Montana Legal Services Association

Montana Health Justice Partnership

The Montana Health Justice Partnership (MHJP) was launched in 2015 as a collaboration between Montana Legal Services, Montana Primary Care Association, and six Federally Qualified Community Health Centers (FQHC), through a pilot grant from MHCF. MHJP provides legal assistance to low-income patients in rural community health centers across the state. Patients receiving treatment at an FQHC can get help with legal issues that have an impact on their health, such as housing in disrepair, medical debt, family violence, denial of senior benefits, employment problems, and health care access. This second grant allowed MHJP to hire a paralegal to assist the staff attorney and enable the program to expand services to FQHCs in Cascade, Hill, Lincoln, Big Horn, Yellowstone, and Silver Bow counties, which contain some of Montana’s most rural and isolated communities. Over the course of this grant, the project provided direct legal assistance to 723 patients, which far exceeded initial estimates. MHJP has been recognized by several national and regional organizations for the breadth and quality of its services and for developing a unique model for serving rural populations. MHJP was able to secure additional funding from several foundations, including the Montana Justice Foundation, and in 2020 its partners agreed to increase their contributions, allowing the project to become fully self-sustaining.

Grant Amount

$100,000

Term

24 month

2017

Montana Medical Association Foundation

Montana Health Information Exchange Feasibility Development Plan

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

Grant Amount

$50,000

2016

Montana Medical Association Foundation

Optimization of Patient Care Through Health Information Exchange in Montana

This project strengthened partnerships to promote health and health information technology through the planning and successful award generation of a health information exchange in Montana. This is part of a multi-stakeholder effort to establish a sustainable, statewide health information exchange that can serve as a patient’s data home and allow health care providers to access and share health-related information statewide. This planning grant resulted in the formation of a new 501(c)3 organization, Big Sky Care Connect: organizational and legal documents were finalized, a 25-member board selected, and organizational structure developed. The new organization was awarded a CMS innovation grant of $20 million and is now in a capital campaign to secure additional matching funds to maximize the potential award from CMS.

Grant Amount

$50,000

Term

12 month

2018

Montana Medical Association Foundation

Prescription Drug Abuse Reduction Initiative

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

Grant Amount

$25,000

Term

24 month

2015

Montana Medical Association Foundation

Improving Interoperability & Capabilities of Behavioral & Indian Health Electronic Health Systems

In 2020, Montana will connect health providers, care coordinators, community service organizations, and other caregivers to a Statewide Health Information Exchange (HIE), which houses and shares (in a secure manner) patient data using a shared infrastructure. This grant will generate $900,000 in additional federal funding for the HIE. This project will also achieve two primary goals. First, it will support whole-person health by enabling the integration of a patient’s physical health information with behavioral health data. Second, it will develop the data interface and processes needed to incorporate Indian Health Service (IHS), tribal, and urban Indian health center (I/T/U) data from the Resource and Patient Management System (RPMS) platform, an electronic health record platform used by many I/T/U providers. For this project, the Montana Medical Association Foundation (MMAF) will partner with the Big Sky Care Connect (BSCC), the Montana organization that is building the HIE. They will work collaboratively with key partners to determine successful outreach strategies and HIE technologies that meet privacy and security needs. Outreach will be conducted by project partners (including Rimrock Foundation, Behavioral Health Alliance of Montana, and BSCC) with potential clinical IHS and behavioral health providers and their clinical partners. Outreach will focus on the value of HIE participation, opportunities, return on investment, clinical use cases, and available assistance to address privacy and interoperability challenges. This project will improve interoperability among all providers, including behavioral health and I/T/U providers, through the exchange of health information, and further empower patients, providers, and payers.

