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Barrett Hospital Foundation

Southwestern MT Rural Accountable Care

Project Term: 24 months; Nov 2015 – Oct 2017
Grant Amount: $50,000

This grant will support the participation of Barrett Hospital in Montana’s first Rural Accountable Care Organization (RACO). Barrett Hospital and HealthCare will join a consortium of regional Critical Access Hospitals being formed to create a RACO among 12 hospitals in Montana, Idaho, and Wyoming that will collectively serve a group of more than 9,000 Medicare patients. The Centers for Medicare and Medicaid Services will track health care spending and measure the quality of care that is provided to these patients. Participating hospitals will have improved access to data to help measure costs, assess quality and safety.

Beaverhead County Public Health

Integrating Behavioral and Physical Health in Rural Southwest MT

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

The National Council for Behavioral Health facilitated a two-day summit for healthcare professionals, education professionals, community resource agencies, and others to educate them about the elements and implementation process for an integrated behavioral health model. Following the summit, a coalition formed by the grantee led the development of a work plan and the implementation of integrated behavioral health in Beaverhead County.

ACE Task Force Mission and Goals

ACE Task Force Pamphlet

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 2 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. MHCF grant funds will be used to build the organizations operational and programmatic base: the initial focus will be 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 grant will help Benefis Medical Group plan to integrate behavioral health into their primary care practice; the project will also support the broader implementation of integrated behavioral health (IBH) by regional partners in Cascade County and north-central Montana including the VA clinic, independent primary care providers, and regional tribal clinics. As part of MHCF’s structured IBH initiative, Benefis Medical Group will receive training and technical assistance from a consultant, complete an IBH business and operations plan, provide a scope of practice for participating providers, and assess of any workforce needs.

Bighorn Valley Health Center

A School-Based Health Center to Improve Screening and Treatment of Depression

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

Bighorn Valley Health Center (BVHC) will partner with the St. Labre School system in Rosebud and Big Horn counties to develop a school-based health center for students, their families, and staff members. First, in collaboration with St. Labre and various community partners, they will provide a comprehensive array of primary care medical and mental health services in an effort to reduce barriers to care, and to screen for and mitigate upstream events that can result in toxic stress to children, with the goal of reducing the impact of behavioral health issues in this community.  Second, the health center and school system will collaborate to create a more trauma-informed environment of healing on campus, which has been shown to not only improve behavioral health outcomes, but also school performance and behavior. The funds will be used for design and startup, but the services are entirely sustainable through billing and content-related policy change.

Grantee Story

Bighorn Valley Health Center

Integrated Healthcare 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.

Billings Clinic

American Indian Healthcare Advocate Program

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

The American Indian Healthcare Advocate Program provided outreach, information, and health insurance enrollment assistance to American Indian people residing on the Crow Reservation, Northern Cheyenne Reservation and the urban American Indian population residing in Billings. Through this program, outreach events, presentations, and informational materials were distributed to over 700 individuals with questions about the Montana Medicaid expansion program and how obtaining health insurance could increase their access to quality health care. 26 individuals were directly enrolled in a health insurance product for which they were eligible but not yet enrolled and 177 individuals 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; Nov 2016 – Oct 2018
Grant Amount: $150,000

This project will develop and implement 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. The project will ensure that patients over the age of 65 are screened appropriately for Alzheimer’s dementia and related dementias (ADRD), and that those diagnosed with ADRD and their caregivers receive high-quality care and support. The project will also result in 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. The practices involved are diverse—they include a large, urban health system, a Billings Clinic-affiliated critical access hospital, and a non-affiliated critical access hospital—which will help ensure that the model created will be useful to and facilitate uptake by primary care practices across the state.

Billings Clinic

Establishing a Montana Psychiatric Residency Training Track

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

This planning grant will help lay the foundation for establishing a psychiatric residency in Montana. The entire state of Montana, outside Yellowstone County, is designated as a mental health professional shortage area. The project will create a comprehensive blueprint that results in the establishment of a Psychiatric Residency Training Track in Montana beginning in 2017. The program will place University of Washington (UW) residents in Montana for the final two years of their psychiatric residency. This model has already been applied in Boise and Spokane: UW residents are based in Seattle for the first two years and then complete training in Boise and Spokane in years three and four. The residency will include a strong emphasis on rural rotations, such that recruitment and retention of psychiatrists to rural areas would be more likely. Partners include the Billings Clinic, University of Washington, and the Veteran’s Administration.

Billings Clinic

Building out the Continuum of Care

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

Billings Clinic seeks to refine the pilot model and the adapt existing electronic health records to better track patients experiencing depression or other mental disorders. This project will improve the clinical model of integrated behavioral health (IBH) in a primary care setting which can be scaled for other care practices, Billings Clinic affiliates, and other health care organizations. The project will expand and improve an existing IBH pilot program active at one Billings Clinic primary care site by creating an efficient and accessible patient registry to allow tracking and management of each patient’s clinical diagnoses; developing protocols for analysis of the registry data; the addition of a mental health assistant for program support across multiple primary care practices; the addition of a program coordinator; and the creation of a scalable IBH model. This project will enable Billings Clinic to expand the IBH model to all primary care locations. Currently, the pilot program follows the primary care patients of four physicians at Billings Clinic West. This project allows for growth to other Billings Clinic family practices over the next two years, ultimately reaching the patients of more than 20 primary care providers.

Blackfeet Community College

Trauma Informed Planning Grant

Project Term: 18 months; Apr 2017 – Oct 2018
Grant Amount: $75,000

This two-part project will (1) 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 (2) 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 project supported the Blackfeet Tribe to plan and implement tribally-run, school-based health services. Through this grant, the tribal health department explored how to utilize tribal authority to provide sustainable, community-based mental and physical health services to youth in public schools and the youth court system. The project was led by the Tribal Health Department in partnership with the Blackfeet Tribal Council and the Browning and Heart Butte Public Schools, with the Indian Health Service and the juvenile justice system as partners.

Blackfeet Tribal Health

Blackfeet EMS 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 medicine 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 including. 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; 2017-2019
Grant Amount: $42,000

This project will fund a project coordinator position to help design and implement Blackfeet Tribal Health’s Tribal Health Improvement Program. The Tribal Health Improvement Program (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. A strong planning coalition that has begun meeting regularly is already in place, and includes representation from Southern Peigan Health Center, Blackfeet Tribal Health, Southern Peigan School based clinic and Indian Health Service. This proposal will fund the project coordinator position for six months with the goal of initiating a signed task order with the State of Montana by month three and implementation of at minimum Tier 1 of the T-HIP program. Tier 1 of the T-HIP program will address high utilizers of health care on the Blackfeet reservation and provide care coordination and outreach to this population.

Blackfeet Tribe

Blackfeet Centralized Third Party Billing System

Project Term: 24 months, Nov 2016 – Oct 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.

Bozeman Health Foundation

Integrating Behavioral Health into an Internal Medicine Team

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

Bozeman Health Foundation, in partnership with Gallatin Mental Health Center, will develop a plan and use it as a roadmap to integrate behavioral health care into an internal medicine team within an existing clinic, which is currently designated as a Level 3 Patient-Centered Medical Home by the National Committee for Quality Assurance.

Browning Alternative School

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

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

This project created a trauma-informed school using Blackfeet cultural values and implemented an adverse childhood experiences (ACEs) survey for students. The project began in the alternative school program (one of the largest and most respected in the state) and then extended to the entire school district. The project focused on training staff in trauma-informed approaches to school discipline.

Cabinet Peaks Medical Center Foundation

Enhanced Transition of Care Involving All Aspects of Wellness for the Residents of Lincoln County

Project Term: 12 months; Apr 2017 – Mar 2018
Grant Amount: $44,236

This project will develop a new approach to discharge planning for hospitalized patients that systematically identifies and addresses the social factors that influence outcomes, such as the ability to afford home heating, food, housing, and medications. The hospital will develop a discharge planning tool that identifies these needs and will work with local clinics, and local aid and social service agencies to provide a safety net of services for patients in need at the time of discharge. The project seeks to reduce readmissions related to socioeconomic barriers to health and to increase the acuity of patients seen in the emergency department as well as utilization of local clinics for outpatient care.

