Lincoln County Health Department

Mental Health Coalition

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.

Grant Amount

$25,000

Term

12 month

2017

Lincoln County Health Department

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

Lincoln County Library Foundation

Troy Library and Opportunity Center Planning Grant

The Lincoln County Library is partnering with the community of Troy to plan a conversion of the Troy Branch of Lincoln County Library into a new Troy Library and Opportunity Center. This Opportunity Center would address community risk factors of substance abuse, human connectivity, poverty, and access to quality mental health care by creating a space that makes healthy, engaging, family-centered programs readily accessible. This grant will support community visioning, develop an operational and sustainability plan addressing capital needs, programmatic funding, and partner roles. Project partners include the Lincoln County, Zero to Five Lincoln County, Communities that Care, Western Montana Mental Health, and the Troy Chamber of Commerce. Additional partners and stakeholders will be engaged throughout the planning process.

Grant Amount

$25,000

Term

12 month

2021

Little Shell Tribe of Chippewa Indians of Montana

Strategic Planning for Little Shell Tribal Departments

The Little Shell Tribe of Chippewa Indians of Montana is the newly federally recognized Tribe of the Ojibwe people. Its service area includes Cascade, Blaine, Hill, and Glacier counties. This strategic planning project will help the Tribe begin developing a high-quality, effective health system by supporting the Tribe to create a mission and vision to meet the needs of its people and by providing expert technical assistance on health system design, infrastructure development, and operations. The Little Shell Tribe will model its new health system on Alaska Southcentral Foundation's award-winning NUKA System of Care. Funding will support a contract with the Southcentral Foundation to provide technical assistance and training throughout the planning process and the early stages of implementation. The project will be completed through close collaboration among the Little Shell Tribal Council, Tribal staff, and community members.

Grant Amount

$196,542

Term

24 month

2021

Little Shell Tribe of Chippewa Indians of Montana

Montana Native American Girl Centered Empowerment Project

The Little Shell Tribe assisted tribes and urban Indian health centers across the state to plan and implement girl-centered, protective asset programs, and to train mentors in each tribal community in Montana. The project focused on building ‘protective assets’ which are strengths and skills that can help young women stay safer, conquer crisis, and better plan for the future. The project hosted two well attended camps and several workshops and held group calls with representation from each tribe and urban Indian health center and trained mentors. The mentors will continue to work across the state through the Tribal Tobacco Prevention Program. The protective asset program expects to improve the self-confidence of Native American girls and provide skill building training that could lower the chances of experiencing adverse childhood experiences and improve school performance.

Grant Amount

$15,000

Term

12 month

2018

Livingston HealthCare Foundation

Integrating Behavioral Health into Primary Care Services in Park County

For this project, Livingston HealthCare successfully integrated behavioral health services into their primary care clinic by creating a collaborative primary and psychiatric care team. They also began implementing universal behavioral health screenings and developed a streamlined system to provide care for patients with physical and mental health concerns at the same visit. Throughout the course of the grant, screening rates for depression increased from 17% to 65%, emergency behavioral health evaluations decreased by 43%, and depression scores improved by 76%.

Grant Amount

$126,717

Term

24 month

2016

Livingston HealthCare Foundation

Rapid Response Behavioral Health Crises Management

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.

Grant Amount

$75,000

Term

12 month

2017

Livingston HealthCare Foundation

Sweet Park Smiles

Sweet Park Smiles is a collaborative effort by Community Health Partners, Livingston HealthCare, and the Livingston Food Resource Center to coordinate and expand oral health resources in Park County. This project helped the county’s primary care providers adopt a framework for addressing oral health and actively support referrals to dentistry. The project trained medical teams in oral health screening, risk assessment, fluoride varnish application, and specialist referrals. Through training and process development coordinated by Community Health Partner’s dental officer, the project also enhanced the ability of Livingston HealthCare providers to screen and apply varnish to children through their routine child check-ups. Training in the application of varnish, charge codes for Medicaid, and referral processes for more serious dental issues will continue for an additional five pediatric teams.

