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.

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

L’espirt Behavioral Health Center will establish a new Montana Assertive Community Treatment (MACT) team to provide community-based treatment to individuals with severe mental illness and substance use disorders in Park and Sweetgrass Counties. MACT allows people with longstanding, severe, or disabling mental illnesses to live and function safely in their homes and communities rather than being hospitalized. Once established, the MACT team will help improve health outcomes and thereby decrease the number of behavioral health crises resulting in emergency room visits, hospitalization, and incarceration. Funds will offset the transition of L’espirit staff onto the MACT team, onboard clients, and technical assistance. Partners include Community Health Partners, law enforcement, hospitals, and the Human Resource Development Council.

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 will plan and develop a crisis system for Sweetgrass County based on the Crisis Now Model. With this grant, Pioneer Medical Center will create a coalition, hire a coordinator, map the current behavioral health crisis system, and develop a strategic plan. 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, mapping, program design, and convenings. Through this grant, Pioneer Medical Center will also engage neighboring counties, including Park, Wheatland, Meagher, Golden Valley, and Stillwater counties, in discussions on a regional crisis framework. Project partners include Sweet Grass County, Sweet Grass County EMS, Billings Clinic, and Billings Clinic Integrated Behavioral Health Program.

Improving PACT Client Outcomes through Medication Optimization and Care Coordination

The South-Central Montana Regional Mental Health Center (SCMRMHC) will explore the feasibility of improving its Program of Assertive Community Treatment (PACT) teams by adding another provider type – a clinical pharmacist – to the team. 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. This project will explore the feasibility of adding a clinical pharmacist to the team to provide medication management which is proven effective in complex populations. Funds will be used for care coordination and supporting a consultant to help determine the feasibility of integrating a clinical pharmacist into the PACT team and recommending a successful finding to the state.

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.

Montana PAX Sustainability Initiative

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

This project will support Substance Abuse Connect (CONNECT) to redesign the crisis system in Yellowstone County. There are multiple crisis services available in Yellowstone County (peer support, inpatient behavioral health, and homeless outreach, for example), but there is a need for strategic alignment among services. With the help of a local coalition known as CONNECT, Rimrock will lead the project, using grant funds to hire an executive director who will work to align the efforts of the current crisis service providers. Partners that make up CONNECT include leadership from the local hospitals (Billings Clinic, St. Vincent Healthcare, RiverStone Health), School District 2, the Indian Health Service, Yellowstone County, the City of Billings, the U.S. Department of Justice, the Yellowstone County Continuum of Care Coalition, and the Behavioral Health Alliance of Montana.Sub-committees of this group lead work on specific tasks in the strategic framework. The project aims to decrease emergency department utilization and criminal justice recidivism in Yellowstone County by developing a sustainable behavioral health crisis system.

Development and Implementation of the Montana Prevention Certification Board

The Montana Public Health Training Center (MPHTC) is housed in the School of Public Health and Community Health Sciences at the University of Montana. MPHTC provides training and professional development to public health professionals and health care providers throughout Montana. This grant will help establish a Montana Prevention Certification Board (MPCB) through MPHTC, whose purpose is to set and maintain professional certification standards for prevention specialists. MPCB will be a member of the International Certification & Reciprocity Consortium, a national body whose function is to grant reciprocity from state to state, set appropriate standards for credentials, and administer a national prevention specialist examination. MPCB will build capacity to supply a well-trained substance abuse prevention workforce by increasing retention, strengthening the knowledge and skills base, creating a supportive network, establishing career paths, and providing active recruitment and cross-training. Official certification ensures public safety and oversight of the profession, requires professionals to demonstrate competency through experience, education, supervision, and passing a rigorous examination, promotes knowledge and skills to provide evidence-based practices, and keeps updated on prevention science. Funding will support the program manager, hire contracted trainers for training, and support the development of the MPCB.

Beaverhead County Crisis Response Task Force

The Beaverhead County Crisis Response Coalition is a collaborative group of community leaders committed to improving county residents' access to crisis-related mental and behavioral health services. The coalition selected the Yellowstone Boys and Girls Ranch, a nonprofit mental health and substance use disorder treatment organization, to lead this project. This project will help define the comprehensive behavioral health crisis system strategy for Beaverhead County. The coalition will establish a formal charter for members, map the current and ideal crisis system, develop a strategic plan, and implement strategies. Funding will hire a project coordinator to help formalize the coalition and a mapping and data support consultant. The coalition consists of key leaders from local public health, law enforcement, schools, hospitals, federally qualified health centers, persons with lived experience, emergency medical services, elected officials, and social service organizations.

Communities that Care Training Expansion

The Addictive and Mental Disorder Division (AMDD) of the Montana Department of Public Health and Human Services (DPHHS) used this grant to increase the number of Montana communities that have a Communities That Care (CTC) program. CTC is a sustainable, evidence-based program designed to promote healthy youth development, improve health and social outcomes, and reduce problem behaviors. A previous MHCF grant helped AMDD hire a CTC program coordinator and contract with the University of Washington to provide intensive training and technical support to help 12 communities implement the program. This grant supported hiring two additional coaches to provide training for CTC facilitators and help expand the program into seven additional communities, including two tribes. Training included one three-day facilitator training, up to three one-day coaching workshops, and a one-day social development strategy training. The project's primary partner is the DPHHS Public Health and Safety Division, which leads the state's public health efforts and coordinates services to local and tribal public health agencies. AMDD's goal is to implement CTC in every county and tribe in Montana, and it has committed to continuing to scale the program by using internal resources to sustain these positions after the grant is done and to support additional coordinators.