Grant Amount

$100,000

Term

12 month

2020

Montana Nonprofit Association

Montana 2020 Census Outreach

This project was designed by the Montana Nonprofit Association (MNA) to build awareness of and engagement in Census 2020 in Montana’s 30 hardest to count communities, including the state’s seven American Indian reservations. This was accomplished by creating a strong coalition of partner organizations across the state, which together conducted a wide variety of outreach, coordination, and mobilization activities. MNA also hired a full-time census coordinator to assist with strengthening and facilitating these partnerships. Activities included outreach to both public-sector and private-sector leaders and organizations, advertisements in newspapers, earned media, mailings of postcards and fliers, posts and contests on social media platforms, and phone calls to households. MNA awarded mini-grants to 22 nonprofit organizations to help reach hard-to-count communities, such as Spanish-speaking, LGBTQ+, refugee, and youth populations. The association was also able to secure $120,000 in CARES Act funding to support its efforts that were disrupted by COVID-19, including outreach to rural communities. Tier I hard-to-count counties saw an average self-response increase of 18.33%, and Tier II counties saw an average self-response increase of 12.97%, compared to an increase of 5.38% in all other counties.

Grant Amount

$50,000

Term

12 month

2019

Montana Office of Public Instruction

School Wellness

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

Grant Amount

$100,000

Term

24 month

2020

Montana Primary Care Association

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 Primary Care Association

Documenting Patient Experiences with Montana’s Medical Expansion

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

Grant Amount

$16,400

Term

12 month

2017

Montana Public Health Association

Montana Public Health 101: Improving the Health of Citizens by Training the Public Health Workforce

This project will help orient and train new public health workers by creating an online learning platform in partnership with the Department of Public Health and Human Services, the Association of Montana Public Health Professionals, the Montana Environmental Health Association, Montana State University Area Health Education Center, the University of Montana, and the Rocky Mountain Public Health Training Center. This new training resource will provide no-cost orientation for new public health workers to the state system and create an additional local board of health training option. This project aims to increase the knowledge and skills of local public health officials, decrease the amount of staff turnover, and mitigate the negative effects of staff turnover when it does occur. Grant funds will be used to develop the content of the online training module and produce the training in an online format. The primary public health entities in the state will be engaged throughout this project and will help disseminate the training and encourage its use once it has been developed.

Grant Amount

$75,000

Term

24 month

2018

Montana Public Health Institute

Montana Public Health Institute Start Up

This grant will fund the creation of the Montana Public Health Institute (MPHI). Over the last six years, we have worked with stakeholders around the state to find ways to strengthen Montana’s public health system. Based on this work, we published a 2019 report, “Creating a Vision for a Healthier Montana: Strengthening the Montana Public Health System.” The report identified public health institute functions that are not currently provided by any other public health entity, such as providing “surge capacity” to respond to public health emergencies; supporting small, rural health departments by procuring grants, and assisting with technical assistance and management of funds; and carrying out rigorous, non-partisan analysis of Montana’s public health system and opportunities to strengthen it. The report concluded with a recommendation to design and start a public health institute in Montana. With consultants from Montana (Jane Smilie) and the National Network for Public Health Institutes (NNPHI), we are now supporting the work of the MPHI Design Team comprising stakeholders from Montana’s county, tribal, state, academic, and non-profit public health organizations. The Design Team recently approved a strategic plan for the MPHI and has started work on establishing the organization. The COVID-19 pandemic creates an urgent need for services that a public health institute can provide. An MPHI will aid our state’s response, guide and support the recovery, and analyze lessons from this crisis to assist in building a more effective public health system. DPHHS has requested that MPHI—once formed—assist with administering certain federal grants expected in the next two months that DPHHS does not have the capacity to administer. To achieve an accelerated startup, the Design Team nominated members to serve as a founding board of directors; the board will incorporate the MPHI as a Montana non-profit in late April 2020. The new MPHI will implement the long-term strategic plan developed by the Design Team, and it will play an immediate and critically needed role in COVID-19 response and recovery. Key partners include DPHHS, county and tribal public health departments, Montana’s public health associations, and the Montana University System.

Grant Amount

$1,850,000

Term

60 months

2020

Montana Public Health Institute

Unlocking the Public Health System’s Potential to Improve Behavioral Health in Montana – An Environmental Scan

