Strategic Communications Development and Support

AWARE (a statewide mental health, substance use, and developmental disabilities provider) is in the process of acquiring and merging with Western Montana Mental Health Center (a mental health and substance use provider). This grant will support public-facing and internal communications throughout the planning and implementation of this transition. Clear, accurate, and effective communications about the reasons for this merger and any changes in services and providers that may occur will be essential to retaining staff and maintaining and building trust with the communities served by these large mental health providers. Grant funds will be used to secure the services of an experienced, respected, Montana-based communications firm.

Crisis Response in Frontier Regions

This is an invited proposal from Eastern Montana Community Mental Health Center (EMCMHC) to expand their crisis work in the Eastern region. EMCMHC is the primary mental health and substance use organization in 17 Eastern Montana Counties. The proposal seeks to add two additional counties (Rosebud and Treasure) to the existing five counties that are currently being served with a mobile crisis platform. Other counties in the region are either already using or will be using the platform through other private and public grants. The proposal will also utilize funds to expand FTE for the existing coordinator and care manager. These two positions will work in tandem to ensure clients are connected and the communities and their stakeholders/coalitions are supported. Eastern will contract with a company called Avel, which will train 1st responders on utilizing mobile tablets to connect to on-call psychiatric nurses.

Program for Assertive Community Treatment

L’espirit is a licensed mental health center based in Park County and serving Park, Sweet Grass, and Gallatin Counties. L’esprit will implement an assertive community treatment (ACT) team in Gallatin County. L’esprit has an existing ACT team that serves Park and Sweet Grass Counties, and they also have outpatient and school-based services in Park County. L’esprit will utilize its existing ACT team and expand its services into Gallatin County. MTHF funds will offset start-up costs for new staff to expand the team. L’esprit will work closely with the Gallatin Behavioral Health Coalition and, specifically the Human Resource Development Council and One Health.

North Central Montana Crisis Coalition

This grant will support Pondera County Health Department to lead a regional collaborative in North Central Montana for Crisis Now planning. Pondera will work with surrounding counties and tribes to support local efforts in place and identify regional collaborations to support individuals in crisis and implementation of the Crisis Now model. Grant funds will hire a coordinator/project manager to lead the effort and a consultant to conduct sequential intercept mapping and help develop a strategic plan for regional crisis services. Partners include Blaine, Chouteau, Glacier, Hill, Liberty, Pondera, Teton, and Toole counties, the Blackfeet Nation, and the Chippewa Cree Tribe. JG Research & Evaluation will support the data infrastructure, collection, and analysis.

Rimrock Consulting Proposal

This grant will support Rimrock to carry out an operational and programmatic assessment to ensure it follows best practices, provides evidence-based treatment, and that its programs become and remain financially sustainable. Rimrock is a behavioral health organization based in Billings, and its programs have a statewide reach. Rimrock will hire a consultant to lead the assessment, and Rimrock's staff and board leadership will support and participate in the effort. There are no external partners identified.

Improving Access to Behavioral Health on the Rocky Boy Reservation

Rocky Boy Health Center (RBHC) has been serving the Rocky Boy reservation since 1976. RBHC provides a full suite of professional health care and services for over 4,000 people with a staff of over 180 employees. RBHC will develop a coalition and map out the behavioral health crisis services needed for their tribe. They will utilize current programs and resources and identify gaps and opportunities to address them. RBHC's project coordinator will oversee the project and coordinate with partners. Loveland consulting will map current services and help develop a strategic plan. The grant funds will be used for meeting expenses and mapping the current services. RBHC will work with multiple organizations important to crisis response in the region, including Chippewa Cree Tribal Courts, Chippewa Cree Justice Center, the Rocky Boy Police Department, and both the Rocky Boy and Box Elder school systems, as well as external hospitals and health departments in the region. The work will be under the oversight of Dr. Debbie Essert, the Integrated Health Division Director.

PACT expansion into the rural counties of South Central Montana.

