PLEASE DO NOT INCLUDE PROTECTED HEALTH INFORMATION IN YOUR APPLICATION

Community-Based Stabilization Services Pilot Grant 

Applications will be reviewed by the Department in the order they are received; however, applicants that demonstrate an exceptional need as determined by the Department will receive priority. Applications will be considered complete if they have answered all required questions and included all requested documentation. If an application is deemed incomplete, it will not proceed through the remainder of the evaluation process. Applications received that do not meet application criteria will not be awarded. The application will close on May 23, 2025. 

Program Description and Purpose 

To address the limited options for court-ordered forensic evaluations (COEs) in Montana and in an effort to mitigate the large number of evaluations that are conducted at the Montana State Hospital Forensic Mental Health Facility (FMHF), DPHHS began paying for Community-Based Court Ordered Evaluations. The Department still observes a large number of individuals on the FMHF waitlist in part due to the lack of professionals who are qualified to not only conduct fitness evaluations but also deliver treatment to stabilize and evaluate defendants and restore them to fitness. Additionally, counties have expressed a need for telehealth technology and services that would assist in providing stabilization services at the local level while the defendant is awaiting admission to FMHF or receiving evaluation services in the community.   

This program seeks to provide one-time only 24-month pilot grants to counties, municipalities, or multi-county entities so they may provide or arrange for community-based stabilization services. This grant is funded through Near-Term Initiative #1: Incentivize Community-Based Court Ordered Evaluations.  Court Ordered Evaluations ordered pursuant to Mont. Code Ann., § 46-14-202 may be performed using on-site and/or telehealth psychiatric services. While this new program seeks to build community capacity for stabilization services, generally, priority will be given to those counties with a demonstrated backlog of individuals awaiting admittance to FMHF for evaluations order pursuant to Mont. Code Ann., § 46-14-202 and a demonstrated need for stabilization services. Additionally, the Department aims to prioritize applications that demonstrate a robust sustainability plan for these services using local funds after the 24-month grant period.  

Funding for the program is provided via the Behavioral Health System for Future Generations Commission, as authorized under HB 872. HB 872 explicitly authorizes certain expenditures and prohibits others. Acceptable uses for HB 872 funds are listed in Section 3 of the Bill.  The Department submits this recommended initiative can be paid for by HB 872 funds as it is:   

From Section 3, subsection (3)(c), “statewide community-based investments to stabilize behavioral health and developmental disabilities service providers and delivery, increase and strengthen the behavioral health and developmental disabilities workforce, increase service capacity to meet identified behavioral health and developmental disabilities services demands, and increase opportunities for Montanans to receive integrated physical and behavioral health care;” or relate to (as cited in Section 3, subsection (3)(f), “planning, operation, or other contract expenses associated with behavioral health settings.”  

Funding will be provided either in an upfront or reimbursement form, depending on the identified needs of the county and details of the approved application for funding. Proof of the county’s contract with a qualified contractor(s), medical provider(s) or other vetted entity/entities will be required for any prepaid provision of funds, as well as demonstration that such contract(s) are serving defendants awaiting admission to FMHF and/or in need of Court Ordered Evaluation. Receipts, invoices, and other supporting materials will be required for any provision of funds based on reimbursement.  

DPHHS aims to provide one-time funding to support start-up costs for innovative community stabilization services at the county level. The Department expects to award $6.5 million in awards.  

DPHHS Priorities 

The primary goal of this BHSFG Near-Term Initiative grant program is to expand capacity for community-based stabilization services across Montana, reducing the likelihood of an individual being placed on the FMHF waitlist. DPPHS will prioritize applications from counties, municipalities, and multi-county entities that identify sustainability partnerships with entities with a proven history of and/or commitment to working with single providers who provide stabilization services at the local level.

