Montana Medical Association Foundation 2016

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 State University - Center for American Indian and Rural Health Equity 2016

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 - Office of Rural Health 2016

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

NeighborWorks Great Falls 2016

Home Matters – Linking Homes and Health Outcomes

 @Melinda Buchheit @Marias Quammen @Anna Lange Melinda, can you tell whether they are actually PROVIDING the MOUD services yet? This is all about planning and securing funding. Fine as-is if you can't tell...

Grant Amount

$10,000

Term

12 month

2016

North American Indian Alliance 2016

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 Valley Hospital Foundation 2016

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

Open Aid Alliance 2016

Licensed Chemical Dependency Treatment Center

This project helped Open Aid Alliance apply for and receive licensure to become a state-approved substance use disorder treatment center. This new licensure will allow the organization to expand their services and create a harm reduction treatment center for individuals who experience stigma as they seek to improve their health; including people living with HIV, people using injection drugs, and people who have been homeless and/or incarcerated. The grantee successfully completed a consulting process, developed feasibility and business plans, and created policies and procedures needed to implement sustainable substance use disorder services. This expansion not only successfully strengthened partnerships in the community but also provided immediate access to treatment for clients and created a new diverse revenue stream for the organization.

Grant Amount

$8,780

Term

12 month

2016

Partnership Health Center 2016

Care Management for Super-Utilizers Program

This project established an innovative pilot to serve “super-utilizers” – frequent utilizers of Partnership Health Center’s services and local emergency rooms. Super-utilizers are the approximately one percent of patients accounting for twenty-two percent of total health care expenditures, and they often suffer from multiple health conditions and socioeconomic barriers to care which contribute to multiple emergency room visits and hospital admissions. The project created a team consisting of a licensed clinical social worker, registered nurse, and primary care provider to coordinate care and conduct home visits and follow-up calls with select patients to address their medical, behavioral and social needs. The health center also successfully redesigned their care approach to prioritize patient needs and focus on interventions that lessened the cycle of hasty emergency department use and inpatient stay. Outcomes included reductions in the number of emergency department visits and inpatient stays and increased self-efficacy among patients. Recognizing the success of the program, Medicaid changed its reimbursement models for this super-utilizer approach to care.

Grant Amount

$148,183

Term

24 month

2016

Poverello Center 2016

Medical Respite Shelter for Homeless Patients

For this project, the Poverello Center partnered with St. Patrick’s Hospital to establish care coordination for homeless individuals recovering from a hospital stay to help them transition from the homeless shelter to transitional housing. The project expanded on Poverello’s existing medical respite program by supporting more robust care coordination, evaluating health outcomes, and strengthening and formalizing partnerships and funding agreements. In partnership with the VA, the Poverello Center successfully converted five of their beds to house veterans. In addition, the project was successful in reducing emergency department readmissions and inpatient stays among the homeless population participated in the program. Care coordination and transitional shelter services will be sustained moving forward through ongoing support from the VA and St. Patrick’s Hospital.

Grant Amount

$50,000

Term

24 month

2016

Providence Montana Health Foundation 2016

Providence Medical Group Integrated Behavioral Health Initiative

With this grant, Providence Medical Group integrated behavioral health into their Grant Creek Family Practice (a patient-centered medical home). Over the course of the project, Grant Creek established universal processes for depression and increased screening rates from 63% to 71%. They also established protocols and started universally screening for substance use disorders, anxiety, and suicide. By developing clinical workflows and applicable billing and coding procedures, Grant Creek was able to create a financially sustainable model for the future. Providence Medical Group leadership is committed to implementing the integrated behavioral health model throughout its remaining eight primary care clinics and will do so starting in 2019.

Grant Amount

$150,000

Term

24 month

2016

RiverStone Health 2016

Expanding Integrated Behavioral Health Care and Training in Primary Care

For this project, RiverStone Health successfully completed a business feasibility plan for expanding its scope of service to provide integrated psychiatric services. The feasibility plan also examined opportunities for RiverStone to serve as an integrated behavioral health rotation site for students in psychiatric nurse practitioner training programs, psychiatry residency programs, and Master of Social Worker students. As a result of the planning, the project was able to successfully formalize an integrated behavioral health training program. Additionally, a community coalition of behavioral health providers was established in Billings and continues to meet to network and share critical information among programs.

