Montana Coordinated Entry System Capacity Building and Implementation Project

The Montana Continuum of Care Coalition (CoC) is the collaborative, statewide agency funded by the U.S. Department of Housing and Urban Development (HUD) to coordinate housing and services for individuals experiencing homelessness across Montana. Their primary functions include facilitating a collaborative process for HUD grant applications, maintaining HUD Homeless Management Information Systems (HMIS) to collect and report homelessness data, establishing statewide funding priorities, measuring performance, and supporting providers of housing services to ensure that people experiencing homelessness are matched to housing opportunities as effectively as possible. Through this grant, the CoC will hire a coordinated entry systems (CES) director responsible for statewide coordination. The CES director will work to standardize and enhance statewide utilization, processes, and data collection in accordance with HUD requirements while reducing the data collection burden on local providers. This project builds upon the CoC’s recent MTHF grant and responds to feedback received from statewide partners regarding HMIS utilization and coordinated entry systems. This grant will also further implement CES in rural and Tribal communities. MTHF funds will be used to support staffing, consulting, and travel costs for the CoC. Project partners include Pathways (the HMIS provider), the Corporation for Supportive Housing, and communities and organizations providing services to people experiencing homelessness.

Housing Stability Services

Opportunities, Inc. is the community action agency serving Cascade County through programs that address housing, energy, Head Start, and behavioral health services for residents with low incomes. This grant will support Opportunities, Inc to plan and develop housing support services for individuals housed in the recently opened Baatz Block Apartments, the community’s first single-site permanent supportive housing (PSH). The Baatz Block apartments were developed by Neighborworks Great Falls, with Opportunities, Inc. the lead partner to provide services on site for residents. The grant will also support Opportunities, Inc to explore revenue streams to sustain housing and substance use treatment services beyond the grant. Partners include Neighborworks Great Falls, Alluvion Health, and Continuum of Care participants. MTHF funds will be used to support staffing costs (primarily in year 1) for services seeking full or partial reimbursement in year 2, including the LAC, Outreach Coordinator, Supportive Services Coordinator, and Housing Stability Specialists.

Butte Permanent Supportive Housing Planning and Development

Action, Inc. is the Community Action Program serving Butte-Silver Bow County, providing a wide range of anti-poverty programs, including housing, energy, and case management. This $40,000, one-year proposal will support Action, Inc. in implementing the community's first purpose-built permanent supportive housing (PSH). PSH serves people with complex medical conditions who are chronically homeless. The model links housing with on-site services such as tenancy support, employment assistance, and medical and behavioral health care to improve health outcomes and reduce the need for high-cost emergency services. Action, Inc. has developed a robust Coordinated Entry System (CES) with 15 community partners actively participating. The group will identify frequent users prioritized for the new units using CES and case conferencing. In response to community input and available property from the County, Butte's PSH will be built in a series of five fourplexes (four units in progress with an estimated 2025 completion and 20 total units planned). The units will be owned and subsidized by the Butte Housing Authority, with property management and tenancy support provided by Action, Inc., and healthcare services provided by the Federally Qualified Health Center Southwest Montana Community Health Center. Funds from MTHF will be used to support project staff responsible for onboarding the first four units and architectural services for the remaining fourplexes.

Housing First Village Supportive Housing Project

HRDC IX is a nonprofit Community Action Agency serving Gallatin, Park, and Meagher counties with programming that includes housing, energy, food, community transportation, early childhood education, and services for the elderly. HRDC IX has particpated in MTHF's Housing is Healthcare initiative since 2018. In that time, they planned, financed, and built, and began to house clients in the "Housing First Village." This innovative program permanent supportive services to people who are chronically homeless and require frequent emergency medical care and corrections interventions. This grant will help HRDC enhance the services provided on site through new and expanded partnerships with clinical providers as well as through exploring the feasibility of providing certain Medicaid services directly. Specifically, HRDC will explore providing the tennancy support services (newly approved for Medicaid reimbursement) and other Medicaid services independently. In addition, HRDC will work to expand the current partnership with Community Health Partners for medical and behavioral health services, and work L'Esprit to secure services from its newly-formed PACT team for residents in need of intensive services. MHCF funds will support staff time to develop onsite services with CHP and L’Esprit and explore the implementation of Medicaid billable services, including the upcoming tenancy support services waiver.