This project will help unlock the potential of Montana's public health system to promote mental wellness, resilience, and protective factors that are critical to improving the health and quality of life of Montanans and preventing adverse outcomes such a mental health crisis, incarceration, abuse or neglect, and self-harm. The project will produce three related reports to guide public health efforts in this area. The Montana Public Health Institute (MTPHI) will carry out an environmental scan to understand how health departments around the country address behavioral health and identify effective programs that Montana health departments could implement. MTHPI will also produce a guide to these interventions for training local health department staff and a brief for state stakeholders summarizing key findings and recommendations. Together these reports will help guide efforts by local and tribal health departments and partners like the Montana Department of Public Health and Human Services (DPHHS) and institutions of higher education to implement evidence-based and evidence-informed interventions to improve mental wellness at the community level and within existing public health programs, like home visitation and chronic disease prevention services. MTPHI will work with partners, including JG Research & Evaluation in Bozeman, MT, and local and state stakeholders. Grant funds will be used to commission an in-depth research effort and present the results of that work in compelling and relevant ways to public health leaders, stakeholders, and policymakers.

Grant Amount

$50,000

Term

12 month

2021

Montana Public Radio

Montana Care Issue Reporting

Montana Public Radio will collaborated with Yellowstone Public Radio to research, produce, and broadcast statewide 16 in-depth stories on current health and healthcare issues in Montana. Funding allowed reporters to travel to remote parts of the state to research and cover issues relevant to rural Montanans and Tribes.

Grant Amount

$20,000

Term

12 month

2015

Montana Rescue Mission

Capacity Building Assessment to Address the Mental Health Needs of the Homeless in Billings

Through this project, MRM hopes to provide on-site behavioral health services to the population they serve in order to address the root health issues associated with homelessness and a primary barrier to achieving stable housing and employment. Grant funds will be used to support staff time and contract for technical assistance with Aune Associates. With technical assistance, MRM plans to work with RiverStone Health and other health providers in Billings to provide behavioral health services and explore opportunities to enter into shared revenue agreements. The goal of this project is to provide needed behavioral health services to a vulnerable population and explore ways to create stable revenue to decrease dependence on grants and donations.

Grant Amount

$15,000

Term

12 month

2019

Montana State University

Dissemination of Rural Perioperative Surgical Home Model and Local Community Capacity Building

Montanans lack access to evidence-based perioperative surgical services, which include patient/family education, preoperative testing and assessment, care coordination across referral and specialty providers, provider co-management, and recovery coordination. A fully functional Perioperative Surgical Home (PSH) currently operates at Bozeman Health. This project will extend PSH functions to nine additional Montana counties. The project addresses critical gaps in Montana’s perioperative care through engagement and collaboration with health partners; extension of PSH services; longitudinal tracking and evaluation of health outcomes for rural, remote and isolated patients; and, dissemination of an evidence-based rural model of PSH and a patient flow algorithm to aid other health entities to prepare patients and families for major surgery fully. Funding will be used for four engagement events located strategically among the nine target counties; longitudinal tracking and assessment of health outcomes by county; dissemination of patient outcome assessments back to the county health officials and practitioners. The health advisory council, lead extension specialist, and local extension agents will facilitate new and strengthen partnerships with community hospitals, critical access hospitals, rural health clinics, federally qualified health centers, independent practices, and health workers.

Grant Amount

$54,261

Term

24 month

2019

Montana State University - Center for American Indian and Rural Health Equity

Responding to Secondary Trauma Among Blackfeet Victim Service Providers

This project’s goal was to serve American Indian social service employees who support victims of domestic violence, elder abuse, child abuse and neglect, sexual assault, and other forms of trauma. As part of this project, a toolkit was successfully created to mitigate the effects of secondary trauma among social service providers. Secondary trauma is recognized as an occupational hazard that contributes to health problems and burnout among victim service providers. The community advisory board met two-dozen times over the course of the grant to evaluate project and ensure the toolkit’s cultural relevance. A training on how to use the toolkit, using a train-the-trainer model, was held with over 50 people in attendance. Following the initial training, the project team received six requests for additional trainings and those trainings are currently being planned. Quantitative data analysis showed that the training resulted in statistically significant increases in awareness, knowledge, and normalization of secondary trauma and a statistically significant increases in awareness of coping strategies to reduce the impacts of secondary trauma among American Indian service providers who were trained to use the toolkit. Organizations engaged in this project have expressed their desire to make organizational changes to reduce the impacts of secondary trauma.

