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.

School-Based Health Program: Pearson Project

The Fort Belknap Indian Community (FBIC) Tribal Health Department, in partnership with the Harlem, Dodson, and Hays-Lodgepole school systems, will begin providing school-based health services. The project aims to improve the health, wellness, and educational systems to support higher academic achievement among all students attending each school. The Tribe will provide behavioral health services and primary care in school-based health centers. The project seeks to improve the overall school climate, enhance the classroom experience for teachers and students, and ultimately reduce student disciplinary referrals and improve academic and health outcomes. Funding will support the contracted position with Xanovea to lead the project and a salaried behavioral health psychologist position. Primary partners are the Office of Public Instruction, the FBIC Tribal Health Department, the FBIC Tribal Council Education Committee, and the Dodson, Harlem, and Hays Lodge Pole Schools. 

Regional Revolving Loan Fund

This Program-related Investment (PRI) will support the Mountain|Plains Regional Native CDFI Coalition to establish a Regional Revolving Loan Fund (RLF). Access to capital, a core tenant of the Indigenous finance industry, is the seed for growth strategies designed to lift struggling Native economies and close the racial wealth gap. This MHCF investment is part of the Foundation’s support for the Coalition’s successful application for $45 million in funding from the U.S. Economic Development Administration (EDA). The project will strategically deploy financial investments into Native CDFIs in Montana, including Plenty Doors Community Development Corporation and NACDC Financial Services, Inc. The RLF will act as a vehicle of economic growth that drives business development and quality job creation. The project will amplify the capacity of coalition members not only by expanding their balance sheets and lending portfolios but also by unifying action and creating opportunities for peer-to-peer learning as they engage in more complex financial deployment strategies. Coalition members will collectively leverage partnerships and networks to attract additional investments, sustaining their work long-term. Replicable models and case studies will be developed and shared in collaboration with the Regional Indigenous Finance Industry Growth Plan and Non-Physical Infrastructure projects. The Regional Revolving Loan Fund will contribute to the other Montana CDFI's sustainability through earned interest revenue and access to additional loan capital.

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.

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.

School-based Case Management Enhancement Project

Heart Butte Public Schools will enhance their collaboration with the school-based health center to promote positive health outcomes within the school and community. This project will build on the already-established relationship between Blackfeet Tribal Health and Heart Butte Schools by providing a liaison to the school-based health center. This will increase awareness and access to school-based services. Heart Butte Public Schools is a K-12 Public School located in the community of Heart Butte, Montana, which is in the southeast portion of the Blackfeet Indian Reservation in Pondera County. Grant funds will be used to hire and support a part of the salary of a full-time case manager. The primary partners for the project are Heart Butte School District and Blackfeet Tribal Health, which operates the school-based health center.

Integrated Behavioral Health

Planning Grant for School-Based Health Center Partnerships in the Helena Public Schools

Helena Public Schools used this grant to develop an implementation plan for providing face-to-face school-based behavioral health services to youth within the schools. Helena Public Schools partnered with community health care providers, including PureView Health Center and the Helena Indian Alliance. Grant funds were used to hire a dedicated staff member to facilitate the planning and coordination of this project. As a result of the project, PureView and Helena Indian Alliance are each now providing behavioral health services in two schools, and the providers also served as in-person therapists for all five 6-12 schools during the fall mental health screenings. Through this screening process, therapists connected more than 50 additional students to case management. Challenges included not being able to get permission to provide physical health services and not being able to serve the K-5 population—who have significant behavioral mental health needs—due to the inability to bill for behavioral health services among this age group. The project leveraged the MTHF grant to secure $300,000 from the Office for Public Instruction for professional development and $38,000 from the state PAXIS program for PAX training and support for K-5 schools.

IFHC IBH: Hope, Healing & Health

The Indian Family Health Clinic (IFHC), which serves more than 9,000 patients in Great Falls and the surrounding area, used this grant to expand its previous integrated behavioral health project, providing accessible, culturally informed behavioral and physical health services. The grantee developed shared care plans to improve collaboration among teams and enhance wraparound services, resulting in better patient outcomes and stronger connections between behavioral health and primary care. Among its many achievements, IFHC remodeled the behavioral health unit to implement pod-based care, which helped improve team communication and collaboration; trained all providers and staff in screening, brief intervention, and referral to treatment, and other evidence-based practices; improved the tracking of patient data and data-driven decision-making processes; implemented safety planning protocols for suicide prevention; created key performance indicators to measure progress; and improved patient outcomes and increased patient satisfaction. This grant has enabled IFHC to secure additional financial support and enhance its financial sustainability. The implementation of third-party billing services, a new electronic health record system, and the increase in patient encounters have all bolstered revenue, helping IFHC secure a more sustainable financial future and ensuring the ongoing success of its integrated care initiatives.