Cascade County Community Care Center

Integrated Behavioral Health Program Development Project

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

This project seeks to strengthen the existing integration of primary care and behavioral health services within the Cascade County Community Care Center. To achieve this goal, the center will add a psychiatric nurse practitioner to their integrated team of five medical providers, three licensed clinical social workers, and two care managers, in order to move their program from partial to full integration. Establishing full integration will allow Cascade County to better partner with Gateway Community Services and the Center for Mental Health in the larger effort to have a well-coordinated referral network where patients can more seamlessly move from organization to organization as needed.

Center for Mental Health

Planning Grant for Integration of Primary Care Services into Mental Health Facilities in Lewis and Clark County

Project Term: 12 months; Ended 2016
Grant Amount: $10,150

This is a planning grant to collaboratively approach the issue of integrating physical and mental health services (integrated behavioral health) in Lewis and Clark County’s crisis center and community health center. The applicant and partners will hire the National Council for Behavioral Healthcare to assist the partners with planning, data collection, identification of the steps, screening tools, referral process, billing for procedures, and procedures for sharing information data.

Final Summary:
This planning grant supported early work to integrate physical and behavioral health services in Lewis and Clark County’s mental health center, crisis center, and community health center. The applicant and partners participated in technical assistance, webinars, and learning communities led by the National Council for Behavioral Health. The project strengthened partnerships and provided more clarity and direction for how each partner could work toward more effectively integrated services in the future. The project did not fully realize its aim of integrating services. One tangible improvement is a shared referral software system that program partners are beginning to utilize.

Center for Restorative Youth Justice

Reducing School-based Arrests for Youth with Behavioral Health Needs

Project Term: 24 months; Apr 2017 – Mar 2019
Grant Amount: $60,000

This project will 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 address 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. Funding will create an integrated, and replicable pilot model for improving behavioral and educational outcomes for at-risk youth, and intervene at the early stages of criminal justice involvement. The project will focus on alternative supports for suspended students and will collaborate with local probation, school counselors and staff to ensure that students and their families receive community resources and support for successful school reintegration.

Center Pole

Oosha Itchik/Healthy Food System

Project Term: 24 months; May 2016 – Apr 2018
Grant Amount: $50,000

The goal of this project is to provide a healthy, sustainable food system for the Crow Reservation while teaching community members about food sovereignty and health. Activities include creating a farm at Center Pole, harvesting wild fruits and vegetables, hunting, and traditional food preservation. These activities will be carried out in partnership with elementary schools and the Tribe’s diabetes prevention program and will be linked to a series of community education and outreach activities intended to disseminate the program throughout the reservation. The Center Pole will also work to develop a tribal ordinance to support local and traditional food production.

Child Bridge

Finding a Way Home Project

Project Term: 18 months; Dec 2017 – May 2019
Grant Amount: $75,000

To improve the placement outcomes and increase permanency for children who are in state custody because parental rights have been permanently revoked, the State of Montana Department of Child and Family Services established a memorandum of understanding with Child Bridge in July of 2017. This contract outlined a program entitled “Finding a Way Home” to allow Child Bridge to work in partnership with the state to achieve permanency for Montana children. While state social workers focus on permanency, it is often difficult to achieve due to factors including length of time in care, number of previous placements, age, and trauma-related behavior. The Finding a Way Home Project will utilize Child Bridge’s extensive database and network across Montana to recruit families for children who have experienced trauma and are in the permanent legal custody of the state.

Clark Fork Valley Hospital

Behavioral and Medical Health Delivery Integration

Project Term: 12 months; Dec 2017 – Nov 2018
Grant Amount: $50,000

This IBH planning grant will help Clark Fork Valley Hospital enhance their current primary care services to include behavioral health. Clark Fork Valley Hospital has partnered with the Family Medicine Network to bring a clinical psychologist and licensed clinical social worker into their primary care offices, and have established telepsychiatry services. Although their behavioral health and primary care services are currently co-located, they wish to advance to a fully integrated system of care. Technical assistance will be provided by the National Council for Behavioral Health.

Community Health Partners

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

Project Term: 24 months; Ended 2017
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. In an effort to improve care and health outcomes while lowering unnecessary costs to our healthcare system, Community Health Partners, the Park County Health Department, Livingston Mental Health Center and Livingston HealthCare have partnered to create the Park County Connect Program. Funds will support a social worker housed in the health department who will design and implement a community-based outreach program for existing emergency department high utilizers and those members of the community at risk for unnecessary utilization of the emergency department. The social worker will coordinate partner organizations to develop referral and tracking systems to ensure that interventions are documented and communicated, enhancing care coordination and improving outcomes. Performance indicators will be identified at both the patient and community level, and all partners will contribute data to the program evaluation process. This two-year project aims to identify relatively simple interventions that can positively affect overall community health and well-being using a model that could be easily replicated in other rural communities.

Community Health Partners

Promotoras de Salud: Bridging Latino Health Disparities

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

Community Health Partners (CHP) will develop a program in the communities of Belgrade and West Yellowstone to reach the growing, isolated communities of Latino immigrants there. Promotoras, or promoters of health, are laypersons who are trained to deliver basic health education and outreach to members of their community. An established partnership between CHP and the Montana State University INBRE Program (IDeA Network of Biomedical Research Excellence) will be leveraged to create a community-based health partnership with Latinos. The project seeks to help reduce health disparities through effective health care education and basic prevention while also empowering the community to become agents of their well-being.

Community Hospital of Anaconda

Integrating Behavioral Health at Community Hospital of Anaconda

Project Term: 12 months; Aug 2017 – Jul 2018
Grant Amount: $50,000

With support and training by the National Council for Behavioral Health, this project will build on the hospital’s existing patient-centered medical home and accountable care organization to explore ways to bridge the gap between primary care providers, inpatient services, emergency department, schools, and community agencies. Ultimately, this plan will remove barriers to treatment, increase knowledge and competencies within the community, and increase access to behavioral and social supports. This project specifically emphasizes the need to integrate community-based providers and partners.

Crisis Intervention Training Montana

A Statewide Crisis Intervention Team Training Collaborative

Project Term: 18 months; 2017-2019
Grant Amount: $100,000

Crisis Intervention Training (CIT) Montana is an umbrella organization that coordinates CIT training and development statewide. CIT programs are local initiatives built on strong partnerships between law enforcement, mental health providers, substance use providers, medical providers, social service providers, and individuals and families affected by behavioral health challenges. CIT attempts to divert individuals with behavioral health needs from the Montana state hospital, criminal justice system, and local hospitals. CIT Montana leads the effort for the education and training of emergency responders across Montana. The overarching goal of CIT is to increase the skill level of law enforcement, first responders, and behavioral health professionals when responding to persons with behavioral health needs who may encounter the criminal justice system. CIT Montana is seeking funding for administrative support for the CIT executive director, creation of a framework for data collection and evaluation, and creation of a business and sustainability plan.

CSKT Tribal Health Department

Understanding and Utilizing Health Care Resources on the Flathead Indian Reservation

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

The CSKT Tribal Health Department accomplished three objectives with this grant: (1) Pursuant to public law 638, assumed the Indian Health Service budget for purchased and referred care (PRC), and tribally managed this program. This vastly expanded the available resources to cover services not available on the reservation; (2) enrolled eligible members in Medicaid now that Montana’s Medicaid expansion has been approved, and enrolled those above the Medicaid income thresholds in private insurance on the exchange; and (3) educated providers that see CSKT members on this new coverage approach, and educated patients on how to effectively use coverage.

CSKT Tribal Health Department

Integrated Behavioral Health Program

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

The 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

Integrated Behavioral Health in Daniels County

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

This project will focus on developing an integrated behavioral health system in Daniels County with the Daniels County Health Department (DCHD) being the convener. The project will utilize the DCHD stakeholders (Daniels Memorial Healthcare Center, Scobey School, Daniels County Sheriff, Daniels County Extension Office, Daniels County Council on Aging, Daniels County Health Department, Daniels County Mental Health Local Advisory Council, behavioral health providers), and form a coalition of diverse organizations and community members to plan an integrated behavioral health system. The goal of the project is for the community as a whole to have a better understanding of behavioral health resources, recognize signs and symptoms of a crisis situation, know what community resources are available, and integrate these resources better. The school will also be equipped to initiate and sustain an anti-bulling campaign and substance abuse education.

