Prinicple Investigator: Rob Stenger, MD, MPH

Funding Organization: HRSA Primary Care Training and Enhancement Program

Funding Amount: $2.5 Million over 5 years

Duration: 2015-2020

This grant project focused on promoting team-based care and health care transformation at FMRWM and several rural partners.  Key activities included supporting multidisciplinary “transformation teams” at rural sites as they developed and implemented two transformation projects over the course of 5 years.  Team members received training in team development and quality improvement through twice yearly in-person meetings.  Residents participated in team trainings and also in the transformation projects during rural rotations.  Participating rural sites included the Community Hospital of Anaconda, Marcus Daily Hospital (Hamilton), St. Luke Hospital (Ronan), St. Joseph Hospital (Polson) and Northwest Community Health Center (Libby).  Transformation teams competed projects in a variety of areas, ranging from improving the treatment of depression to colon cancer screening to pediatric obesity. 

Grant Title: Integrated Behavioral Healthcare Workforce Development: Field Training Experience in a Missoula FQHC

Faculty Principle Investigator(s): Jennifer Robohm, PhD

Funding Organization: Montana Healthcare Foundation

Funding Amount: $44,821.00

Duration of Grant: 2016-2018

The University of Montana Department of Psychology, in partnership with Partnership Health Center (PHC) of Missoula and the Family Medicine Residency of Western Montana (FMRWM) developed a field placement experience for behavioral health graduate students to address critical workforce development needs in Montana. The over-arching goal of the project was to provide an initial, structured, "hands-on" training experience for students interested in learning how to provide integrated behavioral health (IBH) services, while simultaneously addressing key health needs (including managing chronic pain and promoting health behavior change) in PHC's underserved and "at risk" patient population. The field placement familiarized behavioral health students with the primary care setting and FQHC patient population, created opportunities for them to provide integrated behavioral health services under close clinical supervision, and offered interprofessional education (IPE) opportunities among trainees in behavioral health, family medicine, pharmacy, physical therapy, and social work. Grant outcomes included: (1) improved critical health outcomes for PHC patients, (2) expanded PHC IBH offerings, (3) increased IBH training opportunities (to promote workforce development in this area), and (3) enhanced resident physician competence in collaborating with behavioral health professionals to address critical health needs.

Prinicple Investigator: Elizabeth Paddock, MD

Funding Organization: RHEDI, Reproductive Health Education In Family Medicine

Funding Amount: $235,820

Duration: 2018 - 2020

FMRWM is committed to providing residents with the training needed to serve rural communities, and to implement and sustain a full spectrum reproductive health curriculum including abortion training.  In order for interested residents to be fully competent in their family planning procedural skills, there is a need for more robust and longitudinal hands-on training. 

Blue Mountain Clinic (Missoula) is where R1 residents get a significant portion of their early gynecology training; in both procedural skills and management of common gyne issues.  Residents do participate in abortion care at BMC.  The current level of resident exposure and hands-on time is inadequate for competency. While residents are able to continue to grow the majority of their gynecology skills throughout the rest of their training they are not able to get additional training in abortion skills. 

FMRWM does not currently have a curriculum to help residents navigate taking the challenges of trying to introduce a potentially controversial practice into a practice setting where it is not currently offered.  With this grant application we are proposing creation of a “bridging to practice” curriculum to help with this.  While our focus is on abortion training the bridging to practice curriculum would be beneficial for many residents who are learning skills in transgendered care, Point of care Ultrasound, HIV/Hep C treatment, medication assisted therapy for opiate use disorder etc.

In Montana and the majority of the Rocky Mountain West abortion care is often far from where women live; women drive great distances in order to have an abortion.  Clearly there is a need to train more providers who will integrate abortion and other reproductive health services into their practice to serve the communities in the rural West. 

