Community Medical Center 2019

Community Medical Center Integrated Behavioral Health Implementation

This project will integrate behavioral health services into Community Medical Center’s (CMC) primary care clinics and home-based primary care program. The grantee will accomplish this by hiring and embedding licensure-track social workers in to CMC’s Missoula, Frenchtown, and Lolo clinics. With consultation from the National Council for Behavioral Health, the primary care teams will provide universal screening, evidence-based treatment, and data tracking to improve outcomes and allow for care coordination across the hospital platform. Grant funding will be used to hire a behavioral health manager to oversee the project, a new behavioral health clinician, and additional clinical supervision for clinicians. Partners include the University of Montana who will help with the placement of behavioral health student interns and recent graduates.

Grant Amount

$200,000

Term

24 month

2019

Family Medicine Residency of Western Montana 2019

Training Family Medicine Residents and Health Care Trainees to Address Substance Misuse in Montana

With this grant, the Family Medical Residency of Western Montana (FMRWM) created a curriculum and trained family medicine residents in screening, brief intervention, and referral to treatment (SBIRT) to identify and provide effective initial treatment for people with undiagnosed SUDs. The training was provided to a total of 90 staff, residents, faculty, and health care trainees in medicine at the Partnership Health Center. Overall, participants showed a statistically significant and positive change in competence, confidence, readiness, and knowledge on conducting SBIRT with patients. The grant also helped train individuals on how to be SBIRT trainers, including Partnership Health Center's director of behavioral health, FMRWM's behavioral science and addiction medicine faculty members, and the University of Montana's director of integrated behavioral health. This will help strengthen the capacity of FMRWM, Partnership Health Center, and the University of Montana to provide SBIRT training in the future and integrate SBIRT more fully into the residency curriculum. SBIRT is now included as a module for interns, SBIRT training is required for residents, and buprenorphine waiver training is required for interns. While implementation of SBIRT in the clinic was delayed due to COVID, integration with the residency program and Partnership Health Center is underway. 

Grant Amount

$14,961

Term

12 month

2019

Flathead City-County Health Department 2019

Enhancing a Community-Wide System for SBIRT in the Educational Setting in Flathead County

This project will help the Flathead City-County Health Department (FCCHD) to develop and implement a youth–focused Screening, Brief Intervention, and Referral to Treatment (SBIRT) model in Kalispell. As part of this project, FCCHD will implement a system for SBIRT with a focus on youth in educational settings and will coordinate with existing community–wide efforts. The project will use funds to support FCCHD staff training in SBIRT, a project coordinator, and a public health associate through the Centers for Disease and Control. Project partners include Kalispell Regional Health, Flathead Community Health Center, Intermountain, and the alternative school in the Flathead School District. The project is expected to more robustly identify, reduce, and prevent problematic substance use with youth in educational settings and more strategically coordinate existing community–wide SBIRT efforts.

Grant Amount

$50,000

Term

12 month

2019

Holy Rosary Healthcare Foundation 2019

Increasing Access to Integrated Behavioral Health in Eastern Montana

Holy Rosary Hospital will implement an integrated behavioral health model into their clinics in Eastern Montana. The hospital will integrate mental health and substance use disorder services into their family and internal medicine clinics, and will implement screening, brief intervention, and referral to treatment (SBIRT) as a routine part of their primary care practice. Funding will be used to hire a behavioral health specialist and strengthen the hospital’s tele-psychiatry, data analytics, and care coordination. Partners include One Health (the local community health center) and the Eastern Montana Community Mental Health Center.

Grant Amount

$100,000

Term

24 month

2019

Indian Family Health Clinic 2019

Hope, Healing & Health in an Urban Indian Community

The Indian Family Health Center (IFHC) in Great Falls used this grant to develop and implement integrated behavioral health (IBH) services in its clinical and chemical dependency practices to serve the North Central Montana and Great Falls urban Indian communities. IFHC began by assessing its organizational readiness and identifying potential barriers to implementation. It then developed and initiated a plan, which included introducing and implementing care pathways for depression, suicide, and anxiety, as well as screening, brief intervention, and referral to treatment (SBIRT) protocols. IFHC implemented plans for making referrals to specialty care, tracking patients as they move from one level of care to another, and training staff on key elements of IBH. COVID-19 and other logistical problems posed challenges, but IFHC was able to continue providing care—through both in-person and telehealth services—and moved its IBH program forward. The IBH model is now a self-sustaining part of IFHC’s care delivery system.

