At the Montana Healthcare Foundation, we support American Indian-led solutions to health improvement. We build all our strategies and programs in partnership with Tribes, urban Indian health centers, and American Indian-led organizations.

In our work to improve the health of American Indian communities, we have developed three strategic initiatives:

• Strengthening American Indian Health: We provide grants, contracts, and technical assistance to help our American Indian partners build and strengthen their health programs and develop stable long-term revenue sources.
• Supporting American Indian Health Governance and Leadership: Since 2016, we have organized and helped facilitate the American Indian Health Leaders’ quarterly meetings. Tribal health and urban Indian health center directors make up this group. Meetings provide a regular forum for collaboration among the group members and with key partners such as the Montana Department of Public Health and Human Services.
• Reducing American Indian Health Disparities: We support planning and implementing projects that address barriers to health such as trauma, unemployment, poor-quality housing, and lack of access to healthful foods. A primary focus of this work is supporting Tribes to develop and implement programs under Montana Medicaid’s Tribal Health Improvement Program.

Our partners in Indian Country are among our most innovative and successful grantees. We encourage readers to explore our grantee database to learn more about our partnerships with each Tribe in Montana and the impressive, critically important work they are accomplishing.

Our Partnership with the Blackfeet Nation

As an example of how we support Tribes in realizing their own health improvement goals, we are highlighting the Blackfeet Nation – one of our longest-standing partners – and how they are transforming their health system.

In 2015, we made our first grant to the Blackfeet Tribal Health Department, a small grant to help plan a new school-based clinic for students in Browning. That grant – and the vision, commitment, and leadership of the Tribe – helped seed what has grown into a network of three school-based clinics serving kids across the reservation.

Since that first investment, we have worked closely with the Tribal Health Department and the Blackfeet Tribal Business Council (the Tribe’s governing body). We support their work through providing grants, helping apply for federal funds, and providing consultants and staff time to work toward the Blackfeet Nation’s vision of operating a robust health system that improves health and well-being in their community.

Opening A New School-Based Health Center

One of the first grants we gave made as a new foundation in 2015 went to the Blackfeet Tribal Health Department. The Tribe managed to exceed our highest hopes for this small planning grant: with a $20,000 investment, the Tribe not only completed planning for the clinic, but they also managed to form an operating agreement with the Browning school district, renovate a building to house a new clinic, hire staff, and open the Southern Piegan School Health and Wellness Program.

The Southern Piegan School Health and Wellness Program is a school-based health center, providing medical care to students, school staff, and community members. Providing students with easy access to health care can improve their health and positively impact their attendance and academic outcomes. By the end of our grant term in 2017, the clinic had already seen 1,500 students and was fully self-sustaining through insurance reimbursement.

With the first school-based health center’s success, the Tribal Health Department decided to expand the model to two other communities, with a third site focusing on providing behavioral health and dental services coming soon. Overall, the sites serve about 4,000 students across the reservation.

The importance of school-based clinics is children’s health, which is the foundation of a healthy adult life.Roberta Wagner,
SPHC Administrator

Enhancing Emergency Medical Services

Located in northwest Montana, the Blackfeet Nation is nestled against the Canadian border to the north and Glacier National Park to the west. Just over 10,000 people live on the reservation – a mix of enrolled Tribal members, Blackfeet descendants and people from other Tribes, and non-Indians. While the largest town is Browning, many members live scattered across a remote and geographically isolated frontier landscape. The long distances between towns can make it difficult to quickly access health services, making reliable emergency medical transportation vital.

With a $75,000 grant from us in 2017, Blackfeet Tribal Health improved and upgraded the Blackfeet Emergency Medical Services Program. It began by sending three of its emergency medical technicians to training to earn paramedic certification. With a higher level of staff training, the program could start billing insurance for their services at a higher rate. In turn, this revenue enabled them to purchase three new ambulances with better equipment, allowing them to provide a higher level of service for the community. By the end of our grant term, the program was self-sustaining through insurance revenue.

The Long-Term Vision: A New Blackfeet Health Board to Lead the Work Ahead

In 2019, the Blackfeet Tribal Business Council decided to begin taking steps towards assuming management of their health system from the federal government (a process known as compacting under Public Law 93-638) and building a Blackfeet-led health system that provides outstanding care for the community.

They began by visiting the Southcentral Foundation in Alaska to see firsthand what can be achieved when Tribes build their own health systems. Southcentral Foundation is an Alaska Native-owned nonprofit health care organization serving nearly 65,000 Alaska Native and American Indian people in Alaska. Its Nuka System of Care is recognized as one of the world’s most effective health care models.

After the visit, the Blackfeet Tribal Business Council requested that we contract with Southcentral Foundation to help them plan a sweeping redesign of the Blackfeet health system.

One of the first actions the Business Council took was to create a separate health board. The health board could focus entirely on the Tribe’s health needs and create a stable governing body to oversee building the new organization and the assuming management of the health system from the U.S. Indian Health Service. The Business Council appointed five members to the Blackfeet Health Board and tasked them with establishing and maintaining an effective health care delivery system for the Blackfeet Nation.

Even though the COVID-19 pandemic has challenged their early work, the Health Board is already making significant progress. The Tribe has delegated authority to coordinate the current Tribal health programs and facilities so they can work together to provide better preventive and primary care for the community. The Health Board has also begun a nationwide search for a founding CEO to lead the Tribe’s health system into the future.

Our staff works closely with the Health Board, helping plan and coordinate meetings, identify consultants and providing direct technical assistance and administrative support. In a recent meeting, we asked the Health Board what excites them about their work in the long-term. Here is their response:

We Support American Indian-Led Solutions

Our collaboration with the Blackfeet Nation embodies our approach to working with each Tribe in Montana. Our first priority is to establish strong partnerships. Then, to help Tribes achieve their own health improvement goals, we offer the tools they need to get the job done – whether that be grant funding, technical assistance, administrative support by our staff, or contracts with other experts.

Tribes have been among our most successful, innovative, and effective grantees. Over the years, we have watched them accomplished remarkable things, including creating and advancing new projects and collaborating with other American Indian health leaders in the state to learn from each other. For more information on our work with the Tribes and the urban Indian health departments, visit our American Indian Health focus area.