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Barrett Hospital Foundation

Southwestern Montana Rural Accountable Care

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

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

 

Beaverhead County Public Health

Integrating Behavioral and Physical Health in Rural Southwest Montana

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

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

Behavioral Health Alliance of Montana

Advocacy for Behavioral Health Prevention, Treatment, and Recovery

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

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

Benefis Health System Foundation

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

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

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

 

Benefis Health System Foundation

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

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

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

Bighorn Valley Health Center

School-Based Health Center at St. Labre Indian School

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

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

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

Bighorn Valley Health Center

Integrated Health Care Delivery through a Hub and Spoke Model

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

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

Billings Clinic

American Indian Health Care Advocate Program

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

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

Billings Clinic

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

Project Term: 24 months; 2016-2018
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

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

 

Billings Clinic

Integrated Behavioral Health Expansion

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

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

Blackfeet Community College

Trauma Informed Planning Grant

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

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

Blackfeet Tribal Health

School and Community-Based Health Services for Blackfeet Youth

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

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

Blackfeet Tribal Health

Blackfeet Emergency Medical Services Program

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

This project will train and certify six paramedics from Blackfeet Tribal Health’s current emergency 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 the Blackfeet Tribal Health’s Tribal Health Improvement Program (T-HIP). T-HIP is Montana’s innovative new Medicaid waiver program that provides per capita funding for tribes to address factors that contribute to health disparities in the American Indian population residing on the reservation. 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 a 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

Centralized Third-Party Billing System

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

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

Boys and Girls Club of Lewiston

Central Montana Mental Health Alliance

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

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

Bozeman Health Foundation

Integrating Behavioral Health into an Internal Medicine Team

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

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

Bozeman Health Foundation

Behavioral Health Symposium, Work Groups, and Summit

Project Term: 12 months; 2017-2018
Grant Amount: $25,000

For this project, Bozeman Health will partner with leaders from the Gallatin City-County Health Department, the mental health Local Advisory Committee, Gallatin Mental Health Center, United Way of Gallatin County, and MSU’s Student Health Services to host a behavioral health planning symposium in the fall of 2017, working groups through the winter, and a behavioral health summit in the spring of 2018. Outcomes for this project include producing a plan for enhanced and better coordinated behavioral health programs for Southwest Montana that is developed and endorsed by multiple stakeholder organizations and the immediate implementation of plan elements as they are identified. 

Bozeman Health Foundation

Integrated Behavioral Health Implementation

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

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

Browning Alternative School

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

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

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

Cabinet Peaks Medical Center Foundation

Enhanced Transition of Care for Residents of Lincoln County

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

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

Cascade County Community Care Center

Integrated Behavioral Health Program Development Project

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

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

Cascade County Community Health Center

Health Wealth Service Partnership Pilot Program

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

This pilot program will assess, track, and analyze the link between mental, physical, and financial health. Health centers in Great Falls, Hardin, Miles City, and Ashland will partner with Rural Dynamics and Rural Dynamics Consumer Lending to address outstanding accounts receivable balances. Patient balances will be targeted to increase patient responsibility and financial engagement and will also be used to develop a credit builder loan pool and provide low interest, flexible term credit builder loans, and financial planning and education services. The goal of this project is to develop a health care model that includes financial health and definitively proves the impact of financial instability on physical and mental health.   

Center for Mental Health

Integrating Medical Care into a Mental Health Facility

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

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 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, however, program partners were successful in utilizing a shared referral software system.

Center for Restorative Youth Justice

Reducing School-Based Arrests for Youth with Behavioral Health Needs

Project Term: 24 months; 2017-2019
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; Ended 2018
Grant Amount: $50,000

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

Child Bridge

Finding A Way Home Project

Project Term: 18 months; 2017-2019
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.

City of Missoula: Office of Housing and Community Development

Missoula Supportive Housing Collaborative

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

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

Clark Fork Valley Hospital

Sanders County Behavioral and Medical Health Delivery Integration

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

This integrated behavioral health 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 has 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; 2015-2017
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

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

Community Hospital of Anaconda

Integrating Behavioral Health at the Community Hospital of Anaconda

Project Term: 12 months; 2017-2018
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.