Foundations for Change: Supportive Housing Initiative

Opportunities, Inc. is the Community Action Program serving Cascade County through programs that address housing, energy, Head Start, and behavioral health services for residents with low incomes. This grant will help the organization implement the service plan developed over the previous year for the community's first purpose-built permanent supportive housing, the Baatz Apartments. Using the Coordinated Entry System, Opportunities, Inc., and project partners will develop criteria for identifying frequent users, provide pre-tenancy support to individuals to be housed, and prepare the case management team for occupancy. Project partners include NeighborWorks, Great Falls Housing Authority, Alluvion Health, Many Rivers Whole Health, Indian Family Health Clinic, Veterans, Inc., and Volunteers of America. The grantee will also build partnerships with the Little Shell Tribe's housing and health departments. MTHF funds will support the staff salaries and TA for programming, service package development, and revenue opportunities. Staff will work with the TA providers to address identified system barriers, including data fragmentation, partner development, and limited community capacity.

Blue Heron Place Permanent Supportive Housing Project

Partnership Health Center (PHC) is a Federally Qualified Health Center serving Missoula County. This grant will support Partnership Health Center to build and implement a sustainable package of supportive services to residents of the Blue Heron Apartments. Blue Heron provides housing for people with complex health issues who were experiencing chronic homelessness. PHC is already providing some health-related services and generating revenue to sustain staffing. MTHF funds will support the PSH program manager position, which is responsible for developing and implementing the services plan and overseeing case management staff working directly with tenants. Partners include the Missoula County Detention Center, City of Missoula, Poverello Center, All Nations Health Center, two local hospitals, the Missoula Housing Authority, and Homeword. In the grant year, PHC will work to develop its reimbursement model further and implement billing for tenancy support services under the Medicaid 1115 waiver to help address the revenue gap experienced in the first year of operations.

Helena Inn Supportive Housing Project

This grant will support United Way of Lewis and Clark County plan to acquire and rehabilitate the former Helena Inn into 48 permanent supportive housing (PSH) units. PSH serves people with complex medical conditions who are chronically homeless. The model links housing with on-site services such as tenancy support, employment assistance, and medical and behavioral health care to improve health outcomes, reduce the need for high-cost emergency services, and help people remain housed. While Helena has a long history of providing scattered-site PSH, this project would represent Helena's first single-site PSH development. MTHF funds will be used to support staff time to lead the development effort and for consulting services from the Corporation for Supportive Housing (CSH) to create a plan for sustainable staffing and operations. Partners include United Way, St. Peter's Hospital, Helena Housing Authority, Pureview (Federally Qualified Health Center), Many Rivers, AWARE, and the City of Helena. United Way currently leads the Helena’s Coordinated Entry System data collection and case conferencing and is well positioned to lead the PSH project development team.

Permanent Supportive Housing Community Engagement and Development Project

This grant will support United Way of Yellowstone County to plan and develop the community's first single-site permanent supportive housing (PSH). PSH serves people with complex medical conditions who are chronically homeless. The model links housing with on-site services such as tenancy support, employment assistance, and medical and behavioral health care to improve health outcomes, reduce the need for high-cost emergency services, and help people remain housed. Planning activities will include a data match and cost analysis by Montana State University-Billings to help identify the individuals most likely to benefit from PSH; creation of prioritization criteria for placement in PSH; and developing a staffing model and package of services that will be delivered on site. United Way has dedicated staff to overseeing this work. Partners include Homefront (housing authority), the City of Billings, Riverstone (Federally Qualified Health Center), and Intermountain Health (hospital system). Funds from MTHF will be used to conduct a community education campaign to address any questions or concerns about the proposed project, and for predevelopment services with Homeword, an experienced PSH developer.

Butte Permanent Supportive Housing Project

Action, Inc. is the Community Action Program serving Butte-Silver Bow County, providing a wide range of anti-poverty programs, including housing, energy, and case management. This project will support network development, enhance the supportive services package, and develop units devoted to permanent supportive housing. The network will focus on serving people identified in the region's frequent user system engagement (FUSE) list, which generally includes people who are homeless with complex medical needs and who require frequent hospital and emergency services. Funds will support staff time in the network and provide a sustainable services package. Partners include the Public Housing Authority of Butte, St. James/Intermountain Hospital, Butte-Silver Bow County, Southwest Montana Community Health Center, Southwest Montana Continuum of Care Coalition, and the Strategic Alliance for Behavioral Health.

