Montana. Division of Comprehensive Health Planning.

Montana comprehensive health planning news (Volume 1973 VOL 5 NO 1) online

. (page 3 of 3)
Online LibraryMontana. Division of Comprehensive Health PlanningMontana comprehensive health planning news (Volume 1973 VOL 5 NO 1) → online text (page 3 of 3)
Font size
QR-code for this ebook

County), and Fort Benton (Chou-
teau). Recent funding of a 314(c)
grant application entitled, "Educa-
tion for Action," has funded an
additional staff person for educa-
tion and organizational purposes.

A great part of Northcentral
staff and committee time has been
spent in conducting facility reviev/
and comment work, with the as-
sistance of state personnel. Six re-
views have been completed, with
final direct approval of five and
approval with modifications of the
sixth; amounting overall to an in-

crease of 84 acute hospital beds
and 202 nursing home beds. Area
needs for state staff on loan to
conduct facility review work
should be reduced when the 314(c)
positions are filled.


Big Horn, Carbon, Golden Valley,
Musselshell, Stillwater, Sweet
Grass, Wheatland, Yellowstone

The six and seventh Areawide
Planning Objectives call for or-
ganization of county CHP groups
and efforts to improve facilities re-
view and comment capability in
Southcentral Areawide.

Hampered by uncertain staffing
arrangements and the need to more
firmly establish roles and relation-
ships in the areawide organization,
Southcentral has been concentrat-
ing on "home base." Two major
accomplishments have been for-
mation of a city-county health de-
partment for Billings and Yellow-
stone County, and organization of
the Yellowstone Council for Com-
munity Service (formerly Yellow-
stone Council of Social Agencies)
to conduct CHP in Yellowstone
County and the Billings area.

Southcentral has conducted two
Nominal Group-type meetings in
Billings on an "experimental" basis
to train staff and introduce the
technique. A steering committee
has been formed in Billings to plan
further organizational work in Bil-
lings and the surrounding area.

Southcentral has an active Fa-
cilities Committee which has pro-
cessed four applications and pres-
ently has three applications pend-
ing, one of which is for a major
remodeling project at Billings St.
Vincent's Hospital.


Beaverhead, Broadwater, Deer
Lodge, Gallatin, Granite, Jeffer-
son, Lewis and Clark, Madison,
Meagher, Park, Powell, Silver-
bow Counties.

Southwest Areawide, Montana's
only free-standing 314(b) agency,
was not specifically dealt with in
the FY '73 Work Program, and
continuously grows more indepen-
dent of state assistance. The South-
west Areawide Health Planning
Council (SWAHPC) has spawned
active local CHP organizations in


Gallatin County (Bozeman), Silver
Bow County (Butte), and Lewis and
Clark County (Helena). With these
organizational centers, Southwest
has concentrated heavily on ex-
tending service programs and co-
ordination efforts throughout the
remaining nine counties.

With what might be called an
"active staff/passive council" ap-
proach, Southwest has followed a
strategy of encorporating existing
organizations into the CHP net-
work through shared board and
council seats. Southwest is active
in sponsoring mental health cen-
ters, testing clinics, alcoholism and
other drug addiction programs, and
is the only Montana CHP Area-
wide to perform the A-95 review
function for area counties.


Flathead, Lake, Lincoln, Mineral,
Missoula, Ravalli, Sanders Coun-

The first two Areawide Plan-
ning Objectives deal with organi-
zation and improvement of facility
review capabilities in Northwest
Areawide Work in Northwest's
seven counties has been a major
effort, resulting in establishment of
local CHP organizations in all but
Lincoln County. Teams of areawide
and state staff have made extensive
use of the Nominal Group tech-
nique (previously the topic of a
Continuing Education in Public
Health Seminar, mentioned in the
education section) to both create
an organizational nucleus for local
CHP and to representatively docu-
ment expressed community needs
and priorities.

Besides introducing the CHP
concept and program in connec-
tion with an activity (preparation
of a State Plan for Health) of de-
monstrable statewide and local
value, needs assessment meetings
conducted in nominal groups, en-
able citizens to express themselves
more freely without many of the
strictures of more conventional
meeting procedures.

The State Office has been noti-
fied by HEW of approval of a
314(c) grant application, entitled
"Education for Action," which has
funded one position in each area
for one year to continue needs as-
sessment meetings, organizational

work and training of newly estab-
lished local organization members.
In response to the growing numbers
of facilities proposals which must
be reviewed by area planning
groups, particular attention will
be given by the grant-funded
"health educators" to facilities re-
view training of area committees.
This project has permitted reduc-
tion of the number of state staff
involved in organizational work,
and reduced state support expendi-

With an eye toward enabling
Northwest Areawide to assume
the A-95 review function for health-
related federal expenditures, and
to become recognized as the re-
gional health authority, consider-
able effort has been expended to
gain CHP input on revenue sharing
expenditures for health. Northwest
has obtained $65,000 in revenue
sharing funding for the S.O.S.
Health Center, mentioned in the
Manpower section, and funding for
three staff positions in the Mis-
soula-Mineral Health Department
(including a public health nurse).