This is a proposal from S. Central MT Regional Mental Health Center (SCM) to expand their PACT team into Fergus and surrounding rural counties (Judith Basin, Petroleum, Musselshell.) This will allow SCM to provide PACT services (which are more nimble, comprehensive, and sustainable than the limited outpatient services they have been providing) in Fergus. It will also allow them to serve the surrounding rural communities, which currently lack these services. Additionally, SCM will use this project as a pilot that will, if successful, allow them to expand PACT access to other rural communities. Grant funds will offset start-up costs for salaries, vehicle, clinical and administrative support. SCM has some existing staff they will utilize for the rollout but are also recruiting. They will have a blend of onsite and offsite staff to support the model. Partnerships are strong with the leadership from FQHC (One Health), Critical Access Hospital (Central Montana Medical Center), County Commissioners, and the mental health local advisory council actively involved.

Recovery Mentor Program: Expanding Recovery Support Services and Building the Peer Support Workforce Pipeline

Alliance for Youth is a nonprofit organization that advances healthy youth development through a collaborative approach to substance use disorder education, prevention, intervention, and treatment. Sober Life is a program within the Alliance for Youth that provides peer and recovery support services. The goal of the project is to build a Recovery Mentor Program to improve outcomes and access to services and to increase the Certified Behavioral Health Peer Support Specialist (CBHPSS) workforce. They will accomplish this by providing training and real-world experience to those interested in a career as a CBHPSS and developing a pipeline of trained and experienced CBHPSS that area providers can hire. Grant funds will be used towards staffing, training, and travel. Partners for this project include Many Rivers Whole Health, Alluvion Health, Indian Family Health Clinic, the Little Shell Tribe, Child and Family Services, and Veterans and Adult Drug Courts.

Broadwater County Public Health Crisis Resource Coordination

This grant will support Broadwater County to build on the work of the Local Mental Health Advisory Council and develop a strategic plan for an effective behavioral health crisis system. The Broadwater County Health Department will serve as the lead agency. The County is coordinating this effort with Crisis planning work in Jefferson and Lewis and Clark Counties, focusing on aligning resources across the region to implement the Crisis Now model. Other key partners include the Sheriff, County commissioners, Billings Clinic Townsend, Fire and Rescue, and Many Rivers Mental Health Center. Grand funds will support a coordinator and consultants for mapping, strategic planning, and data collection.

Fort Peck Tribes and Roosevelt County Crisis Coalition Planning Grant Project

This grant will support the Fort Peck Tribes in developing a crisis coalition that will serve the reservation and Roosevelt County. The coalition will bring together diverse partners on the Fort Peck Reservation and in Roosevelt County to collaborate on improving their community's behavioral health crisis response system. The coalition will engage health and justice system partners, develop a charter, analyze data related to the behavioral health crisis in the community, create a sequential intercept map of the current crisis system, and develop a strategic plan for improving the local crisis response system according to evidence-based guidelines. Grant funds will be used to hire a crisis coalition coordinator. Primary project partners are the Fort Peck Tribe and Roosevelt County. Coalition partners will include the local justice system, health system, first responders, schools, public health, and other community organizations.

Montana Prevention Certification Administration and Promotion

The Montana Prevention Certification Board is a new non-profit that works statewide to advance the certification of prevention specialists. This grant builds upon an earlier MHCF grant to the University of Montana to establish the certification process and board. The Board’s goal is to broadly implement certification through the prevention workforce and further advance the field of prevention as a viable and effective professional discipline. Once certified, professionals must observe a code of ethical conduct and participate in annual continuing education. Funding will support outreach, marketing, convenings, and a Board Administrator to oversee the work. Partners include key prevention stakeholders in DPHHS, Montana Public Training Institute, Montana Prevention Association, current prevention specialists, and local and tribal public health departments.