Logan Health SBHC Mobile Clinic

Kalispell Regional Medical Center dba Logan Health Medical Center (LHMC) is the medical hub of a nonprofit health system headquartered in the Flathead Valley of northwest Montana. This project will allow LHMC to begin providing primary, preventive, and behavioral health services to students in rural schools located in the communities of Kila, Marion, and Smith Valley and to expand behavioral health services to the Big Fork School District. LHMC will implement a Mobile School-Based Health Center to serve Kila, Marion, and Smith Valley rural schools that do not have the appropriate physical space for an on-site health center. They will also expand mental and behavioral health services to the Bigfork School District and provide these services on-site at the school. Medical, behavioral, and mental health care will be offered to students and staff of these rural schools. Telehealth services will be integrated throughout the school-based program to serve the target populations’ integrated health needs. Grant funds will offset medical and behavioral health providers’ salaries, supplies, and outreach and communications. The primary partners for this project are four school districts, including Kila, Marion, Smith Valley, and Big Fork.

LHMC Meadowlark Phase 3

Logan Health will expand its Meadowlark Initiative from its midwifery clinic into its maternal-fetal medicine clinic and its newly acquired obstetrics practice, Logan Health OB/GYN. This project will implement Meadowlark’s collaborative care model by adding a full-time counselor and a part-time care coordinator to Logan Health’s staff to support women and families across its clinics. Funding will support the project staff and a consultant to provide technical assistance on Meadowlark’s collaborative care model. This is the third Meadowlark project supported at Logan Health since 2017. Over the years, the hospital has developed extensive partnerships with community coalitions and organizations that provide social support to pregnant women and their families. A few identified collaborators on this project include the Early Childhood Coalition of Flathead Valley and the Flathead Valley Perinatal Mental Health Coalition.

MACT in Park and Sweet Grass County

Little Shell Tribe Housing Needs Assessment

The Little Shell Tribe of Chippewa Indians of Montana will collect an accurate assessment of the housing needs and homeless situation of tribal members and develop a housing improvement plan. Because the Little Shell only recently gained federal recognition, there is relatively little specific data on the housing and health needs of enrolled members of the Tribe. To date the Tribe has relied mainly on anecdotal or derivative data to assess health status and assess the need for health and social services. This project will allow the tribe to gather quantitative and qualitative data through household surveys, focus groups, community meetings, and interviews with knowledgeable sources. Grant funds will contribute to the costs of the assessment and housing improvement plan. Expenses include consultant fees, travel expenses, household survey labor and mileage, survey equipment, outreach, and participation incentives. Project partners include Indian Health Service, Rocky Mountain Tribal Leaders Council Tribal Epidemiology Center, and all municipalities in the four-county service area.

Planning for the Financial Sustainability of LiveWell49

LiveWell49 (LW49) is a community coalition focused on improving Park County residents' health and well-being. Its key stakeholders include Livingston HealthCare, Community Health Partners, Livingston School District, Park County Community Foundation, Park County Health Department, and city and county commissions. LW49 used this grant to fund a full-time program assistant who was integral in strengthening the organization and setting it up for long-term sustainability. With the help of this employee, LW49 was able to secure additional funds from a variety of organizations, establish itself as a backbone organization that facilitates community conversations around health improvement, and align and unite community partners.

MCH Integrated Behavioral Health

Mineral Community Hospital (MCH) will integrate behavioral health services into its primary care clinic to improve access to behavioral health for community members with complex social needs and patients experiencing crises. MCH is a 25-bed critical access hospital serving rural western Montana in Superior. The hospital plans to recruit a new behavioral health staff position for the primary care clinic, contract or recruit a psychiatrist to provide program oversight, and update its electronic medical records system to facilitate new screening workflows and data monitoring. Funding will support the new staff position, psychiatric consultation, and direct expenses like training, travel, and marketing. MCH works closely with the Mineral County Health Department and will collaborate on identifying community needs and expanding services.

