professional counselor. These new staff members, along with the existing family nurse practitioner (who is pursuing her advanced certification as a psychiatric nurse practitioner), form the backbone of a model of integrated medication-assisted treatment (MAT) to treat opioid use disorder at sites in Chinook and Harlem.

Teton County Health Department

Addressing Substance Use Disorders through Community Partnerships

Project Term: 12 months; 2018-2019
Grant Amount: $25,244

For this project, the Teton County Addictions Task Force (TCATF) will work with Gateway Community Services (a behavioral health service provider from Great Falls) to implement SAMHSA’s Strategic Prevention Framework to reduce youth substance use in Teton County. TCATF is comprised of the Teton County Health Department, Benefis Teton Medical Center, local law enforcement, local schools, the local advisory committee, social services, and community members. Gateway Community Services will provide training and technical assistance to TCATF to complete each step of the strategic prevention framework. Cultural competence and sustainability are guiding principles of the strategic prevention framework and will be a primary focus of the work that takes place through this project.

Townsend Health Systems

Enhancing Rural Health Through the Expansion of Integrated Behavioral Health Services

Project Term: 18 months; Ended 2019
Grant Amount: $75,000

This expansion grant supported a sustainable integrated behavioral health model at Broadwater Health Center (BHC) in Townsend. BHC redesigned their existing behavioral health services by educating their providers, systematizing their screening for depression, anxiety, and substance use disorders, developing new workflows and care pathways, and engaging the school and community in their efforts. Through this project, BHC is now successfully generating a net income and has developed a clinically appropriate and financially viable model.

Townsend Health Systems

Initiation of a Licensed Addiction Counselor into the Broadwater Health Center Integrated Care Team

Grant Term: 12 months; 2018-2019
Grant Amount: $40,000

This project will add the treatment of substance use disorders into Broadwater’s primary care practice. Grant funding will be used to hire a licensed addiction counselor who will help implement screening, brief intervention, and referral to treatment and medication-assisted treatment for opioid use disorders. Additionally, funds will be used to allow the grantee to seek state approval as a substance use disorder provider, which will be needed for Broadwater to be reimbursed by Medicaid for their services.

Two Eagle River School

Two Eagle River School Wellness Project

Project Term: 12 months; Ended 2019
Grant Amount: $50,000

Two Eagle River School partnered with Freedom Lodge and the Confederated Salish and Kootenai Tribe (CSKT) Tribal Health Department to bring a licensed mental health counselor into the school to provide behavioral health services to the students. Two Eagle River School is a tribal alternative middle and high school serving 110 students on the Flathead Reservation. After multiple suicides in the community over the year before the grant, the school identified an immediate need to address the mental health and historical trauma needs of the students. The project helped equip students and staff with tools and knowledge to address trauma. They are now providing prevention services and CSKT has applied for a grant to support the behavioral health position within the school for the next five years.

 

 

 

UM - Curry Health Center

Enhancing Behavioral Health Integration

Project Term: 12 months; Ended 2018
Grant Amount: $30,000

This project’s goal was to strengthen the Curry Health Center’s level of behavioral health integration between their medical and counseling clinics. The health center succeeded in implementing a process change that promotes more consistent usage of depression screenings and coordinated follow-up care. The health center now exceeds national averages for college health centers for the care of depression with respect to use of the PHQ-9 depression screening at initial and follow up visits. In the fall of 2018, the health center will implement an integrated team including a primary care provider, a behavioral health clinician, health coach, and a university psychology student. This pilot was an innovative way to maximize existing resources at the university and support further integration of services. Technical assistance was provided by the National Council for Behavioral Health.

UM - Department of Psychology

Effective Integrated Behavioral Health Partnerships for Rural Montana

Project Term: 12 months; Ended 2018
Grant Amount: $50,000

This project established the Rural Integrated Behavioral Health (RIBH) Program – a pilot training curriculum to train and certify integrated behavioral health providers across the state. A collaborative venture of the University of Montana’s Department of Psychology, School of Social Work, Montana Office of Rural Health and Area Health Education Center, and the Family Medicine Residency of Western Montana, the RIBH program developed two integrated behavioral health curriculum and has standing classes at the University of Montana. RIBH also developed a website, online modules, and began to explore an developing an integrated behavioral health certificate to be offered through the University of Montana. Additionally, RIBH is actively pursuing a licensed mental health center to endorsement to further expand and solidify sustainability of integrated behavioral health offerings.