Grant Amount

$50,000

Term

12 month

2016

RiverStone Health 2016

Integrated Clinical Pharmacy Services Best Practices

This project focused on supporting clinical pharmacist and primary care integration to improve health outcomes. Important achievements included working with DPHHS to develop administrative rules for Medicaid reimbursement for clinical pharmacist practitioners. The grantee will continue to work on establishing standard outcomes measures across the state that will be used to demonstrate the value of clinical pharmacy services. Ongoing planning and educational sessions will also occur to assist pharmacists who are interested in establishing clinical pharmacy services in a physician practice.

Grant Amount

$25,000

Term

12 month

2016

Rocky Mountain Tribal Epidemiology Center 2016

Feasibility of Maintenance Therapy in Pregnancy Among Opioid Users in Trubal Communities

This planning grant investigated the feasibility of providing medication-assisted treatment for women on the Blackfeet Reservation who are using opioids during pregnancy. This treatment is recommended by the American College of Obstetricians and Gynecologists as an evidence-based standard of care because it can prevent maternal and fetal complications of opioid use and withdrawal, encourage prenatal care and drug treatment, and reduce social complications and criminal activity associated with addiction. The grantee organized a conference on Blackfeet that was attended by more than 90 people. Speakers included clinicians from the Blackfeet Community Hospital, members of the Lummi Tribe, and a neonatologist from Kalispell Regional Medical Center. The conference and feedback from participants were used to generate a final report: Addressing Opioid Use in Pregnancy: Conversations and Next Steps in Blackfeet. Following the conference, members of the Blackfeet Tribe visited the Lummi Opioid Prevention and Treatment Center in WA and were inspired to consider creating a similar program on Blackfeet. They formed an opioid prevention task force which includes employees of the Blackfeet Community Hospital, Silent Warriors, Blackfeet Tribal Health, Blackfeet Community College, and other stakeholders. This task force and their opioid prevention work will continue in 2017 with new foundation funding.

Grant Amount

$25,000

Term

12 month

2016

Special Olympics Montana 2016

Insurance Enrollment, Health Screenings, Follow-Up Care for Special Olympics Athletes

For this project, Special Olympics Montana (SOMT) partnered with the Confederated Salish and Kootenai Tribal (CSKT) Health Department, and the Montana Department of Public Health and Human Services to work towards improving health for those with intellectual disability on the Flathead Reservation. Grant funds allowed for outreach, enrollment, and engagement by SOMT with the CSKT Health Department and other tribal communities. A SOMT tribal outreach director worked in the CSKT Health Department to identify potential CSKT Special Olympics athletes, involve them in SOMT, and facilitate participation in SOMT-required health screenings. CSKT Health Department staff will assisted with insurance enrollment, billed insurance for care received, and ensured robust coordination of care among all each individual’s health providers. The project successfully established relationships among the partners, and outreach and events to identify and engage potential Special Olympic athletes will continue as a result of this project.

Grant Amount

$20,000

Term

24 month

2016

Sprout Oral Health 2016

School Nurse Fluoride Varnish Programs in Montana Elementary Schools

Sprout Oral Health developed and implemented a sustainable School Nurse Fluoride Varnish Program (SNFVP) that can be replicated in schools and Head Start programs throughout the state. When implementing this program, Sprout Oral Health targeted low-income Head Start and elementary aged students as fluoride varnish can significantly reduce tooth decay, a chronic disease which disproportionally impacts children of low socio-economic status. Eighteen schools participated in the program with an average federal Free and Reduced Lunch rate of 70%. From these schools, 121 children received no-cost fluoride varnish. The School Nurse Fluoride Varnish Program Manual and Reimbursement Toolkit has been disseminated through existing and new partnerships, such as Montana Association of School Nurses. The School Nurse Fluoride Varnish Program has now been integrated into the package of community-based dental programs Sprout Oral Health maintains and implements across rural and frontier Montana.