Community Medical Center

Improving Screening and Treatment for Perinatal Drug Use in Missoula

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

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

CSKT Tribal Health Department

Understanding and Utilizing Health Care Resources on the Flathead Indian Reservation

Project Term: 24 months; 2015-2017
Grant Amount: $100,000

The Confederated Salish and Kootenai Tribes (CSKT) Tribal Health Department seeks to accomplish three objectives with this grant: (1) Pursuant to public law 638 assume the Indian Health Service budget for purchased and referred care and tribally manage this program. This will vastly expand the available resources to cover services not available on the reservation; (2) enroll eligible members in Medicaid now that Montana’s Medicaid expansion has been approved, and enroll those above the Medicaid income thresholds in private insurance on the exchange; and (3) educate providers that see CSKT members on this new coverage approach, and educate patients on how to effectively use coverage.

CSKT Tribal Health Department

Integrated Behavioral Health Program

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

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

Daniels County Health Department

Improving Behavioral Health Awareness in Daniels County

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

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

Daniels Memorial Healthcare Center

Developing Regional Behavioral Health Care Services Using Primary Care Resources

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

This planning grant will develop a plan to bring integrated behavioral health services to Daniels Memorial Healthcare Center which treats the frontier Scobey community in eastern Montana. Funding will be used to assist in planning and developing the scope of service for a self-sustainable clinic model in the rural region they serve. This project will build on the behavioral health work that has already been done in the community and will be guided by technical assistance from the National Council for Behavioral Health.

Eagle Shield Center

Blackfeet Community Hospice Project

Project Term: 12 months; 2017-2018
Grant Amount: $26,262

This planning grant aims to achieve two primary objectives: establish a partnership among tribal agencies on the Blackfeet reservation who will collaborate toward developing hospice services for the community and 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 Montana Community Mental Health Center

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

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

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

Flathead Community Health Center

FCHC/Intermountain Integrated Behavioral Health Collaboration

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

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

 

Florence Crittenton

Substance Abuse Treatment for Pregnant and Parenting Women

Project Term: 18 months; 2017-2018
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 Tribal Health

Centralized Billing Capacity Building Project

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

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

Fort Belknap Tribal Health

Diabetes Care Clinic

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

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

Fort Peck Health Promotion Disease Prevention

Staff Recruitment and Telemedicine Systems Project

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

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

Fort Peck Tribal Health Department

Needle Exchange Program

Project Term: 24 months; 2015-2017
Grant Amount: $50,000

This project will revive the Needle Exchange Program that operated on the Fort Peck Reservation from the summer of 2009 to January 2012. As one of the first and only needle exchange programs operated in a rural reservation in the US, Fort Peck’s employed a unique and successful protocol. This program will be 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. The main objective of this intervention will be to reduce transmission of blood-borne illnesses such as hepatitis C and HIV.

Fort Peck Tribal Health Department

Rapid HIV and HCV Testing Services

Project Term: 24 months; 2016-2018
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 - Spotted Bull Recovery Resource Center

Substance Abuse Inpatient Treatment Center Development Project

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

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

Fort Peck Tribes - Spotted Bull Recovery Resource Center

Tatanka Gdes’ka Capacity Building Project

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

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

Friendship House of Christian Service

Capacity Building Assessment for Sustainable Youth Counseling

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

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

Gateway Recovery Services

Peer Support for Substance Abuse

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

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

Glacier County Emergency Medical Services

Integrated Mobile Health

Project Term: 24 months; 2015-2017
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; Ended 2018
Grant Amount: $49,000

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

Healthy Mothers Healthy Babies

Montana Children’s Health Data Partnership Project

Project Term: 12 months; 2017-2018
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.

Healthy Mothers Healthy Babies

Building Bridges for Better Births

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

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

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; 2015-2017
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.

Help Center

Building Billing Capacity for Behavioral Health Services

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

This capacity building project will allow the Help Center to provide additional behavioral health services. The Help Center currently provides some behavioral health services to their clients and have noted the need to provide additional services, including treatment for chronic mental illness and substance use disorders. Through this project, the Help Center will explore the potential of obtaining a substance use disorder treatment endorsement from the state. Grant funds would be used to support staff time to carry out the activities of the project and for the services of a consultant to develop a plan for billing and the specific services that would be provided. By establishing additional behavioral health services and the ability to bill for these services the Help Center will be able to take additional referrals, provide a stronger continuum of care, and achieve financial sustainability.