Grant Amount

$150,000

Term

24 month

2019

Livingston HealthCare Foundation 2019

Livingston HealthCare’s Perinatal Behavioral Health and Substance Use Treatment Pathway

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

Grant Amount

$81,265

Term

24 month

2019

Montana Health Plus 2019

Integrated School Based Healthcare

This project will support screening, brief intervention, and referral to treatment (SBIRT) implementation in school-based health centers. Through this grant, the Montana Primary Care Association (MPCA) will support six federally qualified health centers (FQHCs) that provide school-based health services to implement SBIRT, coordinate with the technical assistance provider (the School-Based Health Alliance), and assist with data collection. MPCA coordinates many activities that support clinical improvement for Montana’s FQHCs, and recently, has developed a strong focus on behavioral health. This grant will increase the capacity of school-based health centers to identify and treat substance use in the students they serve.

Grant Amount

$130,000

Term

12 month

2019

Montana State University - College of Nursing 2019

Screening, Brief Intervention, and Referral to Treatment

This grant supported the Montana State University College of Nursing to develop and implement a curriculum on screening, brief intervention, and referral to treatment (SBIRT) for substance use disorders (SUDs) for their family nurse practitioner and doctorate of nurse practice training programs. A total of 16 students in their second year of graduate studies received training over the course of four months, including both SBIRT and Kognito modules. All of the students said that the training was helpful and informative and would change the way they practice with regard to addressing SUDs. SBIRT training is now integrated as part of the curriculum and will be provided to all future students. Due to the COVID pandemic, the project was not able to conduct in-person training on campus for faculty, but development of the training modules for faculty was begun. Additionally, a module was put together for College of Nursing faculty in Bozeman who were interested in learning more about SBIRT concepts and how to integrate SBIRT into their courses.

Grant Amount

$15,000

Term

12 month

2019

Montana State University Billings 2019

Screening, Brief Intervention, and Referral to Treatment

The Montana State University-Billings College of Nursing will develop and implement a curriculum to train entry-level and advanced practice nursing students in how to use screening, brief intervention, and referral to treatment (SBIRT) to identify and provide effective initial treatment for people with undiagnosed substance use disorders. Both programs will be delivered online to students, many of whom are already working in health care settings throughout the state. As part of this project, MSU will use an online training program designed to help practitioners build their skills in delivering brief interventions, and will work with a technical assistance provider to develop the onlinecurriculum. Funding will be used to cover the instructor’s time to develop the curriculum and cover the licensing costs of the online platform.

Grant Amount

$15,000

Term

12 month

2019

Native American Development Corporation 2019

Implementing Integrated Behavioral Health and Billing to Achieve Sustainability of Health Services for American Indians in Billings

This project will implement a culturally appropriate integrated behavioral health model and third-party billing office into the new Billings Urban Indian Health and Wellness Center. The center is currently providing primary care along with limited specialized mental health and substance use disorder services. This grant will expand upon this work by supporting a billing and coding position along with two new behavioral health provider positions to provide services within the primary care clinic. As part of the project, the center will develop a scope of work for the integrated behavioral health staff and clear pathways for specialty care referrals. Partnerships have been established with RiverStone Health Clinic and St. Vincent Healthcare and will continue to be strengthened throughout the course of this project.

Grant Amount

$150,000

Term

24 month

2019

Partnership Health Center 2019

Missoula Strategic Alliance for Improved Behavioral Health and Well-being

The Missoula community will develop a crisis diversion program by redesigning the behavioral health crisis system. A crisis diversion program can help reduce emergency department admissions, criminal justice encounters, and recidivism. Too often, people who are experiencing a behavioral health crisis end up in the emergency department or in encounters with law enforcement, rather than receiving appropriate care. Providing behavioral health care to people in crisis can de-escalate the crisis, improve outcomes, and reduce the need for higher-cost emergency and law enforcement interventions. Partnership Health Center will serve as the backbone organization, providing project oversight and coordination. Project partners include Providence Health System, Community Medical Center, Western Montana Mental Health Center, Missoula Urban Indian Alliance, and the Missoula Mayor and County Sheriff. The group’s work will be guided by a formal charter that establishes shared goals and expectations. Grant funds will be used to employ a project coordinator and contract for data analytics and sharing among partners. The project will begin by assessing how current health care and corrections resources are used to respond to people in a behavioral health crisis. Guided by the findings and informed by research on best practices, the partners will then develop and implement a new crisis diversion system that uses existing resources more efficiently and effectively to meet the needs of people in crisis.