Community Paramedicine Curriculum

Missoula College used this grant to develop a curriculum in community integrated health care (CIH). CIH allows EMTs and paramedics to expand their roles to provide nonemergency services such as in-home follow-up visits after hospitalization, management of chronic illnesses, fall risk assessments, wound care, and limited behavioral health services. This is the first Montana-based program offering training in community paramedicine to emergency medical technicians (EMTs) and paramedics. Project partners include faculty from the Missoula College Health Professions Department, the University of Montana Social Work and Public Health Departments, Missoula Emergency Services, and the Montana Department of Public Health and Human Services. Grant funds were used to retain a project manager, clinical coordinator, and outreach director; provide stipends to contributing faculty and outside experts; retain an instructional design expert; purchase supplies and equipment for labs; and hire a media company to create audio/visual materials to embed in the curriculum. An interprofessional working group of faculty and health care professionals in medicine, paramedicine, nursing, and social work built the curriculum, which was delivered remotely using online modules, complemented by a clinical rotation. The project graduated 16 CIH providers and is teaching 36 more in its current cohort. It will have a third cohort in the winter and spring of 2024. The project received $55,000 from the Health Resources and Services Administration (HRSA).

Establishing Connections in Eastern and Central Montana: A Planning Grant for the Institute for Neurodiversity and Applied Behavior Analysis

The Montana Center for Inclusive Education (MCIE) at Montana State University Billings will work with partners in Eastern Montana to develop a plan to help rural providers effectively serve children with mental, social, and behavioral differences associated with autism spectrum disorders, developmental disabilities, and mental health disorders. Through this grant, MCIE will develop remote training opportunities for providers and establish a pipeline for referrals of young children who would benefit from telehealth applied behavioral analysis therapy. Applied behavioral analysis therapy helps kids with autism learn skills and lessen problematic behaviors like self-harm. Funding will be used for staffing, supplies, and travel.

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.

Montana Medicaid Survey

The Montana Department of Public Health and Human Services (DPHHS) will survey Medicaid enrollees to learn about their ability to access health services, health-related behaviors, chronic conditions, and environmental factors related to their health. This information will be used by DPHHS, MHCF, and partners to understand and explain the impact of Medicaid on health access and to improve services and health promotion programs. DPHHS will accomplish this goal by selecting a random sample of Medicaid enrollees to complete an online or telephone-based questionnaire. DPHHS is partnering with the University of Wyoming Survey and Analysis Center (WYSAC) to complete this project. Grant funds will cover the survey development and implementation services that WYSAC provides.

Health Care Reporting for Montanans

This grant enabled Montana Free Press (MTFP) to report on critical health issues affecting Montanans, including Medicaid policies, rural nursing home closures, and other pressing topics. The funding supported a health reporter who wrote 39 health-focused stories, which were republished 87 times across 27 publications, and reached nearly 200,000 unique visitors on MTFP’s website during the grant period. The reporter also participated in a residency program with the Glasgow Courier, learning about the paper’s operations, engaging with community members, and co-publishing reporting on local health care challenges. MTFP’s health reporting continues to receive positive feedback, as demonstrated by a recent Statewide News Collective study (a Lenfest Institute for Journalism project) that underscored its service and impact. The study found that “By reading the Montana Free Press, Montanans become more knowledgeable and more invested in their communities.”

Transgender Community Support and Wellness Project

The Montana Gender Alliance (MGA) is a fiscally sponsored Montana Human Rights Network organization. The grant funded MGA to address mental health risks among transgender Montanans, a population that has an elevated risk of social isolation and mental health challenges. MGA conducted a needs assessment and developed training for health care providers to address these risks. MGA conducted in-person and online support groups to address social isolation, connected people with resources, and developed and delivered training focused on mental health for 50 providers.