Grant Amount

$50,000

Term

24 month

2016

St. Vincent Healthcare Foundation 2016

Integrated Prenatal Care Model for Native American Women: Reducing Substance Abuse during Pregnancy

This grant will provide case management and program coordination for pregnant Native American women struggling with addiction by developing a program that creates supportive, integrated access to perinatal care and addiction treatment. The program will support sobriety and provide evidence-based treatment during pregnancy to decrease the occurrence of neonatal abstinence syndrome and fetal alcohol syndrome, as well as to support a path to long-term recovery. The care coordinator position will be a part of the Northern Cheyenne Tribal Health Department. Key partners include the Northern Cheyenne Tribal Board of Health, Indian Health Service, and Rimrock Foundation. Expected outcomes include improved access to prenatal care and substance abuse services for pregnant Native women on and off the Northern Cheyenne Reservation, decreased substance abuse in pregnant women, and a reduction in negative birth outcomes and medical costs associated with drug use during pregnancy.

Grant Amount

$150,000

Term

24 month

2016

University of Montana - Department of Psychology 2016

Integrated Behavioral Healthcare Workforce Development

Through this grant, the University of Montana Department of Psychology, with Partnership Health Center (PHC) of Missoula and the Family Medicine Residency of Western Montana, developed a field placement experience for behavioral health graduate students to address critical workforce development needs in Montana. The project provides a structured, “hands-on” training experience for students interested in learning how to provide integrated behavioral health services, while simultaneously addressing key health needs (including managing chronic pain and promoting health behavior change) in PHC’s underserved and “at risk” patient population. The project built on a prior MHCF grant to the University to develop an integrated behavioral health curriculum.

Grant Amount

$44,821

Term

24 month

2016

University of Montana - ORSP 2016

Assessing Access to Asthma Education Services

For this project, the Pharmacist Managed Asthma Clinics Program at the University of Montana-Skaggs School of Pharmacy assessed current access to asthma self-management education and determined the feasibility of multi-disciplinary, pharmacist-led managed asthma care in Montana’s American Indian communities. Survey and focus group results found that there is indeed a need for asthma self-management education in American Indian communities and health care professionals in Rocky Boy and Missoula Urban Indian Health Center expressed interest in becoming certified asthma educators. A toolkit for health care professionals was successfully developed providing statistics, educator benefits, patient and practitioner resources, and guidance for billing insurance.

Grant Amount

$25,000

Term

12 month

2016

Western Native Voice 2016

HELP Act Outreach and Assistance in Native American Communities

Western Native Voice will engage in outreach and coordination activities to support enrollment of Native American people across Montana in Medicaid or other insurance. The project seeks to identify people (primarily Native Americans living on remote reservations or in urban areas) who may be eligible for coverage, and regional resources available to assist with enrollment, and connect them.

Grant Amount

$25,000

Term

12 month

2016

Youth Dynamics 2016

Substance Abuse Treatment Program Expansion Pilot Program

Youth Dynamics worked to expand its Billings-based program for treating co-occurring mental illness and substance use disorders to Cascade and Missoula counties. Ultimately, it was not able to expand its services to these communities because of leadership and staff turnover. However, through the process, Youth Dynamics reassessed its continuum of care, the communities it currently serves, and its partners. They also successfully advanced a telehealth platform to connect addiction counselors to communities in need of services and implemented an in-house curriculum and pathway to get their license for addiction counseling.

Grant Amount

$136,146

Term

24 month

2016

Barrett Hospital Foundation 2015

Southwestern Montana Rural Accountable Care

This goal of this project was to support Barrett Hospital’s participation in Montana’s first Rural Accountable Care Organization (RACO). The RACO consists of 12 critical access hospitals in Montana, Idaho, and Wyoming that collectively serve more than 9,000 Medicare patients. Barret Hospital’s project developed an evaluation and measurement process for key health outcomes and implemented case management and patient discharge care plans. Highlights include: more than 63 percent of Medicare patients received annual wellness visits (the Centers for Medicare and Medicaid’s goal is 50 percent); a multidisciplinary team was developed to do a monthly review of all patients (reducing the cost of sub-acute care by 15 percent over 6 months); several reports were designed and implemented, giving providers the ability to focus on and follow up with chronic disease patients. The hospital plans to continue working with the RACO workgroup and a consultant and will sustain this project through internal funds. 