Grant Amount

$20,803

Term

12 month

2018

Livingston HealthCare Foundation

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

Lockwood School District - Special Programs Office

Lockwood Mobile School Based Health Center

Through this project, the Lockwood School District worked with St. Vincent Healthcare to plan for and begin delivering health services to the community of Lockwood through the establishment of a mobile clinic. This mobile clinic, donated by the Ronald McDonald Foundation, began providing primary care services to students and the community members of Lockwood in July 2018. This is the first primary health care facility in the unincorporated city of approximately 8,000 residents. The Lockwood School District is continuing to partner with St. Vincent and will expand their scope of services to include behavioral health services in the next 24 months. The construction of a permanent clinic, operated by St. Vincent, is being included in the construction plans for the construction of the Lockwood High School.

Grant Amount

$75,000

Term

12 month

2017

Logan Health

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

Through this grant, Kalispell Regional Healthcare’s (KRH) neonatal intensive care unit staff worked with Montana hospitals to develop and implement a standardized protocol to screen for and manage drug withdrawal in newborns. The grant resulted in several important accomplishments: 1) The grantee developed an educational video for staff using the Modified Finnegan Scoring Tool to assess infants exposed to opiates in utero. 2) The implementation of a new “incentivized parenting program” that fostered a cultural shift away from blaming mothers for their addiction and toward a sympathetic, supportive attitude that encouraged parents to participate in care of their infants and to engage in education and treatment activities; 3) The NICU improved cooperation with state agencies to support families. An independent evaluation of the program suggested that these accomplishments helped reduce foster care placement of infants with Neonatal Abstinence Syndrome (NAS). The prevalence of foster care placement for babies with NAS decreased from 75% (N = 12) in 2015 to 11.1% (N = 9) in 2017 (partial). Continuing an earlier trend, the average length of hospital stays for NAS-affected babies went from 23.5 days (average 2014-2015) to 14.9 days (N = 9) in 2017 (partial).

Grant Amount

$50,000

Term

24 month

2015

Logan Health

Integrated Behavioral Healthcare for High Risk Pregnant Women in Western and North Central Montana

This project implemented the Meadowlark model of care for pregnant women at Logan Health. Meadowlark care integrates behavioral health screening and treatment into routine obstetric care. The project serves at-risk mothers in Flathead County, the Flathead and Blackfoot Reservations, and surrounding areas. After receiving training and consultation from the National Council for Behavioral Health, Logan Health added a therapist and a care coordinator to the obstetrics team. Universal screening and a care pathway for depression was formalized, and substance use screening has begun. Consistent team meetings occur between maternal care departments and community stakeholders. Data on screenings and improvement in care are now part of the electronic health record and are reviewed and monitored consistently. By fully integrating behavioral health screening, diagnosis, and treatment into obstetrics as part of the standard prenatal care practice rather than singling out women felt to be at high risk, Logan Health was able to decrease the stigma associated with mental health issues and increase the availability of these critical services for all patients.

Grant Amount

$150,000

Term

24 month

2017

Logan Health

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

Logan Health

Integrated Behavioral Health for High Risk Pregnant Women Phase II

Kalispell Regional Medical Center (KRMC) will build on its successful 2017-2019 MHCF-funded project to bring integrated behavioral health services into the obstetrics (OB) setting, serving at-risk mothers in Flathead County, the Flathead, Blackfoot Reservation, and surrounding areas. This grant will enable KRMC’s Pathways Behavioral Health program to join the Meadowlark initiative, continue to fine-tune the clinical model, and continue data collection and reporting as a Meadowlark site. The clinical manager for KRMC’s three OB practices will provide project management for this grant. Grant funds will cover a portion of staffing expenses over the next two years to ensure program continuity. The project will also strengthen care coordination services and enable KRMC to screen for and address social determinants of health needs for at-risk mothers and families.

Grant Amount

$50,000

Term

24 month

2020

Logan Health

Integrated Behavioral Health Outreach

Kalispell Regional Medical Center (KRMC) will serve as a hub to support the implementation of integrated behavioral health (IBH) across its growing network of affiliate hospitals. Two affiliate hospitals that have already implemented IBH – Cabinet Peaks Medical Center and North Valley Hospital – will receive ongoing technical assistance to improve their IBH practice. Northern Rockies Medical Center and Pondera Medical Center are just beginning the IBH implementation and will use the funding to hire a full-time behavioral health provider at each location. Marias Medical Center will participate in a planning capacity, with a goal of beginning to implement IBH at the same time as they begin offering primary care services. KRMC will provide leadership and oversee all IBH implementation activities, including universal screening for depression and substance use disorders, care coordination, psychiatric consultation, and rural site training. The National Council for Behavioral Health will provide technical assistance. Expected outcomes include universal screening for behavioral health conditions in the primary care setting, improvement in depression and substance use disorder outcomes, decreased emergency room visits related to mental illness and substance use disorders, and improved coordination of care between participating facilities.