Grant Amount

$25,000

Term

24 month

2016

Montana State University - College of Nursing

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 - Department of Health and Human Development

Increasing Mental Health Access in Gallatin County

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

Grant Amount

$72,270

Term

24 month

2018

Montana State University - Office of Rural Health

Montana RIDE – Regional Initiatives in Dental Education

The Office of Rural Health and Dental Health Sciences department at Montana State University will implement clinical rotations in rural, underserved, and tribal locations for dental students. The Office of Rural Health will establish a public health-oriented dental education program, create a formal network of training locations, and implement a coordinated plan for training, recruiting, and supporting oral health workers. Grant funds will be used for project staff salaries, travel expenses, and contracting with the Rocky Mountain Tribal Leadership Council’s Epidemiology Center (RMTEC) to serve as a tribal liaison. Partnerships include RMTEC, the University of Washington School of Dentistry, and clinical rotation sites.

Grant Amount

$100,000

Term

24 month

2020

Montana State University - Office of Rural Health

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

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

Grant Amount

$25,000

Term

12 month

2015

Montana State University - Office of Rural Health

Montana Community Health Worker Stakeholder Project

This project created a plan to support the broader use of community health workers (CHWs) in Montana. CHWs are frontline public health workers who are trusted members of the communities they serve. They are intended to serve as a liaison between community members and health and social service providers in order to facilitate access to care, transportation, appropriate follow-up, and continuity of services. Over the course of the grant, the project achieved several major accomplishments. 1) It created a Montana CHW curriculum which includes nationally recognized core competencies as well as a focus on issues of importance to Montana. 2) It developed a training program for CHWs. The curriculum is currently offered online through the AHEC system partners and will also be piloted as a classroom training program. 3) As a result of this project, the MT AHEC Program was able to apply for and receive funding for a Behavioral Health Workforce Education and Training Grant from HRSA which pays the cost of training CHWs in Montana.

Grant Amount

$140,772

Term

24 month

2016

Montana State University - Office of Rural Health

Montana – Regional Initiatives in Dental Education

The MSU Office of Rural Health increased the capacity of current Montana-Regional Initiatives in Dental Education (RIDE) Program sites and added additional sites. The RIDE Program creates systems to educate and train dental students from the University of Washington in rural and underserved communities in Montana. This project analyzed the capacity of current RIDE sites, developed new sites in Crow Agency, Hardin, Lame Deer, and Browning, helped create created quality clinical experiences for dental students, offered faculty and preceptor development training, and developed a collaborative model of education. In 2019, the eight RIDE students provided more than 6,300 dental procedures in regional clinics (regional clinics serve children and patients below 200% federal poverty level). To date, 79% of RIDE-trained dentists currently practice in rural and underserved areas. The partnership that the Office of Rural Health developed with the Rocky Mountain Tribal Epidemiology Center as part of this project was vital to developing new sites and systems to place students. The Montana Area Health Education Center will continue to integrate this pilot dental program with other nurse and resident training and residency programs.

Grant Amount

$46,660

Term

12 month

2018

Montana State University - Office of Sponsored Programs

Partnerships to Support Palliative Care in Montana Critical Access Hospitals

This project will develop partnerships which enable Montana critical access hospitals to provide primary palliative care services. Many Montanans are living with serious and life-limiting illnesses in rural settings with limited access to palliative care services. Most critical access hospitals in Montana do not offer palliative care services and challenges associated with providing palliative care in rural areas are well documented. The goal of this project is to provide palliative care education to rural health care providers and improve access to palliative care for rural dwellers who are living with serious and life-limiting illnesses. Partners include the Family Medicine Residency program of Western Montana and four critical access hospitals in western Montana.

Grant Amount

$79,785

Term

24 month

2018

Montana State University Billings

Planning Healthcare Expansion to Address Healthcare Needs in Eastern Montana

This planning grant was awarded to Montana State University Billings and City College to fund the development of a report that will serve as a roadmap for addressing the health care and nursing shortages in Eastern Montana. The report was developed by a consultant and many regional stakeholders, including Billings Clinic, SCL Health St. Vincent, and Eastern Montana Area Health Education Center (AHEC). It identified the issues that must be addressed, such as expanding and restructuring educational programs, providing internship opportunities, hiring more faculty, and gaining accreditation approval. The report will be utilized to prioritize budgeting, build partnerships, and fundraise to meet the evolving needs of the industry. Plans are currently underway to develop AAS degrees in sonography and medical coding. The partnership model implemented for respiratory therapy with Great Falls College will serve as guidance for future program development. City College's new chancellor will work with stakeholders to review recommendations from the report and incorporate them into the college's course planning.