Grant Amount

$100,000

Term

24 month

2019

Providence Montana Health Foundation 2019

Providence Medical Group Integrated Behavioral Health Network Grant

Through this project, Providence Medical Group will spread the integrated behavioral health model from Grant Creek Family Medicine across the Western Montana Service Area by hiring additional licensed clinical social workers to provide coverage and developing a psychiatric consultation model to support nine primary care clinics. Through the addition of LCSWs to the staff in the primary care setting, Providence seeks to provide a seamless care journey for patients to manage their mental health, behavioral health, and comorbid conditions, and to encourage patients to be inherently involved in their treatment plan, care goals, and care plan. Grant funding will be used primarily for staffing the project and for consultation with the National Council for Behavioral Health. Partners include Providence Western Montana psychiatric services, which includes the Urgent Mental Health clinic, inpatient services, and psychiatry.

Grant Amount

$200,000

Term

24 month

2019

Rimrock Foundation 2019

Strengthening Crisis Response and Diversion in Frontier Counties in Eastern Montana

Rimrock and the Eastern Montana Community Health Center (EMCHC) will develop a program that reduces emergency department admissions and criminal justice encounters and recidivism in five Eastern Montana communities (Dawson, Prairie, Richland, Rosebud, Valley). Too often, people in crisis end up in the emergency department or in encounters with law enforcement, rather than receiving behavioral health care that could de-escalate the crisis, improve outcomes, and reduce the need for higher-cost emergency and law enforcement interventions. Rimrock will serve as the “backbone” organization, providing project oversight and coordinating partners. The project will collect data and analyze the existing behavioral health crisis system and resource allocation, update the sequential intercept mapping for the region, implement peer support, and revamp the current behavioral health crisis response. Funding will be used to hire a project coordinator and a peer support supervisor, train project partners, and assist with sequential intercept mapping. Project partners include the hospital leadership and county commissioners in each participating community as well as the Montana Health Network. The project’s goal is to provide community members who are experiencing a behavioral health crisis with timely access to behavioral health care and peer support.

Grant Amount

$100,000

Term

24 month

2019

RiverStone Health 2019

SBIRT Screening and Treatment at School Based Health Center

This project helped RiverStone Health develop a curriculum and training to implement screening, brief intervention, and referral to treatment (SBIRT) to identify and treat substance use disorders (SUDs) in adolescent patients. RiverStone established a standardized and universal SBIRT process to identify, reduce, and prevent problematic use, misuse, and dependence on alcohol and illicit drugs at its two school-based health centers—an elementary and middle school. RiverStone developed a standardized SBIRT workflow for its school-based health clinics, trained school-based health center staff in SBIRT, and worked with school and health partners to implement the process. In total, 270 youth were screened for SUDs. SBIRT reporting is now integrated into RiverStone's quality metrics and will continue as an expectation for school-based health centers. 

Grant Amount

$15,000

Term

12 month

2019

Rocky Mountain College 2019

SBIRT Curriculum and Training Development

This grant supported Rocky Mountain College to develop and implement a curriculum to train physician assistant (PA) students in screening, brief intervention, and referral to treatment (SBIRT) for substance use disorders (SUDs). The training was provided to 72 PA students, many of whom will practice in Montana. Students learned the adolescent SBIRT screening and other screening modalities; intervention, referral, and treatment; and appropriate follow-up procedures. Students demonstrated significant gains in confidence, readiness, and competence in the implementation of SBIRT. Two faculty members have been trained as SBIRT trainers, and the SBIRT curriculum is now part of the PA required curriculum, ensuring the sustainability of SBIRT training and curriculum for future PA classes.  

Grant Amount

$4,138

Term

12 month

2019

St. James Healthcare Foundation 2019

Butte-Silver Bow Strategic Alliance for Improved Mental Health and Wellbeing

The Butte-Silver Bow Community will develop a plan to redesign its behavioral health crisis system to reduce emergency department admission and criminal justice encounters and recidivism. Too often, people in crisis end up in the emergency department or in encounters with law enforcement, rather than receiving behavioral health care that could de-escalate the crisis, improve outcomes, and reduce the need for higher-cost emergency and law enforcement interventions. St. James Healthcare will serve as the “backbone” organization, providing project oversight and partner coordination. This project brings together new and existing partners including St. James Healthcare, the Southwest Montana Community Health Center, the Butte-Silver Bow Sherriff, Butte-Silver Bow Health Department, Action Inc., and the Western Montana Mental Health Center. The partners have established a formal charter that outlines goals and expectations and each organization’s commitments. The project will collect data and analyze the existing behavioral health crisis system and resource allocation, research best practices, and develop a plan for prevention and intervention strategies. Funding will be used to employ a facilitator for sequential intercept mapping, as well as meeting and travel expenses. Ultimately, the project will create a plan to redesign the crisis system by using existing resources differently and identifying key implementation activities.