Grant Amount

$200,000

Term

24 month

2020

Madison County

Integrating Behavioral and Physical Health in Madison County

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

Grant Amount

$28,398

Term

12 month

2016

Madison Valley Hospital Association

Integrated Behavioral Health

Madison Valley Medical Center is a 10-bed critical access hospital serving clients in Southwest Montana. This project will build on two previous MHCF grants to expand access to behavioral health services on-site in the hospital's rural health clinic and Big Sky Medical Center. Madison Valley will establish formal care pathways, advance staff training, strengthen behavioral health-primary care provider relationships, and create systems to improve referral tracking, care coordination, and the use of structured data to measure behavioral health outcomes. This grant will support targeted technical assistance along with on-site behavioral health and support staff. In addition to a partnership with Big Sky Medical Center, a focus for this project will be to establish relationships with behavioral health providers and resources outside the organization to improve patient access.

Grant Amount

$50,000

Term

24 month

2021

Madison Valley Hospital Association

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

Marcus Daly Memorial Hospital

Implemention of Integrated Behavioral Health

Marcus Daly Memorial Hospital will integrate behavioral health services into its five primary care clinics located throughout the Bitterroot Valley in Ravalli County. The hospital will establish a new partnership with Sapphire Community Health, the local federally qualified health center. With the new partnership, Marcus Daly will expand behavioral health screening, provide immediate access to either a behavioral health provider or telehealth appointment (depending on the location), and ultimately seek to improve health outcomes and reduce emergency department use related to behavioral health crisis. Grant funds will help Sapphire Community Health hire a care coordinator and behavioral health clinician to support patients’ needs. The National Council for Behavioral Health will provide technical assistance.

Grant Amount

$125,000

Term

24 month

2020

Messengers for Health

Sustaining the Báa nnilah program for improved holistic health for Apsáalooke people

Through this project, Messengers for Health will explore ways to bill for the services they provided through the Báa nnilah Program. Messengers for Health serve the Crow community and uses a cultural approach to provide health information and link Crow people to health services. Grant funds will be used to work with consultants (Mary Dalton and Big Horn Valley Health Center) and support the training of peer support specialists. Messengers for Health has an existing relationship with Bighorn Valley Health Center and leadership from Bighorn have expressed enthusiasm in exploring ways to support the Báa nnilah Program through potential revenue generation. The overarching goal of this work is to identify ways to support the services being provided by the Báa nnilah Program by identifying sustainable sources of revenue through billing for services.

Grant Amount

$14,857

Term

12 month

2019

Messengers for Health

Traditional Relationships Improve Contemporary Health

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

Grant Amount

$50,000

Term

24 month

2015

Messengers for Health

Indigenous Evaluation and Dissemination of the Báa Nnilah Project

Messengers for Health works to improve the health of people living on the Crow Indian Reservation and outlying areas through community-based projects designed to empower communities to address their unique health issues. For this project, Messengers for Health will partner with two Tribal nations to adapt, implement, and evaluate a chronic disease self-management program – “Báa nnilah” – the grantee developed on the Crow reservation program. The evaluation will help the grantee and tribal partners adapt Báa nnilah for the specific needs of these Tribes, and it will help establish Báa nnilah as an evidence-based program, making it potentially reimbursable through the Tribal Health Improvement Program and providing sustainability for the project over the long term. Partners include Crow, Fort Belknap, and Rocky Boy Indian Reservations. Funding will support community members from the three communities to come together and develop the evaluation plan, support the adaptation of program manuals, and implement and evaluate the program in each community.