Grant Amount

$25,000

Term

12 month

2019

Montana State University Billings

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

Montana State University Foundation

Climate Change and Human Health in Montana – The Film

In January 2021, a team of medical providers and climate scientists (along with 20 more contributors from the state, Tribal, academic, and rural community sources) published "Climate Change and Human Health in Montana: A special report of the Montana Climate Assessment" (C2H2). This project will aid the dissemination of C2H2 by creating a short documentary film. This film will help make the report's critical findings broadly available to communities around the state. The content of the film is intended to help with community discussions and adaptation decisions. It will be distributed through local commercial and public television stations, and it will be available for public forms such as county and Tribal meetings, community gatherings, and medical and public health conferences. The film will highlight the report's critical findings through interviews with physicians, climate scientists, and people living on the landscape (e.g., farmers and ranchers, Native Americans, public health officers, town mayors, and others). It will also provide practical recommendations to help communities plan and adapt. Partners in the project include Montana State University, the University of Montana, and all other partners on the C2H2 author team.

Grant Amount

$10,000

Term

12 month

2021

Montana State University Foundation

Working Together to Respond to Farmers & Ranchers Under Stress in Rural Montana

This project will create the first statewide network focused on stresses that affect farmers and ranchers in Montana. The project will form a Montana Farm/Ranch Stress Prevention Advisory Council comprising of members from the agricultural, health, tribal, veteran, local government, and Montana State University communities. This council will oversee the creation of an online clearinghouse of stress prevention and mitigation resources as well as a variety of radio/television/podcast/webinar educational resources. Funding will be used to convene the Advisory Council as well as to develop and market the online clearinghouse and educational resources throughout Montana. The project’s goals are to open the conversation about the causes and effects of stress, thereby destigmatizing conversation surrounding this topic, and to equip community members with evidence-based resources to assist them in managing their stress. These goals will ultimately lessen the risk of mental illness and suicide among Montana’s farming and ranching communities.

Grant Amount

$32,737

Term

12 month

2019

Montana State University Foundation

Promotion and delivery of Thrive-Montana

The goal of this project was to establish and strengthen state partnerships for the effective promotion and delivery of Thrive for Montana, an evidence-based, internet-delivered cognitive behavior therapy program designed to assist adult Montanans who are experiencing anxiety, depression, and/or suicidal thinking. With the help of partners such as Montana National Alliance for Mental Illness, Montana’s Department of Public Health and Human Services, and One Montana, Montana State University developed marketing messages to reach vulnerable populations throughout the state. The project distributed more than 10,000 promotional materials, facilitated 12 community meetings and six health care organization presentations, engaged 165 health care providers and community organizations in promotional efforts, and enrolled 790 project participants. Of these 790 enrollees, 99 (12.5%) were referred by a health care provider, an increase from 0 at the beginning of the project. Thrive for Montana has secured funding for the development of a youth version of the program.

Grant Amount

$26,904

Term

12 month

2018

Montana State University Foundation

Developing an Assessment of Climate Change and Human Health for Montana

This project will establish a collaboration of health and climate science experts to produce Montana’s first assessment of the impacts of climate change on human health. “Assessing Climate Change and Human Health in Montana” (C2H2 for short) will be released in 2020 as an online web resource and a printed document with associated outreach and educational materials and activities. C2H2 will present health-relevant climate information describing recent trends and future projections; explain how climate change affects aspects of human health; and offer practical recommendations to guide local, state, and tribal efforts to anticipate and adapt to climate-related health threats in Montana. The report will receive both public comment and scientific peer review before its release, and professional evaluation after release. The goal is to provide the best-available science and health-related data at a level that is easy to access and understand by communities, medical professionals, and policy makers in Montana. C2H2 will serve as a Special Report to the 2017 Montana Climate Assessment.

