Bighorn Valley Health Center Incorporated

HEALTH CENTER CLUSTER

HEALTH CENTER CLUSTER

ARP ECONOMIC DEVELOPMENT GRANT FOR RURAL HEALTH CARE FACILITIES

RURAL COMMUNITIES OPIOID RESPONSE PROGRAM - MEDICATION ASSISTED TREATMENT ACCESS - PROJECT TITLE ONE HEALTH RCORP-MAT ACCESS PROJECT REQUESTED AWARD AMOUNT $3,000,000 FOR 3 YEARS APPLICANT ORGANIZATION NAME BIGHORN VALLEY HEALTH CENTER, INC. DBA ONE HEALTH APPLICANT ORGANIZATION ADDRESS 10 4TH STREET WEST, HARDIN, MONTANA 59034 APPLICANT ORGANIZATION FACILITY TYPE FEDERALLY QUALIFIED HEALTH CENTER PROJECT DIRECTOR NAME AND TITLE PATTI JO HILL, MSW, LCSW ONE HEALTH, BEHAVIORAL HEALTH STAFF PROJECT DIRECTOR CONTACT INFORMATION PHONE: (406) 629-3015 EMAIL: PATTI.HILL@ONECHC.ORG OUR PARTNERS IN THIS PROJECT INCLUDE CENTRAL MONTANA HEALTH DISTRICT, BIG SANDY PHARMACY, AND MEADOWLARK COUNSELING SERVICES. WE PROPOSE TO ESTABLISH FOUR NEW MEDICATION ASSISTED TREATMENT (MAT) ACCESS POINTS (STANFORD, MT; HARLOWTON, MT; SHERIDAN, WY; AND CENTRAL MONTANA MOBILE MEDICAL CLINIC BASED OUT OF FERGUS COUNTY, MT) WITHIN OUR PROPOSED SERVICE AREA WHICH COMPRISES EIGHT ENTIRELY RURAL COUNTIES IN CENTRAL MONTANA AND NORTHEASTERN WYOMING: BIG HORN COUNTY, MT, FERGUS COUNTY, MT, GOLDEN VALLEY COUNTY, MT, JUDITH BASIN COUNTY, MT, MUSSELSHELL COUNTY, MT, PETROLEUM COUNTY, MT, WHEATLAND COUNTY, MT, AND SHERIDAN COUNTY, WY. MAT WILL BE DELIVERED IN A MODEL THAT INTEGRATES SUPPORTIVE MENTAL HEALTH SERVICES, ALONG WITH MEDICAL, DENTAL, AND HEALTHCARE NAVIGATOR SERVICES. ENCOUNTERS WITH MAT PRESCRIBERS WILL OCCUR VIA TELEHEALTH AND ROTATING IN-PERSON VISITS. THREE TARGET POPULATIONS HAVE BEEN IDENTIFIED FOR THIS PROJECT: AMERICAN INDIANS (12.6% OF SERVICE POPULATION), PREGNANT, PARENTING, OR OTHER WOMEN OF CHILD-BEARING AGE, AND YOUTH. ALL THREE POPULATIONS WERE SPECIFICALLY CHOSEN: HIGH RATES OF SERVICE AREA YOUTH REPORTING EARLY INITIATION OF DRUG USE; THE PERCENTAGE OF PREGNANT WOMEN RECEIVING PRENATAL CARE IS LOW, AND ACCURATE DATA REGARDING PREVALENCE OF SUD AMONG PREGNANT WOMEN ARE SCARCE; AND THE CROW RESERVATION LIES WITHIN THE SERVICE AREA. TRIBAL MEMBERS ARE KEY STAKEHOLDERS IN THIS PROPOSAL, AND ARE INVOLVED USING A RANGE OF STRATEGIES, INCLUDING PARTNERING WITH TRIBAL ORGANIZATIONS. WE WILL USE INCORPORATE MULTIPLE APPROACHES TO LEVERAGE THE LIMITED AVAILABILITY OF LICENSED MAT PRESCRIBERS INCLUDING USE OF CLINICAL PHARMACY, BEHAVIORAL HEALTH CARE MANAGERS, AND CERTIFIED BEHAVIORAL HEALTH PEER SUPPORTERS. WE ANTICIPATE THE MODEL WILL ATTAIN FINANCIAL SUSTAINABILITY BY THE END OF THE PERFORMANCE PERIOD.

AMERICAN RESCUE PLAN ACT FUNDING FOR HEALTH CENTERS

RURAL COMMUNITIES OPIOID RESPONSE PROGRAM ? MENTAL AND BEHAVIORAL HEALTH - PAPER SUBMISSION, ALL INFO ENTERED AS PROVIDED BY APPLICANT.