Grant Amount

$99,695

Term

24 month

2021

Mission West Community Development Partners

Local Food for Local Families: Montana SNAP Food Box Pilot Project

The Local Food for Local Families: Montana SNAP Food Box Pilot Project will provide fresh, high-quality food items from Montana producers and processors to families with low incomes in Western Montana. The Mission Mountain Food Enterprise Center (MMFEC) will partner with the Community Food and Agriculture Coalition and its Double SNAP Dollars Network to launch a pilot project that explores the sustainability of a long-term food box program using Supplemental Nutrition Assistance Program (SNAP) benefits and Double SNAP Dollars. This incentive allows Supplemental Nutrition Assistance Program (SNAP) recipients to double their benefit dollars for fresh fruits and vegetables. The program will provide boxes of local, fresh foods sourced from the Western Montana Growers Cooperative to food access sites in the Mission Valley, Flathead Indian Reservation, and Missoula's American Indian urban population through the All Nations Health Center. Individuals and families will use their SNAP benefits to purchase weekly food boxes, and the Double SNAP Dollars incentive will subsidize the cost. MMFEC will also develop and coordinate a new statewide partnership: Local Food for Local Families. This partnership will provide support and collaboration opportunities for increasing local and healthy food access for all Montanans and Tribal communities. Grant funding will support project coordination, free food boxes for two distribution sites to generate future interest, marketing, outreach, and project evaluation.

Grant Amount

$99,745

Term

24 month

2021

Missoula Aging Services

Care Transitions Achieving Better Health Outcomes

This project supported a care coordination position to help older adults transition successfully from the hospital back into their homes. This group of patients tends to utilize high-cost services such as inpatient care more frequently than the general population, and social risk factors such as poor housing and social isolation often lead to poor clinical outcomes. The project used an established model that involves home visiting followed by frequent phone or in-person contacts during the month after a hospital stay. The program also identified social risks and helped coordinate appropriate referrals as needed. Missoula Aging Services successfully developed data sharing agreements with the local hospital and other partners to ensure the discharge needs of the patients were met. The program saw a dramatic decrease in readmissions for this senior population and an increase in discharge instructions and care recommendations among patients. Funding from local partners and potentially the local hospital will help continue these care transition efforts.

Grant Amount

$135,250

Term

24 month

2016

Missoula Aging Services

Missoula Aging Services Co-Located Resource Specialist

Funding for this project allowed Missoula Aging Services (MAS) to place one of its resource specialists at the Partnership Health Center (PHC) one day a week. The goal was to reach previously unserved low- and moderate-income older adults and help them access services that will allow them to lead healthier lives and live as independently in their own homes and communities for as long as possible. The resource specialist assisted PHC patients and their caregivers with a variety of social support needs that impact social determinants of health, such as transportation, food, and housing. For example, the specialist assisted with screenings for Medicare and Medicaid eligibility and navigating these programs, identified housing and food insecurity needs, provided caregiving consultations and referrals for home modifications to prevent falls and injuries, and made secondary referrals to programs such as heating assistance and tax credits. This has served as a valuable pilot program, with MAS and PHC planning to establish satellite resource centers at other locations throughout the community in order to reach older adults in need of services right in their moment of crisis.

Grant Amount

$10,000

Term

12 month

2019

Missoula City-County Health Department

Missoula Foster Child Health Partnership: Model Practice for Montana Replication

The goal of this project was to evaluate the Missoula City-County Health Department's Foster Child Health Partnership (MFCHP), a pilot program that coordinates health services for foster children placed in Missoula County and referred by the Department of Public Health and Human Services (DPHHS) Child & Family Services Division (CFSD). It involved creating a documented protocol so the program could be replicated in other Montana counties. The program is designed to improve health outcomes for these high-risk children by securing medical records, coordinating health care plans, ensuring follow-up with providers and specialists, providing in-home monitoring and health education to foster parents, and securing a child's medical and dental home. The evaluation found that the program met its goal of 100% of children obtaining a medical home. The comparison county that did not use the program model only had 67.64% of children in a stable medical home at the end of the data collection period. The program was submitted to the National Association of City and County Health Officials (NACCHO) to get a model practice designation and was given the Promising Practice award. The health department also engaged with the Partnership Health Center and the Kindness, Elegance, Love Project (PHC-KELP) along with other agencies to coordinate services for biological parents after family reunification. The program successfully provided important child health information and referrals to community services to biological parents, closing the informational gap from state guardianship to permanent reunification. 