Grant Amount

$34,200

Term

12 month

2019

St. James Healthcare Foundation 2019

Butte-Silver Bow Strategic Alliance for Improved Mental Health and Wellbeing

The Butte-Silver Bow Community will develop a plan to redesign its behavioral health crisis system to reduce emergency department admission and criminal justice encounters and recidivism. Too often, people in crisis end up in the emergency department or in encounters with law enforcement, rather than receiving behavioral health care that could de-escalate the crisis, improve outcomes, and reduce the need for higher-cost emergency and law enforcement interventions. St. James Healthcare will serve as the “backbone” organization, providing project oversight and partner coordination. This project brings together new and existing partners including St. James Healthcare, the Southwest Montana Community Health Center, the Butte-Silver Bow Sherriff, Butte-Silver Bow Health Department, Action Inc., and the Western Montana Mental Health Center. The partners have established a formal charter that outlines goals and expectations and each organization’s commitments. The project will collect data and analyze the existing behavioral health crisis system and resource allocation, research best practices, and develop a plan for prevention and intervention strategies. Funding will be used to employ a facilitator for sequential intercept mapping, as well as meeting and travel expenses. Ultimately, the project will create a plan to redesign the crisis system by using existing resources differently and identifying key implementation activities.

Grant Amount

$34,200

Term

12 month

2019

St. Luke Community Healthcare Foundation 2019

Integrated Behavioral Health Consolidation Grant

St. Luke Community Healthcare will implement integrated behavioral health in their critical access hospital and rural health clinic. As part of this project, they will develop a patient registry, adopt collaborative care billing, incorporate crisis management systems into integrated behavioral health, fully implement SBIRT (screening, brief intervention, and referral to treatment), and initiate medication-assisted treatment. The project will use funds to staff a care coordinator position, establish psychiatric consultation, including training and consultation from the National Council for Behavioral Health, and provide enhancements to their patient registry. Through this project, St. Luke’s hopes to improve health outcomes and reduce costs by fully implementing their integrated behavioral health model. Additionally, they will make more formal efforts to partner with the Confederated Salish and Kootenai Tribes to ensure effective alignment of resources and services for the Native American population. 

Grant Amount

$75,000

Term

24 month

2019

St. Peter's Health Foundation 2019

Reducing Adverse Outcomes of Perinatal Mental Illness and Substance Use Disorders

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

Grant Amount

$150,000

Term

24 month

2019

St. Vincent Healthcare Foundation 2019

Look Closer: Addressing Perinatal Behavioral Health in Eastern Montana

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

Grant Amount

$150,000

Term

24 month

2019

Western Montana Mental Health Center 2019

Ravalli County Strategic Alliance for Improved Mental Health and Well-Being

This project helped the Ravalli County Strategic Alliance for Improved Mental Health and Wellbeing redesign its behavioral health crisis system to reduce emergency department admissions, criminal justice encounters, and recidivism. The Western Montana Mental Health Center (WMMHC) and Marcus Daly Hospital established the alliance, along with community stakeholders such as Sapphire Health and the Ravalli County Sheriff. The partners agreed to a formal charter that establishes project goals and each partner’s commitments. The Alliance began with an analysis of the existing crisis system and how behavioral health, emergency department, and corrections resources are currently used to respond to people in crisis. It then conducted a comprehensive data analysis of behavioral health needs in the county, completed a sequential intercept mapping, developed a strategic plan, and applied for and received a county tribal matching grant. After outlining a set of strategic priorities, the Alliance took the initial steps of implementing mobile crisis services, which was the top priority identified. It will continue implementing the strategic plan and use a dedicated project manager to ensure coordination of the work continues. COVID-19 delayed the work substantially, and project oversight shifted from WMMHC to Marcus Daly, but the project goals were ultimately realized and partnerships were strengthened.

Grant Amount

$35,000

Term

12 month

2019

Benefis Health System Foundation 2018

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

Benefis Health System used this grant to implement an integrated, team-based model of care to serve the needs of pregnant women and reduce the adverse outcomes of perinatal drug and alcohol use for newborns and their families. The Women’s and Children’s Center works closely with a variety of other community organizations and agencies serving pregnant women, including the City-County Health Department and DPHHS Child and Family Services, to ensure a cohesive and comprehensive approach. The behavioral health provider and care coordinator are co-located with all other providers to ensure easy access to patients and enhanced communication between providers. Benefis implemented consistent screening protocols for mental health and substance use and provides education and ongoing outreach to OB/GYN providers. Benefis developed a successful and sustainable model of care by billing for its integrated behavioral health services and achieving cost savings from improved pregnancy outcomes. It received additional funds from DPHHS to support the establishment of the program.