Grant Amount

$50,000

Term

24 month

2015

Beaverhead County Public Health 2015

Integrating Behavioral and Physical Health in Rural Southwest Montana

For this project, Beaverhead County’s local advisory council on mental health oversaw a community-wide coalition which leads work plan development and implementation of integrated behavioral health in their county. Other coalition accomplishments include: establishing criminal justice, crisis response, ACE (project materials: ACE Task Force Mission and Goals, ACE Task Force Pamphlet), universal screening, and mental health task forces; implementing universal screenings for depression at the University of Montana-Western Student Health Center; and successfully hosting a two-day behavioral health summit which was facilitated by the National Council for Behavioral Health and will continue as an annual event. 

Grant Amount

$22,100

Term

18 months

2015

Billings Clinic 2015

Establishing a Montana Psychiatric Residency Training Track

The goal of this planning grant was to create a blueprint for the establishment of a psychiatric residency training track at Billings Clinic. The University of Washington agreed to be the academic partner in the residency program’s design and launch. As part of the planning process, the project disseminated a survey that estimated costs of Montana’s psychiatry shortage at $3 million annually, which helped reinforce the need for psychiatric residency in the state. The project resulted in the Montana State Legislature allocating an increase of $400,000 annually to graduate medical education funding in the Office of the Commission of Higher Education’s budget. These funds will be crucial for the implementation of the psychiatric residency training track, will ensure the stability of Montana’s primary care and psychiatric physician workforce, and will enhance residency training overall in the state. With the inclusion of federal match dollars, this MHCF investment resulted in an increase of approximately $4.3 million annually for Montana’s residencies.

Grant Amount

$50,000

Term

24 month

2015

Blackfeet Tribal Health 2015

School and Community Based Health Services for Blackfeet Youth

This grant allowed Blackfeet Tribal Health to plan for and establish a school-based clinic to serve students in Browning. During the grant, the tribe formed a successful collaboration with the school district, secured and renovated a building to house the clinic, and hired staff. In the fall of 2016, the new clinic (named the Southern Piegan School Health and Wellness Program) began seeing students. As of late 2017, the clinic had provided care to more than 1,500 students and was preparing to implement a new integrated behavioral health program. The clinic is fully self-sustaining through revenue from insurance billing and will not require grant support to maintain operations.

Grant Amount

$20,000

Term

24 month

2015

Browning Alternative School 2015

Using Blackfeet Cultural Values to create a trauma informed school setting.

The goal of this project was to create a trauma-informed school program by training staff in trauma-informed approaches to school discipline using Blackfeet cultural values. The Browning Alternative School developed trauma-informed teams and implemented culturally-adapted critical incident stress management training so that the community could respond sustainably to crisis situations. Teams were equipped to quickly respond to crises and provide support for trauma and grief. The project also implemented restorative justice practices into the school system to elevate student voices and developed training units for cultural and historical trauma with accompanying resiliency strategies and resources. The trauma-informed program began in the Browning Alternative School and then extended to the entire school district.

Grant Amount

$15,000

Term

18 months

2015

Center for Mental Health 2015

Integrating Medical Care Into A Mental Health Facility

This planning grant supported early work to integrate physical and behavioral health services in Lewis and Clark County’s mental health center, crisis center, and community health center. The applicant and partners participated in technical assistance, webinars, and learning communities led by the National Council for Behavioral Health. The project strengthened partnerships and provided clarity and direction for how each partner could work toward more effectively integrated services in the future. The project did not fully realize its aim of integrating services, however, program partners were successful in utilizing a shared referral software system.

Grant Amount

$10,150

Term

24 month

2015

Community Health Partners 2015

Park County Connect Program: A Community-Based Model to Reduce ER High-Utilization.

