Improving maternal and family outcomes for perinatal substance use disorders and mental illness, including newborn drug exposure, neonatal abstinence syndrome, foster care placement, and perinatal complications. 

The Perinatal Behavioral Health Initiative provides funding and technical assistance to allow medical practices that provide prenatal and post-partum care to implement a coordinated, team-based approach that improves outcomes for women with substance use disorders or mental illness. The team-based model of care pairs obstetric providers with a behavioral health clinician (such as a social worker or licensed addictions counselor), and includes strong care coordination and peer support to reduce the adverse outcomes of perinatal mental illness and substance use disorders for newborns and their families. The Montana Healthcare Foundation and the Montana Department of Public Health and Human Services have partnered to develop this initiative.

Substance use and mental illness during and after pregnancy have serious impacts on the health and well-being of mothers, children, and families around Montana: the problem is on the rise, and affected families are not adequately served by Montana’s current health care system and social services. The number of Montana children in foster care more than doubled since 2011; out of more than 3,200 children in foster care in 2016, 64% were removed from the home for reasons related to parental substance abuse. Among Medicaid patients, the percentage of infants with perinatal drug exposure increased from 3.7% in 2010 to 12.3% in 2016. In a 2017 report, we found that only 6% of Montana’s state-licensed substance use disorder treatment programs serve pregnant women or young families.

Based on national evidence and examples from other states, implementing a supportive, team-based approach to prenatal and postpartum care along with better coordination between health care providers and social service agencies offer a powerful way to improve these outcomes.

For more information about this initiative and the funding opportunity, please watch the webinar below. For additional videos on this topic, please visit our Perinatal Behavioral Health Vimeo album

Funding Opportunity

Grant funding of up to $150,000 for 2-year projects is available. MHCF and DPHHS will also provide in-depth training and technical assistance to grantees throughout the project.

Grant funding will be awarded to providers who work closely with pregnant and postpartum mothers experiencing behavioral health issues. Family practitioners, obstetricians, midwives, and rural hospitals are encouraged to apply. Required grant elements include:

  • Clinical Team: Establish a care team that includes prenatal and post-delivery care with care coordination and “warm hand-offs” to a licensed behavioral health clinician.
  • Community-Wide Reach: Develop partnerships and a defined referral pattern among practices in the community so that most prenatal patients are screened for substance use disorders and those that need care are cared for by the clinical team.
  • Multidisciplinary Collaboration: Develop collaborations among the clinical team, child protective services, public health and home visiting programs, criminal justice, and other agencies as appropriate.
  • Unmet Social Needs: Screen for social needs and use care coordination and collaboration with local organizations to address needs such as transportation, housing, and additional intensive treatment.
  • Culture Change and Communications: Develop and promote (both in the hospital and community) a supportive approach that engages women and increases participation in prenatal care and substance use disorder treatment.
  • SBIRT: Implement screening, brief intervention, and referral to treatment for pregnant women.
  • Collaboration with Tribes or Urban Indian Health Centers: Develop a strong collaboration with the appropriate tribal or urban Indian health centers if caring for a substantial number of American Indian families.

To apply, please email MHCF Program Director Tressie White. Grant decisions will be based on the selection criteria below.

Selection Criteria

Invited grant applications for this initiative will be evaluated accourding to the following criteria:

Importance of perinatal behavioral health issues in your community: The volume of prenatal and post-partum care provided in your practice or hospital, and the prevalence of perinatal behavioral health issues in the population you serve.

Need: The grant will fill a need that cannot be met by other resources available in the community(ies) served.

Sustainability: A short-term grant investment will catalyze improvements that endure long after the grant funding runs out. When funding will be used to establish or support new programming, the strongest proposals will demonstrate a clear, feasible plan to sustain the programming through third-party reimbursement or shared savings within the health care system.

Creating partnerships: The proposed project will create or advance new and substantive partnerships that result in more efficient and effective use of resources, and collaboration between organizations that may not typically work together, such as health care providers (hospitals, clinics, behavioral health treatment centers), public health (local or tribal health departments), and other organizations (such as community developers, county sheriffs, or schools). The strongest proposals will include specific plans for the involvement of and collaboration with and among the major health resources in the community.

Focus on at-risk populations and health disparities: The proposed project will serve a region or population of high need, as measured by the existence of health disparities, poor access to health care, health professional staffing shortages, geographic remoteness, or other factors clearly described in the proposal. Health disparities are defined as the higher rates of illness experienced by certain populations, including socially or economically disadvantaged families, racial and ethnic minorities, children, and older adults. In all our initiatives, we seek to decrease health disparities and to improve health and well-being among those at greatest risk.

Solutions exist: Effective, evidence-based interventions exist to address the problem but are not already being implemented.

Workable in Montana and culturally appropriate: Infrastructure, community support, and strong partners exist to implement the intervention; the intervention is tailored to work well within the community(ies) that will be served.

Feasibility and scale: There is a high probability that this MHCF investment will lead to success.  The strongest proposals will also have a high potential for being replicated successfully in other communities. The dollar amount of the proposed project budget is appropriate to the scale and complexity of the project.

Contribution to a diverse grantee portfolio: We seek to support a range of projects across Montana. We recognize that preparing a high-quality grant application may be more difficult for smaller communities that lack staff and resources. We may give preference to proposals based on their contribution to the overall diversity and balance of our portfolio, and to proposals from regions with the greatest demonstrated need.