Eagle Shield Center

Blackfeet Community Hospice Project

Project Term: 12 months; Dec 2017 – Nov 2018
Grant Amount: $26,262

This planning grant aims to achieve two primary objectives: (1) establish a partnership among tribal agencies on the Blackfeet reservation who will collaborate toward developing hospice services for the community; and (2) provide 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, a solid partnership will be established in the community and the workshop on available hospice services in the Blackfeet community will increase the community’s knowledge of end-of-life care needs and services.

Eastern MT Community Mental Health Center

Addressing Behavioral Health Crisis and Jail Diversion Through Peer Support

Project Term: 24 months; Dec 2017 – Nov 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.

Flathead Community Health Center

Integrated Behavioral Health Collaboration

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

Flathead Community Health Center (FCHC) will prepare an Integrated Behavioral Health Business and Operations Plan that clearly and thoroughly addresses all aspects of development and implementation of an Intermountain and FCHC Integrated Behavioral Health Collaboration. The plan will guide the startup of the collaboration in terms of focus on patient-centered and team-based service delivery, and scopes of service and practice, and provide the blueprint for achieving economic sustainability beyond the implementation phase.

Florence Crittenton Home Services

Substance Abuse Treatment for Pregnant and Parenting Women

Project Term: 18 months; Aug 2017 – Dec 2018
Grant Amount: $75,000

This project will plan for and begin implementation of outpatient substance abuse services for Florence Crittenton’s clientele, and will explore residential treatment options for pregnant and parenting women and their children. Florence Crittenton provides comprehensive services to pregnant and parenting teens, and although many of their clients have substance use disorders, currently they are only able to address this problem through referrals and contracts with outside providers. This project will look at ways to build capacity, conduct research, and develop a comprehensive treatment model to best serve this population while developing collaborative partnerships and improving outcome tracking. A main goal is developing cohesive partnerships with healthcare and other service providers. Expanding services will allow Florence Crittenton to blend trauma and mental health treatment with substance abuse treatment which will improve outcomes for families, as well as improve efficiencies in program service delivery.

Fort Belknap Indian Community

Centralized Billing Capacity Building Project

Project Term: 24 months; Apr 2017 – Mar 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 HPDP

Fort Peck Tribes HPDP Staff Recruitment and Telemedicine Systems Project

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

This project will develop long-term, innovative solutions to the critical shortage of health providers on the Fort Peck reservation. The project will seek to develop formal agreements with larger healthcare systems, professional healthcare provider organizations, and universities who will agree to partner with the Fort Peck HPDP program to regularly send licensed healthcare professionals to serve the tribes. The project will also explore developing the capacity to use telemedicine to deliver needed healthcare services.

Fort Peck Tribal Health Department

Needle Exchange Program

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

This project revived a needle exchange program that operated on the Fort Peck Reservation from the summer of 2009 to January 2012. The main objective of this intervention was to reduce transmission of blood-borne illnesses such as hepatitis C and HIV. Fort Peck developed and implemented a unique and successful needle exchange protocol which was one of the first operated in a rural reservation in the US. This program reinstated and expanded to provide injection drug users with clean needles, education, sharps containers for safe disposal of needles, and referrals to addictions counseling if needed.

Fort Peck Tribal Health Department

Rapid HIV and HCV Testing Services

Project Term: 24 months; May 2016 – Apr 2018
Grant Amount: $50,000

This project will expand Fort Peck’s current needle exchange 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. A more systematic system for screening is intended to facilitate both prevention and treatment of this serious and costly disease. HIV screenings will be provided at an annual community-wide screening (which will be available to non-Native community members), and the adult and juvenile correction facilities. The project involves partnerships with the tribal corrections facilities, Roosevelt County Health Department, and Indian Health Services.

Fort Peck Tribes

Fort Peck Substance Abuse Inpatient Treatment Center Development Project

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

The Fort Peck Tribes will develop a business plan 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. The business plan will include logistical details for the new center as well as plans for integration between the inpatient and outpatient facilities, third-party billing, integration with outpatient primary care and behavioral health, and coordination with other treatment facilities. The project will be carried out through a partnership among 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. While the population of focus will be Native American patients from the Fort Peck region, the facility would also serve non-Native patients.

Fort Peck Tribes - Spotted Bull Recovery Resource Center

Fort Peck 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 toward Sustainable Counseling of Youth with ACES in South Billings

Project Term: 12 months; Apr 2017 – Mar 2018
Grant Amount: $10,000

This project will 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 will prepare an initial assessment for incorporating a counseling program that would become self-sustaining through billing insurance, and a map for establishing services.

Gateway Recovery Services

Peer Support for Substance Abuse

Project Term: 18 months; Dec 2017 – May 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 County Emergency Medical Services

Integrated Mobile Health

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

Glacier County Emergency Medical Services (GCEMS) will implement a novel program in which they will provide home-based medical care in partnership with regional healthcare providers located in North Central Montana. The project seeks to improve health outcomes among medically vulnerable individuals identified by the hospital and medical providers, reduce unnecessary emergency department (ED) use and hospital readmission, and, ultimately, to save health care dollars by preventing unnecessary ambulance transports, emergency department visits, and hospital readmissions. The project builds on ideas from “community paramedicine” programs that are emerging in other parts of the US and adapts them to serve the specific needs of Glacier County. The grant will fund a pilot in two communities, East Glacier Park and Babb, which include a high percentage of American Indians, elderly, at-risk children, and veterans. Services to be provided by EMS personnel include (1) home observation for ED patients judged to be at risk but too stable for admission; (2) home health services during off hours; (3) support for hospice patients to remain at home rather than going to the ED for crises; (4) home visits and calls to patients discharged from the ED or hospital and at high risk for readmission; and (5) 911 triage—establishing a call center for non-emergent, low-acuity callers to avoid unnecessary emergency transports. The proposal includes several strategies for sustainability, including intra-agency savings (reduced EMS calls), shared savings with hospitals (funding services using savings on readmission and uncompensated care), and changes that would make these services reimbursable by public and private insurance programs.

Hays Lodgepole School District 50

Fort Belknap Indian Community Homeless Youth Feasibility Study

Project Term: 12 months; Aug 2017 – Jul 2018
Grant Amount: $49,000

The Hays-Lodgepole Public School and the Fort Belknap Indian Community Council will assess 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. By coordinating with other community organizations and tribal departments, this project will analyze housing and care needs, investigate successful housing and service coordination models, and identify potential funding sources for constructing and operating a shelter. With proper planning, the school and community hope to coordinate services to meet basic needs and provide a solid foundation that will improve education outcomes, personal health, and future success.

Healthy Mothers Healthy Babies

Building Bridges for Better Births

Project Term: 12 months; Apr 2017 – May 2018
Grant Amount: $25,000

This project will develop a coalition of partners (including hospitals, medical providers, public health departments, and community organizations) to highlight evidence-based models and best practices for treatment and prevention in pregnant and postpartum women and infants affected by Neonatal Abstinence Syndrome. Funding will be used to convene twelve community partner meetings to gather information on treatment models, assessments, screening policies, and capacity building strategies for addressing substance use disorders and mental illness across the Montana health care system.

Helena Indian Alliance

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 2017
Grant Amount: $20,000

This project seeks to support effective, office-based treatment of opioid addiction by physicians (opioids include drugs such as heroin and oxycodone). Buprenorphine is an opioid that is used in medications that are approved for office-based treatment of opioid addiction, such as Suboxone. Providers must receive special approval from the Drug Enforcement Agency (DEA) to use buprenorphine-containing products for this purpose. This proposal will engage primary care providers in developing, piloting, and evaluating a practical, best-practices guide grounded in the challenges unique to Montana.

Holy Rosary Healthcare Foundation

Eastern MT Integrated Behavioral Health Collaborative

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

This project will provide integrated primary care and behavioral health care to patients in eastern Montana through developing and piloting an innovative, collaborative care model. The primary care team at Holy Rosary Healthcare and behavioral health experts from Eastern Montana Community Mental Health Center will collaborate to provide more seamless, integrated care for a full spectrum of mental health issues, addiction, and primary care medical conditions. Desired outcomes include increased patient access to behavioral health and primary care services, earlier diagnosis and treatment implementation, and lower occurrences of crisis situations due to earlier intervention. Through improving health outcomes, successfully integrated care models have also shown promise as a way to control rising health care costs.

