Partnerships between behavioral health providers and other organizations that provide health services – like primary care, social services, and criminal justice agencies – can be a powerful and effective way to get people the behavioral health services they need.

However, creating new partnerships between organizations with separate missions and structures can be challenging. Finding and fostering innovative partnerships is one of the Montana Healthcare Foundation’s primary strategies for supporting and improving health in the state. This month, we highlight two different partnerships that illustrate how creativity and a willingness to collaborate can result in streamlined operations and improved access to quality health services.

Eastern Montana Community Mental Health Center & Eastern Montana Hospitals

In Eastern Montana, the Eastern Montana Community Mental Health Center’s (EMCMHC) service area covers nearly 48,000 square miles. That’s about the size of the state of New York. EMCMHC’s CEO Brenda Kneeland recognized that to make behavioral health services available to people across Eastern Montana, she would have to find an innovative way to get behavioral health providers into communities across the region.

Brenda decided to look for health care partners willing to collaborate with the mental health center and co-locate services. She found that the same people getting treatment from EMCMHC were also getting treatment from the local hospitals. By contracting EMCMHC therapists to the primary care clinics based at those hospitals, the mental health center and hospitals could together provide convenient and holistic care for patients.

To support this new partnership model, EMCMHC became a primary partner in the Montana Health Network’s Eastern Montana Integrated Behavioral Health Project. This project is funded by a three-year, $280,000 grant from the Montana Healthcare Foundation and works to integrate behavioral health services into primary care in Eastern Montana. The project’s goals are to improve health outcomes, contribute to a more effective crisis system, and reduce the use of emergency services.

Even though a person’s physical health is closely intertwined with their mental health, developing a partnership between two organizations – which historically operated separately – was challenging. Since this type of partnership between primary care and specialty behavioral health was new in the region, there was a learning curve to figure out what worked and what didn’t.

What worked well from the start was the partners’ commitment to figuring out better ways to care for people in their communities.

Here is how the partnerships worked:

1. To make therapists more widely available in the community, EMCMHC contracted its employees to local hospitals at a reasonable rate. To the hospitals EMCMHC partnered with, this arrangement made more sense financially than if the hospitals hired their own therapists as part of a traditional therapy model.
2. Therapists log their time into EMCMHC’s electronic medical record and document the services they provide into the hospital’s electronic medical record. The therapists offer services in an integrated behavioral health model, and they work as integral members of the treatment team.
3. The patients seen by the therapists are patients of the hospital and the hospital bills for their services. To the patients, the therapists are hospital employees.

This partnership is a win-win for both entities. Primary care providers can now offer integrated behavioral health services sustainably to their patients, and the mental health center is able to reach people throughout its service area.

EMCMHC is currently partnering with four hospitals in Eastern Montana with plans to expand to two more hospitals this year.

“For this kind of partnership to work, you need to be transparent and set common goals for health care in your community. We want to be sure we are providing the best care for friends and neighbors – and we want local people serving local people. We know we are making an impact. Two sites reported that integrated behavioral health services at their hospital likely prevented two youth suicides.” – Brenda Kneeland, EMCMHC CEO

Intermountain & Greater Valley Health Center

In the Flathead Valley, Intermountain provides specialty behavioral health services to children. The Greater Valley Health Center (the local federally qualified health center) offers primary care services for the community and runs school-based health centers in Linderman Education Center and Evergreen Elementary School.

The partnership started with relationship building between the leadership of both organizations: Intermountain’s CEO Jim Fitzgerald and Greater Valley’s CEO Mary Sterhan. Jim and Mary wanted to improve access to behavioral health services for children. To do that, they decided to partner to incorporate Intermountain’s behavioral health services into Greater Valley’s school-based health centers.

The organizations’ partnership was supported initially by a planning grant and technical support from the Montana Healthcare Foundation. The planning project helped the organizations develop their relationship and think through the logistical details of integrating their structures.

Offering behavioral health services through the Greater Valley Health Center’s school-based health clinic would allow them to provide better access to behavioral health services and holistic care to children and their caregivers.

Here’s how it works:

1. Intermountain employees provide behavioral health services at the school-based health center, and the services are documented and billed through Greater Valley Health Center. The partnership leverages the reimbursement structure available to Greater Valley as an FQHC.
2. Greater Valley Health Center contracts with Intermountain for a behavioral health director that oversees the health center and school-based behavioral health programs and staff. This provides Greater Valley with additional clinical expertise and support.
3. The behavioral health director oversees Intermountain outpatient therapists and the Comprehensive School and Community Treatment (CSCT) program in the schools. This supports a strong partnership between the school-based behavioral health services and CSCT services in the schools.
4. The organizations host joint staff meetings and focus on creating a team and getting everyone on the same page.

This kind of partnership wouldn’t be possible without the staff from both organizations working steadily through many operational details together. They have a high-quality team that is passionate about providing services in the schools, and they are genuinely making a difference for the students.

“Partnerships between two complex organizations is challenging, but we’ve found a sweet spot. We are open about our weaknesses and leverage each other’s strengths. We want to create something that will last beyond us. Our partnership is more than just transactional – it’s transformational.” – Jim Fitzgerald, Intermountain CEO

“It takes trust, transparency, and focusing on the clients and providing the resources they need. We’re willing to have tough conversations with each other and talk about what’s not working. We are always looking for ways to improve our services and better serve the students and their families and caregivers.” – Mary Sterhan, Greater Valley Health Center CEO

These are just two examples of many innovative partnerships developing between behavioral health providers and other organizations that serve people. While each example is unique, the goals are the same: meeting people where they’re at and providing the behavioral health services that genuinely make a difference.

MHCF seeks to support the development of partnerships like these – partnerships between organizations that are genuinely committed to finding new and better ways to deliver behavioral health services to people where and when they most need them. If you are part of a behavioral health organization and have an innovative partnership with another community organization in mind, please get in touch: we’ll see if there’s a way MHCF can support your idea.