Holy Rosary Healthcare Foundation

Eastern Montana Integrated Behavioral Health Collaborative

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

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

Horses Spirits Healing

Equine Assisted Activities and Therapy for Veterans and Returning Military

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

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

Human Resources Development Council of District IX

Assessment of Chronic Homelessness Community Costs

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

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

Intermountain Deaconess Children's Services

Services for At-Risk Helena Youth in Alternative High Schools

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

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

Intermountain Deaconess Children's Services

Intermountain/PureView Integrated Behavioral Health Collaboration

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

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

Kalispell Regional Healthcare

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

Project Term: 24 months; 2015-2017
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.

 

Kalispell Regional Medical Center: Pathways Treatment Center

Integrated Behavioral Health Implementation

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

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

Lewis and Clark County

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

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

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

Lewis and Clark County

Mental Health Strategic Plan

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

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

Lincoln County Health Department

Mental Health Coalition

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

This project’s goal was to establish a community mental health 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 needs and available services. The coalition was successfully established, met regularly, developed and approved a community-wide strategic plan for behavioral health, and became an Elevate Montana Affiliate so that they could work towards creating a trauma-informed community. The mental health coalition also successfully established care coordination for schools and mental health providers to better identify and link existing organizations and resources. Finally, the coalition now has a trained mental health first aid instructor who will continue to provide training, education, and information to the community.

Lincoln County Health Department

Lincoln County Substance Use Disorder Follow-Up and Referral

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

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

Livingston HealthCare Foundation

Behavioral Health Crisis Management

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

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

Livingston HealthCare Foundation

Integrating Behavioral Health into Primary Care Services in Park County

Project Term: 24 months; 2016-2018
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 the 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

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

Messengers for Health

Traditional Relationships Improve Contemporary Health

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

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

Missoula Aging Services

Care Transitions Achieving Better Health Outcomes

Project Term: 24 months; 2016-2018
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 health care spending.

Missoula City-County Department of Grants and Community Programs

Missoula County Collaborative Care Planning Summit

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

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

Missoula Urban Indian Health Center

Walking Well with Traditional Healing

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

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

Missoula Urban Indian Health Center

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

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

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

Montana Budget and Policy Center

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

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

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

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

Montana Budget and Policy Center

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

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

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

Montana Budget and Policy Center

Medicaid Policy Analysis and General Operating Support

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

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

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

Montana Department of Public Health and Human Services

Improving the Health of Montanans through Local and Tribal Public Health

Project Term: 24 months; 2014-2018 (project extension)
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 available to the public via DPHHS’ portal for the county health departments and Community Health Assessments are available on our website.

Montana Department of Public Health and Human Services

Montana Oral Health Program

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

This grant will help develop and implement a framework for oral health improvement in Montana. The Montana 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 Department of Public Health and Human Services

Analyzing and Understanding the Impact of Medicaid Expansion on Montanans

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

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

Montana Free Press

In-Depth Health Care Reporting in Montana

Grant Term: 12 months; 2018-2019
Grant Amount: $10,000

This project will allow the Montana Free Press to research, investigate, report, and publish in-depth stories about health care and health care policy in Montana. Stories will be complemented with video interviews published online and a social media campaign aimed at reaching and engaging key audiences and advancing civic discourse. Grant funding will enable the Montana Free Press editor to travel around the state, interview key stakeholders, and research important issues central to the biggest health care debates facing Montana. The resulting journalism will be a critical source of reliable information for voters and citizens engaging in those debates. 

 

Montana Human Rights Network

General Operating Support

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

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

Montana Legal Services Association

Montana Health Justice Partnership – Part 1

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

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

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

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

Project Materials:

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

Montana Legal Services Association

Montana Health Justice Partnership – Part 2

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

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

Montana Medical Association Foundation

Montana Health Information Exchange Feasibility Development Plan

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

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

Montana Medical Association Foundation

Prescription Drug Abuse Reduction Initiative

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

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

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

Montana Primary Care Association

Documenting Patient Experiences with Montana’s Medicaid Expansion

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

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

Montana Public Radio

Montana Care Issue Reporting

Project Term: 12 months; 2015-2018 (project extended)
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 2017
Grant Amount: $25,000

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

Mountain Home Montana

Substance Use Disorder Treatment for Pregnant and Parenting Teens

Project Term: 18 months; 2017-2018
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 - Center for American Indian and Rural Health Equity

Responding to Secondary Trauma among American Indian Victim Service Providers

Project Term: 24 months; 2016-2018
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.