Grant Amount

$69,653

Term

24 month

2018

Missoula College

Community Paramedicine Curriculum

Missoula College will develop a curriculum in Community Paramedicine (sometimes referred to as "Community Integrated Healthcare” or “CIHC”). This will be the first Montana-based program that offers training in community paramedicine to emergency medical technicians (EMTs) and paramedics. Community paramedicine allows EMTs and paramedics to expand their roles to provide certain non-emergency services, such as in-home follow-up visits after hospitalization, management of chronic illnesses, fall risk assessments, wound care, and limited behavioral health services. Missoula College will convene an inter-professional working group of faculty and health care professionals in medicine, paramedicine, nursing, and social work to build the curriculum. The curriculum will be delivered remotely using online modules, complemented by a clinical rotation, and is designed to provide emergency responders around the state with access to the training. Funding will support a project manager, instructional design, and curriculum development content experts. Partners include faculty from the Missoula College Health Professions Department, the University of Montana Social Work and Public Health Departments, emergency service providers, including Missoula Emergency Services, Inc., and the Montana Department of Public Health and Human Services Community Integrated Health Program Specialist.

Grant Amount

$54,000

Term

12 month

2022

Missoula County

Missoula County Collaborative Care Planning Summit

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

Grant Amount

$20,000

Term

12 month

2016

Missoula County

Missoula Benefits: Exploring Options for Uninsured Residents

The goal of this project was to explore options for providing affordable health insurance to uninsured residents in Missoula County. Missoula County Commissioners, Missoula County Risk and Benefits, and Partnership Health Center worked together to determine the key demographic features of the uninsured in Missoula County; the viability of creating a local health insurance option built on Missoula County’s health insurance plan, and Partnership Health Center’s clinical resources; and the financial and organizational mechanics needed to create a health insurance program for county residents who are not currently insured through their employers or federal programs. The project developed a steering committee composed of leaders from the city, county, and local organizations. The committee reviewed benefit options from other states, learned about the complexities of insurance pools, contracted with a benefits expert to develop options for Missoula, and came to a better understanding of Montana’s insurance regulations. Missoula County analyzed the available data to determine who is in the insurance gap and what the level of need is for benefits support. The county also explored the feasibility of using an insurance product offered by the Montana Health Coop that would allow it to pay the co-pay for people served by Missoula’s two federally qualified health centers (Partnership Health Center and All Nations Health Center).

Grant Amount

$25,000

Term

12 month

2019

Missoula Food Bank and Community Center

Place-Based Health Care: Increasing Access Through Partnership

The Missoula Food Bank and Community Center (MFB&CC) and Partnership Health Center teamed up to expand access to medical, dental, and behavioral health services for people experiencing food insecurity in Missoula County. They did this using a co-location model, wherein a satellite clinic was placed at the food bank to allow for onsite health care visits—both by appointment and walk-in. The grantee contracted with an architecture firm to design the clinic to be housed inside the MFB&CC facility. The construction of the clinic was funded by the Missoula Redevelopment Agency (MRA) with Tax Increment Financing (TIF) which totaled $433,840. The clinic opened in July 2021 and has been able to provide services to those visiting the food bank who have both urgent and non-urgent medical needs. People who don’t have an appointment can often be seen by a provider within a 20-minute window. And because the clinic is open during evening hours, people in need have more options to receive care. The Montana DPHHS Food Farmacy Program provided an additional $10,000 for the project.

Grant Amount

$66,350

Term

24 month

2018

Montana Budget and Policy Center

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

This project developed and disseminated (via an accompanying proposal from Montana Women Vote) two reports that helped guide efforts to enroll newly eligible people in Medicaid and help them use health care effectively. The Medicaid Expansion in Indian Country: Effective Strategies for Outreach and Enrollment report was released September 2016 and was presented to the HELP Oversight Committee, which resulted in the inclusion of a recommendation to the Governor and Legislative Finance Committee to develop and implement coordinated and expanded efforts to enroll American Indians in the Medicaid expansion. The Medicaid Expansion Outreach and Enrollment: Effective Strategies for Expanding Access to Coverage report was released March 2016.

