Northern Cheyenne Healthy Housing Needs Assessment

The Northern Cheyenne Tribal Housing Authority will conduct an in-depth housing needs assessment for the Northern Cheyenne Nation. The assessment will focus on housing needs and incorporate health, education, employment, economic development, and social services related to housing. Funding from the U.S. Department of Housing and Urban Development Office of Native American Program Training and Technical Assistance will support a consultant to conduct the assessment. Montana Healthcare Foundation funding will support the direct expenses incurred through local data collection activities, including field staff labor, equipment, mileage, and respondent incentives. Project partners include Northern Cheyenne Tribal Health, the Tribal Board of Health, and the Tribal Health Improvement Program.

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 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.

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

The Postpartum Doula Project, a program of Roots Family Collaborative, will provide free or sliding-scale postpartum doula services in Gallatin and surrounding counties for families in the critical developmental stage following birth. Roots Family Collaborative's mission is to connect all families to the support they need from pregnancy to parenthood. This planning grant will support a year-long process during which the organization will examine and build program staff capacity, identify new and existing strategic partnerships, develop an advisory council, identify and overcome barriers to creating long-term sustainability for the program, and develop a handbook for program implementation.

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) 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.

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

This project will develop on-site primary care with integrated behavioral health services for residents and employees of St. John’s United (SJU) senior living facilities. SJU is a significant provider of senior living opportunities, with campuses in Billings, Laurel, Red Lodge, and Hamilton. Its services include transitional inpatient rehabilitative care, skilled nursing, memory care, assisted and independent living, permanent supportive housing for older adults, home health, hospice, outpatient rehabilitation, and home and community-based services. The project goals include lower turnover, lower insurance premiums, higher work satisfaction for staff, and fewer hospital admissions and falls. They hope to achieve reduced rates of anxiety and depression and improved quality of life for both employees and residents. SJU’s work plan includes gathering initial health assessment data to develop implementation and service delivery targets. Funds will support the salaries of the team developing the project as well as consultation fees from mental health professionals. SJU will establish a new partnership with South Central Regional Mental Health Center for consulting services and future contracts with mental health providers.

Meadowlark Initiative

St. Luke Community Healthcare will continue participating in The Meadowlark Initiative and enhance the behavioral health services it provides to women and families on the Flathead Reservation. This project will develop a patient registry to improve St. Luke’s data collection and analysis capacity, strengthen care coordination for pregnant women and families, and build a self-sustaining Meadowlark Initiative program. Funding will support care coordination and staff training on the electronic medical record. Partners include the Confederated Salish and Kootenai Tribes Tribal Health Department and St. Joseph Healthcare.

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. Peters Hospital (SPH) will expand its data system to include the Coordinated Entry System, which identifies the most appropriate housing resources for homeless individuals. Currently, SPH’s system tracks data points of frequent users of jails, shelters, hospitals, and crisis public services (known as “Frequent User System Engagement” or “FUSE” clients). By enhancing its current data dashboard and expanding it to partner with the Coordinated Entry System, SPH will improve the community's capacity to monitor outcomes and keep clients housed. The new system will also help SPH and partners track and coordinate the supportive services needed to keep clients housed. Grant funds will support staffing costs for building and managing the upgraded data system. Our partners include the Helena Housing Authority, United Way, PureView Health Center, God’s Love, Good Samaritan Ministries, Lewis and Clark County Jail, and other organizations within the Coordinated Entry System.

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 will implement a replicable model for partnership between community land trusts and private sector building industry professionals as an innovative way to create more affordable housing. Trust Montana is located in Missoula and works to increase the number of permanently affordable homes in the state. This project will accelerate affordable home development by leveraging private developer construction financing, nonprofit grant acquisition expertise, land donations, related charitable tax benefits, and community land trusts' growing public and government support. Funds will support current staff in developing a tool kit and outreach plan and assisting rural communities across the state. Partners include WGM and Blueline Development, Inc.

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.