Quality Improvements in Supportive Housing

The Human Resource Development Council of District IX (HRDC IX), a nonprofit community action agency serving Gallatin, Park, and Meagher counties, used this grant to improve the identification of individuals who would benefit most from permanent supportive housing (PSH) and to connect them with services to help them maintain housing. The goals were to further reduce the utilization of emergency departments, the criminal justice system, and homelessness services by people in crisis; pursue opportunities to increase Medicaid billable services to establish a more sustainable funding model; strengthen partnerships with community, medical, and governmental organizations; and improve the PSH services provided to the residents of Housing First Village (HFV). The project was successful at helping residents maintain housing at HFV or transition to other housing options; increasing access to preventative health care appointments by 81% and behavioral health appointments by 47% among residents; decreasing the utilization of emergency health services by 42%, and decreasing bookings at Gallatin County Detention Center by 31%. Hiring an on-site resource coordinator, with support from Community Health Partners, helped connect residents to health services and to apply for Medicaid, SNAP, WIC, and other benefits. Residents reported an increased sense of safety and community at HFV, as well as a significant increase in the utilization of case management, transportation, and food services.

Baatz Block Apartments

NeighborWorks Great Falls (NWGF) is a nonprofit housing and services provider serving Cascade County. This grant will support planning efforts for the redevelopment of the Baatz Block Apartments in downtown Great Falls into 25 units of permanent supportive housing for people with complex medical conditions who are homeless and require frequent emergency medical services and corrections interventions. Funds will support Beaux-Simone Consulting in working with NWGF and service providers to coordinate roles, responsibilities, budgets, services, gaps, and tenant identification before lease-up. The consultant will train all front-line service staff and develop operations documents, including an operation manual, tenant handbook, and community standards. Community partners include Opportunities, Inc., Great Falls Housing Authority, YWCA, Alluvion, and Many Rivers.

FUSE Partnership Program

Opportunities, Inc., a community action program serving Cascade County, used this grant to enhance the Frequent User System Engagement (FUSE) list for Great Falls, thereby improving the identification and support of individuals in permanent supportive housing and reducing the reliance on emergency health and justice system services. The FUSE list parameters that were previously used yielded a list that was difficult to produce and included too many people. Opportunities, Inc. hired a FUSE coordinator to convene a diverse group of stakeholders and develop updated FUSE selection parameters, creating a more manageable and accurate list. The coalition also examined existing systems in the Great Falls area that serve the FUSE population to identify service gaps, enhance care coordination, and develop systematic processes for prioritizing clients and delivering services. These changes needed to be made in advance of the opening of the Baatz Block Apartments, the community's first single-site permanent supportive housing project. Opportunities, Inc. is pursuing Medicaid billing under the state’s Medicaid HEART Waiver to support case management services, seeking new grant opportunities from local, state, and federal sources, as well as private foundations. The organization is also leveraging its partnerships to provide housing and health care support.

Sustaining and Expanding the FUSE Initiative in Missoula

Partnership Health Center (PHC), a federally qualified health center serving Missoula County, used this grant to develop and enhance permanent supportive housing services for residents of Blue Heron Apartments. The goal was to help people with complex medical conditions maintain stable housing and get the medical, dental, and behavioral health care they need without taxing the community's emergency medical, law enforcement, and justice systems. As the lead service provider for Blue Heron Apartments, PHC collaborates with a range of medical, housing, and government partners to develop individualized plans for tenants. Grant funds helped support the program manager's salary, who oversees community health workers and community care teams, coordinates with partners, and enrolls clients in appropriate programs.

In the first year of occupancy, Blue Heron tenants recorded a 75% reduction in emergency room visits and an 83% reduction in inpatient admissions. All 30 units at Blue Heron are currently occupied, with minimal turnover, and many residents are adapting to community living after years of surviving on the streets. PHC is working to increase revenues and improve the sustainability of tenant services by implementing the Tenancy Support Services Medicaid 1115 Waiver and group therapy sessions.