Strategic Planning of Additional Hospital-Based Medical-Legal Partnerships

The Montana Legal Services Association (MLSA) is a nonprofit law firm that provides free legal information, advice, and other services to low-income people. Through previous MHCF funding, MLSA has built and now sustains work with the Montana Primary Care Association, seven federally qualified health centers, and Providence St. Patrick Hospital to address the health-harming legal needs of patients to achieve better health outcomes. The organization used this most recent grant to create and implement a strategic plan for expanding its successful medical legal partnerships (MLPs) to include more patients and health care providers throughout Montana. The overarching goal is to create a system where civil legal assistance in hospital settings is a standard patient intervention. Funds were used to hire Health Management Associates (HMA), a national expert in MLPs, to develop outreach materials, provide sample contracts, compile data, and coordinate meetings. HMA set up meetings with three hospitals and one health service provider across the state and explained the costs associated with the program, the legalities, and the privacy issues related to this type of project. HMA also connected MLSA with the Montana Hospital Association, a statewide nonprofit that every acute care hospital in the state is a member of. While MLSA had not yet formalized partnerships with the four health care providers by the end of this grant (primarily due to the costs associated with having an attorney on staff) it did secure a $214,000 federal grant to expand MLPs to two urban Indian health clinics with the support of a $25,000 matching grant from our Early Explorations initiative in late 2023.

Montana Professional Health and Wellbeing Program

The Montana Medical Association Foundation created a coalition with other health care organizations to establish the Montana Professional Health and Well-being Program (MPHWP) to assist and rehabilitate licensed Montana health care professionals who are physically or mentally impaired due to excessive substance use or physical or mental disease, disorders, or defects. The goal is to provide support to these professionals and protect public safety. Partners include the Montana Nurses Association, Montana Dental Association, Montana Medical Association, Montana Hospital Association, and Behavioral Health Alliance of Montana. Grant funds were used to bring together these health organizations and other experts to form a nonprofit and an organizing board. During its first year, the board learned about health professional assistance programs, gained an understanding of relevant Montana laws, sought out potential technology vendors, appointed a medical director, developed a plan to deliver services, provided educational programs, and restored local community support programs. While the MPHWP did not win a state government contract to provide services to health care professionals in need of support, it is working to achieve its goals in other ways, such as providing educational programs for health professionals. Having established a governing board, adopted policies and procedures, and hired staff, the MPHWP is well-positioned to provide medical assistance services to health care professionals to support their health and well-being and protect public safety.

Indigenous Foundations in Systems of Education: Shifting the Academic, Holistic Health, And Behavioral School Supports Provided to Montana’s American Indian Students

The Montana Office of Public Instruction (OPI) will work to improve American Indian student academic and wellness outcomes by adjusting its support for academics, holistic health, and behavioral health. OPI serves as the state education authority in Montana and acts as the state-level governmental organization for education. OPI has incorporated Native American knowledge within its Tribal Relations and Resiliency Unit. Through this project, OPI will contract with the Elder and Cultural Wisdom Council to provide training to additional units within the organization. The units include American Indian Student Achievement, Coordinated School Health, and Indian Education for All. Each team will update its strategic plans and implement policies and practices to create necessary changes in the services offered to districts. Grant funds will support the consultant, cover the strategic planning efforts, and travel for meetings.

Partnering to Provide Equitable Care to Unhoused Individuals Impacted by Opioid Use Disorder

Montana State University College of Nursing (MSU CON) partnered with the Open Aid Alliance (OAA) to pilot a medication-based treatment program for opioid use disorder among unhoused clients who face many barriers to accessing this lifesaving treatment. With the support of nursing, social work, and pharmacy students, MSU and OAA conducted interviews with 110 unhoused individuals with opioid use disorders to better understand what accessible, client-centered treatment would look like to them. The interviews revealed that syringe service programs (SSPs) would be an acceptable treatment provider, so the project contacted SSPs in Polson, Kalispell, Butte, and Billings. Following several strategic meetings, MSU, OAA, and the SSPs submitted a proposal to the Community Partnerships to Advance Science for Society (ComPASS) program. It received a $6 million grant over five years. The project will use these funds to continue utilizing a community-engaged approach to SSP-based, nurse-led, and peer-supported medications for opioid use disorder.

Improving Mountain Home’s Continuum of Care for Indigenous Women and Children

Mountain Home Montana provides shelter for young mothers who need support to create safe, stable, and nurturing homes. Through this project, Mountain Home also sought to improve its programming for Native women and families. It used this planning grant to hire a current staff member as a mental health center administrator to coordinate the referral process, provide timely follow-up to referred families, and improve waitlist management. This helped build trust in general, and in several cases, provided safe and effective removal of Native women from human trafficking situations. Mountain Home partnered with All Nations Health Center to hold weekly office hours on-site for its human trafficking task force, Project Beacon, and it developed connections with Native individuals and coalitions located within the Confederated Salish Kootenai Tribe. Mountain Home trained staff on culturally informed doula and mental health practices and improved the cultural competency of childcare programming. To overcome transportation challenges, Mountain Home partnered with Native communities and organizations across the state to grow its referral connections and get transportation assistance when needed. Through this work, Mountain Home increased the rate of Native residential enrollment from 16% to 38%. This grant also helped the organization secure additional funding from long-time funders and new funders, including a Maternity Group Home grant of $250,000 per year for three years from the Family Youth Services Bureau.