Montana PAX Sustainability Initiative

The Economic Impact of a Montana Law Income Housing Tax Credit Program

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.

All Nations Housing Feasibility Study

All Nations Health Center is an urban Indian health center located in Missoula; it serves over 4,000 Native American people. This project will help the center conduct a feasibility study for a new facility incorporating housing and an integrated care clinic. Homeward, a local affordable-housing developer, will conduct the study, including housing development costs and available funding resources for financing. MASS Architecture Design will finish a preliminary architecture report detailing the logistics of an integrated care clinic. The Native American Development Corporation will support organizing finance options for the new building. Funding will support the contractors to complete the feasibility study, housing development costs, building design, and finance options.

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.

Pivoting from Emergency Food Response to Food Sovereignty (FSC) Programming with Healthy Local Foods

The Arlee Community Development Corporation (CDC) sought to establish a walk-in, choice-based food pantry and resource center that provides access to more local nutritious food and food education to communities in the Jocko Valley. By collaborating with a range of partners, including Confederated Salish and Kootenai (CSKT) Tribal Health, CSKT Food Sovereignty Initiative, Mission Mountain Food Enterprise, and Montana Growers Cooperative, Arlee CDC was able to serve more hard-to-reach populations with a variety of food options, services, and educational programs. Patrons of the food pantry were educated about SNAP benefits and received assistance with SNAP applications. Arlee CDC accessed food from local growers and producers, provided meal kits to families, offered cooking and food preservation classes, educated about ancestral food preparation, and provided garden boxes to encourage families to grow their own food. Arlee CDC received a $15,000 grant from Hopa Mountain, got access to $15,000 - $20,000 in federal Emergency Food Assistance Program funding, and obtained other in-kind and financial donations from partners.

Regional Integrated Behavioral Health Integration Project

Billings Clinic is a health care system that serves the state of Montana through a network of regional affiliate hospitals. For this project, nine critical access hospitals (which began implementing integrated care through a prior grant) will continue the process of transforming their primary care practices to a high-quality integrated behavioral health model, and up to five additional sites will join the network and begin implementing integrated care. The project aims to promote a deep understanding of integrated care practice and benefits, support long-term, sustainable engagement at rural sites, and promote integrated care conformity across the Billings Clinic affiliate network's Montana sites. Billings Clinic will continue network development activities and data sharing, with close collaboration and support of the Billings Clinic Regional Services team and the Montana Healthcare Foundation's technical assistance providers. Funding will support startup costs for additional care managers for the region (located in a rural affiliate site) and remotely support the rest of the facilities.

Butte SPIRIT Home, Scaling up Staffing to Support SUD Recovery Home Sustainability

The Butte Spirit Center, which operates the Butte SPIRIT Home, a transitional housing and addiction recovery home for adult males, used this grant to attain approval as a substance use disorder (SUD) treatment program from the state of Montana. The goal was to enable the home to access Medicaid and other private insurance revenue to sustain its current operational model. The home was successful at getting approval as a Montana Medicaid biller and is licensed to provide care as a clinically managed low-intensity residential service provider (ASAM Level 3.1). In addition to the executive director, the home hired a clinical director, residence manager, and assistant residence manager. Staff retention has been excellent, with staff finding the Butte SPIRIT Home to be a good workplace offering a competitive benefits package. The home has served 26 men overall and has graduated five residents, all of whom remain in contact with the home to ensure their success in recovery. Based on an internal evaluation and feedback from partner organizations, the Butte SPIRIT Home provides a quality sober living environment that is helping people in early recovery to succeed. Working with a third-party biller, the home has attained reimbursement for services through Medicaid. Current reimbursement levels indicate that the Butte SPIRIT Home could be 100% sustained by the billable services that the home is already providing.