UM - Department of Psychology

Integrated Behavioral Health Workforce Development: Field Training Experience

Project Term: 24 months; Ended 2018
Grant Amount: $44,821

Through this grant, the University of Montana Department of Psychology, with Partnership Health Center (PHC) of Missoula and the Family Medicine Residency of Western Montana, developed a field placement experience for behavioral health graduate students to address critical workforce development needs in Montana. The project provides a structured, “hands-on” training experience for students interested in learning how to provide integrated behavioral health services, while simultaneously addressing key health needs (including managing chronic pain and promoting health behavior change) in PHC’s underserved and “at risk” patient population. The project built on a prior MHCF grant to the University to develop an integrated behavioral health curriculum.

UM - Department of Psychology

Integrated Behavioral Health Workforce Development Initiative

Project Term: 24 months; 2017-2019
Grant Amount: $141,104

This project will plan for and implement an Integrated Behavioral Health (IBH) Workforce Development Initiative at the University of Montana. This initiative will recruit students, expand IBH training opportunities, place students in rural integrated care programs, and provide appropriate supervision. Grant funding will be used to hire an assistant psychology professor to direct the initiative. This project will build on prior MHCF grants to the University which helped develop IBH training and certification curriculum for psychology, social work, and counseling students. The project has strong partners from other university departments, as well as the Family Medicine Residency of Western Montana, Curry Health Center, Missoula Urban Indian Health Center, and CSKT Tribal Health.

UM - ORSP

Assessing Access to Asthma Education Services

Project Term: 12 months; Ended 2017
Grant Amount: $25,000

For this project, the Pharmacist Managed Asthma Clinics Program at the University of Montana-Skaggs School of Pharmacy assessed current access to asthma self-management education and determined the feasibility of multi-disciplinary, pharmacist-led managed asthma care in Montana’s American Indian communities. Survey and focus group results found that there is indeed a need for asthma self-management education in American Indian communities and health care professionals in Rocky Boy and Missoula Urban Indian Health Center expressed interest in becoming certified asthma educators. A toolkit for health care professionals was successfully developed providing statistics, educator benefits, patient and practitioner resources, and guidance for billing insurance.

United Way of Yellowstone County

Collaborating to End Homelessness and Addiction in Yellowstone County

Project Term: 12 months; 2018-2019
Grant Amount: $50,000

Two coalitions in Yellowstone County are tackling two of the biggest problems in the region: methamphetamine use and the lack of safe, affordable housing. The community seeks to align the work of these teams using a collective impact model. To foster efficiency and synergy the grantee will contract with one individual to oversee the coordination of start-up efforts, including stakeholder engagement, needs assessment, resource assessment, and planning. The grantee hopes that an investment in the critical building blocks of collective impact will lay the right foundation to substantially reduce methamphetamine use and to make homelessness brief, rare, and nonrecurring in Yellowstone County. Partners currently include health care organizations, behavioral health treatment providers, nonprofits working on homelessness and substance abuse prevention and treatment, criminal justice, and law enforcement.

University of Montana

Montana Interprofessional Student Hotspotting

Project Term: 24 months; 2019-2021
Grant Amount: $95,967

This project will pilot a cross-disciplinary student hotspotting program to work with Partnership Health Center’s Complex Care program. Student hotspotting, an initiative of the Camden Coalition of Healthcare Providers, is a team-based, patient-centered approach to serving patients with complex medical and social needs. Led by University of Montana College of Health Professionals and Biomedical Sciences (CHPBS) faculty, the program will create student teams that provide home-based non-clinical interventions to high-utilizing patients in Partnership Health Center’s Complex Care program. Funding will be used for the operational, administrative, and training costs to develop and implement the training program at the University of Montana. Partners include the Montana Geriatric Education Center, Partnership Health Center, the Camden Coalition of Healthcare Providers and University of Utah Interprofessional Education and Student Hotspotting, who will provide training and technical support for the program. The project’s goal is to improve patient quality of life, integrate medical, behavioral, and social care, and increase utilization of primary care services through home-based, non-clinical interventions that address the social determinants of health.

University of Montana

Improving Access, Training, and Recruitment for American Indian Health Care

Project Term: 24 months; 2019-2021
Grant Amount: $97,359

The University of Montana will work to improve care for American Indians and Alaska Natives (AI/AN) in Montana by increasing cultural awareness among medical students and improving access to care for specific medical services. Medical residents and health professions students at the Family Medicine Residency of Western Montana and the University of Montana will learn cultural humility through the development of a didactic curriculum for both learners and practicing professionals, as well as an immersion clinical experience at the Confederated Salish and Kootenai Tribes (CSKT) Tribal Health. The clinical experience will enhance cultural training and allow active recruitment of residents and students to work in AI/AN health care upon graduation. This project will also development models for new services to be provided by resident and faculty physicians at CSKT Tribal Health, beginning with maternal and obstetrical care. New services will help to address current barriers to care experienced by Tribal Health recipients. Grant funds will help develop curricula, provide resources for the creation of new models of care, and improve and expand the clinical training opportunities in AI/AN settings. This will help meet the overall goal of improving care for one of Montana’s largest underserved populations.