Grant Amount

$150,000

Term

24 month

2018

Billings Clinic 2018

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

This grant was designed to help the Broadwater Health Center (BHC) enhance its existing integrated behavioral health program by adding substance use disorder (SUD) services, which are in high demand within the community. BHC secured state approval as a SUD provider, implemented universal screening for SUDs, and hired a licensed addiction counselor (LAC). State approval as a SUD provider allowed for the reimbursement of addiction services and access to the state’s SUD block grant for prevention activities. This project faced many challenges, including the departure of BHC's CEO and other staff members, opposition from medical providers, and the hiring of an LAC who did not adapt his approach to BHC's model of brief, focused counseling and referral to stepped care. The LAC left the organization, which halted SUD treatment, but therapy continued for depression, anxiety, and other mental health conditions. BHC was later acquired by the Billings Clinic, giving it access to the Billings Clinic Regional Services and the IBH Expansion Project, which is also supported by the Montana Healthcare Foundation. The organization is now in a rebuilding phase with new medical providers, but it will likely have improved infrastructure and support going forward. 

Grant Amount

$40,000

Term

12 month

2018

Billings Clinic 2018

Regional Integrated Behavioral Health Expansion Program

The goal of the Billings Clinic Regional Integrated Behavioral Health (IBH) Expansion Program was to bring together a network of nine independent hospitals and clinics to offer integrated behavioral health services based on a standardized approach to collaborative care. By hiring a project coordinator, the Billings Clinic achieved the critical task of relationship building between network sites and continuously engaging them as part of a group effort. The project also brought increased awareness of the importance of data collection and use to improve treatment, and it enabled each site to access the Cerner EMR for standardized screening, data collection, and reporting clinical measures. Another major accomplishment was connecting primary care providers in rural areas to psychiatrists at the Billings Clinic for IBH consultation and general peer support. The number of consultation sessions about specific cases increased measurably, and this peer-to-peer support helped increase satisfaction among rural providers, decrease burnout, and improve the overall patient experience. By the end of the project, three of the nine facilities had embedded behavioral health providers in their primary care practices, enabling greater access to services for their patients. Billings Clinic will continue to pursue the implementation of collaborative care across its affiliate network system, including any new affiliates acquired in the future. This may be sustained through budget support by Billings Clinic and the rural affiliates, as well as grants from governmental sources and private donors.

Grant Amount

$262,739

Term

12 month

2018

Bozeman Health Foundation 2018

Implementation of Integrated Behavioral Health

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.

Grant Amount

$150,000

Term

24 month

2018

Community Medical Center 2018

A Collaborative Approach to Improving Screening and Treatment for Perinatal Drug Use in Missoula

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.

Grant Amount

$150,000

Term

24 month

2018

Flathead City-County Health Department 2018

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

The goal of this project was for the Flathead County Health Department (FCHD) to identify existing community resources to prevent individuals suffering from behavioral health disorders from unnecessarily getting involved in the criminal justice system due to a lack of adequate treatment and support. Using the Sequential Intercept Model mapping process, FCHD identified gaps in service and developed a community plan to improve outcomes. Through community engagement, FCHD created work groups for co-responder and housing/mental health projects to address the need for more behavioral health care services. The department successfully applied for funding for a co-responder pilot, and two therapists have been hired and are working with law enforcement. Kalispell Regional Healthcare and the Community Action Partnership of Northwest Montana successfully applied for a Montana Healthcare Foundation Housing is Health Care grant. FCHD, Kalispell Regional Healthcare, North Valley Hospital, and the Flathead Community Health Center have established a joint steering committee for community mental health, and they are supporting one full-time position to steer the mapping process and help Flathead County improve its mental health systems. The project secured $213,000 in additional funding, and a new mobile crisis team was launched. 