Final Summary:
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 include: a stronger partnership between Eastern Montana Mental Health Center and Holy Rosary Healthcare; implementation of universal PHQ9 (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 such as  credentialing protocols for behavioral health staff at Holy Rosary Hospital, cost-reporting requirements for rural health centers for co-located staff, and clinical workflows for depression screening and treatment. 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. (HSHI) offers equine assisted activities and therapy for returning military personnel in southeastern Montana. This project will result in an updated business plan to encompass future growth and sustainability. The plan will involve researching and solidifying long-term funding options, securing new community affiliations, and becoming an accredited center through the Professional Association of Therapeutic Horsemanship International which will enable HSHI to apply for additional veteran scholarship funding.

HRDC of District IX

Assessment of Community Costs of Chronic Homelessness

Project Term: 12 months; Ended 2016
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. For this project, HRDC will develop partnerships with other community organizations on an initiative that seeks to improve health outcomes for homeless people in Gallatin County through addressing their housing needs. The project will create a framework for a coordinated community health response to chronic homelessness through a baseline assessment of the community-wide costs of homelessness and how those costs may be reduced through the implementation of the “Housing First” model in Gallatin County. The project will also determine the extent of need for Housing First units in the community to promote public and private investment in the model. Housing First is an evidence-based approach that provides stable housing as the foundation for improving treatment outcomes for those with chronic mental and physical illnesses, as well as improving participation in personal health care, financial stability, and the ability to achieve self-sufficiency.

Final Report: Assessing Community Costs of Chronic Homelessness in the Gallatin Valley

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

Intermountain, in partnership with three Helena alternative school programs (Project for Alternative Learning, Access to Success, and the Career Training Institute), will plan and implement a new project to provide onsite and on-call behavioral health services for alternative school students in the Helena area struggling with mental health and substance abuse issues.

Intermountain Deaconess Children's Services

Integrated Behavioral Health Collaboration

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

This project will support the development of an Integrated Behavioral Health Business and Operations Plan that clearly addresses all aspects of developing an Integrated Behavioral Health collaboration between Intermountain and PureView Integrated Behavioral Health. The plan will guide the startup of the collaboration in terms of focus on patient-centered and team-based service delivery, and scopes of service and practice, and provide the blueprint for achieving economic sustainability beyond the implementation phase.

Kalispell Regional Healthcare

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

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

Through this grant, Kalispell Regional Healthcare’s (KRH) neonatal intensive care unit staff will work with Montana hospitals to develop and implement a standardized protocol to screen for and manage drug withdrawal in newborns. Neonatal Abstinence Syndrome (NAS) is a drug withdrawal syndrome that sometimes occurs when infants exposed to opioids and other potentially harmful drugs in utero are delivered. This project will help to establish a strong, consistent approach to NAS among the hospitals that deliver babies in Montana. To accomplish this, KRH will work with other tertiary care hospitals to develop a standardized screening protocol, and then train staff in rural hospitals and work with them to develop and implement consistent policies and procedures for NAS. Second, KRH will develop and pilot a collaborative, multidisciplinary program to provide parents of infants with NAS with support and drug and alcohol counseling while their newborns are hospitalized.

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.

 

Lewis and Clark County

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

Project Term: 24 months; Aug 2017 – Jul 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: $45,000

This grant will support development of a county-wide Mental Health Strategic Plan, using a sequential mapping approach that looks at where people with mental illness interact with corrections, medical care, emergency response, and behavioral health services, and taking a step-by-step approach to helping the county develop a plan that improves outcomes and utilizes existing resources most effectively. The plan will be carried out by the Local Advisory Council, which includes broad representation of city and county leadership, hospitals, providers of mental health services, substance abuse services, criminal justice legal staff and law enforcement.

Lincoln County Health Department

Mental Health Coalition

Project Term: 12 months; Apr 2017 – Mar 2018
Grant Amount: $25,000

This project will form a community coalition (led by the county health department and including mental health and medical providers, law enforcement, and schools) to develop a behavioral health strategic plan to assess current mental health needs and available services. The Lincoln County Health Department will then use that plan to lead a multi-agency effort to identify and develop projects to fill gaps in community behavioral health needs.

Livingston Healthcare Foundation

Behavioral Health Crisis Management

Project Term: 24 months; Dec 2017 – Nov 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 1) yearly improvement in behavioral health care quality indices, 2) declining suicide rate, 3) declining rate of substance abuse in Park County and surrounding rural communities, and 4) 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; Nov 2016 – Oct 2018
Grant Amount: $126,717

Livingston HealthCare will create a collaborative primary and psychiatric care team by hiring a licensed clinical social worker with mental health certification. The project will connect primary care providers and psychiatric department with the goal of creating a seamless, coordinated care team that improves accessibility of services and clinical outcomes. The practice will implement universal behavioral health screening, and develop a streamlined system that provides care for patients with physical and mental health concerns at the same visit. The program will also develop treatment protocols to provide medically-assisted treatment for people with chemical dependency. The licensed clinical social worker will serve as a liaison between primary care and psychiatry to ensure appropriate and effective referrals and increase access to a full spectrum of mental health services.

Lockwood School District - Special Programs Office

Lockwood Mobile School Based Health Center

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

For this project, the Lockwood School District and St. Vincent Healthcare will partner to develop a school based health center in a mobile unit located on the Lockwood School campus. This health center will not only provide comprehensive health care services for Lockwood students and staff, but will also be available to the entire community. Grant funding will be used to support staffing for the health center and will help re-purpose the mobile unit (formerly a dental care unit). Initially, the health care center will focus on offering preventative and primary care services, but ultimately hopes to expand to include behavioral health and dental services.

Madison County

Integrating Behavioral and Physical Health in Madison County

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

The Madison County Mental Health Local Advisory Council, pertinent Madison County departments, Madison Valley Medical Center, Ruby Valley Hospital, and Western Montana Mental Health Center will work in collaboration with one another to integrate behavioral and physical health services in Madison County. The initial phase will focus on developing an integrated system that addresses mental health maintenance and prevention of behavioral problems, awareness and early intervention, access to care, crisis response, coordinated care, continuity of care and follow-up, and sustainable behavioral health services.

Messengers for Health

Traditional Relationships Improve Contemporary Health

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

Messengers for Health, a Crow non-profit, will carry out two projects with this grant: (1) broadening a cancer screening outreach program to include colon cancer screening for men; and (2) implementing and evaluating a culturally-based chronic disease self-management program for illnesses such as diabetes. Messengers for Health has been working in the area of cancer screening since 1996, in partnership with Professor Suzanne Christopher at Montana State University (MSU), using a community-based participatory research framework. The program uses a volunteer-driven, culturally-based model to encourage women to seek screening for breast and cervical cancer. To contribute to the chronic disease self-management program, this grant will support the development of a training manual for volunteers, and pilot test the elements of the model with patients of Bighorn Valley Community Health Center.

Missoula Aging Services

Care Transitions Achieving Better Health Outcomes

Project Term: 24 months; Nov 2016 – Oct 2018
Grant Amount: $135,250

This grant will support a care coordination position to help older adults transition successfully from hospitals back to their homes, with a focus on dual-eligible Medicare and Medicaid patients. 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 will use an established model that involves home visiting followed by frequent phone or in-person contacts during the month after a hospital stay. The program will also identify social risks and help coordinate appropriate referrals as needed. This project builds on a current effort funded by the Center for Medicare and Medicaid Services which has been shown to reduce hospital re-admissions and reduce healthcare spending.

Missoula County

Missoula County Collaborative Care Planning Summit

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

This project will bring the National Council for Behavioral Health to Missoula to facilitate a two-day community-wide integrated behavioral health planning summit. Attendees will include community leaders in the fields of primary health care, behavioral health, post-secondary education, criminal justice, law enforcement, local government, and advocates for the mentally ill. The summit’s goal will be to develop an integrated collaborative care plan for Missoula County with a holistic approach to mental health and primary care.