Grant Amount

$10,000

Term

12 month

2015

Montana Budget and Policy Center

Report on the Impact of Medicaid Repeal on Montana’s Budget, Healthcare Provider, and Individuals

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

Grant Amount

$8,000

Term

12 month

2016

Montana Budget and Policy Center

Medicaid Policy Analysis

This grant provided general operating support for the Montana Budget and Policy Center who will continue their work with Healthy Montana Coalition partners to disseminate information about Montana’s Medicaid expansion. During the grant period, the grantee helped to organize 15 events, conducted outreach to more than 18,000 Montanans, and produced three reports. The Medicaid Expansion in Indian Country: Effective Strategies for Outreach and Enrollment report was released September 2016 and was presented to the HELP Oversight Committee, which resulted in the inclusion of a recommendation to the Governor and Legislative Finance Committee to develop and implement coordinated and expanded efforts to enroll American Indians in the Medicaid expansion.

Grant Amount

$50,000

Term

12 month

2017

Montana Continuum Care Coalition

Supportive Housing Capacity Building in Montana

The Montana Continuum of Care Coalition (CoC) will review organizational models and develop strategic and data sharing plans to strengthen their structure. The Montana CoC is a critical organization that provides homeless shelter utilization data, homelessness resources, and demand information systems. It serves as a conduit for housing and urban development (HUD) resources for the state of Montana. This planning project will produce a work plan and develop data-sharing plans to align the various existing government information systems that track relevant statistics on homelessness and health outcomes. In turn, this will allow the CoC to better more effectively plan and collaborate with stakeholders to align services for Montana’s homeless and insecurely housed. The CoC will contract with the Corporation for Supportive Housing (CSH) who will assess staffing and structure and facilitate strategic planning. Funds will be used for project coordination and to hire CSH as a technical assistance contractor. Partners include members of the Supportive Housing Innovation Accelerator Program Workgroup, which consists of the Montana Department of Commerce, the Montana Department of Public Health and Human Service, and the CoC board of directors. The CoC’s goal for this project is to strengthen its capacity to apply for HUD grant funding successfully and build effective partnerships to meet the supportive housing needs across the state.

Grant Amount

$61,566

Term

24 month

2019

Montana Department of Public Health and Human Services

Community Integrated Healthcare Emergency Medical Services

This project will help the Montana Department of Public Health and Human Services (DPHHS) develop a framework to support the statewide implementation of community integrated healthcare (CIH). A part of the project, the DPHHS Emergency Medical Services (EMS) and Trauma Systems will select six EMS pilot sites to begin providing CIH services. Each site will train EMS staff to provide an expanded range of services such as wound care, post-hospitalization follow-up, medication set ups, home safety checks, and other services in the home. At the end of the grant term, the pilot projects will be evaluated, and DPHHS will convene a payer group to consider reimbursement for CIH based upon the results. Grant funds will be used primarily for supporting pilot sites to implement CIH in their systems and for program evaluation. As part of the project, partnerships will be developed with regional hospitals, critical access hospitals, Indian Health Services, VA hospitals and clinics, local clinics and providers, and community stakeholders – all of whom are essential for implementing this project successfully. The goal of the program is to reduce unnecessary EMS transports and unwarranted emergency department visits, and to improve health outcomes among medically vulnerable patient populations, meet community health needs where there are current gaps, remove barriers to health, and address disparities also affecting health outcomes.

Grant Amount

$160,000

Term

24 month

2019

Montana Department of Public Health and Human Services

Behavioral Health Workshop for Public Health

This project will support staff from local and tribal health departments to attend a workshop on “Mental Health and Substance Abuse in Montana: The Role of Public Health.” This workshop, which will be held in Great Falls and Miles City, will provide information and training on frameworks, tools, resources, and funding available to support local and tribal public health departments to prevent and reduce substance abuse and mental illness in the communities they serve. The Public Health and Safety Division is partnering with the Addictive and Mental Disorders Division to create the workshop agenda, content, and identify speakers. Grant funding will be used to support travel costs for health department staff who may otherwise be unable to attend the workshop due to limited operational budgets. Tribal health and rural health department staff working in counties that have identified behavioral health as a top community health concern will be prioritized to receive a travel scholarship. The overarching goal of this work is to build the capacity of local and tribal health departments to prevent and reduce behavioral health concerns in the populations they serve.