Grant Amount

$47,565

Term

24 month

2018

Healthy Mothers, Healthy Babies - The Montana Coalition 2018

Building Bridges for Better Births

This grant provided funding for Building Bridges for Better Births (B4), a Healthy Mothers, Healthy Babies (HMHB) project designed to connect community partners, build out a strong referral network, and implement evidence-based integrated behavioral health models to treat perinatal substance use disorders and drug-exposed infants. HMHB focused on supporting grantees of The Meadowlark Initiative, which was launched by the Montana Healthcare Foundation in 2017 to improve maternal health outcomes, reduce newborn drug exposure, and keep families together and children out of foster care. Through partnership and collaboration with a wide variety of stakeholders, mapping resources in communities to identify needs, and convening partners for information sharing, Meadowlark sites have been able to improve the quality of care they provide. Non-Meadowlark sites and support organizations outside the medical provider network have also benefited from learning about the Meadowlark model. By sharing its screening protocol for primary care providers, HMHB has helped increase the number of practices that have adopted screening routines. HMHB continues to work statewide to address perinatal behavioral health issues and support Meadowlark grantees in strengthening community partnerships.

Grant Amount

$68,000

Term

24 month

2018

Helena OB/GYN & Associates 2018

Integrated Behavioral Health Support for Women During Prenatal, Postnatal, and Postpartum

With the help of a Meadowlark Initiative grant, Helena OB/GYN & Associates successfully implemented an integrated behavioral health program for its patients in Lewis and Clark County. The goal was to create a proactive, community-based care delivery model for women, mothers, pregnant women, and those exposed to perinatal drug use. Helena OB/GYN set up a comprehensive screening and assessment system for all levels of obstetric and women’s health patients. This involved hiring two licensed behavioral health specialists to provide services, both through telehealth and in-person visits. Helena OB/GYN also partnered with community organizations, including Saint Peter’s Hospital and Florence Crittenton Home, to ensure women have access to all levels of substance use treatment, including medication-assisted treatment, as well as social services. Several of the nurses at Helena OB/GYN became certified lactation specialists in order to assist nursing mothers. The practice will be able sustain this model of care by billing for its integrated behavioral health providers. Its leadership understands the importance of these services and is fully committed to continuing this model of care without receiving additional funding sources.

Grant Amount

$150,000

Term

24 month

2018

Lincoln County Health Department 2018

Lincoln County Substance Use Disorder Follow-up and Referral

The Lincoln County Health Department (LCHD) developed a behavioral health community coalition to implement a new diversion program that operates in the hospital emergency department and the county detention center and routes people with substance use disorders (SUDs) to treatment rather than the criminal justice system. The goal is to reduce admissions to the county detention center and overall recidivism. The project began with initial data collection, data sharing, and qualitative interviews that helped identify areas of need and strategic priorities. The coalition of organizations established effective communication and collaboration practices to improve the overall mental health system within the community. NARCAN training on how to treat people for known or suspected opioid overdoses was provided to staff, and 125 individuals in crisis received support and follow-up. Overall, recidivism rates for emergency department and inpatient hospitalization were significantly reduced, but improvements for psychiatric and criminal justice recidivism were lower due to challenges with establishing relationships with certain partners. The pilot nursing program in the detention center and misdemeanor probation/pretrial supervision has led to decreased medical expenses. This will allow for more funding for nursing services in the detention center, which will continue to include chemical dependency assessment and referral upon release. The project has secured funding for installing telehealth equipment in the detention center and piloting a program to ensure that inmates can see mental health and SUD providers. 

Grant Amount

$20,000

Term

12 month

2018

Logan Health 2018

Integrated Behavioral Health in Primary Care

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-basedThe goal of this project was to integrate behavioral health care into Logan Health's nine primary care clinics to improve the identification and treatment of mental illness and substance use disorders (SUDs). Through this grant, Logan Health established universal screening protocols for behavioral health, care pathways to ensure appropriate support and intervention, evidence-based treatment, and effective care management tracking. Logan Health emphasized building strong relationships between primary care and behavioral health care providers. It developed a workflow for referrals from its care navigation team to the integrated behavioral health team. Dashboards provided by the technical assistance contractor offered a quick view of successes and opportunities and were shared with teams monthly, helping to drive continuous process improvement. Of the 8,920 patients seen during the project, 96% were screened for depression, and 33% were screened for SUDs. Among patients treated for depression, 70% demonstrated measurable improvement. Among those treated for SUDs, 57% showed measurable progress. Logan Health has developed a financially sustainable model that will continue to improve and support behavioral health integration over the long term 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.