Four Bands Workforce & Professional Development

NACDC Financial Services, a community development financial institution (CDFI) located in Browning, will create the infrastructure to incubate businesses and train community members as part of the Mountain|Plains Native CDFI Coalition’s Native finance industry project. This project will address the health consequences of poverty, unemployment, and lack of economic opportunity by placing candidates in quality jobs in the region's Native economies. NACDC will design and implement a skills development program for Native CDFI staff, including a regional recruitment strategy and workforce training program, and will leverage partnerships to explore workforce wrap-around services. Funding will be used as sub-award grants to the other Montana-based Native CDFIs to pilot workforce and professional development innovation.

Integrated Behavioral Health 2.0

The Billings Urban Indian Health and Wellness Center (BUIHWC) will implement a cohesive, collaborative, and culturally appropriate approach to patient care by integrating behavioral health into its primary care clinic. As one of the five urban Indian health centers in Montana, BUIHWC serves Native American people living in Billings and Yellowstone County. This project will hire a project manager to help the organization implement the integrated behavioral health program and collaborate with community health partners. Anticipated results of this program include improved patient outcomes, lower operations costs, and reduced stigma surrounding mental health. Funding will support the project manager position and additional technical assistance. Project partners include community health programs associated with the Native American Development Corporation.

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.

Northern Cheyenne Healthy Housing Needs Assessment

The Northern Cheyenne Tribal Housing Authority (NCTHA) used this grant to conduct a Healthy Housing Needs Assessment for the Northern Cheyenne Tribe, which focused on housing needs and incorporated health, education, employment, economic development, and social services related to housing. With the help of a consultant, NCTHA convened community meetings to educate people about the survey that would be distributed and the importance of community participation. NCTHA worked with partners to develop the survey; queried multiple tribal, county, and private databases to gather addresses; and hired and trained 10 survey workers. Compiling valid addresses and getting people to respond to the survey were challenges. NCTHA recognized that the work it did to identify addresses would benefit residents and other service agencies including the fire department, police department, transportation department, and elderly meals program, and was able to share this information to help facilitate their work. The community housing needs assessment, available later in 2025, will identify the tribe’s most pressing housing challenges. It will also enable NCTHA and other tribal entities to use factual evidence to support grant applications as they gather the funds to meet the tribe’s housing needs.

Integrated Behavioral Health Initiative Implementation at Northern Montana Hospital

Northern Montana Hospital (Northern), based in Havre, will implement integrated behavioral health throughout its health system to universally screen primary care patients for behavioral health conditions and improve health outcomes. Northern will hire a care coordinator and two therapists who will work with the primary care teams to implement integrated behavioral health throughout the Northern health system. Funding will support staffing, project oversight, and updates to the electronic health record to support population health and data analytics. Northern will receive technical assistance from the Montana Healthcare Foundation's technical assistance team and data collection and analysis assistance from JG Research and Evaluation. Throughout the project, Northern will work with the local federally qualified health center, mental health center, Rocky Boy Reservation, and Northern Montana College.

Meadowlark Initiative Implementation at Northern Montana Hospital

Northern Montana Hospital (Northern) will implement The Meadowlark Initiative to decrease drug use in pregnancy, reduce child removals, identify individual needs for each patient and their family, and build a safe team-based approach to support better perinatal outcomes. Northern will coordinate OB/GYN, family practice, and behavioral health providers and provide care coordination to identify and connect resources from the community to patients when needs are identified. Funding will support a care coordinator and licensed addiction counselor, and the project will also draw on Northern's behavioral health team. Project partners include Rocky Boy Health Center and Sweet Home Medical Center.

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.