Prinicple Investigators: Jennifer Robohm, PhD; Ellen Bluett, PhD; Brett Bell, MD

Funding Organization: Montana Healthcare Foundation

Funding Amount: $14,961

Duration: 2019-2020

The FMRWM will train residents and other health care trainees at Partnership Health Center (PHC) to better address substance misuse by their patients by:

• Introducing them to the SBIRT model.
• Enhancing the capacity of PHC''s behavioral health staff to collaborate in the care of patients who misuse substances.
• Providing opportunities for residents to observe and practice SBIRT skills. To accomplish these ends, grant funds will be used to train 3 FMRWM faculty (2 behavioral science, 1 addiction medicine) and PHC's Director of Behavioral Health to provide SBIRT training to FMRWM faculty and residents, PHC's behavioral health team, and other healthcare trainees working at PHC.

Grant funds will be used to:

• Hire a consultant to train the program leads identified above.
• Cover the costs of providing faculty development and SBIRT training.
• Evaluate resident attitudes, knowledge, and skills in providing SBIRT.
• Pay for curriculum development/adaptation and program/grant management and evaluation.

Because PHC houses the continuity clinic for 24 of FMRWM's 30 residents, it is essential that members of PHC's behavioral health team have more capacity to manage substance use concerns identified by the residents and other health care trainees. This training project will increase the SBIRT knowledge and skills of FMRWM residents and other health care trainees at PHC and enhance the overall capacity of PHC/FMRWM to roll out a full SBIRT program in the future.

Prinicple Investigator: Darin Bell, MD

Funding Organization: Montana Healthcare Foundation

Funding Amount: $100,000

Duration: 2019-2020

This project Is designed to address two interrelated goals, aimed at improving care for American Indians (AI) and Alaska Natives (AN) in Montana. The first goal is to improve the cultural humility of medical residents and health professions students at FMRWM and the UM.  This will be accomplished through a didactic curriculum for both learners and practicing professionals, as well as an immersion clinical experience at Tribal Health of the Confederated Salish and Kootenai Tribes.  The clinical experience will enhance cultural training and allow active recruitment of residents and students to work in AI/AN healthcare upon graduation. The second goal is to provide improved access to care for specific needed medical services identified by Tribal Health.  This will be accomplished though through trainings and support for Tribal Health staff as well as partnerships with FMRWM residents and faculty for the provision of new services.

Prinicple Investigators: Jennifer Robohm, PhD; Hayley Blackburn, PharmD

Funding Organization: Montana Healthcare Foundation

Funding Amount: $24,984

Duration: 2020-2021

The University of Montana has attained a planning grant to support development of:

• A remote "Climate and Health" course for undergraduate students participating in the Climate Change Studies program and graduate students in health professions training programs.
• On-line training opportunities (a certificate program or continuing education opportunities) for health care providers already practicing across the state.

These training opportunities will enhance workforce preparedness with regards to the looming physical and mental health impacts of climate change in Montana, particularly for vulnerable and underserved populations. UM will collaborate with partners around the state to determine the extent of the need for such programming, to identify stakeholders who would benefit from such programming, and to identify content experts for future curriculum development. We will use grant funding to conduct outreach and the needs assessment, to confirm the viability of these ideas, and to identify the content/training methods which will best suit the needs of our intended audiences. We also plan to develop curriculum for a pilot course and collect participant feedback. Finally, we plan to problem-solve technological and other obstacles around content delivery and program sustainability. These grant-supported planning activities will culminate in a business/strategic plan which will serve as the blueprint for program implementation.

Prinicipal Investigators: Darin Bell, MD; Co- Amy Matheny,MD;  Brett Bell, MD

Funding Organization: HRSA (Health Resources and Services Administration) PCTE-RTPC (Primary Care Training and Enhancement - Rural Training in Primary Care

Funding Amount: $2.5 million over 5 years

Duration: 2020-2025

The ERAT Program is designed to improve rural resident training and enhance the primary care workforce serving rural and medically underserved populations in the State of Montana by:

• providing global enhancement of rural training for all residents with special focus on a) interprofessional, team-based care; b) skills in combatting the opioid crisis; c) use of telehealth; and d) preparation to work with underserved and culturally diverse populations.
• developing and implementing both a rural intensive training track with an optional AI/AN focus; and a longitudinal rural ambulatory experience for interested residents;
• providing site-specific training to primary care faculty and preceptors at rural healthcare sites with the goal of improving resident education as well as healthcare access and availability in rural areas.