The Medicaid Tribal Health Improvement Program (T-HIP) offers an unprecedented opportunity for Tribes to create programs focused on wellness and disease prevention. We support the development of these programs by providing grant funding and technical assistance and by convening T-HIP directors.
American Indian people in Montana experience higher rates of many illnesses and live shorter lives, on average, than non-Native Montanans. These statistics reflect long standing inequities, not only in health care but in basic needs such as housing, food, and employment. Historically, the funding for wellness and disease prevention programming has met only a tiny fraction of the need.
The state of Montana worked with Tribes to create T-HIP in 2017. The program allows Tribes to receive Medicaid funding for designing and delivering culturally based wellness and disease prevention programs to their communities. T-HIP allows Tribes to build 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.
Beyond T-HIP, through this initiative we also support planning for programs to address the basic needs for health, such as housing, food security, education, and employment.
We provide grants or contracts with consultants to help Tribes plan for and develop new programs and evaluation strategies, and to cover start-up costs for new T-HIP programming. All funding under this initiative is by invitation only.
Only Tribes and Tribal government agencies are eligible to apply for funding under this initiative.
Successful invited grant or contract applications must meet the following criteria:
- 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 Indian Health Services 638 contract for health promotion/disease prevention services, or use grant funds in part to develop the contract.
- Tribes may use grant 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.