Missoula Urban Indian Health Center

Walking Well With Traditional Healing

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

The Missoula Urban Indian Health Center (MUIHC) serves the urban Indian population in Missoula County and surrounding areas in Western Montana by offering a comprehensive holistic healing model for those struggling with historical trauma. This project will focus on increasing MUIHC’s capacity to provide culturally adapted, evidence-based, and trauma-informed awareness and care to the more than 540 active clients they see every year. As part of the project, they will incorporate the self-help techniques of the Community Resiliency Model for community members, and the Trauma Resiliency Model for counselors and therapists to incorporate into client therapy.

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 (released Sep 2016) 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 Mar 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 Montanans Face Uncertainty of Health Coverage with Threat of ACA Repeal, published in Jan 2017. The report generated two news stories and was mentioned in nine others.

Montana Department of Public Health and Human Services

Montana Oral Health Program

Project Term: 12 months; 2017-2018
Grant Amount: $100,000

This grant will help develop and implement a framework for oral health improvement in Montana. The Department of Public Health and Human Services has already begun 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 will allow the state to 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 Legal Services Association

Montana Health Justice Partnership

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 below). 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 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.

 

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

The Montana Health Justice Partnership, a collaboration between the Montana Legal Services Association and the Montana Primary Care Association, will provide legal assistance to patients in several rural community health centers. Such “Medical-Legal Partnerships for health” are active in nearly 40 states. In this model, an attorney works as part of a clinical team to address 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. Through this grant, an attorney will provide services for patients in community health centers in Havre, Libby, Great Falls, Billings, Dillon, Fairview, and Lolo. The Montana Primary Care Association will provide the networks, relationships, trust, and project management needed to make this project successful.

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 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.

Montana Public Radio

Montana Care Issue Reporting

Project Term: 12 months; Ended 2016
Grant Amount: $20,000

Montana Public Radio will collaborate with Yellowstone Public Radio to research, produce, and broadcast statewide 16 in-depth stories on current health and healthcare issues in Montana. This funding would allow reporters to travel to remote parts of the state to research and cover issues relevant to rural Montanans and tribes.

Articles:*

  1. Montana Legislature Questions Cost of Air Ambulance Services (Dec 1, 2015)
  2. Montana Healthcare Leaders Aiming for Reform, Innovation (Jan 20, 2016)
  3. Montana Primed for Growth in Healthcare Spending, Jobs (Jan 27, 2016)
  4. Montana’s Growing Demand for Health Professionals Spurs Education Initiatives (Feb 22, 2016)
  5. Tester: ‘Veterans Choice Managers Inept,’ New Law Needed (Mar 3, 2016)
  6. Chronic Pain Patients Propose Policy Changes (Mar 10, 2016)
  7. Chronic Pain Patients Lobby For ‘Bill of Rights’ (Mar 11, 2016)
  8. Veterans Health Fix Failing in Montana (Apr 18, 2016)
  9. Montana’s ‘Pain Refugees’ Leave State for Treatment (Apr 25, 2016)
  10. Pain Helped Him Pull the Trigger (Apr 26, 2016)
  11. State Medical Board Examines Pain Treatment, Opioid Abuse Questions (May 23, 2016)
  12. Montana’s Medicaid Expansion Jobs Program Facing Scrutiny (Nov 21, 2016)
  13. Montana Healthcare Leaders Want to Ditch Fax Machines, Build An ‘Information Utility’ (Dec 8, 2016)
  14. Tester: Obamacare Repeal Has ‘Real World Impacts’ (Jan 8, 2017)
  15. Obamacare Brings Insurance, Jobs to Montana’s Indian Reservations (Jan 12, 2017)
  16. Montana Healthcare Employment Up in 2016, Future Uncertain (Jan 25, 2017)

*Disclaimer: The statements and conclusions of these articles are those of the Grantee and not necessarily those of the Montana Healthcare Foundation.

Montana Women Vote

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

Project Term: 12 months; Ended 2016
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.

Mountain Home MT

Substance Use Disorder Treatment for Pregnant and Parenting Teens

Project Term: 18 months; Apr 2017 – Oct 2018
Grant Amount: $73,754

This project will develop a strategy for integrating substance use disorder treatment into Mountain Home Montana’s wrap-around care for pregnant and parenting mothers. Outcomes include developing a strategy and funding plan to implement and sustain substance use disorder treatment services; an evaluation system to track outcomes; and a Medicaid youth endorsement which will allow Mountain Home Montana to bill for providing mental health support to mothers under 18 years old. Project goals include building the capacity to increase the number of patients served from 50 to 200 per year by 2021, resulting in fewer substance-related evictions, more family reunifications, and fewer children placed in foster care.

MSU - Office of Rural Health

MT Graduate Medical Education Council Rural Residency Sustainability Initiative

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

The project will address the need to provide rural training opportunities for medical residents in Montana. The project will develop a toolkit to help rural practices become effective training sites for medical residents, nurse practitioners, and physician assistant students, and develop a sustainable financial model for rural graduate medical education in Montana.

MSU - Office of Rural Health

Community Health Worker Stakeholder Project

Project Term: 24 months; Nov 2016 – Oct 2018
Grant Amount: $140,772

This grant will create 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. Strong evidence demonstrates that CHWs can improve health outcomes in a cost-effective way. While CHWs and CHW-like roles are becoming more common in the U.S. and Montana, there is little consistency in how the role is defined, or in the training, employment, and funding of these positions. This plan will include standardized training curriculum for CHWs, identification of payment models to support policy-level changes needed to sustain these positions, and education for providers on how to utilize them. A stakeholder group comprising payers, providers, and health departments will provide broad-based perspective; and focused work groups will develop a model curriculum, training delivery models, and address policy issues related to scope, credentials, payment models, and sustainability.

MSU - Sociology & Anthropology

Responding to Secondary Trauma among American Indian Victim Service Providers

Project Term: 24 months; May 2016 – Apr 2018
Grant Amount: $25,000

This grant will create a program to address secondary trauma (trauma experienced by people who serve victims of violence). Secondary trauma is recognized as an occupational hazard that contributes to health problems and burnout among victim service providers. The program will serve employees in programs that support victims of domestic violence, elder abuse, child abuse and neglect, sexual assault, and other forms of trauma. Desired outcomes include an increase in awareness, normalization, and knowledge of secondary trauma, as well as an improvement in individual and organizational responses. Over the long term, this project will help address the shortage of behavioral healthcare and victim support providers.

MT Children's Health Data

Montana Children’s Health Data Partnership Project

Project Term: 12 months; Dec 2017 – Nov 2018
Grant Amount: $50,000

This project seeks to advance a statewide framework to address key determinants of health for children in Montana by collaborating with public and private sector practitioners to develop benchmarks that will guide and support community coalitions around the state. Healthy Mothers Healthy Babies currently works with 20 early childhood coalitions around Montana, all of which have varying levels of capacity and often unique but related goals and strategies. This project will partner with the Montana Early Childhood Coalition to support local and regional networks and coalitions and allow them to apply a collective impact framework that relies on mutually agreed-upon priorities and metrics that can be used to jointly plan efforts to address key health determinants and to measure outcomes.

MT DPHHS

Improving the Health of Montanans through Local and Tribal Public Health

Project Term: 24 months; Ended 2016
Grant Amount: $1,344,740

This project will support county and tribal health department strategic planning and programming through a collaboration with the Montana Department of Public Health and Human Services (DPHHS). As part of its efforts to support health departments around the state, DPHHS undertook a department-wide effort to provide counties with County Health Profiles, which are specific, county-level health data. This data offers an important new tool to help communities in Montana identify health needs and make plans to address them. County Health Profiles are now available to the public via DPHHS’ portal for the county health departments.

MT Human Rights Network

Documenting Patient Experiences with Montana’s Medicaid Expansion

Project Term: 3 months; Ended 2016
Grant Amount: $20,000

This project will produce a series of stories of individuals who have gained coverage under the Medicaid expansion. These stories will be captured in a printed storybook for distribution.

MT Medical Association Foundation

MT Health Information Exchange Feasibility Development Plan

Project Term: 18 months; Aug 2016 – Jan 2018
Grant Amount: $50,000

Through this grant the Montana Medical Association Foundation and partners will explore the potential for creating a health information exchange for Montana. The grant will support creation of a governing board structure and workgroups that will be utilized to determine state needs and to hear reports on a pilot Health Information Exchange project existing in Montana. This private-public partnership is intended to explore the viability of a health information exchange while working under a clearly designed governance structure to develop an infrastructure and path forward to implementation. A consultant will assist to drive the completion of this effort within a defined timeframe. There are many partners for this project including 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, among others.