Helena FUSE: CSH Contract

St. Peter's Health Foundation is the leading organization in Helena that is creating permanent supportive housing (PSH) using the frequent user's systems engagement (FUSE) model, which seeks to improve health outcomes among people who are experiencing homelessness and frequently require emergency medical and correction services. The FUSE leadership team used this grant to hold Helena's second annual Housing is Health Care Summit in October 2023 to engage community members and stakeholders, raise awareness and understanding of the challenges facing people experiencing homelessness, and advance effective solutions. With technical assistance from the Corporation for Supportive Housing (CSH), the team gathered 250 attendees representing social services providers, health care partners, local government representatives, landlords, affordable housing developers, and other community stakeholders. Sessions addressed trauma-informed care, supportive housing best practices, and bridging housing and criminal justice. One panel discussion featured Helena community members sharing their lived experiences of homelessness. Following this summit, the Helena FUSE team will continue working with CSH to advance the creation and long-term sustainability of PSH.

Yellowstone County CoC Site Visit to Boise

United Way of Yellowstone County, the lead convener for the Billings area Continuum of Care, used this grant to support a site visit to a high-performing permanent supportive housing (PSH) program in Boise, Idaho. The goal was to bring together a group of key stakeholders from Billings to learn about Boise's successes and increase their engagement in and commitment to developing PSH in Billings. The group included 15 community members representing city and county government, hospital systems, housing and homelessness service providers, the federally qualified health center, and behavioral health providers. They spent two days with City of Boise staff and other providers, touring facilities and learning from their experiences. Representatives from the Corporation for Supportive Housing were on hand to facilitate daily debriefing and discussions. This trip was the first time community decision-makers had been on a site visit and could see firsthand the different options for service packages and delivery methods. Upon returning, participants continued to meet to plan for PSH in Billings. City Council and County Commissioners members have publicly supported PSH, and relationships between individuals and organizations have been strengthened, culminating in identifying a project site and development team. 

West Yellowstone Housing Coalition

The West Yellowstone Housing Coalition will address the pressing housing challenges community members face, particularly emergency responders, health care workers, educators, and public works personnel. The project will commence with a comprehensive housing needs assessment, followed by developing and implementing a housing strategy plan tailored to this rural, tourism-based community. To achieve the project goals, the West Yellowstone Community Foundation will collaborate closely with the Town of West Yellowstone and HRDC IX, engaging a wide range of community members through facilitated community meetings. Grant funds will be primarily utilized to complete the housing needs assessment and hire a part-time housing manager responsible for implementing the identified housing solutions.

Supportive Housing Units for FUSE or like populations

Community Action Partners of Northwestern Montana (CAPNM) will lead efforts to develop permanent supporting housing in Kalispell, joining several larger Montana communities in the development phase of the Montana Healthcare Foundation's our Housing is Healthcare initiative. CAPNM has purchased 18 rental units and is working to obtain 17 additional units, which will be used to provide housing and supportive services for homeless people who frequently require emergency department care and hospitalization. This project will allow CAPNM to support the building and delivery of supportive services in these units. CAPNM will provide pre-tenancy support, tenancy support, and case management for participants. CAPMN will work with local partners to develop a service delivery plan for residents of the new units and work with CSH to develop a quality delivery model and sustainability framework. Funds will be used for consultation with Corporation for Supportive Housing and project management expenses. Current core partners include the community health center and city commissioners.

Community Engagement Specialist, Ravalli County

The District XI Human Resource Council (HRC) will develop a detailed housing and service coordination plan for implementing supportive housing in Ravalli County. HRC will contract with a community engagement specialist to convene local government and health, housing, and social service providers. This group will develop a community action plan that identifies the need for housing and supportive services and the resources available in the community. Funding will support the project coordinator, provide administrative and technical assistance resources, and cover convening expenses. The Steering Committee of the Bitterroot Affordable Housing Coalition (BAHC) is a partner for this project; its membership includes leaders from human service programs, housing providers, and local government agencies. The project will result in commitments from local organizations and agencies to provide coordinated services.

Northeast Montana Supportive Housing Planning Grant

The Great Northern Development Company (GNDC) will implement a supportive housing learning collaborative that engages stakeholders across a six-county region of northeast Montana and the Fort Peck Reservation. Located in Wolf Point, GNDC provides housing education, first-time home buyer assistance, home rehabilitation, and affordable housing finance services in northeast Montana. The project will create a registry of tenancy support services and care management providers that serve the housing insecure and homeless population and an action plan to increase housing access and coordinate service providers with clients engaged in housing programs. GNDC intends to engage city councils, county commissions, and chambers of commerce in the region to identify key partners. GNDC will contract with the Corporation for Supportive Housing to facilitate stakeholder engagement, community education, and the development of best practices to share with the community. Funding will support the contract with the Corporation for Supportive Housing, project management, and stakeholder convenings.