MSU - Department of Health and Human Development

Increasing Mental Health Access in Gallatin County

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

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

MSU - Office of Rural Health

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

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

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

MSU - Office of Rural Health

Community Health Worker Stakeholder Project

Project Term: 24 months; 2016-2018
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.

Native American Development Corporation

Billings Urban Indian Health and Wellness Center

Grant Term: 12 months; 2018-2019
Grant Amount: $75,000

This project will support the Native American Development Corporation (NADC) in planning, technical assistance, and initial staffing to re-establish an urban Indian health center in Billings. Consultants will create a strategy to address identified health needs, develop operational plans, design surveillance systems to track performance and assist in preparing community action plans. NADC will contract with Helena Indian Alliance to provide third-party revenue training and support and electronic health record implementation and IT support. Another consultant will provide guidance on the development of a clinical model and expert support for the development of policies and procedures for the organization. Key partnerships will be created with other support organizations in the Billings area and with tribal and urban health programs.

NeighborWorks Great Falls

Home Matters: Linking Homes and Health Outcomes

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

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

Neighborworks Great Falls

A Housing and Health Care Plan for Cascade County

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

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

NeighborWorks Montana

Manufactured Housing Rehabilitation and Replacement Collaboration

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

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

North American Indian Alliance

Strategic Planning Initiative

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

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

North American Indian Alliance

Electronic Health Record and Revenue Cycle Optimization Project

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

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

North Valley Hospital Foundation

Virtual Access for Behavioral Health Care Services

Project Term: 24 months; 2015-2017
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 Health Care for Students

Project Term: 24 months; 2016-2018
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; 2017-2018
Grant Amount: $75,000

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

Northern Cheyenne Tribal Board of Health

Injury Prevention Project

Project Term: 24 months; 2015-2017
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; 2017-2018
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 integrated behavioral health 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 helped Open Aid Alliance apply for and receive licensure to become a state-approved substance use disorder treatment center. This new licensure will allow the organization to expand their services and create a harm reduction treatment center for individuals who experience stigma as they seek to improve their health; including people living with HIV, people using injection drugs, and people who have been homeless and/or incarcerated. The grantee successfully completed a consulting process, developed feasibility and business plans, and created policies and procedures needed to implement sustainable substance use disorder services. This expansion not only successfully strengthened partnerships in the community but also provided immediate access to treatment for clients and created a new diverse revenue stream for the organization.

Open Aid Alliance

Overdose Prevention and Naloxone Access Project

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

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

Park County Health Department

Recovery Court Program Strategic Planning

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

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

Partnership Health Center

Care Management for Super-Utilizers Program

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

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

 

Poverello Center

Medical Respite Shelter for Homeless Patients

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

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

Providence Montana Health Foundation

The Bridge to Hope Project

Project Term: 12 months; 2017-2018
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 reduce the rate of maternal-infant separation in the hospital setting as a result of NAS treatment, engage addicted mothers in the care of their infant through support group sessions, and increase addicted mothers’ voluntary participation in area drug treatment programs by the time of their infants’ discharge. 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 Saint Joseph Medical Center.

Providence Montana Health Foundation

The Wrapped in Hope Project

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

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

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

Project Materials:

Providence Montana Health Foundation

Providence Medical Group Integrated Behavioral Health Initiative

Project Term: 24 months; 2016-2018
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.

Providence Montana Health Foundation

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

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

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

Public Health System Improvement Office

Improving Health Through Collaborations

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

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

PureView Health Center

Universal Substance Use Disorder Screenings and Warm Handoffs

Project Term: 12 months; 2017-2018
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.

PureView Health Center

Development of East Helena School-Based Health Center

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

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

Richland County Health Department

Connecting Resources for Emotional Wellness

Project Term: 12 months; 2017-2018
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, the Richland County Mental Health Local Advisory Council 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; 2017-2019
Grant Amount: $63,135

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

RiverStone Health

Integrated Clinical Pharmacy Services Best Practices

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

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

Project Materials: 

RiverStone Health

Good Behavior Games and Trauma Informed Schools

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

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

RiverStone Health

Expanding Integrated Behavioral Health Care and Training in Primary Care

Project Term: 12 months; 2016-2017
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’s goal was to reduce the risk of hospital re-admission for high-risk seniors and disabled individuals. This pilot project successfully recruited 13 RSVP (retired senior volunteer program) volunteers to work with 47 discharged patients from St. Peters Hospital in Helena and four other rural hospitals. A care coordination training toolkit was developed and agreements for accessing patients’ health records were secured. Only two of the patients who took part in the program were re-admitted to St. Peters (which was well below the 20 percent re-admission rate that the hospital had experienced prior). Local health care providers found the program to be useful in reducing hospital re-admissions and plan to support it moving forward. 