Crow Nation Innovation Center

The Crow Nation Innovation Center will develop a facility to support community development for the Crow Reservation and surrounding area. Through this project, a signature space in the Crow community will be created to spur innovation and entrepreneurial development as well as local income and jobs. This grant will serve as a match for federal funding secured from the U.S. Economic Development Administration (EDA). Partners include The Steele Reese Foundation, First Interstate Bank Foundation, and the Northwest Area Foundation.

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.

Postpartum Doula Project

Roots Family Collaborative, an organization working to connect families to the support they need from pregnancy to parenthood, used this planning grant for its Postpartum Doula Project, which will provide free or sliding-scale postpartum doula services to families in Gallatin and surrounding counties during the critical developmental stage following birth. The overarching goal is to ensure that all families have access to high-quality postpartum doula care, regardless of their socio-economic background or ability to pay. With the help of a contracted project manager and an outside consultant, Roots Family Collaborative evaluated the staffing capacity needed to manage the strategic planning and program implementation; identified new and existing strategic partnerships; created an advisory council to help develop the strategy and guide decisions; and created a comprehensive handbook to use during program implementation. It has increased its fundraising efforts to support the program and continues to work toward long-term financial sustainability. The team is now ready to launch the project, starting with a two-year pilot phase.

RVMC Integrated Behavioral Health

Ruby Valley Medical Center (RVMC) will integrate behavioral health services into its primary care practice. RVMC is a critical access hospital in Sheridan serving seven rural communities in western Madison County and southern Jefferson County. This project will help RVMC identify a champion to lead the project and provide team training for its providers to enhance the organization’s standard way of delivering care. Funding will support staff training on the integrated behavioral health model, developing organizational workflows to support the model, and integrating a counselor into the primary care office.

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.

West Elementary School-Based Clinic

The Southwest Montana Community Health Center (SWMTCHC) will expand school-based health services to the students of West Elementary in the Butte school district, the second school in which they will offer health services. The health center will help improve the students' health, which, in turn, will support their attendance and education. SWMTCHC will provide the medical and behavioral staff needed to offer services to students on-site at West Elementary. Funding will support a part-time behavioral health provider. Project partners include West Elementary School and the Butte School District.

St. John’s United Workplace Integrative Behavioral Health Initiative

St. John's United (SJU), a senior living provider with campuses in Billings, Laurel, Red Lodge, and Hamilton, used this planning grant to develop a primary care clinic model to be used within its retirement communities. The goal is to address the physical and mental well-being of both employees and residents, which will lead to reduced rates of anxiety and depression, better health outcomes, lower staff turnover, fewer hospital admissions, and improved life satisfaction. The SJU team conducted a thorough baseline wellness assessment of residents and staff members. Results from the employee survey showed a need for services and support in the areas of stress and anxiety, tobacco use, sleep, blood pressure, and weight. Results from the resident assessment showed a need for mental health support services. The team decided the optimal intervention would be to hire a full-time mental health clinician to provide on-site mental health services, psychoeducational groups, mindfulness training, and referrals. The SJU human resources director developed a position description for the behavioral health provider. The team is prepared to launch a comprehensive marketing strategy to encourage employees and residents to engage with the new mental health provider and participate in psychoeducational groups.

Meadowlark Initiative

St. Luke Community Healthcare, located on the Flathead Reservation in Ronan, Montana, used this grant to improve implementation of the Meadowlark model of care, aiming to enhance the behavioral health services it provides to women and families on the reservation. This project was successful in setting up a dashboard and automating data extraction to facilitate the monitoring of OB patients’ care; implementing routine screenings for substance use disorders, depression, and anxiety; ensuring that patients receive a prompt referral when needed; strengthening care coordination for pregnant women and families; and forging community partnerships to maximize access to resources. The registered nurse care manager, licensed clinical social worker, and licensed clinical professional counselor collaborated closely to review patient caseloads with providers and ensure that patients receive the care they need, particularly postpartum care throughout the first year. St. Luke Community Healthcare is committed to sustaining this program and the required positions to continue serving women and families on the reservation.

Integrated Behavioral Health Support Program Expansion

St. Peter's Health (SPH) will expand and strengthen its established integrated behavioral health program. This project will increase the evidence-based screening cadence and enhance team-based care by expanding specialized support services. SPH will hire a licensed addiction counselor and behavioral health navigator and embed these positions into the ambulatory clinics to provide outpatient substance abuse services. The addition of the licensed addiction counselor position will allow SPH's addiction medicine and behavioral health providers to work to the top of their licensure, and the behavioral health navigator will assist in identifying social needs, connecting patients to the appropriate level of care, facilitating referrals, and ensuring continuity of care. Grant funds will support the licensed addiction counselor's salary and a stipend for a Carroll College Master of Social Work Program intern. Over the past several years, SPH has formed strong relationships with community partners, including other health care providers, mental health providers, DPHHS Child and Family Services, Lewis & Clark County Home Visiting Program, and many community-based organizations which will help support the effectiveness of this project.