University of Montana Foundation

Capacity Building for the University of Montana Public Health Training Institute

Project Term: 24 months; 2019-2021
Grant Amount: $96,683

The University of Montana (UM) will develop a Public Health Training Institute within the School of Public and Community Health Sciences. Training opportunities will be developed to build the capacity of public health practitioners and the broader health care system. Through a partnership with the Public Health Workforce Development Group, made up of members of the non-profit public health entities and the state health department, nine training topics have been identified as areas of need to build the capacity of Montana’s public health workforce. Through this project, the needs of the broader health care system, including primary care, behavioral health, and tribal and urban Indian health centers, will be identified and five additional trainings will be developed to meet those needs. Trainings will be delivered online for free or, for sustainability purposes, for a nominal fee. Grant funds will be used to cover the cost of program staff to carry out the data gathering and analysis, for consultation with subject matter experts as the training modules are developed, and to cover the costs of travel for meetings and marketing. Through this project, UM will strengthen the partnerships it has developed with the state health department, the non-profit public health entities, and local health departments. New partnerships will be developed with the boarder health care field, including the Montana Hospital Association and Montana Primary Care Association. The project’s goal is to build the capacity of the public health and broader health workforce while simultaneously building the capacity of the School of Public and Community Health Sciences to establish a Public Health Training Institute that will serve as a state-wide resource for health training.

Watson Children's Center

Healthy Foundations: Access to Primary Care and Mental Health Treatment

Grant Term: 12 months; Ended 2019
Grant Amount: $15,000

The Watson Children’s Shelter implemented the Healthy Foundations program, a new home visiting program that targets at-risk pregnant women and women who have recently given birth with the goal of preventing child abuse and neglect. Through a newly strengthened relationship with Saint Patrick’s Hospital, Watson Children’s Center was able to expedite appointments for parents participating in the program who displayed emergent behavioral health needs such as anxiety and postpartum depression and even acute mental health crisis. While several options for revenue generation were explored throughout the course of this project, ultimately the Watson Children’s Shelter opted to maintain fidelity to the Health Foundations program model which restricted their ability to implement changes that could potentially lead to new sources of revenue. However, the children and families served through the Healthy Foundations project gained expedited access to needed mental health outpatient services. The program achieved its goal of increasing access to needed mental health outpatient services to children and families, and while establishing a new source of revenue was not achieved, Watson Children’s Center believes the information gained through this project was valuable and may lead to organizational changes in future.

Western Montana Mental Health Center

Integrated Behavioral Health for Western and South-Central Montana

Project Term: 12 months; Ended 2016
Grant Amount: $22,400

With this grant, the Western Montana Mental Health Center (WMMHC) consulted with the National Council for Behavioral Health to provide training on integrated behavioral health (IBH) to 11 health center directors, and to incorporate IBH into WMMHC’s mission and vision. In addition to IBH strategic planning, WMMHC led an effort to review the integration of behavioral health services in the community of Livingston by bringing together health leaders and stakeholders. After the initial meeting of stakeholders, task forces were created to focus on developing a community care pathway for youth, increasing utilization of volunteers, improving management of individuals in crisis, and strengthening partnerships among organizations. The task forces met individually and collectively on multiple occasions throughout the course of the grant. The crisis management team reviewed data on how many people have been to the emergency department during a mental health crisis. Challenges that they identified included transportation, response time by the crisis response team, lack of prompt access to care, and the need to divert people from the emergency department to more appropriate levels of care. The crisis management team will continue to meet monthly to improve admissions from the Livingston emergency department to WMMHC’s crisis facilities.

Western Montana Mental Health Center - Recovery Center Missoula

Recovery Center Missoula Pregnant and Parenting Women

Project Term: 24 months; 2017-2019
Grant Amount: $150,000

This project will increase substance use disorder and medication assisted treatment access for pregnant and post-partum women through creating residential treatment homes in Missoula and Lake County. The home in Missoula will be an expansion of Recovery Center Missoula’s home and will serve woman transitioning from inpatient care to residential treatment. The home in Lake County will begin offering treatment and supportive services for pregnant and parenting mothers struggling with addiction. Grant funding will be used for start-up costs and home upgrades.

Western Native Voice

HELP Act Outreach and Assistance in Native American Communities

Project Term: 12 months; 2016-2017
Grant Amount: $25,000

Western Native Voice will engage in outreach and coordination activities to support enrollment of Native American people across Montana in Medicaid or other insurance. The project seeks to identify people (primarily Native Americans living on remote reservations or in urban areas) who may be eligible for coverage, and regional resources available to assist with enrollment, and connect them.

