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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; Ended 2019
Grant Amount: $50,000

The Boys and Girls Club of Yellowstone County, Yellowstone Boys and Girls Ranch, Tumbleweed, and Lockwood Schools partnered to provide behavioral health services to youth attending Boys and Girls Club activities at Lockwood Schools. While a new, valuable partnership was formed among these entities, the goal of providing sustainable behavioral health services to Lockwood youth was not achieved. Though Lockwood school is a school-wide Title 1 school, the number of youths who attended the Boys and Girls Club who were on Medicaid or eligible for Medicaid was significantly lower than anticipated at the start of this project. Additionally, of the youth who had third-party health insurance, the majority had plans that would not cover the type of behavioral health therapy being offered through this project. This resulted in an inability to bill for services which made this model unsustainable. While this project did not yield the desired results, the three organizations remain in contact and are continuing to explore other ways to provide behavioral health services to the youth participating in Boys and Girls Club after-school activities. Staff will continue to engage the Yellowstone Boys and Girls Club as conversations with the Lockwood School District, St. Vincent hospital, and the Yellowstone Boys and Girls Ranch around school-based health services take place.

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; Ended 2019
Grant Amount: $74,916

The Eastern Montana Community Mental Health Center worked to develop peer support services – with a focus on crisis prevention – in three eastern Montana communities: Plentywood, Glasgow, and Glendive. The Plentywood and Glasgow projects experienced some staff turnover, which kept them from being fully implemented by the end of the grant. However, the Glendive project was able to hire their peer support staff and successfully implement the program. This project served 67 people and provided over 500 peer support services. The peer supporters were able to divert 99% of the people they worked with from higher levels of behavioral health care. The communities where this work took place now have strong peer support teams and a commitment to using this model in the future with plans to expand to other eastern Montana communities.

EmpowerMT

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; Ended 2019
Grant Amount: $40,000

Friendship House expanded its services and began providing behavioral health counseling to young people in low-income neighborhoods in Billings. With technical assistance from Aune Associates, they recruited a student counselor, hired her once she became licensed, and began billing for her services. With the licensed counselor in place, Friendship House was able to invoice insurance providers and began generating income. Because of the success of the project, Friendship House plans to replicate this process and bring on additional counselors to meet the behavioral health needs of their community.

Glacier Community Health Center

Dental and Behavioral Health Integration

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

The Glacier Community Health Center integrated a dental clinic into its already-established integrated behavioral health model. They are now able to provide their patients with bidirectional warm hand-offs among their medical, behavioral health, and dental services. The grant funding helped support the development of screening procedures, staff training, and workflow implementation. Oral health, behavioral health, and medical conditions are now being screened and assessed in each department of the health center. Continuous quality improvement processes are in place to review staff and patient perceptions of the model and patient outcomes moving forward.

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; Ended 2019
Grant Amount: $97,350

Lewis and Clark County created the Criminal Justice Services Department to reduce community risks with justice-involved individuals. This department will coordinate among local partners who interface with the justice system. As part of this project, the county also implemented a universal health screening system for people booked in the detention center. The county is committed to sustaining the new department, and they invested $100,000 over the next three years to ensure the implementation of a criminal justice data warehouse. Once they establish the data warehouse, the county anticipates having the appropriate systems in place to track recidivism and outcomes among the justice-involved population.

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; Ended 2019
Grant Amount: $30,000

The Montana Generational Justice Foundation partnered with hospitals and health care organizations across the state to provide legal services to patients. The services they offered patients included estate planning, health care power of attorney, and advanced directives. The grant’s advisory committee (with representatives from the Montana Hospital Association, Helena College Nursing Program, Veterans Affairs, the National Guard, medical providers, and lawyers) created an advanced directive document for statewide use. The advanced directive document will be available on the MSU Extension Services website. As part of this project, the Montana Generational Justice Foundation also created an initial sustainability plan to offer legal services at health care clinics across the state using a set fee covered by the health organization.

Montana Office of Public Instruction

School Wellness Initiative

Project Term: 24 months; 2020-2022
Grant Amount: $100,000

The Office of Public Instruction (OPI) will partner with the Montana Healthcare Foundation (MHCF) to support the implementation of a new initiative focused on school wellness. This initiative will support new partnerships between schools and high-performing health care providers (including federally qualified health centers, rural health centers, tribal health departments, and behavioral health providers) to create school-based health centers. The initiative will target roughly 70 schools with the highest concentration of students most in need of services, as judged by academic and health data (including alternative schools and those with the lowest academic performance). OPI will use grant funding to hire a new staff person dedicated to supporting the initiative. As part of this project, OPI will help enlist school participation and provide trauma-informed care training, coaching, and academic data reporting support. They will also help schools plan and implement participation in their Multi-Tiered System of Support (MTSS) for students with behavioral issues, and identify and implement restorative discipline practices. Partnerships will be developed with local school districts, clinical service partners, public health, and the School-Based Health Alliance. The project’s overall goal is to improve student health and academic outcomes by providing in-school access to health care services and fostering a supportive school climate.

 

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.