Expansion of Behavioral Health Programs in Missoula

This grant enabled Cancer Support Community Montana (CSCMT), which provides support, education, and hope to improve the quality of life of those impacted by cancer, to open a Missoula Chapter in in the former Cold Springs Elementary School building. The goal was to bring a new resource to Western Montana that could transform the cancer experience, increase access to care, and address depression and anxiety for patients and their families. CSCMT’s Missoula Chapter is now fully functioning, with a full-time executive director, a full-time program director, and a full-time development and operations manager. It offers a comprehensive program of support for people with cancer and their caregivers, including monthly support groups, weekly new participant orientations, education programs, mind/body classes, behavioral health services, and wigs and other supplies. The program director is providing one-on-one mental health counseling and developing a community so people have the support they need during their time of difficulty. The Missoula Chapter has successfully localized services in the community in a warm home-like environment that is patient-centered and free of charge. It has built relationships with local cancer centers, other support groups, and community members; recruited a Chapter Board; started building its donor network of individuals and businesses; and executed several successful fundraising campaigns, which will help it continue to provide all services at no cost to community members.

Increasing Capacity and Food Quality to Create a Healthy Culturally Based Reservation Food System

Center Pole is a 23-year-old grassroots, Native-led organization on the Crow Indian Reservation in southeastern Montana. Its food security project aims to improve its capacity to procure, produce, store, and distribute healthy foods to people on the reservation and in the surrounding areas. Despite the challenges of decreased food supplies and higher food prices, Center Pole achieved several of its objectives. It completed improvements to its warehouse, expanded its mostly indigenous food network, received a wide variety of local food donations, and trained 42 community food interns in food safety, distribution, and preparation. Center Pole is working with community elders to learn about the edible wild plants in the area and how they can be used by local populations. It is also focusing on requesting healthier foods from its sources, including the Montana Food Bank Network.

Rocky Boy Food Sovereignty Project

Rocky Boy's Indian Reservation is in the remote Bear Paws mountains of North Central Montana. The remote location has contributed to a food desert on the Reservation, with the nearest grocery store selling fresh foods over 30 miles away. The Chippewa-Cree Tribe's Rocky Boy Food Sovereignty Project will develop a food chain of healthy products grown and produced on the Reservation. The project will help plant gardens, develop and market new value-added food products such as flour and pasta, and establish food handling laws. Locally grown and raised food products will be branded and made available to the community. Funding will help the purchase tools to support the food packaging and support a project coordinator who will develop and implement the program and build toward financial sustainability. Partners include the Stone Child College, the Rocky Boy Diabetes Program, Rocky Boy Public Schools, and the Chippewa Cree Agriculture and Sustainability Program team, which will serve as a board oversight for the project.

Community Medical Center’s Consolidation Grant

Community Medical Center (CMC) is a large hospital in Missoula that serves the surrounding region. This project will expand CMC's capacity to provide the entire continuum of care for patients with mental illness and substance use disorders by fully integrating behavioral health into its primary care clinics, expanding services through telehealth to specialty and walk-in clinics, and thoroughly training and integrating its clinical teams. Funding will support a social worker to serve as a centralized behavioral health care manager for the project. This person will provide the personnel, psychiatric consultation, and clinical supervision needed to implement the project. Partners include the University of Montana's Behavioral Health Workforce Education and Training Program, Walla Walla University's Masters in Social Work Program, Andy Laue, LCSW, who provides group clinical supervision for the behavioral health providers, and other community behavioral health providers who offer individual clinical supervision and psychiatric consultation to the team.

Aaniiih/Nakoda Food Sovereignty on the Fort Belknap Indian Reservation

The Day Eagle Hope Project, a Native nonprofit on the Fort Belknap Indian Reservation that addresses health and wellness issues, used this grant to provide fresh fruits, vegetables, and protein to all four communities on the reservation and to demonstrate healthy living and cooking for every home. Partners included the Fort Belknap Tribe, Fort Belknap Public Health, Indian Health Service, and Aaniiih Nakoda College. The project identified American Indian farmers and ranchers from Fort Belknap and the Chippewa Cree Tribe to supply high-quality, ranch-raised beef—including Bear Paw Livestock Yards and Bear Paw Meats—and oversaw every stage of the process, from production to processing to distribution. The Fort Belknap Tribe donated eight buffalo for meat distribution on a yearly basis, and the Peoples Partners for Economic Development provided a mobile processing unit to come on site for the kill. The project partnered with the Turner Hutterite Colony to supply locally grown vegetables and sponsored a youth event where young people received education on healthy living and a large bag of fresh produce. This project will be sustained through tribal support, local support, and possibly USDA funding.