The target outcomes and outputs for this grant program are listed below 

• Increased infrastructure and capacity for provision of a comprehensive suite of healthcare services in carceral settings.  
• Increased number of county jails using stabilization services at the local level 
• Increased number of defendants receiving stabilization services at the local level 
• Decreased time spent by county employees transporting defendants to and from FMHF  
• Reduced acuity and psychiatric decompensation of defendants 
• Reversed growth trend in the FMHF waitlist  
• Decreased average number of days spent on the FMHF waitlist  

Key Terms
Stabilization Services: Psychiatric and clinical treatment provided to a pretrial defendant that is often necessary to prevent or reverse psychiatric decompensation and facilitate participation in a court-ordered initial fitness evaluation, ordered pursuant to Mont. Code Ann. 46-14-202).  This level of treatment is not necessarily the equivalent of the treatment contemplated by and ordered by a court pursuant to Mont. Code Ann. 46-14-221, which would be ordered to achieve “restoration to fitness.” However, depending upon the presentation and needs of the defendant, it may result in “restoration to fitness.” This form of treatment has, in recent years, almost exclusively been provided at the FMHF prior to a fitness evaluation. Stabilization services required in connection with an evaluation ordered pursuant to Mont. Code Ann. 46-14-202, include medical and psychiatric assessment as well as medical and psychotropic compliance. Reimbursable community-based stabilization and restoration services should and can be provided in non-FMHF settings if the specific nature of a defendant’s needs can be met in the community.

Proposed Project Cost Guidance  
   Applicants should submit proposals with costs that are accurate and verifiable; a project budget is required with each application. Applicants may submit proposals that do not cover the full cost of a project if they identify the sources of other funds that will be leveraged to cover the full cost.     

Allowable Uses
     Potential allowable uses of these one-time funds include costs for stabilization services, such as:  

• Contracted services (Examples of known entities providing such services in Montana are Wellpath, Traditions Behavioral Health, and Liberty, but may include others)
• Medication management and costs (including long-term injectables)  
• Training/ professional development  
• Technology   
• Transportation  
• Hiring and staffing (employees related to stabilization services) 
• Administrative services  

Additional services may be considered but must align with the outcomes and outputs of this pilot grant program.  

Eligibility and Application Requirements
     To be eligible to apply for this grant, applicants shall:  

• Be a MT County, Municipality, or Multi-County Entity  
• Have the administrative support infrastructure to meet the grant criteria, including ongoing reporting requirements  
• Have knowledge of state and federal laws, regulations, and policies applicable to stabilization  
• Demonstrate a need for the requested stabilization-related services  
• Use funds for stabilization-related services only  
• Submit a long-term sustainability plan for stabilization services post-grant funding  

Reporting Requirements
     Counties, municipalities, or multi-county entities selected for an award under this program will be required to:  

• Track activities and services throughout the grant period (maximum of 24 months) 
• Monitor outcomes through administering surveys to members served and other activities 
• Report the number of individual members served 
• Provide data (including reporting related to outcomes and outputs) 
• Be able to demonstrate financial sustainability of the program following one-time-only funding investment 
• Meet all reporting requirements subsequently outlined in the grant application process 

The cadence and format of this reporting will be determined by DPHHS and the provider after a provider is selected under this program.  

All applications must be submitted via Submittable. Applications will be reviewed and evaluated by DPHHS. Approval notices will be sent out to applicants via Submittable.  Accepted providers will be required to sign formal agreements that include additional terms and conditions.  

Payment Information 

This grant will be paid on a reimbursement basis with up-front payments approved on a case-by-case basis for start-up costs. Awardees must adhere to all components of the Community-Based Stabilization Services Pilot Grant Agreement.  

Description and Purpose

The Montana Department of Health and Human Services (DPHHS) is soliciting proposals from eligible in state healthcare providers to fund costs associated with participation in Electronic Health Record data contribution to Big Sky Care Connect (BSCC), Montana’s Health Information Exchange (HIE). 

Access to complete and up-to-date patient information enables providers to make informed decisions, coordinate care, improve care quality, and reduce service duplication. This program aims to reduce financial barriers to technical integration and enhance information exchange participation for behavioral health, children’s mental health, and developmental disability service providers across Montana.  

