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

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.


Boys and Girls Clubs of Yellowstone County

Joint-Service Behavioral Health Model Pilot for the Lockwood Clubhouse

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

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

Bozeman Health Foundation

Behavioral Health Symposium, Work Groups, and Summit

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

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

Center for Restorative Youth Justice

Reducing School-Based Arrests for Youth with Behavioral Health Needs

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

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

Child Bridge

Finding A Way Home Project

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

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

Crisis Intervention Training Montana

A Statewide Crisis Intervention Team Training Collaborative

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

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

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.


Strategic Planning to Expand Youth Development to Rural & Tribal Communities in Montana

Project Term: 12 months; 2019-2020
Grant Amount: $25,000

EmpowerMT will build youth leadership and promote trauma-informed, culturally relevant after school programs for middle and high school youth. They will do this by evaluating the outcomes of their current programs and completing a strategic planning process for expanding services to better meet the needs of rural and tribal schools in northwestern Montana. EmpowerMT’s current program promotes positive social-emotional learning (SEL) outcomes to support behavioral health in the youth they serve. Funding will be used to contract for program evaluation services and staff time to carry out the evaluation and strategic planning processes. Staff will also identify and evaluate SEL curriculums that have been shown to improve behavioral health outcomes in middle school and high school youth. EmpowerMT currently partners with schools in Missoula, Ronan, and Whitefish and will expand partnerships with schools in Thompson Falls and Hot Springs, as well as other schools in northwestern Montana. They will also work with the University of Montana, the Salish Kootenai Tribal College, the Confederated Salish and Kootenai Tribal Education Department, and local Indian education for all parent advisory boards. The overall goal of this project is to evaluate and improve EmpowerMT’s SEL programs and services to better serve rural and tribal schools and improve the behavioral health outcomes of youth.

Flathead City-County Health Department

Developing a Plan to Transform the Behavioral Health System through Mapping

Grant Amount: $25,000
Dates: 2020-2021

The Flathead City-County Health Department will map the behavioral health system in Flathead County to identify specific treatment needs. As part of this project, a modified sequential intercept mapping (SIM) process will be used with a multidisciplinary team including experts in mental health, substance use disorders, law enforcement, housing, health, social services, and individuals directly impacted by mental health disorders. Grant funds will be used for project staff salaries and consultant fees for the mapping process. Partnerships for this project include Kalispell Regional Healthcare and the Flathead Community Health Center. Additional partners will also be invited to participate in the mapping process, including Sunburst Mental Health, Western Montana Mental Health, and law enforcement. The project’s overall goal is to map the behavioral health system in Flathead County to identify resources within the community, gaps in services, and the development of a community plan for improvement.

Friendship House of Christian Service

Transforming South Billings Youth and Families by Addressing Community Counseling Needs

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

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

Glacier Community Health Center

Dental and Behavioral Health Integration

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

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

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.

Jefferson County Mental Health Local Advisory Council

Support Our Youth Through Positive Parenting

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

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

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.

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.

Lincoln County Health Department

Mental Health Coalition

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

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

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.

Montana Generational Justice Foundation

Estate Planning to Prevent Health Care Exploitation and Fraud

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

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

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.

North Valley Hospital Foundation

Virtual Access for Behavioral Health Care Services

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

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

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.

Women in Action

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

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

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

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.