High utilizers of the emergency department drive up costs unnecessarily and are not entering the healthcare system at an access point that is prepared to address their underlying needs. To improve care and health outcomes while lowering unnecessary costs to the health care system, Community Health Partners, the Park County Health Department, Livingston Mental Health Center, and Livingston HealthCare partnered to create the Park County Connect Program. Grant funding supported a social worker, housed in the health department, who designed and implemented a community-based outreach program for people while frequent the emergency department on a regular basis. This pilot project successfully established relationships between the partnering agencies and facilitated the connection of emergency department high utilizers with primary care providers. The program continues to expand care coordination to other community agencies and hopes to eventually build a more comprehensive care coordination and data sharing platform into the community.

Grant Amount

$93,000

Term

24 month

2015

Community Health Partners 2015

Promotoras de Salud: Bridging Latino Health Disparities

This project’s goal was to develop a program to reach the growing and isolated members of the Latino communities in Belgrade and West Yellowstone with education on basic health care and disease prevention. The program trained six individuals to be “promotoras,” or “promoters of health.” Promotoras received basic training in nutrition, diabetes management and prevention, and STI prevention which they then shared with their friends and community members in informal settings. The project’s success in reaching and engaging the Latino community led the Gallatin City-County Health Department to move the program’s operations in-house thereby ensuring its sustainability. 

Grant Amount

$20,000

Term

24 month

2015

CSKT Tribal Health Department 2015

Understanding and Utilization of Health Care Resources on the Flathead Indian Reservation

The Confederated Salish and Kootenai Tribal (CSKT) Health Department accomplished all objectives for this project. Through public law 638 they assumed the Indian Health Service budget for purchased and referred care and now manage the entirety of this program for the tribe. The grant funding allowed the CSKT Health Department to provide Medicaid and insurance outreach and enrollment services to clients of the Flathead reservations. Seven outreach events were held throughout the course of the project and enrollment in Medicaid and private insurance, employee plans, and marketplace plans continuously increased. Finally, CSKT trained providers and patients on the new coverage approach and on how to effectively use health care coverage.

Grant Amount

$100,000

Term

24 month

2015

Fort Peck Tribal Health Department 2015

Fort Peck Needle Exchange Program

This project revived the Needle Exchange Program that operated on the Fort Peck Reservation from the summer of 2009 to January 2012 and expanded it to provide injection drug users with clean needles, education, sharps containers for safe disposal of needles, and referrals to addictions counseling if needed. As one of the first and only needle exchange programs operated in a rural reservation in the US, Fort Peck’s employed a unique and successful protocol. The project’s main goal is to reduce the transmission of blood-borne illnesses such as hepatitis C and HIV. This program successfully now serves more than 200 clients on the Fort Peck Reservation and will be sustained indefinitely through a HRSA grant.

Grant Amount

$50,000

Term

24 month

2015

Fort Peck Tribes Health Promotion Disease Prevention Program 2015

Staff Recruitment and Telemedicine Systems Project

This project’s goal was to develop long-term, innovative solutions to the critical shortage of health providers on the Fort Peck Reservation. The project successfully developed formal agreements with Yale Children’s Psychiatric Center and Harvard to provided behavioral health services using telemedicine, and the MSU-Bozeman School of Nursing to send students as part of their curriculum to assist in school-based health centers. Recruiting relationships for health care professionals were also strengthened with Yale, Harvard, UM and Wala Wala. With the help of more effective recruitment and retention methods, Fort Peck HPDP is better equipped to bring quality health care to their community.

Grant Amount

$25,000

Term

24 month

2015

Glacier County Emergency Medical Services 2015

Montana Integrated Mobile Health

For this project, Glacier County Emergency Medical Services (GCEMS) implemented the state’s first Integrated Mobile Health Program (IMH). IMH is a new and evolving health care delivery model that builds on the concepts of community paramedicine and adapts them to serve the specific needs of the local community. The project’s primary goal was to improve the health of the community and reduce the number or emergency room admissions and hospital readmission. GCEMS successfully developed and implemented the IMH program to work alongside local health care providers and develop individualized, in-home treatment plans for patients who visit the emergency department regularly or who are at-risk for being readmitted into the hospital. Throughout the course of the grant, the program completed 1,148 patient visits which consisted of chronic illness management, respite services, end-of-life care, wound care, and other treatments and services prescribed by health care providers based on individual patient needs. As a result of this program, the grantee reported a nearly 90 percent decrease in hospital visits among the enrolled patients (from 387 to 40 visits). At the close of the grant in 2017, the project was working towards sustainability, however, the program was ended by the county in 2018 due to ongoing GCEMS budget concerns.