Parental Mental Health Support Program Expansion

St. Peter's Health (SPH) will expand and strengthen its established Meadowlark Initiative program. This project will increase evidence-based screening cadence and access to services and enhance team-based care by expanding specialized support services. SPH will hire a licensed addiction counselor and behavioral health navigator and embed these positions into the obstetrics clinic to provide outpatient substance use and mental health services. The addition of the licensed addiction counselor position will allow SPH's addiction medicine and behavioral health providers to work to the top of their licensure, and the behavioral health navigator will assist in identifying social needs, connecting patients to the appropriate level of care, facilitating referrals, and ensuring continuity of care. Grant funds will support the behavioral health navigator's salary. Over the past several years, SPH has formed strong relationships with community partners, including other health care providers, mental health providers, DPHHS Child and Family Services, Lewis & Clark County Home Visiting Program, and many community-based organizations which will help support the effectiveness of this project.

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.

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.

Engaging Private Sector Building Industry Professionals in Partnerships to Develop Permanently Affordable Homes for Montanans

Trust Montana used this grant to explore ways to increase the availability of permanently affordable homes by forming partnerships between community land trusts (CLTs) and private sector building industry professionals. This project encouraged affordable home development by leveraging private developer construction financing, nonprofit grant acquisition expertise, land donations, charitable tax benefits, and the growing public and government support for CLTs. Trust Montana created outreach and educational materials targeted to various stakeholders, including builders, engineers, architects, planners and municipalities. It conducted in-person presentations to explain the CLT model and how it works. Trust Montana has now brought several new housing projects towards completion, including Deer Lodge, Lockwood, Roberts, and Missoula projects. It continues to be approached by private builders wishing to partner in developing permanently affordable homes. Additionally, it has developed fee structures for consulting, stewardship, and technical assistance to diversify its organizational operations and rely less on philanthropy.

Building Support to Advocate Effectively for Public Health at the State Level and Nationally

The Network for Public Health Law used this grant to commission a feasibility study to identify barriers, challenges, and opportunities to strengthen public health advocacy at the local, state, and national levels. The goal of this project is to address the chronic lack of funding for public health, which has resulted in county, tribal, state, and federal agencies being unable to carry out the core activities needed to protect and promote health effectively. The seven-page report that was written identified six key opportunities for action: 1) develop and advocate for pro-health policies, 2) cultivate friends of public health, 3) build and strengthen state-level advocacy organizations, 4) develop and disseminate effective, consistent messaging, 5) train the current and future workforce, and 6) unlock funding. The report was disseminated to study participants and partners in the public health field and posted on the Network’s website. The next steps are to convene advocacy and legal experts, funders, and key leaders to react to report findings and discuss actions to strengthen and align public health advocacy efforts at the local, state, and national levels, and to assess the existing capacity for public health advocacy at the state and national levels. The Network has received funding from the CDC Foundation and de Beaumont Foundation for $250,000 each, as well as in-kind support from the American Heart Association. In November, the study’s authors presented the results at the APHA Advocacy for Leaders annual workshop, and they submitted abstracts for several related conferences in 2023.

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.

Butte Housing is Health Care Data Coordination Project

Action, Inc. is the nonprofit community action agency for the six-county region around Butte and works to develop pathways out of poverty for area residents. This grant will support Action, Inc. to create a database that allows the Butte Housing is Health Care Initiative partners to track and coordinate housing units and supportive services. It will begin by working with partners – including the Butte Housing Authority, St. James Healthcare, and Southwest Montana Community Health Center – to assess the data systems they currently use to track homeless individuals and their interactions with health, justice, and social service systems. Then, the team will agree to a set of data elements that will allow partners to track and more effectively manage outcomes for these individuals and build them into the new data tracking platform. Funding will support project coordination staffing, consultation, and data system access. The new shared data system will enable the partners to align housing units with supportive services, creating a more effective permanent supportive housing program for the region.