EXPANDING ACCESS TO INTEGRATED MEDICATION ASSISTED TREATMENT IN FRONTIER MONTANA

RURAL COMMUNITIES OPIOID RESPONSE PROGRAM ? NEONATAL ABSTINENCE SYNDROME - RURAL COMMUNITIES OPIOID RESPONSE PROGRAM – NEONATAL ABSTINENCE SYNDROME

HEALTH CENTER INFRASTRUCTURE SUPPORT

RURAL COMMUNITIES OPIOID RESPONSE-IMPLEMENTATION

RURAL COMMUNITIES OPIOID RESPONSE-IMPLEMENTATION

ARP ECONOMIC DEVELOPMENT GRANT FOR RURAL HEALTH CARE FACILITIES

HEALTH CENTER PROGRAM SERVICE EXPANSION - SCHOOL BASED SERVICE SITES (SBSS)

RURAL HEALTH CARE SERVICES OUTREACH GRANT PROGRAM

HEALTH CENTER CORONAVIRUS AID, RELIEF, AND ECONOMIC SECURITY (CARES) ACT FUNDING

FY 2024 BEHAVIORAL HEALTH SERVICE EXPANSION - THE BIGHORN VALLEY HEALTH CENTER, INC. DBA ONE HEALTH (ONE HEALTH), A FEDERALLY QUALIFIED HEALTH CENTER (FQHC) IN RURAL MONTANA AND WYOMING, IS APPLYING FOR BEHAVIORAL HEALTH SERVICE EXPANSION (BHSE) FUNDS TO INCREASE THE NUMBER OF PATIENTS RECEIVING MENTAL HEALTH SERVICES AND INCREASE THE NUMBER OF PATIENTS RECEIVING SUD SERVICES, INCLUDING TREATMENT WITH MEDICATIONS FOR OPIOID USE DISORDER (MOUD) IN A SIXTEEN-COUNTY AREA OF RURAL MONTANA AND WYOMING. FOUNDED BY PHYSICIAN LEADERS IN RESPONSE TO COMMUNITY NEEDS, ONE HEALTH OPENED ITS DOORS IN HARDIN, MONTANA, IN OCTOBER 2012 AND HAS BEEN CONSISTENTLY GUIDED BY ITS MISSION TO IMPROVE THE WELLBEING OF EVERYONE BY PROVIDING ACCESSIBLE, QUALITY HEALTH CARE TO THE WHOLE COMMUNITY. WITH THIS PROPOSAL WE INTEND TO MAKE STRATEGIC INVESTMENTS TO SCALE UP AN INNOVATIVE APPROACH TO DELIVERING A MODEL OF COORDINATED, EVIDENCE-BASED, TRAUMA-INFORMED MENTAL HEALTH AND SUD SERVICES TO COMMUNITY MEMBERS LIVING IN OUR RURAL SERVICE AREA. WE WILL BUILD ON SUCCESSFUL WORK WITH EXISTING COLLABORATORS TO CONNECT WITH THE PRIMARY TARGET POPULATION OF THIS PROJECT, WHICH INCLUDES ALL RESIDENTS OF THE DESIGNATED SERVICE AREA. BHSE FUNDS WILL SUPPORT THE ADDITION OF 5.0 FTE NEW BEHAVIORAL STAFF, INCLUDING FOUR LICENSED BEHAVIORAL HEALTH CLINICIANS. BY DECEMBER 31, 2025, WE EXPECT TO PROVIDE MENTAL HEALTH SERVICES TO 1,187 NEW PATIENTS, SUD SERVICES TO 172 NEW PATIENTS, INCLUDING MOUD TO 137 NEW PATIENTS ACROSS OUR SERVICE AREA.