Grant Amount

$50,000

Term

24 month

2015

Helena Indian Alliance 2015

Development of Best Practices for Excellence in Opiate Dependence Treatment

This project created a best practice manual for the treatment of opioid use disorders utilizing medication-assisted treatment (MAT). The project successfully designed and implemented a registry for capturing the treatment data of individuals suffering from opiate and methamphetamine use disorders. The purpose of the data collection is to correlate treatment approaches with long-term outcomes. While there has been a tremendous increase in MAT for opiate and other substance use disorders, there remain many important open questions about the details of treatment over an extended period and the outcomes associated with differences in treatment approach. Registries such as this can become an important tool in determining answers and molding evolving therapy.

Grant Amount

$20,000

Term

18 months

2015

Holy Rosary Healthcare Foundation 2015

Eastern Montana Integrated Behavioral Health Collaborative

This project focused on integrating primary and behavioral health care for patients in eastern Montana. The primary care team at Holy Rosary Healthcare and behavioral health experts from Eastern Montana Community Mental Health Center sought to provide seamless integrated behavioral health (IBH) services for patients with a full spectrum of mental health issues, addiction, and primary care medical conditions. Outcomes included: a stronger partnership between Eastern Montana Mental Health Center and Holy Rosary Healthcare, implementation of universal depression screenings for adult patients in primary care practice, and a detailed IBH implementation plan that maps out a model for the new services and addresses specific business operations questions. The partners plan to expand a full IBH model for all primary care physicians and providers (including youth) in the Holy Rosary Healthcare primary care clinic.

Grant Amount

$25,000

Term

12 month

2015

Intermountain Deaconess Children's Services 2015

Services for At-risk Helena Youth in Alternative High Schools

For this project, Intermountain collaborated with an alternative learning school to provide behavioral health services to students. The collaboration resulted in a 63 percent increase in screenings for substance use disorders and an increase in referrals to higher levels of care, substance use disorder assessments, and other community-based support. Unfortunately, the project struggled with the turnover of key staff and did not see as much of a decrease in reported or suspected substance or alcohol use as anticipated. However, the project did strengthen the relationship between the school and Intermountain and laid the foundation for future collaborations.

Grant Amount

$45,000

Term

18 months

2015

Lewis and Clark County 2015

Mental Health Strategic Plan

This project convened a group of key stakeholders to develop a strategy addressing how people with mental illness and/or substance use disorders encounter and flow through the criminal justice system. The strategy included sequential intercept mapping which has three main components: 1) it reflects how individuals move through the local criminal justice system, 2) it indicates points for intervention or diversion of people with mental illness and/or substance use disorders, and 3) it provides a visual depiction of the ways in which treatment systems interact with the local criminal justice system. Stakeholders also identified priorities for change, developed an action plan, and helped create a new sustainable county department to address restorative justice and court services.

Grant Amount

$20,000

Term

24 month

2015

Logan Health 2015

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

Messengers for Health 2015

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

Montana Budget and Policy Center 2015

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 Medical Association Foundation 2015

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 Public Radio 2015

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 State University - Office of Rural Health 2015

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 Women Vote 2015

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

NeighborWorks Montana 2015

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 Valley Hospital Foundation 2015

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

Northern Cheyenne Tribal Board of Health 2015

Injury Prevention Project

The grant allowed the tribe to establish the Northern Cheyenne Injury Prevention Program. The grantee formed a strong coalition and provided multiple car seat safety clinics, safety checks, seat belt law awareness, and data sharing. In a major success, the coalition provided data and advocacy that ultimately supported a decision by the Tribal Council to rescind the Secondary Seat Belt Ordinance and implement a Primary Seatbelt Ordinance in September 2018. The tribe is assessing options to fund ongoing injury prevention activities, including seeking federal injury prevention funding and possibly including this program in T-HIP Tier 2.