Grant Amount

$94,500

Term

24 month

2019

Montana Supreme Court

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 Women Vote

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

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

Grant Amount

$25,000

Term

12 month

2015

Montana's Peer Network

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

Mountain Home Montana

Substance Use Disorder Treatment for Pregnant and Parenting Teens

This planning project worked to develop a strategy for integrating substance use disorder treatment into Mountain Home Montana’s wrap-around care for pregnant and parenting mothers. Over the course of the project, Mountain Home Montana expanded and deepened partnerships with providers and strengthened their referral network and processes to better serve young families struggling with substance abuse. They successfully provided robust staff training around substance use disorder issues and levels of treatment, clarified referral processes, and hired an in-house therapist who is also a licensed addictions counselor. Mountain Home also obtained a Medicaid youth endorsement, which allows billing for case management and therapeutic services for clients under age 18 and they adopted an evidence-based evaluation tool to measure their program’s successes and challenges. As a direct result of policy shifts for substance use disorder treatment, staff training, and capacity, Mountain Home was able to reduce evictions from their residential program due to substance abuse from 20% to 6%. Beyond these direct results, Mountain Home also leveraged this planning grant into a five-year award from the federal Family and Youth Services Bureau to support residential programs.

Grant Amount

$73,754

2017

Mountain Shadow Association

Kaala’s Village Development Project

Mountain Shadow Association (MSA) will move a planned family healing center on the Crow reservation (Kaala’s Village) from the feasibility study phase into the development phase. MSA will hire a supportive housing consultant to help them with the development. The project will be informed and guided by a community-based advisory board that will meet monthly to receive updates on the developer’s work plan progress and ensure that the project remains grounded in the values, needs, and vision of the community and remains focused on meeting the immediate integrated health care needs of local families. Grant funds will be used to convene the advisory board and contract with BeauxSimone Consulting to assist MSA and the advisory board in solidifying a development team, finalizing the concept plan, identifying a property management company, and securing additional funding for Kaala’s Village (‘Kaala’ is the Crow word for ‘grandmother’). Partners that are committed to participating in the advisory board include the Apsaalooke Nation Housing Authority, the City of Lodge Grass, Plenty Doors Community Develop Corps, the Casey Family Foundation, Big Horn Valley Health Center, Tribal Legislative Health and Human Services Committee, Tribal IQWA Coordinator, Indian Health Services, Lodge Grass Schools PTO, peer support specialists, USDA Rural Development, and Meadowlark Counseling. The grantee hopes to create a final conceptual model that can support a successful capital campaign and integrate appropriate partners, resulting in the full implementation of Kaala’s Village.

Grant Amount

$50,000

Term

12 month

2019

Mountain-Pacific Quality Health Foundation

Comprehensive Medication Management Pharmacist Training and Pilot Program for Primary Care

Mountain-Pacific Quality Health Foundation partnered with Capita Consulting to train five care management pharmacists on comprehensive medication management (CMM), an evidence-based approach to improve patient outcomes. The trained pharmacists then worked with a panel of complex patients to establish a CMM model of care. The project achieved positive results, but the pharmacists discovered that the amount of time it takes to manage the needs of complex patients was higher than they anticipated, making sustainability a challenge. The project identified promising options for ongoing sustainability, but they were not able to explore billing and practice implementation procedures to support the program during the grant term.

Grant Amount

$21,912

Term

12 month

2018

Mountain-Pacific Quality Health Foundation

Implementing Trauma-Informed Care and Approaches with Montana Indian Health Care Organizations

Mountain-Pacific Quality Health collaborated with Indian Health Service facilities, Tribal health departments, and urban Indian centers to support implementation of comprehensive approaches to trauma-informed care that effectively address trauma and its impact on American Indian and Alaska Native (AIAN) populations in Montana. Mountain-Pacific helped put trauma-informed policies and procedures in place through staff trainings—held in person for the first year and virtually during the COVID pandemic—as well as guides for trauma screening, treatment, and referral. In order to help Indian health organizations' clinical and nonclinical staff understand the impact of trauma, recognize the symptoms, and know how to respond appropriately, Mountain-Pacific held webinars and open office hours to promote awareness and provide instructional education. It also offered quality improvement tools and resources to help organizations assess, implement, and evaluate their strategies and worked with non-AIAN communities to help them understand and implement trauma-informed care. Mountain-Pacific emphasized the importance of using culturally appropriate Indian healing methods as tools to build resiliency and recovery from trauma. The project developed strong collaborations with stakeholder organizations and local and state health departments to ensure that community members' needs continue to be met.