Women in Action

Identifying and Addressing Gaps in Big Sky’s Mental Health Services

Project Term: 24 months; 2018-2020
Grant Amount: $14,760

This grant will support initial steps to strengthen behavioral health and address gaps in Big Sky’s behavioral health resources. Women in Action will work with the Yellowstone Club Community Foundation to bring together stakeholders including Big Sky Medical Center, mental health and substance use providers, the Help Center, the Big Sky school district, and Haven, to catalog existing resources and create innovative solutions to Big Sky’s unique behavioral health demands. Funds will be used to support a partial FTE to help initiate the planning, coalition building, and develop a strategic plan for the community.

Yellowstone Boys and Girls Ranch

Substance Use Disorder Treatment Program

Project Term: 24 months; 2017-2019
Grant Amount: $75,000

This project will allow the Yellowstone Boys and Girls Ranch to expand their substance use disorder services and will support their application to the State of Montana Chemical Dependency Bureau for substance use disorder treatment licensure. Once they receive their state license, the Yellowstone Boys and Girls Ranch will be able to expand their services to additional counties and enhance their partnerships in each region. The project’s goal is to hire three additional licensed addictions counselors to provide outpatient and intensive outpatient services, and school-based services to meet the needs of communities served by Yellowstone Boys and Girls Ranch.

Youth Dynamics

Substance Abuse Treatment Program Expansion Pilot Program

Project Term: 24 months; 2016-2018
Grant Amount: $136,146

Youth Dynamics will expand its Billings-based Substance Use Disorder Treatment Program to Cascade and Missoula counties. This program is designed for youth with serious co-occurring emotional disturbances and substance use disorders. It will provide substance abuse treatment as well as mental and physical health services. Following initial treatment, a year-long aftercare program will focus on giving kids the skills and connecting them with the resources they will need to successfully maintain sobriety. Youth Dynamics has established partnerships with several organizations in each community that have agreed to help with referrals and program development, including the Cascade County Juvenile Probation Office and the Missoula Court-Appointed Special Advocates Program.

Youth Homes

Enhancing Wilderness Therapy through Aftercare and Parent Programming

Project Term: 12 months; Ended 2018
Grant Amount: $26,088

This project’s goal was to enhance the wilderness youth therapy program’s services by adding case management and expanding programming for caregivers. The wilderness youth therapy program offered a 45-day wilderness trip for youth ages 13-17 with co-occurring behavioral issues and a simultaneous program for parents and family members. The program sought to reduce criminal justice involvement and placement with child and family services, as well as to increase family placement and academic achievement. As a result of this project, 88 percent of the youth who participated were placed with their families and 94 percent continued to earn high school credits following the program (prior to participation, 82 percent of youth demonstrated academic failure). In addition, the percentage of youth employed in their communities increased from 6 to 24 percent within two months of program completion. Unfortunately, Youth Homes’ wilderness youth therapy program was closed due to state budget cuts and the long-term impacts on child welfare, criminal justice, family engagement, and academic performance of the youth who participated in the program could not be evaluated.

YWCA of Helena

WINGS Re-Entry Transitional Housing Program

Project Term: 12 months; Ended 2018
Grant Amount: $50,000

This project’s goal was to integrate a behavioral health clinician into the YWCA’s transitional women’s housing program and secure state approval for a level three sober living home for women and children, which would allow for a range of reimbursable services for behavioral health. Through this project, the YWCA successfully completed a building inspection, developed the policies and procedures, and planned for the programming that will be implemented once state approval is obtained. In the course of the project, the YWCA experienced a leadership turnover which created challenges in applying for state approval and this objective was ultimately not achieved. However, the YWCA did hire a behavioral health clinician, which was a major achievement in advancing programming and strategies and positions the organization to successfully obtain state approval in the future.

YWCA of Helena

Implementing Behavioral Health Services

Grant Term: 12 months; Ended 2019
Grant Amount: $15,000

Through this grant, YWCA Helena submitted their application to become a state-endorsed Substance Use Disorder Facility that provides intensive outpatient therapy. YWCA also established a new relationship with Intermountain who will be assisting in with billing. YWCA experienced turn over during this project but was able to maintain momentum through their work with the consultant for this project, Dan Aune. The need for updated technology was identified to aid in billing for services. YWCA is exploring ways to obtain funding to purchase the software needed. Through this grant project, YWCA developed a new working relationship and established the capacity to begin providing a new behavioral health service, through their substance use disorder endorsement; this will result in a new service being provided to the YWCA’s clients and new, sustainable revenue for the organization.

 

2019 Call for Proposals

Find out about this year’s available grants.