MT Medical Association Foundation

Prescription Drug Abuse Reduction Initiative

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

The Montana Medical Association (MMA) is proposing to work with Family Practice residency programs to incorporate training modules on Prescription Drug Abuse into the residency curriculum to educate new physicians on best practices in prescribing opioids (drugs such as oxycodone and hydrocodone). MMA also hopes that these residents will, in turn, share best practices with practicing physicians while on rotations around Montana.

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

NeighborWorks Great Falls

Home Matters – Linking Homes and Health Outcomes

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

This grantee will evaluate changes in health status and health-related behaviors among low-in first-time time homebuyers, using a set of measures developed by NeighborWorks America’s Healthy Homes & Communities program. The project would be carried out in partnership with the local health department, Benefis Healthcare, and the Great Falls Clinic, with the intent of engaging these health system partners in a longer-term discussion of how they might partner with housing and community development organizations to address the health risks of substandard housing.

NeighborWorks Montana

Manufactured Housing Rehabilitation and Replacement Collaboration

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

Substandard housing creates risks for health problems such as asthma and hip fractures, among others. This project seeks to identify new partners and collaborative, scalable solutions to repair and replace old and poorly maintained manufactured homes in western Montana, with an initial focus on Pablo and Missoula. Manufactured housing is an important form of affordable housing in Montana, but upwards of 30,000 homes are in need of repair or replacement. This project will explore shared interests with the healthcare and energy sectors, and create a task force in western Montana to identify collaborative solutions to make manufactured home repair and replacement accessible and affordable – leading to improved health outcomes for low-income people.

North American Indian Alliance

Strategic Planning Initiative

Project Term: 12 months; Aug 2017 – Jul 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 Healthcare Services

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

This project will plan and implement telebehavioral health services in three schools, a clinic, and a skilled nursing facility in the Whitefish geographic area. Services will include both mental health and behavioral health treatment. The project will take a stepwise approach to expanding services to each site, beginning with the Columbia Falls high school. In this first phase, the project will design a tool for screening and referring students, coordinating care between the telehealth provider and the school, and using the telemedicine equipment.  In the next phase, the project will expand to Whitefish and operate as part of a school-based clinic that is opening there this year. In both cases, the aim is to begin services in the high school and then build to offer services to middle and elementary students. In the third phase, the project will expand to the rural Eureka school system and a skilled nursing facility in that community.

North Valley Hospital Foundation

School Based Integrated Behavioral Healthcare for Students

Project Term: 24 months; Nov 2016 – Oct 2018
Grant Amount: $150,000

This project will bring integrated behavioral health services into a school-based health center serving at-risk students in Columbia Falls and Whitefish. The project will ensure that behavioral health screening, diagnosis, and treatment are fully integrated into the clinical care provided to students at the existing school-based health center in Columbia Falls and work to increase integration with primary care providers serving the students in Whitefish. With an initial grant from MHCF, North Valley Hospital established telepsychiatry services at the school. This new grant would enable the hospital to hire an on-site behavioral health provider(s) 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.

Northern Cheyenne Tribal Board of Health

Revenue Enhancement Project

Project Term: 18 months; Apr 2017 – Oct 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 2017
Grant Amount: $99,453

The Northern Cheyenne Tribal Board of Health will establish an injury prevention program. Montana has one of the nation’s highest rates of motor vehicle injury among American Indians. The project will establish a comprehensive, public health approach to injury prevention on the Northern Cheyenne Indian Reservation. Key elements include (1) revising the current Tribal Safety Belt Ordinance; (2) conducting community-based activities to increase the use of seat belts and child restraints, such as community education campaigns and partnering with Head Start to distribute and encourage the use of child seats; and (3) collaborating with law enforcement to strengthen traffic safety.  The grant will fund a fulltime injury prevention coordinator to lead the activities. The Indian Health Service and Centers for Disease Control and Prevention offer longer-term funding for tribal injury prevention programs: this grant will also help the tribe establish the foundation needed to successfully apply for these longer-term grants.

Northern Rockies Medical Center

Integrating Behavioral Health in a Critical Access Hospital

Project Term: 12 months; Dec 2017 – Nov 2018
Grant Amount: $50,000

This project will develop a plan to integrate behavioral health services into the Northern Rockies Medical Center’s outpatient practice, which serves the Cut Bank community in northern Montana. In addition to planning to offer IBH services, the project will develop a plan for a referral system with options for those struggling with substance use disorders and mental health issues. Potential partnerships that this project will foster include a local private practice counselor, Indian Health Services, Crystal Creek Lodge Treatment Center, Kalispell Regional Health, and Marias Medical Center.

Open Aid Alliance

Licensed Chemical Dependency Treatment Center

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

This project will help Open Aid Alliance apply for a chemical dependency treatment facility license allowing them to provide intensive outpatient services utilizing harm reduction philosophy. The project will work in cooperation with other treatment providers to accommodate referrals and provide services to people who are currently using IV drugs but are contemplating change. Partners include other treatment facilities in Missoula, behavioral health professionals, the University of Montana, and correctional facilities.

Open Aid Alliance

Overdose Prevention and Naloxone Access Project

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

Naloxone is an injectable drug used to reverse the effects of opioid and is life-saving in the treatment of overdoses. This proposal will make naloxone available to opioid-addicted patients through Missoula’s needle exchange, and provide training for these individuals and family members on proper use. There is mounting evidence that this approach effectively prevents overdose deaths. Funding will be used to plan the program.

Park County Health Department

Recovery Court Program Strategic Planning

Project Term: 12 months; Aug 2017 – Jul 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; Aug 2016 – Jul 2018
Grant Amount: $148,183

This project will employ a targeted approach to treating so-called “super-utilizers,” the approximately one percent of patients accounting for 22 percent of total healthcare expenditures. Super-utilizers often suffer from multiple chronic conditions, mental health concerns, and myriad socioeconomic barriers to care, contributing to multiple ER visits and hospital admissions. Partnership Health Center’s Super-Utilizer Care Management teams will, through home visits and a partnership of community resources, deliver comprehensive care to these patients with the goals of reducing emergency department use, hospital admissions and healthcare costs; increasing patient health and satisfaction; and transitioning patients to primary-care settings.

Poverello Center

Medical Respite Shelter for Homeless Patients

Project Term: 24 months; May 2016 – Apr 2018
Grant Amount: $50,000

The Poverello Center Medical Respite Program partners with St. Patrick Hospital, Community Medical Center, and other Missoula area providers to provide rooms and care coordination for homeless individuals who are recovering from illness, injury or acute medical conditions and require privacy, rest and additional care for full recovery. This proposal will expand on the existing medical respite program by supporting more robust care coordination by the Center; evaluate the health outcomes achieved by the program; and strengthen and formalize partnerships and funding agreements with the hospitals that refer to the center. The long-term goal is to decrease medical costs and to improve the overall health of homeless individuals in Missoula and the surrounding communities.

Providence MT Health Foundation

Bridge to Hope Project

Project Term: 12 months; Dec 2017 – Nov 2018
Grant Amount: $42,600

This project will provide support for mothers whose newborns are experiencing Neonatal Abstinence Syndrome (NAS) on the Flathead Reservation. The project builds on a previous MHCF’s grant that helped create the Wrapped in Hope Project which addressed perinatal drug use in the region, and will now extend care to families after delivery. This project is designed to 1) reduce the rate of maternal-infant separation in the hospital setting as a result of NAS treatment; 2) engage addicted mothers in the care of their infant through support group sessions, and 3) increase addicted mothers’ voluntary participation in area drug treatment programs by the time of their infants’ discharge. An ongoing series of 10 maternal support group sessions will be conducted by a licensed addiction counselor in partnership with a pediatrician and nursing staff while the newborns are hospitalized for NAS treatment, and mothers will receive materials and modeling related to the holistic care of their infants aimed at facilitating mother-infant bonding. The project will be conducted in partnership with the CSKT Tribal Government and Wrapped in Hope staff at St. Joseph Medical Center.