Roosevelt County and Fort Peck Tribes Crisis Coalition Planning Grant Project

This project will support Roosevelt County in developing a crisis coalition. The coalition will bring together diverse partners from Roosevelt County and the Fort Peck Reservation to collaborate on improving their community's behavioral health crisis response system. Through this project, the coalition will engage health and justice system partners, begin regular coalition meetings, and develop a coalition charter, analyze data related to the behavioral health crisis in the community, create a sequential intercept map of the current crisis system, and begin to develop a strategic plan for improving the local crisis response system according to evidence-based guidelines. This grant is being made in tandem with a grant to the Fort Peck Tribes for the same work, and the county and Tribes have agreed to partner throughout the project. Grant funds will be used to hire a crisis coalition coordinator. Coalition partners will include the local justice system, health system, first responders, schools, public health, and other community organizations.

Increasing Access to Care for Adolescents with Unmet Mental Health Needs

The Rural Behavioral Health Institute (RBHI) is a nonprofit working to reduce suicide among Montana youth by administering universal screenings in school districts around the state, providing brief "bridge" care to at-risk students, and providing follow-up and referral to mental health providers as needed. With this grant, RBHI will develop a registry to strengthen its case management processes. It will implement new custom software to track the impact of behavioral health services on students’ mental health over time and will develop formal relationships with mental health partners statewide. Grant funds will be used to support the development of custom case management and analytics software and integrations with current software platforms. Partners for the project include the Helena School District, PureView Health Center, Helena Indian Alliance, Elysian Mental Health Foundation, and Sunflower Counseling. 

High-Risk Targeted Case Management Pilot Project

Alternatives, Inc. will improve behavioral health outcomes and recidivism in Billings by hiring two case managers to coordinate care for high-risk offenders, focusing on individuals discharged from Montana State Prison, Women’s Prison, and other secure correctional facilities throughout the state. The case managers will be embedded with probation and parole offices in Billings, ensuring a team-based approach to care. Over the course of the project, the case managers will coordinate care for up to 140 offenders and connect them to treatment and community support. Grant funds will be used to offset the onboarding of the case managers. Project partners include the Department of Corrections, Rimrock, RiverStone, and Billings Urban Indian Health and Wellness Center. The Department of Corrections is dedicating probation officers and space to ensure a team-based approach to working with offenders.

Flathead County Implementation Grant

This grant will support the Flathead County Health Department to implement the Crisis Now Model, with the goal of decreasing the number of behavioral health crises resulting in emergency room visits, hospitalization, and incarceration. The Flathead County Health Department (FCHD) leads a coalition that includes critical stakeholders in Flathead County, including Greater Valley Health Center, Flathead County Sherriff’s Office, Kalispell Police Department, Logan Health, Flathead County Commissioners, Western Montana Mental Health Center, Montana Public Health Institute, and other supporting agencies. This grant will support the implementation of a crisis line (988), expand the community's mobile crisis team, and create a crisis-receiving facility as a more effective alternative to hospitalization or incarceration for people in crisis. The coalition will use the grant funds for a coordinator to oversee the project, expansion of the mobile crisis team, and plan for the crisis-receiving facility.

Gallatin Behavioral Health Coalition

The Gallatin Behavioral Health Coalition (Coalition) will decrease the number of behavioral health crises that result in incarceration or hospitalization by implementing the Crisis Now Model. The Coalition is focused on building a more complete behavioral health continuum in Gallatin County. Its members include Gallatin County, Bozeman Health, the City of Bozeman, the Help Center, Community Health Partners, Connections, Montana State University, Bozeman School District, the Yellowstone Club Foundation, the Bozeman Health Department, advocates, and those with lived mental health and addiction experiences. This project will support the implementation of the crisis line (988), expand the mobile crisis team, and implement a crisis receiving facility as a more effective alternative to hospitalization or incarceration for individuals in crisis. More broadly, the coalition will continue to plan and support the implementation of a complete continuum of community-based behavioral health services – from prevention to early diagnosis and treatment – for the region. Grant funds will support a coordinator for project management, evaluation, and communications.