Sustaining Food Security with MNT Service Delivery

FAST Blackfeet used this grant to develop a sustainable method of funding for its Food Pharmacy Program (FPP), which provides medical nutrition therapy (MNT), group nutrition classes, fruit and vegetable vouchers, and specialized food pantry food boxes to participants who are referred by their health care provider for a nutrition-related chronic disease or food insecurity. The goal was to establish a method of third-party billing so FAST Blackfeet could receive reimbursement for its MNT services. FAST Blackfeet hired consultants to provide technical assistance to help create the new billing system and coordinate the effort with the Blackfeet Tribe, Blackfeet Tribal Health, Blackfeet THIP, and Montana Medicaid. The Blackfeet Tribal Business Council signed a contract, to be administered by Blackfeet Tribal Health, that allows the FAST registered dietitian to provide MNT to patients at the Southern Piegan Health Center (SPHC). Services will be billed at the tribe’s all-inclusive Medicaid reimbursement rate, and the revenue generated will be shared between SPHC, Centralized Billing, and FAST Blackfeet (15/5/80). Because MNT visits for adults 21 and older are not covered by Medicaid, the consultants submitted a proposal to Montana Medicaid to expand coverage to that age group. Medicaid has requested time to review the proposal before making a decision. The consultants also helped create systems for evaluating the FPP. While FAST Blackfeet has not yet seen any revenue from this project, the systems are in place to generate revenue. Additionally, as the community becomes more familiar with MNT services, there will be more opportunities for revenue through Medicaid billing.

Working Toward a Healthy, Food Secure Blackfeet Nation

FAST (Food Access and Sustainability Team) Blackfeet used this grant to reduce food insecurity, increase food access, and improve nutrition intake and knowledge in the Blackfeet Nation. Due to the pandemic, the FAST Blackfeet O’yo’p’ Food Pantry saw a 3.6-fold increase in its participant numbers, requiring it to expand its operations to meet the demand. With the help of this grant, FAST Blackfeet was able to continue distributing food five days a week year-round, both in the food pantry in Browning and through its O’yo’p’ on Wheels Mobile Food Pantry, which serves eight outlying communities located within reservation boundaries. Under the direction of its new executive director, visitors to the pantry are now able to choose, handle, and load their own food, which has resulted in greater satisfaction among participants. FAST Blackfeet has strengthened its partnerships, including with the Montana Food Bank Network, which provides food, helps procure equipment, and assists in obtaining small and large grants. The Montana Food Bank Network helped FAST Blackfeet conduct its annual survey, which led to modifications in the pantry’s food offerings, delivery logistics, and public communications. FAST Blackfeet was able to resume its in-person nutrition workshops and dietician services, which are well-regarded within the community and help empower participants to make healthy food choices.

Spotted Bull Recovery Resource Center Behavioral Health Capacity Building Project

Spotted Bull Resource Recovery Center (SBRRC) is the primary addiction treatment service provider in Fort Peck, offering chemical dependency services and inpatient treatment to the Fort Peck Indian Reservation and surrounding community. With this grant, SBRRC will add mental health services to the care it offers people with substance use disorders. To accomplish this, SBRRC will provide training to its staff to help them develop the necessary clinical competencies, contract with a mental health provider for therapeutic services, implement culturally relevant healing practices, and develop a third-party billing system. Funding will support the contract with a mental health consultant and behavioral health telehealth providers. It will also support the project's evaluation and travel for site visits. The project will be completed through established partnerships with the Indian Health Service, Volunteers of America, and Our Home, Inc.

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.