Providence MT Health Foundation

Wrapped in Hope

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

The Hope Project of Lake County and the Flathead Reservation is a collaboration between Providence Montana Health Foundation and St. 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 will implement a collaborative, team-based approach that provides holistic, respectful, family-centered care. They will hire licensed clinical social workers (LCSWs) with expertise in addictions, and implement a comprehensive, coordinated approach to providing prenatal care and coordinate supportive services for pregnant women struggling with addiction. Beyond the direct impacts of drug use during pregnancy, an accompanying problem is that women struggling with addiction often have poor or no prenatal care, often because of fears of criminal prosecution and social service involvement. A second component of the program will focus on community outreach to encourage people to seek care early in pregnancy or prior, and inform them of the availability of supportive services. The Best Beginnings program (focused on early childhood) and the County Health Department’s Parents as Teachers program will also serve Hope Project families.

Project Materials

Wrapped in Hope: Confidential Healthcare & Chemical Dependency Support

Providence MT Health Foundation

Providence Medical Group Integrated Behavioral Health Initiative

Project Term: 24 months; Nov 2016 – Oct 2018
Grant Amount: $150,000

With this grant, Providence Medical Group will integrate behavioral health into Grant Creek Family Practice, a patient-centered medical home. The practice would hire a licensed clinical social worker to work in the primary care setting, with the goal of providing patients seamless, effective care. Partners include eight other Providence system patient-centered medical homes in the region, and they will share best practice information, as well as specialty support from Providence Western Montana psychiatric services, which includes an urgent mental health clinic, inpatient services, and psychiatry. The goals of this project include a reduction in emergency department utilization by established patients, a reduction in emergent mental health issues, an increased patient satisfaction score, and cost savings through avoided health costs resulting from the current fragmented system.

PureView Health Center

Universal Substance Use Disorder Screenings and Warm Handoffs

Project Term: 12 months; Dec 2017 – Nov 2018
Grant Amount: $13,440

This project will help PureView Health Center implement universal substance use disorder screenings for all patients over 12-years old. Patients will be screened for substance use disorders, and if necessary, will be referred and given a warm-handoff to the health center’s behavioral health team. The project will contract with Boyd Andrew Community Services who will provide a full-time licensed addiction counselor to be housed at the health center. PureView will bill Boyd Andrew for the services of the counselor, and Boyd Andrew will invoice the health center for this position. Supervision of the counselor will be through Boyd Andrew; however, to patients, the counselor will appear to be a member of PureView’s behavioral health team.

 

Richland County Health Department

Connecting Resources for Emotional Wellness

Project Term: 12 months; Aug 2017 – Jul 2018
Grant Amount: $28,328

This project will use an 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, Richland County will bring together multiple agency stakeholders to identify resources and gaps in support services. A map identifying “opportunities of interception” will be created and processes will be developed to intervene and improve individual emotional wellness. Also, areas or services that could be supported by partners to reduce the overall cost of mental health crisis will be identified. This project will initiate the creation of a toolbox that will allow the project to be replicated easily in other communities.

Rimrock Foundation

Residential Treatment for Pregnant American Indian Women

Project Term: 24 months; Dec 2017 – Nov 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 focuses on supporting the integration of clinical pharmacists into primary care practice to improve health outcomes. Studies on incorporating pharmacists into the health care teams consistently show improved outcomes and a decrease in overall healthcare costs. This project will identify the core elements of successful healthcare teams, develop solutions to identified barriers, and develop resources to facilitate the cost-effective scaling up of partnerships between small and rural practices across the state with clinical pharmacists in these communities. Partners will include RiverStone Health, Montana Pharmacy Association, the University of Montana Skaggs School of Pharmacy, and the Montana Medical Association.

Payer Panel Discussion Slides

Integrated Clinical Pharmacy Services: Best Practices Toolkit

RiverStone Health

Good Behavior Games and Trauma Informed Schools

Project Term: 24 months; Dec 2017 – Nov 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

RiverStone Health will complete a business feasibility plan for expanding its scope of service to include providing integrated psychiatric services to patients; and will develop a plan for an integrated behavioral health training rotation focused on psychiatric prescribers. The feasibility plan will also examine opportunities to serve as an integrated behavioral health rotation site for students in psychiatric nurse practitioner training programs, psychiatry residency programs, and masters of social worker students. Results of this project will help other Montana community health centers integrate behavioral health into primary care, with a focus on adding psychiatric care. The grantee will also investigate the feasibility of adding a training program for existing primary care providers in Montana.

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 focuses on reducing the risk of readmission for seniors and disabled individuals judged to be at high risk at the time of discharge from the hospital. The grantee will extend Helena’s RSVP program to rural towns in three counties. Volunteers in the RSVP program provide resource coordination, peer support, and assistance with issues such as taking medications correctly. The RSVP program has been credited with helping to reduce readmissions in St. Peter Hospital in Helena.

Rocky Mountain Tribal Epidemiology Center

Prevention and Support for Pregnant Blackfeet Women Using Opioids

Project Term: 12 months; Apr 2017 – Mar 2018
Grant Amount: $75,000

This project will support RMTLC and their Boston University-based partners to work with the Blackfeet tribe and the Indian Health Service Blackfeet Community Hospital to address opioid prevention among pregnant women on the Blackfeet reservation. Funds will be used to conduct focus group/key informant interviews with clinicians and substance-using pregnant women; produce a gap analysis to determine treatment shortfalls; and work with the tribe to create a feasibility analysis and protocol for medication-assisted treatment to include integrated behavioral health, assessing the accuracy of prenatal screening, analyzing reimbursable billing, and helping to establish a referral system for care. The grant will also be used to foster relationships between the Lummi and Blackfeet tribes, as well as organizations working on similar issues in the Flathead region.

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 on Blackfeet

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

In 2016, MHCF supported RMTEC 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 will continue that work, through task force strengthening and capacity-building; focus groups/key informant interviews with clinicians and substance-using pregnant women; producing a “gap analysis” to determine treatment shortfalls for substance-using pregnant women on Blackfeet; and working with the tribe to produce a feasibility analysis and business plan for developing services to address perinatal drug use. The project will also work on perinatal screening for substance use disorders, with a focus on establishing a strong system of care for women who screen positive. The grant will also foster the relationship between the Lummi and Blackfeet tribes, and the Blackfeet and tribes working on similar issues in the Flathead region. The tribe is also requesting that the grantee work towards creation of a tribal resolution for an opioid treatment facility on Blackfeet.

Saint Vincent Healthcare

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 Montana Healthcare Foundation implementation grant.

 

Salish Kootenai College

Type 2 Diabetes Intervention for At-Risk Youth

Project Term: 24 months; Aug 2017 – Jul 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 (SKC) nursing students will work with the CSKT Tribal 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.

Shodair Children Hospital

Integrated Behavioral Health Planning Project

Project Term: 12 months; Apr 2017 – Mar 2018
Grant Amount: $50,000

This project will enhance Shodair’s current services through adding substance use disorder treatment to their current inpatient services; and developing a plan to provide pediatric psychiatric consultation in primary care clinics. Both efforts will use an integrated behavioral health framework. With the help of the National Council for Behavioral Health, the plan will assess organizational readiness and capacity for implementation, develop a staffing plan for hiring and sustaining a licensed addiction counselor to provide treatment for substance use disorders and build a data sharing and evaluation plan for tracking patient outcomes. Additionally, the project will partner with primary care providers to develop a pilot pediatric psychiatric consultation network enabling local psychiatrists to consult with patients and providers face-to-face or via telemedicine.

Sidney Health Center

Bakken Behavioral Health Project

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

Sidney Health Center, in collaboration with the Richland Health Network and the Local Advisory Council for Mental Health (LAC), will establish behavioral health services in the Rural Health Clinic. The grant will support staff training related to administration, billing, and behavioral health services.

Southern Peigan School Health

Behavioral Health Services for At-Risk Youth

Grant Amount: $75,000
Project Term: 12 months; Aug 2017 – Jul 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. The project will be a part of Montana Healthcare Foundation’s Integrated Behavioral Health Initiative. 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; Aug 2016 – Jul 2018
Grant Amount: $20,000

Special Olympics Montana (SOMT) will partner with the Confederated Salish and Kootenai Tribal Health Department (CSKT), and the Department of Public Health and Human Services to work towards improving health for those with intellectual disability on the Flathead Reservation. A SOMT tribal outreach director will work in the CSKT Health Department one day a week to identify potential CSKT Special Olympics athletes, involve them in SOMT, and facilitate participation in SOMT-required health screenings. CSKT staff will assist with insurance enrollment, bill insurance for care received, and ensure robust coordination of care among all of each individual’s health providers.