MACT in Park and Sweet Grass County

Strategic Alliance for Improved Behavioral Health

This grant will support the Strategic Alliance for Improved Behavioral Health to decrease the number of behavioral health crises resulting from incarceration or hospitalization by implementing the Crisis Now Model. The Strategic Alliance for Improved Behavioral Health (Alliance) is a coalition that includes critical stakeholders in Missoula County, including Providence St. Patrick Hospital, Community Medical Center, Partnership Health Center, Western Montana Mental Health Center, All Nations Health Center, the Missoula City-County Health Department, and the City Council and County Commission. This grant will support implementation of a crisis line (988), expand the community's mobile crisis team, and create a crisis receiving facility as a more effective alternative to hospitalization or incarceration for people in crisis. More broadly, the Alliance will also continue to plan and support implementation of a more complete continuum of behavioral health services -- from prevention to early diagnosis and treatment -- for the region. The Alliance will utilize the grant funds for a coordinator to oversee the project and a consultant for updating the resource mapping and strategic planning.

Crisis Coalition Formation, Improvement, and Sustainability

Pioneer Medical Center (PMC) used this grant to plan and develop a crisis system for Sweetgrass County based on the Crisis Now Model. The goal was to improve how the county deals with behavioral health crises, providing a more effective alternative to hospitalization or incarceration for people in need. PMC formed a coalition that includes Sweet Grass County government officials, Sweet Grass County EMS, Billings Clinic, and Billings Clinic Integrated Behavioral Health Program, among others. PMC hired a coordinator to oversee the project, mapped how county agencies and health care resources were currently responding to behavioral health crises to identify opportunities for improvement, developed a strategic plan, and used data to inform decisions and measure outcomes. The project contributed to a reduction in justice-system interventions and an increase in awareness of behavioral health issues and how to handle people in crisis among the agencies involved. This project led to new partnerships and better coordination between law enforcement, public health, and health care. The county has budgeted for staff salaries to help sustain these changes.

Improving PACT Client Outcomes through Medication Optimization and Care Coordination

The South-Central Montana Regional Mental Health Center (SCMRMHC) used this grant to explore the addition of a clinical pharmacist to its Program of Assertive Community Treatment (PACT) teams. PACT allows people with longstanding, severe, or disabling mental illnesses to live and function safely in their homes and communities rather than being hospitalized. Traditional PACT teams consist of a supervisor, program assistant, psychiatrist, peer specialist, and mental health professionals. By adding a clinical pharmacist, SCMRMHC aimed to enhance medication management, improve coordination between psychiatric and medical care, and ultimately improve overall health outcomes. Partners included RiverStone Health, the provider of preventive and primary care services for the majority of PACT clients, and Pharmacy 1, the on-site pharmacy that dispenses medications for PACT clients. Grant funds were used to support PACT staff, providers, and pharmacists to participate in planning meetings, treatment meetings, and integrated behavioral health and comprehensive medication management training. This project increased awareness of the role of clinical pharmacists in managing complex medication regimens, monitoring for medication adverse effects, identifying drug interactions, and providing medication information. Challenges included high staff turnover, poor communication with RiverStone Health, and the lack of an electronic medical record system. Due to insufficient reimbursement from Montana Medicaid, the project cannot justify a full-time clinical pharmacist position at this time. No other funding sources have been identified.

Butte-Silver Bow Behavioral Health Systems Improvements and Sustainability Project

The Butte-Silverbow City-County Health Department will implement the Crisis Now Model to decrease the number of behavioral health crises resulting in emergency room visits, hospitalization, and incarceration. The Crisis Now Model includes a crisis line (988), a mobile crisis team, and a crisis-receiving facility, and provides a more effective alternative to hospitalization or incarceration for people in crisis. Funding will support a coordinator to oversee the project, the expansion of the mobile crisis team, and planning for the crisis-receiving facility. Project partners include members of the Butte-Silver Bow Strategic Alliance, including St. James Healthcare; Action Inc; Southwest Montana Community Health Center; Western Montana Mental Health Center; and Community, Counseling, and Correctional Services, Inc.