Building Bridges for Better Births

Building Bridges for Better Births aims to improve community-based support systems for families through pregnancy and after birth by facilitating relationships between prenatal care providers and family support providers. The program will support the development of community teams, a critical component of The Meadowlark Initiative® model of care. Community teams are made up of social service providers, peer recovery coaches, and related caregivers who all play an essential role in supporting pregnant and postpartum women and their families. This project is a continuation of Healthy Mothers Healthy Babies'work to support The Meadowlark Initiative® in previous years.

Feather Woman Healing Lodge Business Plan

Heart Butte Public Schools, located on the Blackfeet Reservation, hired RJS & Associates to develop a business plan for creating the Feather Woman Healing Lodge, a new facility that would serve students who are homeless or experiencing a mental health crisis. The school district has already purchased two modular homes that will be able to shelter up to 12 students—six girls and six boys—at a time. Through this project, RJS completed a business plan that outlines staffing needs, operation and maintenance costs, insurance costs, risk management, potential funding sources, and other operational infrastructure needed for the facility, as well as the next steps required to advance the project. The project was delayed due to difficulties in securing a partnership with Blackfeet Tribal Health programs (which have been impacted by COVID and leadership changes), but Heart Butte Public Schools is actively developing that partnership.

New Clinic Addition/Design

Helena Indian Alliance (HIA), an urban Indian health center based in Helena and serving the surrounding counties, used this grant to support the redesign of its clinic so it could expand and improve its integrated physical, behavioral, and dental health care services. HIA contracted with SMA Architecture to complete the design phase of the project, which included the creation of a schematic design; structural, civil, mechanical, plumbing, electrical, and architectural scopes; project specifications; and construction and bid documents. This project builds on two prior grants that involved developing a master plan and a structural assessment of the current building. With the plans and design in place, HIA was able to secure funds for the construction costs, estimated at roughly $1.1 million; receive approval from the Billings Area Indian Health Services to move forward; and select a contractor.

Eastern Montana Perinatal Behavioral Health

Holy Rosary Healthcare will join the Meadowlark Initiative and improve access to mental health and substance use disorder care for pregnant women in Miles City and Eastern Montana. The project will integrate behavioral health services into Holy Rosary’s obstetrics clinic. As part of this project, Holy Rosary Healthcare will hire a care coordinator to work directly with patients and foster connections with social service organizations in the community. In addition to hiring a new staff person, grant funding will help establish telepsychiatry services and support coaching from the National Council for Behavioral Health to ensure the project’s success and sustainability. Partners include the Montana Health Network, the Eastern Montana Community Mental Health Center, and Rimrock Foundation.

Tracking and Evaluation of Outcomes for Residents Housed Through Coordinated Entry

The Human Resource Development Council of District IX, Inc. (HRDC) leads the Bozeman community’s coordinated entry, homeless shelter, and Housing First Village, in addition to providing many essential services to families with low incomes. To better understand how the system is currently used and identify housing and service gaps in the community for the housing insecure population, HRDC will develop a database to track housing vouchers and service utilization. Creating a database and information system will allow HRDC to gather data from housing and service providers. It will also help providers coordinate care and resources for recently housed individuals to ensure they remain stably housed. Funding will support technical assistance to develop the data platform, staff project coordination, and database maintenance. Partners for this project include agencies in Bozeman that currently serve the homeless population, including Community Health Partners, Bozeman Health, faith-based organizations, and other community service providers.

HRDC Rural Housing Planning Grant: Home Rehabilitation

The Human Resource Development Council of District IX (HRDC), which serves southwest Montana with community assistance programs, used this grant to build pathways for low-income homeowners to remain stably housed in a healthy, safe environment. This project focused on developing home rehabilitation programming, planning for new housing needs, and partnership building in HRDC’s rural service area, including Park County, Meagher County, and the town of West Yellowstone. In Meagher County, HRDC presented the results of its 2021 Meagher County Housing Needs Assessment to the county commission and community partners. This new resource will guide potential partners as they explore the development of quality, affordable housing. In West Yellowstone, HRDC staff and the school board are transferring property and development plans previously owned by HRDC to the local school district to provide quality rental housing for teachers in the community. In Park County, HRDC worked to expand community engagement around the Park County Housing Action Plan and to grow the Park County Housing Coalition (PCHC), including developing a community investment fund, working with local employers to house the local workforce, and providing continued community education. HRDC staff prepared and will submit a Community Development Block Grant (CDBG) Rural Rehabilitation application in partnership with Park County to get state funding to complete safety upgrades for households unable to afford such improvements.