Sprout Oral Health

School Nurse Fluoride Varnish Programs

Project Term: 24 months; May 2016 – Apr 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.

St. Luke Community Healthcare Foundation

Integrated Behavioral Health for Lake and Sanders Counties

Project Term: 12 months; Aug 2017 – Jul 2018
Grant Amount: $50,000

This project will develop a plan to enhance St. Luke’s integrated behavioral health program into multiple sites across its outpatient practice. In addition, the project will develop a training system for using a primary licensed clinical social worker as a mentor and teacher to students who need to earn clinical hours, so that more patients can be seen and the ratio of patients to mental health workers can be decreased. Partners include institutions which award social worker certifications including Salish Kootenai College, Walla Walla School of Social Work, University of Montana, and Montana State University.

St. Peter Hospital Foundation

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

Project Term: 12 months; Aug 2017 – Jul 2018
Grant Amount: $50,000

This project will develop a behavioral health screening and treatment program at St. Peter’s Hospital. The goal of the project is to have a fully developed plan and educated personnel to successfully integrate and sustain behavioral health within St. Peter’s entire primary care practice by the end of the grant term.

St. Vincent Healthcare

ARRIVE: Integrated Prenatal Care

Project Term: 24 months; Nov 2016 – Oct 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.

St. Vincent Healthcare

Building out the Continuum of Care

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

This project would contribute to St. 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 tele-health for rural patients that require a level of care beyond the scope of what the team can provide onsite at the primary care clinics.

Sweet Medical Center

Integrated Behavioral Health Planning and Development

Project Term: 12 months; Aug 2017 – Jul 2018
Grant Amount: $48,215

This project will complete a planning and capacity building initiative to integrate behavioral health into the health center’s operational infrastructure, workforce, and sustainability plan. Initial steps have already been taken towards integration including a partnership with the Center for Mental Health, securing a family nurse practitioner (who is working toward a psychiatric nurse practitioner license), and a move towards a team-based care model. Partners include the local mental health local advisory council, school, sheriff’s department, and local public health.

Townsend Health Systems

Enhancing Rural Health Through the Expansion of Integrated Behavioral Health Services

Project Term: 18 months; Apr 2017 – Oct 2018
Grant Amount: $75,000

Townsend Health Systems will enhance its current medical and mental health services by developing an integrated behavioral health (IBH) practice that is sustainable. Townsend will develop a comprehensive process to assess current organizational capacity for successful integration of primary care and behavioral health, which may include screening and brief intervention for substance use disorders (SUD), and exploration of SUD treatment. This grant will result in the health center having an operational infrastructure, workforce, and sustainability plan.

Two Eagle River School

Two Eagle River School Wellness Project

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

This grant will fund a partnership between Two Eagle River School and Tribal Health of the Confederated Salish and Kootenai Tribes (CSKT) 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 past year, the school has identified an immediate need to address the mental health and historical trauma needs of the students. The project is supported by the CSKT Tribal Council and will form a new partnership with CSKT Tribal Health. Freedom Lodge is a non-profit that will provide training to the therapist to address historical trauma within the school and assist with the evaluation of the project.  

 

UM - Curry Health Center

Enhancing Behavioral Health Integration

Project Term: 12 months; Apr 2017 – Mar 2018
Grant Amount: $50,000

This project will strengthen and advance the level of behavioral health integration at the University of Montana’s Curry Health Center with a focus on the interface between the medical and counseling clinics. Nationally, the demand for behavioral health services in college health centers continues to grow, and the Curry Health Center frequently serves students with behavioral health needs. Students seek behavioral health care in both the health center’s medical and counseling clinics, and the health center could be better positioned to meet student needs if the two clinics were more fully integrated. Work on integration at the Curry Health Center is ongoing, and with the help of the National Council for Behavioral Health, this project will provide additional expertise on how to further integrate behavioral health services across the clinic to better meet the needs of University of Montana students.

UM - Department of Psychology

Integrated Behavioral Healthcare Workforce Development

Project Term: 24 months; Aug 2016 – Jul 2018
Grant Amount: $44,821

The University of Montana Department of Psychology, with Partnership Health Center (PHC) of Missoula and the Family Medicine Residency of Western Montana, will develop a field placement experience for behavioral health graduate students to address critical workforce development needs in Montana. The project will provide an initial, 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. This project builds on a previous 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

The Pharmacist Managed Asthma Clinics Program at the University of Montana-Skaggs School of Pharmacy will assess current access to asthma self-management education and determine the feasibility of multi-disciplinary, pharmacist-led managed asthma care in Montana’s American Indian communities. This project will adapt current toolkits to expand the program into pharmacies on the reservations and urban communities. In addition to looking at the need for asthma programs in American Indian communities in Montana, the program will help patients and health care professionals understand the need and importance of asthma management. Partners include the Native American Center of Excellence, Missoula Urban Indian Health Center, Rocky Boy Health Board, the Montana Asthma Control Program, and the Improving Health Among Rural Montanans program.

University of Montana

Effective Integrated Behavioral Health Partnerships

Project Term: 12 months; Ended 2016
Grant Amount: $50,000

The University of Montana will develop and implement an integrated behavioral health curriculum for its psychology, social work, and counseling students, as well as the Western Montana Family Medicine Residency. This curriculum will ultimately be used to train and certify integrated behavioral health providers across the state.

Western MT Mental Health

Integrated Behavioral Health for Western and South Central MT

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

With this grant, Western Montana Mental Health Center (WMMHC) will contract with the National Council for Behavioral Health to provide training in integrated behavioral health (IBH) to 11 Western Montana Mental Health Center directors, and then begin strategic planning in each of the 14 counties in which they work toward the goal of implementing an IBH model in each county. The project will also result in a pilot IBH implementation project in Livingston.

Final Summary:
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 1) developing a community care pathway for youth; 2) increasing utilization of volunteers; 3) improving management of individuals in crisis; and 4) strengthening partnerships among organizations. Task forces met individually and collectively on multiple occasions. The crisis management team reviewed data on how many people have been to the emergency department during a mental health crisis. Challenges identified include 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. This team now meets monthly to improve admissions from the Livingston Emergency Department to WMMHC’s crisis facilities; and they are now providing tele-assessment to improve crisis response time, and have clarified WMMHC’s protocol for admission to the crisis facilities.

Western Native Voice

HELP Act Outreach and Assistance in Native American Communities

Project Term: 12 months; Ended 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.

WMMHC 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.

Yellowstone Boys and Girls Ranch

Substance Use Disorder Treatment Program

Project Term: 24 months; Dec 2017 – Nov 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; Nov 2016 – Oct 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; Apr 2017 – Mar 2018
Grant Amount: $26,088

This project will add case management and expanded programming for parents to a well-established wilderness youth therapy program. The program currently offers a 45-day wilderness therapy trip for youth ages 13-17 who have co-occurring behavioral issues, and a simultaneous program for parents and family members. The family program is run by a licensed therapist who utilizes best practices to teach effective parenting. Additional case management services will allow the family program to be offered to Medicaid clients (roughly half of the client base) who would benefit. Partnerships for this project include Youth Court, Tribal Social Services, Child and Family Services, Dan Fox Family Care Program, and Western Montana Mental Health.

YWCA of Helena

WINGS Reentry Transitional Housing Program

Project Term: 12 months; Apr 2017 – Mar 2018
Grant Amount: $50,000

This project will fund an onsite Licensed Clinical Social Worker/Licensed Addictions Counselor (LCSW/LAC) for transitional women’s housing program. The program currently serves women with co-occurring substance abuse and mental disorders who have been released from incarceration and/or treatment and are at moderate-to-high risk for re-incarceration. The applicant currently serves 26 women and their children in a dorm-style, trauma-informed, sober-living transitional housing program. Funding will allow the applicant to apply for Montana’s first licensed, level three sober living group home serving women and their children, which will allow them to bill for and provide a range of behavioral and substance use disorder treatment services.

2018 Call for Proposals

Find out about this year’s available grants.