Montana CES and Local/Tribal Continuum Capacity-Building and Engagement Project

The Montana Continuum of Care (CoC) will engage communities and reservations in rural Montana to identify practical, community-based solutions to homelessness. The project will perform an audit to assess whether and how the current system of care (called the Coordinated Entry System) for families experiencing homelessness is meeting the needs of local communities. Based on this information, the CoC will develop a strategy and an action plan. This plan will also engage tribal communities and develop strategies to promote newly eligible tribal housing projects. Funding will support a consultant who will provide technical assistance and help CoC develop detailed strategic and outreach plans. Partners include the Montana Youth Action Board, Native Homeownership, and the Pathways Community Network Institute.

Baatz Block Apartments Technical Assistance

NeighborWorks Great Falls has partnered with Homeword Development to rehabilitate the historic, abandoned Baatz building in downtown Great Falls into 24 permanent supportive housing units. Permanent supportive housing combines affordable housing with support services to improve health and social outcomes for people experiencing chronic homelessness in addition to complex, chronic physical and behavioral conditions. The services are designed to build independent living and tenancy skills and connect people with community-based health care, treatment, case management, employment assistance, and other services. The project is the community’s first purpose-built permanent supportive housing. The team has secured $10 million in tax credits and other funding from state and local sources to construct the project. This grant was used to fund technical assistance and support provided by BeauxSimone Consulting (BSC), including engagement of a design team and community partners, coordination of regular service planning meetings, conducting focus groups that included both experts and those with lived experiences, and the development of MOUs between service providers and property owners. While the project has experienced delays due to construction market conditions, its strong financial standing will most likely result in a successfully completed supportive housing building by the summer of 2025. The project expects to sustain the Baatz Block Apartments through partnerships and grants.

Richland County Rural Housing Planning Grant

The Richland County Housing Authority (RCHA) will develop a community action plan focusing on Richland County’s homeless and housing insecure populations and coordinating housing and supportive services for this population. RCHA will contract with the Corporation for Supportive Housing to identify housing insecure individuals who frequently use community systems. It will also build partnerships with community service providers that can provide tenancy support and care coordination. The Richland County Health Department has identified housing as a critical health issue. It has partnered with the RCHA to convene stakeholders and develop a community plan to address housing access and service support for vulnerable populations. Funds will support the technical assistance contractor, project management, and convening. Partners engaged in preliminary steering committee discussions include the Richland County Health Department, Sidney Community Health Center, Eastern Montana Community Mental Health Center, law enforcement, and Prairie Hills Recovery center.

Helena Coordinated Entry System Data Coordination

St. Peter's Health Foundation used this grant for its Helena Coordinated Entry System (CES) Data Coordination project to enhance Helena's Homeless Management Information System (HMIS) database. The goal was to improve the tracking of housing vouchers and service utilization for those identified as homeless or at high risk of homelessness and better identify housing and service gaps in the community. One of the project's key achievements was improving data collection processes, which has led to more accurate and comprehensive data entry to address client needs. The project was also successful in its efforts to expand CES partners and HMIS users, which has led to the development of a comprehensive work plan to help match service providers with those in need, the creation of a more fluid system for the distribution and utilization of vouchers, and the enhancement of data sharing and collaboration among community partners. The strong relationships formed with key partners such as United Way and the Helena Housing Authority will help sustain these activities, as will the use of interns and volunteers for data entry and administrative tasks.

Great Falls Housing is Healthcare Data Project

YWCA Great Falls used this grant to enhance the Great Fall's Homeless Management Information System (HMIS) database to improve the tracking of housing vouchers and service utilization for those identified as homeless or at high-risk of homelessness, and to identify housing and service gaps in the community. During the project, community partners were able to place 35 people experiencing chronic homelessness – including many people with complex medical conditions – into housing. The project updated Great Falls’ “coordinated entry” homelessness screening tool to capture more detailed information and expanded the network of organizations entering information into the coordinated entry system, which now includes more of the community's available beds. This enhanced information helped Great Falls secure funding from the Montana Continuum of Care to support the development of the Baatz Building, which will be the community's first single-site permanent supportive housing project.