Grant Amount

$98,284

Term

24 month

2018

Native American Development Corporation

Medication Assisted Treatment Clinic Feasibility Planning

The Billings Urban Indian Health and Wellness Center (BUIHWC), operated by the Native American Development Corporation (NADC), will undertake a planning process to expand its substance use disorder treatment services to include medication-assisted treatment (MAT). BUIHWC currently offers outpatient mental health therapy and substance use disorder outpatient counseling. This planning project will help BUIHWC establish policies and procedures for adding MAT to their service line. Partners include Rimrock Foundation, Riverstone Health, St. Vincent, Billings Clinic, Indian Health Services Area Office, and the surrounding reservation communities. Grant funding will serve as a catalyst revenue source to initiate the project while NADC continues to leverage third-party pay sources and other sustainable funding opportunities. Ultimately, BUIHWC aims to provide American Indian people with comprehensive, collaborative, and coordinated care to address the opioid use crisis in the Billings community.

Grant Amount

$20,000

Term

12 month

2020

Native American Development Corporation

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

Native American Development Corporation

Billings Urban Indian Health and Wellness Center

This grant supported planning for and opening the Billings Urban Indian Health and Wellness Center. In December 2018, the new center began providing comprehensive primary care and behavioral health services to the American Indian community in Yellowstone County. They are continuing to expand the services they provide. They are now an approved provider for Medicaid, Medicare, and private insurers and have hired a state approved substance use provider. This structure will enable them to collect reimbursement for the services they provide and will ensure long term sustainability. As part of this project, they also successfully established meaningful partnerships with other health organizations in the community and will begin to implement an integrated behavioral health model of care within their primary care clinic.

Grant Amount

$75,000

Term

12 month

2018

NeighborWorks Great Falls

Baatz Block Apartments Technical Assistance

In partnership with Homeward Development, NeighborWorks Great Falls is redeveloping the Baatz building in Great Falls to create 24 permanent supportive housing units. Permanent supportive housing combines affordable housing with support services (like health care, case management, employment health, and other social services) to address the needs of people who have experienced chronic homelessness. This will be the first permanent supportive housing site in Great Falls. NeighborWorks Great Falls and Homeward Development have secured $10 million in tax credits and other funding to cover construction costs. This grant will cover technical assistance for support services from BeauxSimone Consulting to establish best practices and procedures for property management and service alignment among partners (including YWCA, Alluvion Health, Opportunity Inc., and the Center for Mental Health).

Grant Amount

$20,000

Term

12 month

2022

NeighborWorks Great Falls

Home Matters – Linking Homes and Health Outcomes

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

Grant Amount

$10,000

Term

12 month

2016

NeighborWorks Great Falls

Housing is Healthcare: A Plan for Cascade County

Neighborworks Great Falls, in partnership with Benefits Health Systems and with the guidance of the Corporation for Supportive Housing, developed a supportive housing plan for their community. Supportive housing will be designed to serve a population that is homeless and using high-cost emergency and hospital services frequently, often complicated by untreated mental illness and substance use disorders. The project helped the partners gather and analyze data on the overlap of the frequent users of the criminal justice and health care systems. The data clearly showed the cost of regular users to both the health care and criminal justice system, which in turn, drew in buy-in from additional law enforcement and health care partners. The project also created an inventory of housing in Great Falls and mapped the health care resources available to each population in the county. Finally, the data analysis and inventory mapping allowed the project partners to reach out to other housing partners and begin to collaborate on a plan to establish permanent supportive housing in Great Falls.

Grant Amount

$60,000

Term

12 month

2017

NeighborWorks Montana

Manufactured Housing Rehab and Replacement Collaboration

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

Grant Amount

$20,000

Term

18 months

2015

North American Indian Alliance

Electronic Health Record and Revenue Cycle Optimization Project

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

Grant Amount

$15,000

Term

12 month

2016

North American Indian Alliance

Butte Urban Indian Health Alliance Strategic Planning Initiative

The goal of this project was to create a strategic plan to help the North American Indian Alliance Butte (NAIA) move into its next decade of service. A consultant worked with the NAIA’s board of directors and executive director to complete a community needs assessment. After surveying the community and collecting feedback, the consultant developed recommendations for how to adjust the organization’s programming and services to better serve the community. However, due to leadership turnover, the report was not finalized or implemented.