Grant Amount

$150,000

Term

24 month

2018

Madison Valley Hospital Association 2018

Madison Valley Medical Center Integrated Behavioral Health

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

Grant Amount

$93,900

Term

12 month

2018

Montana Health Network 2018

Eastern Montana Integrated Behavioral Health Program

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

Grant Amount

$280,000

Term

24 month

2018

Montana Primary Care Association 2018

Behavioral Health and Substance Use Disorder Integration into Primary Care

Through this project, the Montana Primary Care Association hired a full-time integrated behavioral health (IBH) director to support system wide IBH implementation in federally qualified health centers (FQHCs). MPCA provided technical assistance to all the FQHC's in the state on IBH and medication-assisted treatment (MAT) through in-person trainings, webinars, and videos. MPCA used the Integrated Practice Assessment Tool (IPAT), a core elements tracker, and other survey questions to gauge the progress of the health centers throughout the project. At the end of the project period, 100% of the health centers had implemented screening, brief intervention, and referral to treatment (SBIRT), and the number of health centers that offer behavioral health services increased from 49 to 71. The average IPAT score, which represents the level of behavioral health integration that the health centers achieved, increased from 4.08 to 4.65.

Grant Amount

$200,000

Term

24 month

2018

Montana Supreme Court 2018

2018 Montana Statewide Drug Court Conference

This grant helped the Montana Supreme Court organize and host the 2018 Montana Statewide Drug Court Conference. All of the state-supported drug courts and most of the tribal healing to wellness courts attended. In total, 225 people participated in the conference, and covered topics included medication-assisted treatment and the implementation of sustainable treatment models. Each court developed an action plan, and the drug court administrator will continue to support the implementation of the plan’s goals and coordinate activities. Beyond the conference, the Montana Supreme Court has strengthened relationships with tribal healing to wellness courts and increased its emphasis on medication-assisted treatment and sustainable treatment models utilizing Medicaid. They will continue offering a statewide drug court conference on a bi-annual basis.

Grant Amount

$12,988

2018

Montana's Peer Network 2018

Statewide Peer Support Outcomes Collection Project

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

Grant Amount

$43,774

2018

Providence Montana Health Foundation 2018

A Collaborative Approach to Screen and Treat Perinatal Drug Use

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.

Grant Amount

$150,000

Term

24 month

2018

St. James Healthcare Foundation 2018

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

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.

Grant Amount

$150,000

Term

24 month

2018

St. James Healthcare Foundation 2018

Increasing Access to Integrated Behavioral Health in Silver Bow County

This grant helped the Integrated Behavioral Health (IBH) project at St. James Healthcare expand behavioral health services into the organization's primary care and obstetrical practices. In response to the tremendous need for these services in the Butte community, the project worked to develop strategies to provide the full continuum of care for patients with mental illness and substance use disorders and thoroughly train and integrate the clinical teams. St. James hired two clinicians to provide behavioral health care, trained staff and providers on team-based care and the core elements of IBH, implemented universal screening for behavioral health conditions, and added behavioral health screening and warm hand-off data to its clinical quality dashboards. By elevating behavioral health data to the same level as traditional physical health measures, St. James helped legitimize and normalize this model of care for patients, new staff, and providers. The project achieved a score of 7.75 out of 9 on the National Council for Behavioral Health's Integration Tracker, up from a score of less than 5, and improved from a 2 to a 5 (out of 6) on the Integrated Practice Assessment Tool (IPAT). Nearly 70% of all patients were screened for behavioral health conditions at least once, and 98% of patients with thoughts of suicide completed a suicide risk assessment. The program adopted telehealth to increase access to care during the pandemic and achieved sustainability with patient revenue.

Grant Amount

$130,000

Term

24 month

2018

St. James Healthcare Foundation 2018

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

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.

Grant Amount

$150,000

Term

24 month

2018

St. James Healthcare Foundation 2018

Increasing Access to Integrated Behavioral Health in Silver Bow County

This grant helped the Integrated Behavioral Health (IBH) project at St. James Healthcare expand behavioral health services into the organization's primary care and obstetrical practices. In response to the tremendous need for these services in the Butte community, the project worked to develop strategies to provide the full continuum of care for patients with mental illness and substance use disorders and thoroughly train and integrate the clinical teams. St. James hired two clinicians to provide behavioral health care, trained staff and providers on team-based care and the core elements of IBH, implemented universal screening for behavioral health conditions, and added behavioral health screening and warm hand-off data to its clinical quality dashboards. By elevating behavioral health data to the same level as traditional physical health measures, St. James helped legitimize and normalize this model of care for patients, new staff, and providers. The project achieved a score of 7.75 out of 9 on the National Council for Behavioral Health's Integration Tracker, up from a score of less than 5, and improved from a 2 to a 5 (out of 6) on the Integrated Practice Assessment Tool (IPAT). Nearly 70% of all patients were screened for behavioral health conditions at least once, and 98% of patients with thoughts of suicide completed a suicide risk assessment. The program adopted telehealth to increase access to care during the pandemic and achieved sustainability with patient revenue.

