Improving the health and well-being and reducing disparities in health and life expectancy among American Indian people in Montana.
American Indian people in Montana experience higher rates of many illnesses and die 18 years earlier, on average, than non-Native Montanans. These statistics represent severe and longstanding inequalities, yet historically, the funding for wellness and disease prevention programming has met only a tiny fraction of the need.
The Tribal Health Improvement Program (T-HIP) is a groundbreaking new opportunity the state of Montana worked with tribes to create in 2017. It allows tribes to receive Medicaid funding for designing and delivering culturally based wellness and disease prevention programs to their communities.
T-HIP offers an unprecedented opportunity to focus on wellness and disease prevention. It does this by enabling tribes to build robust disease prevention programs and address barriers to health such as trauma, unemployment, poor-quality housing, and lack of access to healthful foods. Establishing effective T-HIP projects will need successful planning, careful evaluation, and stable and disciplined program development work over many years.
Tribes are doing most of this work on their own. We play a supporting role by providing technical assistance from our staff and consultants. We also organize meetings for T-HIP staff from around the state and give grants to jumpstart planning and implementation.
Grantees must meet the criteria listed below. Please note that only tribes and tribal government agencies may apply for funding under this initiative.
- Document commitment from tribal leadership to implement the T-HIP program.
- Identify key staff and the tribal department where the T-HIP program will be established.
- Have in place an IHS 638 contract for health promotion/disease prevention services, or use grant funds in part to develop the contract.
- Tribes may use these funds to pay for the services of a contractor if needed. Any contractor chosen should have expertise in American Indian public health systems and a track record of successful efforts to engage and support tribal health systems.
If you are interested in applying for a T-HIP implementation grant, please contact our office.
2020 Year in Review
In our first annual report, you'll find an overview of the progress we've made in each of our priority areas and the strategic approach we too in our response to COVID-19.
Reducing Disparities Grantees
American Indian Governance and Policy Institute
Grant Amount: $99,956
The University of Montana’s American Indian Governance and Policy Institute (AIGPI) will develop a comprehensive tribal public policy needs assessment. The assessment will inform AIGPI’s tribal policy research and analysis agenda for the next ten years. AIGPI’s mission is to coalesce the research and service resources available within the Montana University System and work with tribes to address core causes of poor socioeconomic conditions and health on Montana reservations. This work will be achieved by enhancing tribal governing structures through tribal-level policy changes to improve government function, strengthening regulatory authority, and supporting self-governance. AIGPI will provide tribal policymakers with a critical service consisting of credible, in-depth research and analysis to further tribal leader’s efforts to strengthen reservation economies and build community and individual health and prosperity. Partners will include Rocky Mountain Tribal Leaders Council and representatives from each Montana Tribe. Grant funds will be used to support the time, effort, travel, and meeting costs for AIGPI’s director to conduct outreach, data collection, data analysis, and convening an advisory committee.
Kaala's Village Development Project
Project Term: 12 months; 2019-2020
Grant Amount: $50,000
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.
Integrated Behavioral Health for Urban Indian Center
Project Term: 24 months; 2019-2021
Grant Amount: $150,000
Helena Indian Alliance will implement integrated behavioral health in their primary care clinic and behavioral health department. As part of this project, they will perform evidence-based screenings for behavioral health disorders in their primary care clinic, train their staff on screening, brief intervention, and referral to treatment for substance use disorders (SBIRT). They will also implement integrated services and make referrals for behavioral health on the same day that a patient presents to the medical clinic. The warm handoff model will be used for primary care as well as behavioral health to ensure treatment for the whole person at each visit. Grant funds will be used for training and implementation of the project, hiring a care coordinator or behavioral health provider for the clinic, providing psychiatric consultation, and developing sustainability. The project’s goal is for the integrated behavioral health model to be a permanent and lasting resource in the clinic and community.
Improving Access, Training, and Recruitment for American Indian Health Care
Project Term: 24 months; 2019-2021
Grant Amount: $97,359
The University of Montana will work to improve care for American Indians and Alaska Natives (AI/AN) in Montana by increasing cultural awareness among medical students and improving access to care for specific medical services. Medical residents and health professions students at the Family Medicine Residency of Western Montana and the University of Montana will learn cultural humility through the development of a didactic curriculum for both learners and practicing professionals, as well as an immersion clinical experience at the Confederated Salish and Kootenai Tribes (CSKT) Tribal Health. The clinical experience will enhance cultural training and allow active recruitment of residents and students to work in AI/AN health care upon graduation. This project will also development models for new services to be provided by resident and faculty physicians at CSKT Tribal Health, beginning with maternal and obstetrical care. New services will help to address current barriers to care experienced by Tribal Health recipients. Grant funds will help develop curricula, provide resources for the creation of new models of care, and improve and expand the clinical training opportunities in AI/AN settings. This will help meet the overall goal of improving care for one of Montana’s largest underserved populations.
Confederated Salish Kootenai Tribe Family Education Services
Project Term: 12 months; 2019-2020
Grant Amount: $26,118
The Families First Children’s Museum (FFCM) will provide family education classes and resources for the Confederated Salish and Kootenai Tribal (CSKT) community intended to foster healing and help develop resilient communities. The project will introduce new, relevant, and evidence-based curricula within three separate tracks: parents/caregivers, foster parents, and childcare providers. Funding will be used to hire native instructors and support curriculum development. Through current partnerships with CSKT, the Department of Human Resource Development, and Salish Kootenai College, as well as growth in collaboration with the Tribal Health Department, Tribal Education Department, local childcare providers, and organizations like the Montana Department of Public Health and Human Services, FFCM’s work will extend to reach more families and create connections between parent education skill development and a stronger family resource network.