Grant Amount

$10,000

Term

12 month

2019

Montana Department of Public Health and Human Services

Montana Oral Health Program

This project helped develop and implement a framework for oral health improvement in Montana. The Montana Department of Public Health and Human Services began to develop a statewide framework to improve oral health, and in the fall of 2016, they held a Dental Action Summit which brought together 34 oral health stakeholders to establish strategic direction in addressing oral health disparities. Grant funding allowed the state to successfully make progress on priority areas that were identified including: improving community-level outreach and technical support for water fluoridation and dental sealants, developing a dental health workforce plan that includes in-depth examination of dental therapists to expand access to care, collecting and disseminating timely surveillance on oral health outcomes, and conducting a demonstration project that would provide case management through a “dental home” model for Medicaid-enrolled children to increase access to effective care.

Grant Amount

$100,000

Term

12 month

2017

Montana Department of Public Health and Human Services

Analyzing and Understanding the Impact of Medicaid Expansion on Montanans

In 2015, Montana enacted a law that provided Medicaid expansion benefits for low-income Montanans. As of January 2018, 90,000 people were covered by this program, which was designed to provide high-quality and affordable health care to people in need. Because this legislation was scheduled to sunset in June 2019, the Montana Department of Public Health and Human Services wanted to analyze available demographic and health data of the Montana Medicaid Expansion population to understand the value and impact of the program. A research/data analyst and a technical writer were hired to extract and analyze data from Montana’s Medicaid system and create a dashboard to report information on number of enrollees and services delivered, such as preventive services, cancer screenings, treatment for mental illness and substance use, and management of other chronic illnesses. The dashboard concept has since been expanded to other programmatic areas, and the department now has eight interactive data dashboards. The project helped DPHHS provide information to and answer questions from legislators on the practical value of this program. The data analysis showed the positive impact of Medicaid expansion, which was crucial to the Legislature’s decision to continue the program.

Grant Amount

$90,500

Term

12 month

2018

Montana Department of Public Health and Human Services - Senior and Long Term Care Division

Interdepartmental Housing Integration Project

The Montana Department of Public Health and Human Service (DPHHS) will establish an Interdepartmental Housing Integration Project. The project will align strategies and action plans across disparate state departments, agencies, and local stakeholders to use existing resources more effectively to address homelessness, housing insecurity, and health service integration priorities. The project will create a platform that integrate three separate housing and health care data systems to share information on homeless high-utilizers, which will enable the coordination of services to improve outcomes for those individuals. The state will also evaluate and, if feasible, finalize appropriate Medicaid changes to support health-related tenancy support services. Initial partners include DPHHS; the Department of Commerce, Montana Housing Division and the Community Development Division; the Montana Continuum of Care Coalition; and the Montana Healthcare Foundation's Frequent Users System Engagement grantee communities. Grant funds will cover a full-time staff person dedicated to grant management activities, costs associated with stakeholder planning and meetings, data analytics coordination, and contracted assistance.

Grant Amount

$150,000

Term

24 month

2020

Montana Environmental Health Association Foundation

Montana Environmental Health Association Foundation

The Montana Environmental Health Association (MEHA) will produce a study looking at the environmental health specialist (or “sanitarian”) workforce’s current status and future needs, including ways to improve recruitment and retention. MEHA is a nonprofit group of professionals who work to protect public health through monitoring and limiting exposure to health hazards in our everyday environment, including air, water, soil, and food. Grant funds will support a contractor who will work with MEHA to complete this study.

Grant Amount

$10,000

Term

12 month

2020

Montana Food Bank Network, Inc.

Hardin Rural Health Food Box Program

The Montana Food Bank Network (MFBN) will partner with Big Horn Valley Health Center (based in Hardin, MT) to screen patients for food insecurity and provide food boxes and referrals to other community resources to those in need. Grant funds will be used to purchase food for the food boxes, train the clinic staff, print materials, and support the program coordinator.

Grant Amount

$10,000

Term

12 month

2020

Montana Free Press

In-Depth Health Care Reporting in Montana

This project allowed the Montana Free Press to research, investigate, report, and publish in-depth stories about health care and health care policy in Montana. The independent news site experienced tremendous growth in exposure and pick-up rate during the grant period, and many of their most popular stories and podcasts were directly related to health care and policy in Montana. 