Grant Amount

$130,000

Term

24 month

2018

St. Peter's Health Foundation 2018

Integrating Behavioral Health into St. Peter’s Health Medical Group

St. Peter's Health (SPH) used this grant to implement integrated behavioral health (IBH) in its nine primary care clinics to improve the overall health and well-being of its patients and the community. SPH started with minimal IBH in its primary care clinics but is now implementing the model throughout its network. SPH has expanded its IBH team from three to five members; began offering team-based IBH care to all primary care patients; worked to identify patients in need of a higher level of support; provided screening, brief intervention, and referral to treatment (SBIRT) training to all team members and providers; and established universal screening protocols for depression and suicide. SPH is tracking its progress with the help of a population health data scientist. Additionally, SPH has taken on a leadership position in Helena's larger mental health community by joining various mental health-related organizations and sponsoring local suicide prevention and mental health activities.

Grant Amount

$130,000

Term

24 month

2018

Teton County Health Department 2018

Addressing Substance Use Disorders in Teton County through Community Partnerships

The goal of this project was to support the Teton County Community Alliance for Resiliency and Educational Support (C.A.R.E.S.) in developing an evidence-based planning process to address substance use and mental health issues in Teton County. The Alliance hired a coordinator; convened 24 partners from a variety of sectors, including public health, health care, law enforcement, education, mental health, faith, and social services; and merged with the existing Local Mental Health Advisory Council. The Alliance used the Strategic Prevention Framework developed by SAMHSA as its guide, and key members attended a four-day training on how to implement the framework. The Alliance published the Teton County C.A.R.E.S. Strategic Plan for Behavior Health Priorities in Teton County, which included data and statistics about substance use that were used to select appropriate interventions and activities and establish metrics to evaluate those interventions. Teton County C.A.R.E.S. collaborated with Choteau, Dutton-Brady, and Power school administrators to secure funding for the Paxis Institute to provide behavioral health training to school administrators, teachers, and staff. It also helped the Teton County EMS director secure funding for two EMTs to attend a Mental Health First Aid Train the Trainer five-day workshop.

Grant Amount

$25,244

Term

12 month

2018

Billings Clinic 2017

Integrated Behavioral Health Expansion Project

This project allowed the Billings Clinic to improve and expand an existing integrated behavioral health (IBH) pilot program in one of its locations to all three of its primary care sites, ensuring that all patients have access to timely screening, diagnosis, and treatment for mental health conditions. The Billings Clinic now has seven full-time therapists and case managers and two consulting psychiatrists, which has allowed for approximately 94% of all patients to receive behavioral health screening and has led to significant improvement in outcomes for those receiving treatment for depression. While screening for substance use has been challenging, primary care providers and residents in internal and family medicine are receiving training in early identification and intervention for patients with alcohol and drug use. Additionally, an on-site training on medication assisted treatment (MAT) is scheduled for 2021, which will allow providers to obtain the certification required to provide this service. The grantee established a data registry to track and improve care for IBH patients. The registry project was challenging due to issues of electronic health record compatibility, but the grantee is now beta testing this feature. Now that IBH has become standard operating procedure in all Billings primary care clinics, the Billings Clinic is working to expand IBH to all regional affiliates.

Grant Amount

$150,000

Term

24 month

2017

Clark Fork Valley Hospital 2017

Sanders County Behavioral and Medical Health Delivery Integration

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

Grant Amount

$50,000

Term

12 month

2017

Community Hospital of Anaconda 2017

Integrating Behavioral Health at Community Hospital of Anaconda

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

Grant Amount

$50,000

Term

12 month

2017

Daniels Memorial Healthcare Center 2017

Developing Regional Behavorial Healthcare Services Using Primary Care Resources

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

Grant Amount

$50,000

Term

12 month

2017

Eastern Montana Community Mental Health Center 2017

Peer Support: Addressing Behavioral Health Crisis and Jail Diversion Needs

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.

Grant Amount

$74,916

Term

24 month

2017

Gateway Community Services 2017

Peer Support for Cascade County

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.

Grant Amount

$75,000

Term

24 month

2017

Healthy Mothers, Healthy Babies - the Montana Coalition 2017

Building Bridges for Better Births

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.

Grant Amount

$25,000

Term

12 month

2017