Jefferson Valley Community Integrated Health Launch

Jefferson Valley EMS & Rescue (JVEMSR) will begin offering community integrated health (CIH) services – often also referred to as "community paramedicine" – for residents of the Jefferson Valley. CIH can fill the health care gaps in care between hospital and emergency visits, home health, and hospice care. Jefferson Valley CIH will provide scheduled health care in people's homes, community gathering areas, walk-in hours in Whitehall, and at events such as mobile vaccine clinics. It will also be available to provide transportation to and from medical appointments and hospital stays. JVEMSR will create a steering committee for the project and will partner with multiple care providers in their area, including Saint James Healthcare, Whitehall Medical Clinic, and Mercury Street Medical Clinic for referrals. Funding will support the project director and CIH care technicians.

Troy Library and Opportunity Center Planning Grant

The Lincoln County Library is partnering with the community of Troy to transform the Library into a new Troy Library and Opportunity Center (TLOC). This grant was used to support the initial visioning and development of the center, which will provide improved access to services and resources for people in rural communities who are struggling with substance abuse, lack of human connectivity, poverty, and mental health issues. The planning team, which grew to 19 community agencies over the course of the grant, utilized a variety of methods to gather community feedback, including surveys, meetings, canvassing, and visioning sessions. Lincoln County Library has begun developing an operations plan, and a standard operating procedures document will be formalized as soon as the building design phase is underway. The partners are also working on a sustainability plan that addresses both capital and program needs, which will be revisited as the building and facilities are further developed. Five of the partner agencies have committed to providing support for the project. Some organizations have already begun offering services in the existing building, which has led to an expansion of community programs and services in Troy that are improving the quality of life for families and expanding healthy opportunities.

Strategic Planning for Little Shell Tribal Departments

The Little Shell Tribe of Chippewa Indians of Montana is the newly federally recognized Tribe of the Ojibwe people. Its service area includes Cascade, Blaine, Hill, and Glacier counties. This strategic planning project will help the Tribe begin developing a high-quality, effective health system by supporting the Tribe to create a mission and vision to meet the needs of its people and by providing expert technical assistance on health system design, infrastructure development, and operations. The Little Shell Tribe will model its new health system on Alaska Southcentral Foundation's award-winning NUKA System of Care. Funding will support a contract with the Southcentral Foundation to provide technical assistance and training throughout the planning process and the early stages of implementation. The project will be completed through close collaboration among the Little Shell Tribal Council, Tribal staff, and community members.

Integrated Behavioral Health

Madison Valley Medical Center in Ennis used this grant to integrate behavioral health into its primary care services. Building upon a successful integrated behavioral health (IBH) planning grant that was driven by the local advisory council on mental health, this project aimed to provide early identification and more effective treatment of depression and substance use disorders, increase revenue from integrated care, and reduce emergency room visits related to behavioral health conditions. The Madison Valley team received technical assistance from the National Council for Mental Wellbeing and the Montana Healthcare Foundation. The team was able to recruit a therapist, educate staff about IBH, establish consistent screening protocols, and track behavioral screenings and referrals. Having to input, track, and report data manually posed a challenge, but the team is working to build a new electronic medical record system with more data capabilities. The Madison Valley team will continue its IBH journey through a consolidation grant and will work with the Montana Healthcare Foundation’s IBH technical assistance team.