MT PAX Sustainability Initiative

The University of Montana Center for Children, Families, and Workforce Development used this grant to help ensure the sustainability of the PAX: Good Behavior Game (PAX) in Montana's elementary schools. PAX is a school-based preventive intervention teachers use to teach self-regulation, build good behavior skills, and help them stay on task. PAX has been shown to contribute to a positive classroom environment with long-term outcomes, including better academic outcomes and long-term improvements in mental health and substance use. The grantee contracted with the National Implementation Research Network, DPHHS Addictive and Mental Disorders Division, and the Office of Public Instruction. The partners developed implementation and leadership teams at the state, regional, and district levels to oversee PAX's planning, monitoring, training, and funding. The project built a statewide coaching infrastructure with systems for training, coaching, data use, communication, and policy development for PAX and any evidence-based practice. In 2023-24, 65 schools implemented PAX, impacting 17,794 students. Evaluations showed sustained schoolwide implementation in committed districts and improvements in students' self-regulation, self-management, and self-control, particularly among high-risk students. The center received an additional year of funding from the DPHHS Behavioral Health and Development Disabilities Division to support statewide PAX implementation, and it continues to work with state leaders to provide long-term funding.

Development of Recovery Support Services Funding Model and Peer Support Capacity Building, Implementation, Evaluation and Integration Into Crisis Intervention Program

Alliance for Youth is a nonprofit organization that advances healthy youth development through a collaborative approach to substance use disorder education, prevention, intervention, and treatment. Sober Life is a program within Alliance for Youth that provides peer and recovery support services. With this grant, Alliance for Youth will partner with Alluvion Health to provide peer support services for Alluvion's Crisis Intervention Program. The Crisis Intervention Program decreases relapse rates among people struggling with substance use disorders and diverts people in crisis away from emergency rooms and jails. This partnership will help develop a sustainable funding model for peer support and expand services in Great Falls and North Central Montana. Funding will support staff salaries and contracts for billing and clinical supervision for peer support. Partners include Alluvion Health and the local Crisis Intervention Program organizations.

Tribal-County Crisis Coalition Launch (Blackfeet – Glacier)

The Blackfeet Nation and Glacier County Health Department will launch a "Tribal-County Crisis Coalition" (Coalition) that aligns resources from law enforcement, behavioral health, and medical services across the Blackfeet Nation and Glacier County. The Coalition will conduct sequential intercept mapping (SIM) to understand how people in crisis currently interact with law enforcement, emergency medical services, and behavioral health, and use the results of this mapping to outline a more effective model for crisis response. The project will also develop a sustainable implementation plan. The project will be led by the Glacier County Health Department and the Piikani Lodge Health Institute staff. Loveland and Associates will support mapping, data analysis, and strategic planning. Funding will support the coordination efforts, consultation, travel, and convening expenses. Partners include law enforcement, the Blackfeet Tribe's Culture and Hope Program, and Blackfeet Tribal Health.

Uncovery Treatment Center Expansion Project

The Open Aid Alliance (OAA), a state-approved substance use disorder treatment organization serving the greater Missoula community, used this grant to expand and revamp its service delivery model. OAA hired a clinical director, who helped make significant progress over the first year of the project, but that position is currently vacant. Due to a significant increase in the number of unhoused people accessing services, OAA decided to offer open-access chemical dependency evaluations four days a week without requiring appointments. This model better serves participants and has eliminated most no-show appointments. Because ongoing clinical engagement was challenging, OAA adopted a continuous welcome-back cycle so that people can come in and out of care more fluidly. It has also focused on outreach-based services that can be delivered in congregate settings. This grant helped OAA launch the beginning phases of a nurse-led MOUD (medications for opioid use disorder) program, and it is in the process of applying for mental health center status with the state, which will help it expand beyond offering substance use treatment only. OAA increased revenues through its new services, has secured a grant from Missoula County, and is confident that services and activities will be sustained in the future.

Park County Peer Support Specialist Program for Mobile Crisis Response in Park County

The Park County Behavioral Health and Crisis Response Coalition is a collaborative group of community leaders committed to improving county residents' access to crisis-related behavioral health services. The coalition selected the Park County Sherriff's Office to lead this project. The sheriff’s office is currently implementing a mobile crisis support team that goes into the community to help individuals with mental illness or substance use disorders. This project will integrate peer support specialists into the mobile crisis team, providing more effective outreach, engagement, and support for individuals experiencing behavioral health crises. This project will develop policies and procedures, training manuals, and overall infrastructure to support the onboarding of peers into the mobile crisis team. Funding will support hiring two peer support specialists and support clinical supervision, training, supplies, and travel. The project's primary partnership is with the Park County Behavioral Health and Crisis Response Coalition members, including local public health, law enforcement, the City of Livingston, Livingston Healthcare, Community Health Partners, the Human Resource Development Center, Mental Health Advisory Council, L'esprit Behavioral Health Center, and Park County.