Grant Amount

$99,453

Term

24 month

2015

One Health 2015

School-Based Health Center at St. Labre Indian School

For this project, Bighorn Valley Health Center (BVHC) partnered with St. Labre Indian School to start a school-based health center for students, their families, and school staff members. Using a modular building provided by the school, BVHC configured the space to support the provision of medical, dental, and behavioral health services. In 2017, the clinic had over 1,300 visits and more than 70 percent of patients were screened for depression. Patients with positive depression screening results were referred to the care of a behavioral health provider who ensured that they received appropriate support – either directly or through a referral with a partner organization. In addition, this project developed a learning collaborative (consisting of BVHC behavioral health staff and select counselors and coordinators from St. Labre) to better support the school’s staff in their work to foster a trauma-informed approach to school discipline and culture. In the second year of the grant, the collaborative expanded to include staff from the Pretty Eagle School Campus in St. Xavier. While MHCF funding was utilized for the design and implementation of this project, a financial analysis indicates that the project will be entirely self-sustaining at the conclusion of the grant.

Grant Amount

$100,000

Term

24 month

2015

Open Aid Alliance 2015

Overdose Prevention and Naloxone Access Project

This project helped Open Aid Alliance build strategic partnerships and create training opportunities for service providers and people who use injection drugs to improve prevention, recognition, and response to opiate overdose. Open Aid Alliance trained nearly 100 people to recognize an overdose and to respond and administer naloxone. The project fell short of their projected goal of training 360 people, however, they added overdose recognition and response to their website. This project also helped Open Aid expand their programming by exploring a substance use disorder treatment provider endorsement. This exploration led to increased partnerships in the community, strengthened business operations, and ultimately improved the continuum of substance use disorder care in Missoula County. The most profound and meaningful outcome of the project was the relationship building, strengthening partnerships, and positive legislative work to increase access and availability of naloxone throughout Montana.

Grant Amount

$15,000

Term

18 months

2015

Providence Montana Health Foundation 2015

The Wrapped in Hope Project

The Wrapped in Hope Project was a collaboration between Providence Montana Health Foundation and Saint Joseph Hospital, with strong support from the Confederated Salish and Kootenai Tribal government, to implement a multi-disciplinary approach to drug use during pregnancy through both clinical and home-based services. Both hospitals implemented collaborative, team-based approaches that provide holistic, respectful, family-centered care. They also hired licensed clinical social workers with expertise in addictions to provide care and coordinate supportive services for pregnant women struggling with addiction. A second component of the program focused on community outreach encouraging women to seek care in early pregnancy and informing them of available supportive services. This project achieved significant accomplishments both on the programmatic and community change level, including: 1) Women struggling with substance abuse while pregnant can now go to any health care provider in the Mission Valley and receive non-judgmental, quality health care, recovery support, and referrals. 2) Because of the project’s partnership efforts, local health care professionals have an increased knowledge and awareness about neonatal abstinence syndrome, the importance of working with Child Protective Services, motivational interviewing, pain and opioids, and other relevant topics impacting pregnancy and addiction. 3) This project has created and sustained a model of community collaboration for addressing the public health crisis of women and their babies impacted by substance abuse during pregnancy.

Grant Amount

$100,000

Term

24 month

2015

Rocky Boy Health Board 2015

Centralized Coding, Billing, and Revenue Maximization Project

The goal of this project was to develop a sound administration and stable revenue base, which would allow the tribe to design and run effective, tribally-led health programs. During the course of the project, eight tribal health employees completed a coding course through Stone Child College, one patient registration clerk and two benefits coordinators were hired, three staff completed Indian Health Service third-party billing and account management training, and two staff members attended the National Indian Health Service patient registration. One year after the completion of the grant, the grantee reported an overall increase of third-party revenue of over $2 million (52.74%). 

Grant Amount

$99,608

Term

24 month

2015