RURAL COMMUNITIES OPIOID RESPONSE PROGRAM-PSYCHOSTIMULANT SUPPORT

RURAL HEALTH OPIOID PROGRAM

RURAL TRIBAL COVID-19 RESPONSE

RURAL COMMUNITIES OPIOID RESPONSE PROGRAM-OVERDOSE RESPONSE

RURAL HEALTH OPIOID PROGRAM

RURAL HEALTH CARE SERVICES OUTREACH GRANT PROGRAM - TARGET POPULATION: OUR TARGET POPULATION WILL BE THE RESIDENTS OF BIG HORN COUNTY, MONTANA, WITH A FOCUS ON TWO HIGH-RISK SUBPOPULATIONS, AMERICAN INDIANS AND LOW-INCOME RESIDENTS. THE COUNTY’S POPULATION IN 2024 WAS 12,851, OF WHOM 66% SELF-IDENTIFY AS AMERICAN INDIAN & ALASKA NATIVE (AI/AN), AND 56% ARE LOW-INCOME (UNDER 200% FPL). BIG HORN COUNTY IS A FRONTIER COUNTY (POPULATION DENSITY 2.6 PERSONS/MILE) ENCOMPASSING MOST OF THE CROW INDIAN RESERVATION. IT IS AN IMPOVERISHED AREA, WITH A MEDIAN HOUSEHOLD INCOME OF $49,100, 26% OF PERSONS LIVING BELOW THE FEDERAL POVERTY LEVEL (FPL), AND 56% LIVING BELOW 200% OF FPL. CHRONICALLY FACING SHORTAGES OF HEALTH PROFESSIONALS IN THE AREA, OUR COMMUNITY IS FEDERALLY DESIGNATED AS A MEDICALLY UNDERSERVED AREA AND A HEALTH PROFESSIONAL SHORTAGE AREA (HPSA). WE SUFFER FROM AN EXCESSIVELY HIGH RATE OF POOR HEALTH OUTCOMES, WITH MARKED HEALTH DISPARITIES ALONG RACIAL AND ETHNIC LINES. OUR COMMUNITY’S MENTAL HEALTH PICTURE IS BLEAK, WITH TRAGICALLY HIGH RATES OF DEPRESSION AND SUICIDE, INTRICATELY LINKED TO THE EPIDEMIC RATES OF ADVERSE CHILDHOOD EXPERIENCES. NUMBER OF CONSORTIUM MEMBERS: 4 LIST OF CONSORTIUM MEMBERS: BIGHORN VALLEY HEALTH CENTER, INC. DBA “ONE HEALTH,” BIG HORN COUNTY PUBLIC HEALTH DEPARTMENT, BIG HORN HOSPITAL ASSOCIATION, BIG HORN COUNTY AMBULANCE EVIDENCE-BASED PRACTICE MODEL: COMMUNITY HEALTH WORKERS (CHW). WE WILL IMPLEMENT CHWS AT EIGHT COMMUNITY SITES IN OUR SERVICE AREA. EXPECTED OUTCOMES: ANTICIPATED OUTCOMES INCLUDE: EXPANDING ACCESS FOR COMMUNITY MEMBERS TO INTEGRATED HEALTHCARE, INCLUDING MENTAL HEALTH CARE AND SUBSTANCE USE DISORDER (SUD) TREATMENT; IMPROVING SCREENING RATES FOR DEPRESSION, SEXUALLY TRANSMITTED INFECTIONS (STI) AND SUD AMONG OUR SCHOOL-AGED YOUTH; INCREASING ACCESS TO COMPREHENSIVE FAMILY PLANNING EDUCATION AND BIRTH CONTROL FOR SCHOOL-AGED YOUTH; AND IMPROVING RE-INTEGRATION OF JUSTICE-INVOLVED COMMUNITY MEMBERS WITH SUD. CAPACITY TO SERVE RURAL UNDERSERVED POPULATIONS: THE LEAD ORGANIZATION, BIGHORN VALLEY HEALTH CENTER, INC. DBA “ONE HEALTH,” HAS BEEN PROVIDING COMPREHENSIVE, INTEGRATED PRIMARY CARE—INCLUDING MEDICAL, BEHAVIORAL HEALTH/SUBSTANCE USE DISORDER TREATMENT AND DENTAL—TO RESIDENTS OF RURAL AND FRONTIER COUNTIES IN CENTRAL AND EASTERN MONTANA SINCE ITS INCEPTION IN 2012. ALL THE CONSORTIUM MEMBERS ARE LOCATED IN A FRONTIER COUNTY AND HAVE BEEN PROVIDING CARE TO RESIDENTS FOR DECADES. FUNDING PREFERENCE: BIGHORN VALLEY HEALTH CENTER, INC. DBA “ONE HEALTH” IS REQUESTING A FUNDING PREFERENCE BASED ON QUALIFICATION 1. BIG HORN COUNTY IS IN A DESIGNATED HPSA.

FY 2020 EXPANDING CAPACITY FOR CORONAVIRUS TESTING (ECT)

RURAL COMMUNITIES OPIOID RESPONSE (PLANNING)

FY 2023 EXPANDING COVID-19 VACCINATION

DLT OPIOID GRANTS

FY 2020 CORONAVIRUS SUPPLEMENTAL FUNDING FOR HEALTH CENTERS

FY 2023 BRIDGE ACCESS PROGRAM

RURAL COMMUNITIES OPIOID RESPONSE (PLANNING)