Involving stakeholders and community members: The proposed project includes a strong plan to ensure that community members and other stakeholders are engaged and included in the work.

Collaboration with tribal leadership: Projects that involve a substantial focus on American Indian populations must demonstrate collaboration with the appropriate tribal health authorities, such as the relevant tribal council(s), the health directors of the relevant tribes, or the relevant urban Indian health centers.

Integrated Behavioral
Health Initiative

Focus Area: Behavioral
Health

Perinatal Behavioral Health Resources

Our Work in Perinatal Behavioral Health

Perinatal Behavioral Health Grantees

Saint Vincent's Healthcare Foundation

Look Closer: Addressing Perinatal Behavioral Health in Eastern Montana

Project Term: 24 months; 2019-2020
Grant Amount: $150,000

This project will help St. Vincent Healthcare increase access to mental health and substance use disorder care for pregnant women in Eastern MontanaThe project will do this by developing an integrated prenatal care program and expanding it to four additional OB sites affiliated with St. Vincent Healthcare and Riverstone Health Center. Grant funds will primarily be used for hiring a prenatal services liaison who will provide coordination to women in all participating sites. Partners include Rimrock Treatment Center and associated prenatal care providers in Eastern Montana (Billings OB/GYN Associates, St. Vincent’s West Grand Family Medicine, St. Vincent Maternal Fetal Medicine, St. Vincent’s Midwifery and Women’s Health, and RiverStone Health). The project’s overall goals are to increase the rates of women who receive prenatal care and substance use disorder screening, intervention, and treatment, and to reduce the rate of infants who are substance-exposed before birth.  

Saint Peter's Health Foundation

The Reducing Adverse Outcomes of Perinatal Mental Illness and Substance Use Disorders in the Greater Lewis and Clark County Area Project

Project Term: 24 months; 2019-2021
Grant Amount: $150,000

This project will help St. Peter’s Health (SPH) work to reduce the adverse outcomes of perinatal mental illness and substance use disorders. The project will do this through implementing screening, treatment, and referral protocols; expanding integrated behavioral health services within SPH OB provider clinics and the inpatient women and children’s unit; expanding nurse care coordination staff and support resources in the Helena community; and developing applicable data management and reporting capabilities. Grant funds will be used primarily for hiring a behavioral health specialist and a care coordinator to help implement and support the project. Partnerships include Helena OB/GYN who will work with SPH to develop a community wide approach including outreach and development of partnership with the Women’s Clinic of Helena and Helena pediatric clinics. The project’s overall goal is to reduce substance abuse and stabilize mental health disorders in the perinatal and postpartum populations and reduce the necessity of Child Protective Services intervention and foster care removals.

Community Hospital of Anaconda

The Reducing Adverse Outcomes of Perinatal Substance Use Disorder Project

Project Term: 24 months; 2019-2021
Grant Amount: $150,000

This project will allow the Community Hospital of Anaconda (CHA) implement a comprehensive, team-based, family inclusive continuum of care for perinatal patients with substance use disorders and mental health issues. As part of the project, CHA will build on its existing infrastructure to integrate behavioral health services into prenatal care. It will also work with community partners to addresses the accompanying social needs, including transportation, food insecurity, housing, employment, and social support. Grant funds will be used primarily for staff support and to hire a licensed clinical social worker to help implement the program. Partnerships include associate primary care clinics and local behavioral health agencies. The project’s overall goal is to reduce barriers to treatment for pregnant women and their families struggling with substance use disorders and mental illness and increase access to social support.

Livingston HealthCare Foundation

The Perinatal Behavioral Health and Substance Use Treatment Pathway Project

Project Term: 24 months; 2019-2021
Grant Amount: $81,265

This project will allow Livingston Healthcare (LHC) to reduce the adverse outcomes of perinatal behavioral health conditions for mothers, newborns, and their families in the Park County region. The project will do this by developing team-based, early intervention and coordinated care between LHC providers and local resources and agencies. Grant funds will be primarily used to develop care pathways to address substance use and mental health referrals, staff training, and marketing and outreach services. Partnerships include the Park County Health Department and Community Health Partners. The project’s overall goal is to increase the number of women in the community who receive appropriate prenatal care, increase the number of perinatal patients who receive behavioral health and substance use disorder treatment, decrease crisis encounters for this population, and decrease incidences of children removed from families due to guardian substance abuse.

Bozeman Health Foundation

The Perinatal Substance Abuse in Southwest Montana Project

Project Term: 24 months; 2019-2021
Grant Amount: $110,000

This project will allow Bozeman Health to develop and implement an effective model of care for OB/GYN patients who have behavioral health needs. Through this project, Bozeman Health will integrate behavioral health provides into their current care teams and expand the model of team-based care to partners in the community. Grant funds will be used to add additional behavioral health providers, who will be available for warm hand-offs and same day visits, into existing care teams who care for pregnant women. Partners include Gallatin County Health Department and Roots Family Cooperative who will assist in addressing social needs of women and families. The project’s overall goal is to improve timely access to effective evidenced based care to help serve women and families that are affected by drug and alcohol use or mental health issues during the most crucial time of development. 

2019 Call for Proposals

Find out about this year’s available grants.