Grant Amount

$10,000

Term

24 month

2018

Montana Free Press

Statewide Coverage of COVID-19 on Individuals, Communities, the Health Care System, and Legislation

The Montana Free Press will cover the impact of COVID-19 on the physical and mental health of Montanans as well as the state’s response in the upcoming legislative session. For this reporting, the Montana Free Press will use their staff reporter as well as their freelance reporting team. Grant funds will be used to enable reporters to focus on the health and health policy impacts of the coronavirus pandemic. The Montana Free Press has established partnerships with news organizations across the state. They will provide their stories free of charge to local and statewide news organizations, further strengthening these partnerships. The project’s overall goal is to provide high-quality, sustained, statewide coverage of the COVID-19 pandemic and its impacts on individuals, communities, health care infrastructure, and legislation in Montana.

Grant Amount

$20,000

Term

12 month

2020

Montana Free Press

Health From More Angles: Intersectional Health Care Reporting and Analysis for Montana Communities

Montana Free Press (MTFP) is a nonprofit news source that provides in-depth reporting on topics that impact the state and local communities. This project will incorporate health coverage into the regular beats of MTFP's full-time and freelance staff – including education, economics and data, social welfare, and the environment – resulting in roughly 20 stories covering eight health topics. Reporters will write in-depth stories on complex health issues that merit statewide attention and identify solutions that may already exist in the community. Like the rest of MTFP's coverage, these stories will be provided free of charge on its website and to its network of partnering local newsrooms and radio stations. This project will inform Montanans of the costly health issues in the state so they can make knowledgeable decisions about their health and the health of their communities.

Grant Amount

$39,870

Term

12 month

2021

Montana Generational Justice Foundation

Estate Planning to Prevent Health Care Exploitation and Fraud

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.

Grant Amount

$30,000

Term

12 month

2019

Montana Health Network

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 Health Network Health Inc.

Eastern Montana Integrated Behavioral Health Project

The Eastern Montana Integrated Behavioral Health Project will support integrating behavioral health (IBH) into primary care for five rural healthcare facilities in eastern Montana (Baker, Ekalaka, Broadus, Malta, and Jordan). The grant will also allow three current IBH sites (Forsyth, Culbertson, and Terry) to refine and improve their initial IBH implementation efforts supported under MHCF's previous IBH network grant to the Montana Health Network (MHN). The goals for the project are to 1) implement routinescreening and early intervention for behavioral health and substance use issues in primary care; 2) improve care coordination between treating facilities; and 3) develop a sustainable integrated behavioral health model for existing and new facilities. Through implementing IBH in these facilities and consolidating the practice in previous grant sites in MHN’s network, the project seeks to improve health outcomes, contribute to a more effective crisis system in eastern Montana, and reduce the use of emergency services. MHN will use grant funds to provide project management, technical support and training, psychiatric consultation, and care coordination services. MHN will partner with Eastern Montana Community Mental Health Center (EMCMHC) and Frontier Psychiatry to provide clinical services to patients at individual sites.

Grant Amount

$279,722

Term

36 month

2021

Montana Health Plus

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 Health Research and Education Foundation

Montana Medicaid Expansion Impact Study

This project allowed the Montana Hospital Association (MHA) to work with the nationally recognized consulting firm Navigant to develop an independent assessment of the financial impacts, fiscal performance, and health care impacts of Montana’s Medicaid expansion. The report was released during the legislative session during which reauthorization of the program was being debated. The report provided independent, rigorous analysis that informed stakeholders of the costs, cost-benefits, and overall objective, third-party analysis of the impact of Medicaid expansion on Montana’s health care system and economy. (The Montana Health Research and Education Foundation is the foundation arm of MHA.)

Grant Amount

$54,100

2018

Montana Health Research and Education Foundation

Survey of Statewide Emergency Medical System Capacity and Threat in Montana

This grant allowed the Montana Health Research and Education Foundation (MHREF) to conduct a survey and analysis of emergency medical services (EMS) capacity in Montana in order to identify EMS gaps, analyze their impact on hospital services, and recommend solutions for filling those gaps. MHREF worked with the Montana Department of Public Health and Human Services (DPHHS) Division of EMS and Trauma to survey and interview 42 hospitals and 61 EMS organizations. A collaborative report between DPHHS, MHREF, and the consulting firm Eleva Group was completed, providing new information on the status of and threats to Montana's EMS system and recommendations for developing a successful and sustainable approach for improvement. Participating organizations are now convening a stakeholder group to implement the recommendations from the analysis.

Grant Amount

$24,000

Term

12 month

2019