Funding

A qualifying provider would be eligible for the following:

• Integration costs: Up to $15,000 in provider EHR integration costs to be invoiced by the Provider to BSCC at the completion of the integration project. BSCC will submit costs to DPHHS for reimbursement and pay to the Provider, not to exceed $15,000 per provider. The $2,500 for integration fees and the up to $12,500 in integration costs will be reimbursed by DPHHS at successful completion of the project. All integration work must be completed by February 2026.
• Participation costs: Up to $15,000 for the cost of BSCC participation fees.  Any annual participation fees in excess of $15,000 required of the provider by BSCC will be the sole responsibility of the provider.
• NOTE: Maximum total provider amount for all costs (either to Provider or BSCC) will be $30,000. Facility EHR integration costs will be reimbursement-based, not prospective funding.

Qualifications 

Providers applying for funds under this program must:

• Be enrolled as a Montana Medicaid provider in good standing
• Provide services within adult behavioral health, children’s mental health, and/or developmental disability service areas 
• Serve a minimum number of 500 patients annually 
• Currently have a modern EMR/EHR solution with the ability to exchange clinical data electronically
• Be willing/able to contribute required clinical data to the BSCC HIE
• Be able to provide required clinical data to BSCC near real-time or at a minimum of one time daily 
• Please note that Skilled Nursing Facilities/Nursing Homes are not eligible for this program

Provider Requirements

Providers must agree to the following:

• Complete outbound integration to BSCC with a minimum of a HL7 V2 ADT Feed and HL7 V3 CCD feed or equivalent as approved by Montana Medicaid.
• Complete integration work by February 2026
• Maintain these feeds for a minimum of 2 years.
• Work with BSCC to meet USCDI data quality standards.

This application will remain open on a rolling basis until June 30th, 2025 (11:59 PM).

Program Description and Purpose 

Individuals with intellectual and developmental disabilities (IDD) often need life-long supports and services to ensure health and safety while also accessing and participating in their local communities. These supports and services are often provided on a day-to-day basis by Direct Support Professionals (DSPs).

There is a significant need and in turn value to investing in DSP workforce stabilization and promoting stronger capacity across the continuum to support people with IDD. Specifically, this initiative calls for piloting a DSP credentialing structure to test best practice approaches to DSP stabilization through career ladders. The DSP Workforce Capacity Grants provide one-time grants to five (1 per DDP region) service providers for, on average, 25 DSPs to become credentialed through the National Alliance for Direct Support Professional platform eBadge Academy, a web-based credentialing platform. The Developmental Disabilities Program (DDP) will pre-purchase access to the credentialing platform on behalf of selected agencies, as well as some technical assistance support from NADSP. Grant funds will cover staff time for DSPs participating in the credentialing program as well as “backfilled” staff to cover the shift time of staff enrolled in the credentialing program; payroll processing, grant reporting and tracking and other administrative costs incurred by selected provider agencies; and one-time incentive bonuses to DSPs once they reach credentialing tiers, as modeled below: 

DSP – I (Tier 1) –$1,000 

DSP – II (Tier 2)  – $1,500 

DSP – III (Tier 3) – $2,000

DSPs enrolled in the NADSP eBadge Academy must complete the following under each tier to be eligible for the one-time bonuses; a DSP may achieve all three Tiers. 

DSP-I 

To earn a DSP – I certification, the DSP must earn 15 total E-Badges, including: 

• The Code of Ethics Commitment E-Badge 
• The 50 hours of Accredited Education E-Badge 
• At least one E-Badge in Crisis Prevention and Intervention 
• At least one E-Badge in Person-Centered Practices 
• At least one E-Badge in Health and Wellness and 
• At least one E-Badge in Safety 

 DSP-II 

To earn DSP – II certification, the DSP must earn 30 total E-Badges, including: 

• The DSP-I E-Badge
• The 100 hours of Accredited Education E-Badge 
• At least one E-Badge in Evaluation and Observation 
• At least E-Badge in Communication 
• At least one E-Badge in Professionalism and Ethics and 
• At least one E-Badge in Community Inclusion and Networking 

DSP-III 

To earn DSP – III certification, the DSP must earn 50 total E-Badges, including: 

• The DSP-II E-Badge 
• At least one E-Badge in Empowerment and Advocacy 
• At least one E-Badge in Community Living Skills and Supports 
• At least one E-Badge in Education, Training, and Self-Development 
• At least one E-Badge in Cultural Competence