Grant Amount

$50,000

Term

12 month

2017

North Valley Hospital Foundation

Virtual Access for Behavioral Healthcare Services

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

Grant Amount

$50,000

Term

24 month

2015

North Valley Hospital Foundation

School Based Integrated Behavioral Healthcare for Students

This project helped North Valley work towards integrating behavioral health services into a school-based health center serving at-risk students in Columbia Falls and Whitefish. A previous grant from MHCF, helped North Valley establish telepsychiatry services at the school. This new grant was intended to help the hospital hire an on-site behavioral health provider who would offer mental health and substance use disorder screening and treatment to the high-risk student population and develop and implement a fully-integrated system of care in the hospital’s outpatient clinics. The project experienced some staff turnover, and they are currently recruiting for this position. Even so, during the grant North Valley realized a 23% improvement in depression screening rates for their primary care clinic and a 71% improvement in depression scores for the integrated behavioral health population during the time when the behavioral health position was filled.

Grant Amount

$150,000

Term

24 month

2016

Northern Cheyenne Tribal Board of Health

T-HIP Planning and Implementation

This project helped the Northern Cheyenne Tribal Board of Health (NCTBH) plan for and implement Tier 1 of the Medicaid Tribal Health Improvement Program (T-HIP). T-HIP implementation coincided with the COVID-19 pandemic, which substantially impacted the project. The life expectancy for the people of the Northern Cheyenne Reservation is approximately 57 years for men and 61 years for women, nearly 20 years shorter than that of Caucasian Montanans. The overall goal of this project was to reduce the risk of developing chronic diseases among this population and strengthen community action for improving the reservation’s overall health. Funds were used to hire a T-HIP director to oversee and implement Tier 1 over six months, as well as a medical director, but the medical director was not able to attend on site due to the pandemic. Funding also went towards the purchase of Daphne software, which is used to manage clients, document encounters, create care/action plans, schedule appointments, conduct assessments and surveys, and generate required T-HIP reports. One significant accomplishment was the hiring of four drivers to provide crucial transportation services for patients needing to get to the hospital in Billings. The project helped the Tribe conduct COVID-19 community surveillance testing that included 500 T-HIP clients. The T-HIP program is self-sustaining from Medicaid reimbursements, which will allow the program to continue building out Tier 1 implementation and to expand to Tier 2 and Tier 3 over the next couple of years.

Grant Amount

$50,000

Term

12 month

2019

Northern Cheyenne Tribal Board of Health

Northern Cheyenne Tribal Healing to Wellness Court Development

The Northern Cheyenne Tribal Board of Health will develop a strategic plan to create a drug court component to the Northern Cheyenne Recovery Center. Many tribal communities have used the Tribal Healing to Wellness Court successfully. Developing this model will help solidify partnerships with the between the tribal health and judicial systems and enable the Tribe to develop an intensive case management approach for clients, implement team “wrap around” meetings, and provide family therapy and peer support. Funding will be used for staff training, and development of a strategic and state compliance plan.

Grant Amount

$50,000

Term

12 month

2019

Northern Cheyenne Tribal Board of Health

Northern Cheyenne School Wellness Project

Through this project, the Northern Cheyenne Tribal Board of Health will provide essential mental health and primary care services through a mobile unit and three school-based settings on the Northern Cheyenne Nation. The schools include Northern Cheyenne Head Start, Lame Deer Public Schools, and the Northern Cheyenne Tribal School. The first year of the grant will focus on planning: creating policies and procedures, preparation for on-site care, increasing trauma-informed engagement, measuring school climate, and implementing alternatives to out-of-school discipline policies. The remaining years of the grant will allow for piloting and implementing new health services. Funding will support a project coordinator, community liaison, a mobile clinic, and medical supplies at all three on-site clinic locations. Partners include the three school sites, the Montana State University College of Nursing, and the Montana Office of Public Instruction.

Grant Amount

$274,998

Term

36 months

2021