AWARE PACT Service Expansion-Region 4

AWARE used this grant to expand its existing Program for Assertive Community Treatment (PACT) team in Lewis and Clark County in order to serve people with severe disabling mental illness who require long-term, intensive support that exceeds traditional outpatient services. With technical assistance from the National Council for Mental Wellbeing and the Western Interstate Commission for Higher Education, AWARE was able to help 95% of its clients become involved and engaged with the community and maintain stable housing. AWARE established long-term and formal relationships with several landlords in the Helena community and an MOU with the housing authority, which will help ensure ongoing access to stable housing. Other accomplishments include completing a costing tool, updating the PACT business plan, and adding additional staff to the PACT team. AWARE faced significant challenges due to the COVID-19 pandemic and workforce shortages, which impacted the number of clients served and the implementation of the program. AWARE averaged 55-60 clients throughout the grant period rather than the desired 80. Additionally, AWARE was unable to serve the rural counties around Lewis and Clark. AWARE is confident that the situation will improve and that the current team will be able to expand its caseload and begin supporting the rural areas

PACT Team Expansion & MACT Implementation

The Center for Mental Health (CMH) used this grant to expand its existing Program for Assertive Community Treatment (PACT) team in Lewis and Clark County and Cascade County, as well as implement a new Montana Assertive Community Treatment (MACT) team in Region 10 counties, including Glacier, Phillips, Pondera, Conrad, and Chinook. The goal was to help people with severe disabling mental illness who require long-term support and rehabilitate them to their highest level of functioning. Funding from this grant helped CMH develop training, hire staff, access technical assistance to expand its teams and serve a greater number of chronically ill people over a larger area, implement evidence-based programs, and complete a cost tracking tool to help sustain the program’s costs. PACT and MACT teams serve people with a chronic, disabling illness on a 24/7 basis so they can live an independent life within their community. By collecting data on these patients and the costs of the services provided, CMH is able to show the value of these services and demonstrate the cost savings of not using costly hospitalization and incarceration. CMH faced significant challenges due to the COVID-19 pandemic and workforce shortages, which impacted the number of clients served and its ability to expand its services into some rural counties. The project received technical assistance from the National Council for Mental Wellbeing and the Western Interstate Commission for Higher Education, which helped it create well-trained, sustainable teams that will continue beyond the grant period.

MACT Services in Eastern Montana

Eastern Montana Community Mental Health Center (EMCMHC) successfully implemented three Montana Assertive Community Treatment (MACT) programs that target people with severe disabling mental illness who require long-term ongoing support that exceeds traditional outpatient services. With technical assistance from the National Council for Mental Wellbeing and the Western Interstate Commission for Higher Education, EMCMHC was able to transition existing services, clients, and staff to the MACT model of care in the following counties: Carter, Powder River, Fallon, Custer, Treasure, Rosebud, Garfield, McCone, Phillips, Valley, Daniels, Roosevelt, Sheridan, Richland, Dawson, Prairie, and Wibaux. A total of 103 clients are currently being served through the three MACT teams, and outcomes include a significant reduction in emergency department utilization, hospitalizations, and interface with the criminal justice system. EMCMHC confronted a number of challenges, including delays due to COVID-19, difficulty getting clinical staff buy-in, needing to serve a vast rural area, and high staff turnover. Despite these challenges, EMCMHC has implemented two fully operational MACT teams, and the third team is close to full implementation. EMCMHC has established sustainable reimbursement through Montana Medicaid and has leveraged its success to secure a $3.6 million SAMSHA grant to help build out the continuum of care throughout the region.

Designing A More Effective Behavioral Health Service Continuum in Lewis & Clark County

Lewis and Clark County Public Health created this project to redesign the behavioral health crisis system in Lewis and Clark County. The goals were to reduce emergency department admissions, reduce and de-escalate behavioral health-related criminal justice encounters and recidivism, and optimize crisis response with a Mobile Crisis Response Team (MCRT) in order to improve the overall behavioral health and public safety in the county. A Behavioral Health Systems Improvement Leadership Team, which included a newly hired behavioral health program specialist, worked to identify needs and gaps in the current system and recommend improvements. The team developed a strategic plan, completed a comprehensive data analysis, and set priorities for implementation. The project successfully launched the MCRT, which served 172 people and diverted 102 from the emergency department, for an estimated savings to the system of more than $212,000. The project secured an $11,000 county tribal matching grant and technical assistance to guide crisis stabilization and receiving facilities in the county. The program was recognized by the National Association of Counties (NACo) with a 2021 NACo Achievement Award. Having established a formal charter with St. Peter's Health, the county sheriff, county commissioners, Shodair Children's Hospital, and PureView Health Center, the program is well-positioned to continue its work into the future.

Rimrock Program for Assertive Community Treatment (PACT)

Rimrock will implement a new Program for Assertive Community Treatment (PACT) team that serves Yellowstone, Musselshell, Big Horn, Carbon, Stillwater, Golden Valley, and Wheatland counties. PACT is the core service of a tiered delivery system that targets people with severe disabling mental illness who require long-term ongoing support that exceeds traditional outpatient services. The goal of the service is to rehabilitate each client to their highest level of functioning. PACT teams are mobile and deliver services in community locations to meet clients where they are. Grant funds will build this new PACT program's capacity through technical assistance by the National Council for Behavioral Health and bridge funding to help offset the cost of hiring and training new staff. Project partners include the Southcentral Montana Mental Health Center, Billings Clinic Behavioral Health Service, and the Montana State Hospital. This project aims to stabilize 196 clients with severe disabling mental illness and reduce admission to inpatient psychiatric hospitals.