Advancing Peer Support

Partnership Health Center (PHC) is a federally qualified health center serving the greater Missoula community. PHC provides a mobile support team that goes into the community to help individuals with mental illness or substance use disorders. This project will integrate peer support specialists into the mobile crisis team, providing a broader range of support for individuals experiencing behavioral health crises. PHC will convene partners participating in the Strategic Alliance for Improved Behavioral Health to make sure all the peer support efforts of the group are coordinated and will hire three new peer support specialists to work with the mobile crisis team. Funding will support convening and bringing on new staff. The project's primary partnership is with the strategic alliance; members include local public health, the City of Missoula, the University of Montana, All Nations Health Center, Western Montana Mental Health Center, Providence, Community Medical Center, and Missoula County.

Substance Abuse CONNECT Crisis Diversion Project

The Rimrock Foundation used this grant to fund the Substance Abuse CONNECT Crisis Diversion Project, which worked to redesign the crisis system in Yellowstone County. The goal was to unite and align the various crisis services available in Yellowstone County—from peer support to inpatient behavioral health to homeless outreach—and decrease emergency department utilization and criminal justice recidivism. Project partners included leaders from more than 90 organizations, including hospitals, schools, government agencies, and nonprofits. Funds were used to hire an executive director who focused on bringing partners together under a common plan. Rimrock updated a strategic plan for implementing Crisis Now as well as for strengthening the broader behavioral health continuum; initiated the community's first mobile crisis team; and set up task force groups to work on treatment, diversion, and prevention. It secured a Crisis Diversion Grant from the state of Montana, $1.3 million in mental health mill levy funds, and $225,000 annually to support the mobile crisis unit.

Development and Implementation of the Montana Prevention Certification Board

The goal of this grant was to establish the Montana Prevention Certification Board (MPCB) through the Montana Public Health Training Center (MPHTC). Through establishing professional certification standards for prevention specialists, the new board is intended to increase the supply of well-trained substance use prevention professionals. The board will accomplish this by strengthening the knowledge and skills base of prevention providers, creating a supportive peer network, establishing career paths, and providing active recruitment and cross-training. During the grant MPCB created an eight-member board and hired a board administrator. MPCB achieved its goal of becoming a member of the International Certification & Reciprocity Consortium, a national body that grants reciprocity from state to state, sets standards for credentials, and administers a national prevention specialist examination. MPCB has already credentialed six applicants, and 35 more are in process. It has been marketing its certification through in-person events, a website, and social media. MPCB has received funding from the Montana Department of Public Health and Human Services to support the development of prevention-related training.

Beaverhead County Crisis Response Task Force

The Beaverhead County Crisis Response Coalition used this planning grant to improve access to the county's crisis-related mental and behavioral health services. The project's goals were to identify strengths and weaknesses in the current crisis response protocols and work to build a comprehensive crisis system that improves access to critical community care while reducing inappropriate contacts with law enforcement and the hospital emergency department. The Yellowstone Boys and Girls Ranch, a nonprofit mental health and substance use disorder treatment organization, led the project, working closely with a collaborative group of community leaders from health care, law enforcement, schools, government, and social service. Funding was used to hire a project coordinator who performed data research, administrative duties, stakeholder engagement, and consultant coordination. The consultants were hired to assist with county-wide mapping, strategic planning, and data analysis. The project built and strengthened its coalition membership, completed the sequential intercept mapping (SIM) process that identified prioritized goals, and applied for and received a Crisis Diversion Grant from the state to continue its work and begin the implementation phase. The Crisis Diversion Grant will provide additional funding opportunities from various private and public sources.