Indigenous Evaluation and Dissemination of the Báa Nnilah Project

Messengers for Health works to improve the health of people living on the Crow Indian Reservation and outlying areas through community-based projects designed to empower communities to address their unique health issues. For this project, Messengers for Health will partner with two Tribal nations to adapt, implement, and evaluate a chronic disease self-management program – “Báa nnilah” – the grantee developed on the Crow reservation program. The evaluation will help the grantee and tribal partners adapt Báa nnilah for the specific needs of these Tribes, and it will help establish Báa nnilah as an evidence-based program, making it potentially reimbursable through the Tribal Health Improvement Program and providing sustainability for the project over the long term. Partners include Crow, Fort Belknap, and Rocky Boy Indian Reservations. Funding will support community members from the three communities to come together and develop the evaluation plan, support the adaptation of program manuals, and implement and evaluate the program in each community.

Local Food for Local Families: Montana SNAP Food Box Pilot Project

The Local Food for Local Families: Montana SNAP Food Box Pilot Project will provide fresh, high-quality food items from Montana producers and processors to families with low incomes in Western Montana. The Mission Mountain Food Enterprise Center (MMFEC) will partner with the Community Food and Agriculture Coalition and its Double SNAP Dollars Network to launch a pilot project that explores the sustainability of a long-term food box program using Supplemental Nutrition Assistance Program (SNAP) benefits and Double SNAP Dollars. This incentive allows Supplemental Nutrition Assistance Program (SNAP) recipients to double their benefit dollars for fresh fruits and vegetables. The program will provide boxes of local, fresh foods sourced from the Western Montana Growers Cooperative to food access sites in the Mission Valley, Flathead Indian Reservation, and Missoula's American Indian urban population through the All Nations Health Center. Individuals and families will use their SNAP benefits to purchase weekly food boxes, and the Double SNAP Dollars incentive will subsidize the cost. MMFEC will also develop and coordinate a new statewide partnership: Local Food for Local Families. This partnership will provide support and collaboration opportunities for increasing local and healthy food access for all Montanans and Tribal communities. Grant funding will support project coordination, free food boxes for two distribution sites to generate future interest, marketing, outreach, and project evaluation.

Health From More Angles: Intersectional Health Care Reporting and Analysis for Montana Communities

This grant supported Montana Free Press to report on health care issues impacting Montanans. Reporting covered a range of issues, including youth homelessness, rural emergency care shortages, the impact of climate change on mental health, COVID-19 testing availability at the height of the pandemic, and a range of other topics. In all, the grant supported 54 health-specific stories, which were republished in 109 print news outlets and 51 digital news outlets. Stories were provided to news outlets free of charge. The depth and variety of news organizations republishing the reporting demonstrated the demand for health journalism that informs and educates Montanans on public health issues. The quality of journalism produced was notable: did not go unnoticed and received awards from the Montana Newspaper Association. The health journalism produced through this project helped the Montana Free Press build relationships with and receive funding from other organizations that fund health journalism.

Eastern Montana Integrated Behavioral Health Project

The Eastern Montana Integrated Behavioral Health Project will support integrating behavioral health (IBH) into primary care for five rural healthcare facilities in eastern Montana (Baker, Ekalaka, Broadus, Malta, and Jordan). The grant will also allow three current IBH sites (Forsyth, Culbertson, and Terry) to refine and improve their initial IBH implementation efforts supported under MHCF's previous IBH network grant to the Montana Health Network (MHN). The goals for the project are to 1) implement routinescreening and early intervention for behavioral health and substance use issues in primary care; 2) improve care coordination between treating facilities; and 3) develop a sustainable integrated behavioral health model for existing and new facilities. Through implementing IBH in these facilities and consolidating the practice in previous grant sites in MHN’s network, the project seeks to improve health outcomes, contribute to a more effective crisis system in eastern Montana, and reduce the use of emergency services. MHN will use grant funds to provide project management, technical support and training, psychiatric consultation, and care coordination services. MHN will partner with Eastern Montana Community Mental Health Center (EMCMHC) and Frontier Psychiatry to provide clinical services to patients at individual sites.