 

Rocky Mountain Tribal Epidemiology Center

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

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

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

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

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

Rocky Mountain Tribal Epidemiology Center

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

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

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

This project will continue that work through task force strengthening and capacity-building, focus groups/key informant interviews with clinicians and substance-using pregnant women, the production of a “gap analysis” to determine treatment shortfalls for substance-using pregnant women on Blackfeet, and the production of a feasibility analysis and business plan for developing services to address perinatal drug use. 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 tribe has also requested that the grantee work towards the creation of a tribal resolution for an opioid treatment facility on Blackfeet.

Saint James Healthcare Foundation

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

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

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

Saint James Healthcare Foundation

Butte Supportive Housing Collaborative

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

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

Saint Luke Community Healthcare Foundation

Integrated Behavioral Health for Lake and Sanders Counties

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

This project will develop a plan to enhance Saint 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.

Saint Peter's Health Foundation

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

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

This project will develop a behavioral health screening and treatment program at Saint 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 Saint Peter’s entire primary care practice by the end of the grant term.

Saint Vincent Healthcare Foundation

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

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

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

 

Saint Vincent Healthcare Foundation

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

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

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

Saint Vincent Healthcare Foundation

Building out the Continuum of Care

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

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

Salish Kootenai College

Type 2 Diabetes Intervention for At-Risk Youth

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

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

Shodair Children's Hospital

Integrated Behavioral Health Planning Project

Project Term: 12 months; 2017-2018
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

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

Southern Peigan School Health

Behavioral Health Services for At-Risk Youth

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

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

Special Olympics Montana

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

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

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

Sweet Medical Center

Integrated Behavioral Health Planning and Development

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

Townsend Health Systems will enhance its current medical and mental health services by developing an integrated behavioral health 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, and exploration of treatment. This grant will result in the health center having an operational infrastructure, workforce, and sustainability plan.

Townsend Health Systems

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

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

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

Two Eagle River School

Two Eagle River School Wellness Project

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

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

UM - Department of Psychology

Effective Integrated Behavioral Health Partnerships for Rural Montana

Project Term: 12 months; 2015-2016
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.

UM - Department of Psychology

Integrated Behavioral Health Workforce Development: Field Training Experience

Project Term: 24 months; 2016-2018
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

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

Watson Children's Center

Healthy Foundations: Access to Primary Care and Mental Health Treatment

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

For this project, the Watson Children’s Shelter will implement Healthy Foundations, a new home visiting program that targets at-risk pregnant women and women who have recently given birth with the goal of preventing child abuse and neglect. Through this project, the shelter will work with Providence Hospital to explore methods for linking pregnant women and new moms with prenatal/postnatal care and behavioral health care services in a timely manner. Grant funding will be used for staff time to implement the project and for a consultant who will help the shelter to explore how to stably fund components of their services through billing insurance. Key partners include Providence Hospital and a local steering committee dedicated to addressing the social determinants of health in Missoula.

Western Montana Mental Health Center

Integrated Behavioral Health for Western and South-Central Montana

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

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

Western Montana Mental Health Center - Recovery Center Missoula

Recovery Center Missoula Pregnant and Parenting Women

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

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

Western Native Voice

HELP Act Outreach and Assistance in Native American Communities

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

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

Yellowstone Boys and Girls Ranch

Substance Use Disorder Treatment Program

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

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

Youth Dynamics

Substance Abuse Treatment Program Expansion Pilot Program

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

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

Youth Homes

Enhancing Wilderness Therapy through Aftercare and Parent Programming

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

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

YWCA of Helena

WINGS Re-Entry Transitional Housing Program

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

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

YWCA of Helena

Implementing Behavioral Health Services

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

This project will allow the YWCA of Helena to plan for and implement long-term, sustainable substance use disorder services that will generate revenue for the YWCA and lead to better health outcomes for the women and children they serve. A consultant will help the YWCA determine specific services that need to be implemented including outpatient services and obtaining a sober living facility license. Partners include child protection services, local family drug court, and local health care providers including PureView Health Center.

 

2018 Call for Proposals

Find out about this year’s available grants.