Northwest Areawide has become
the allocation authority for an area
share of a $27,000 alcoholism pro-
gram and another drug abuse pro-
gram, and is establishing local
drug evaluation committees for in-
put on drug related expenditures.

Following needs assessment
meetings in northwest communi-
ties, public health activity, such
as formation of county health
boards and hiring public health per-
sonnel, has been a frequent occur-
rence. Northwest has also been
successful in developing Indian in-
put in planning activity.


Carter, Custer, Daniels, Dawson,
Fallon, Garfield, McCone, Phil-
lips, Prairie, Powder River, Rich-
land, Roosevelt, Rosebud, Sheri-
dan, Treasure, Valley, Wibaux

The fifth Areawide Planning
Objective calls for organization of
an areawide planning group in the
Eastern Area.

Extensive activity has develop-
ed formal agreement with the Eco-
nomic Development Association of
Eastern Montana (EDAEM) to as-
sume areawide CHP functions for
the entire Eastern Area. This agree-
ment was formalized in mid
August of 1973.

In its three year history, EDAEM
has established an extensive or-
ganization with three members
from each of eighteen counties and
two Indian reservations. The or-
ganization has been primarily in-
volved in economic and social de-
velopment, with established com-
mittees in the fields of agriculture,
education, finance, recreation and
tourism, transportation and water
development, and conservation. As
EDAEM has not been primarily
involved in health planning, mem-
bership is nearly ninety-five per-
cent consumers.

Over twice the geographical size
of any existing Montana CHP Area-
wide, EDAEM has three districts:
Northeast District 1, Daniels, Phil-
lips, Roosevelt, Sheridan, and Val-
ley Counties; Eastcentral District

II, Dawson, Garfield, McCone,
Prairie, Richland, and Wibaux
Counties; Southeastern District

III, Carter, Custer, Fallon, Powder
River, Rosebud and Treasure Coun-

EDAEM has prioritized prob-
lems in committee areas and has
developed long and short range
goals and objectives and action
plans. The EDAEM lists as its first
purpose "to provide the leadership
required for developing and imple-
menting plans for the orderly de-
velopment, improvement, conser-
vation, and efficient use of human
and natural resources; and to take
the necessary action to insure im-
provement of economic opportuni-
ties for the people in Eastern

State View

The statewide activity of Mon-
tana CHP has evolved from many
concerns, with preparation of a



State Plan for Health as a central
theme. Organizational work, under-
way to expand the base from which
representative input on the writ-
ten plan may be obtained, has
been conducted through county
needs documentation meetings on
the "Nominal Group" pattern.

The three-level State Health
Plan will represent state, areawide,
and county or local perspectives on
Montana's health needs fol'owing
the simple strategy of determining
what is presently available, what is
needed and desired, and evaluating
and recommending alternate ways
of meeting these needs. Mary Jane
Crigler and Dave Turner, have
formed a team to prepare the first
written draft of the plan.

Establishment of an Areawide
Health Planning Organization in
eastern Montana to complete area
organization of the state has been
a major concern of the State Office

in FY '73. Arrangements were form-
alized in early FY '74 with the
Economic Development Associa-
tion of Eastern Montana to assume
responsibility for Eastern Area
health planning.

Montana CHP has obtained 314
(c) grant funding which has placed
an additional staff person in each
area to educate interested local
citizens in effective methods of
CHP, and to aid in collecting input
for the State Plan by conducting
additional public meetings. In addi-
tion, HJR 18, calling for a Legisla-
tive Council study of Montana's
public health system, was passed
by the 1973 Legislature and will
provide major input into the State

The State Office is being called
upon increasingly to act as publish-
er for studies, manuals, guides and
statistical compilations of health
planning information. Efforts con-

CHP Conducts
Indian Follow-up

In the wake of Governor Judge's
Indian Cultural Awareness Confer-
ence, State CHP has been involved
in "follow-up" on conference re-
sults and findings. At the end of
their three-day meeting, Indians
and professional health care pro-
viders presented recommendations
to the Governor.

In response to the question
"What do you see as the best
means for attacking the problems
in delivering health care to Mon-
tana Indians?" conferees gave first
priority to involving more Indian
students in health careers.

Additional recommendations ask-
ed increased funding for improve-
ment of conditions related to poor
Indian health and suggested in-
creasing political awareness of In-
dian problems — particularly preju-
dice. More detailed responses have
been tabulated and distributed to
participants and decision makers.

Conference Chairman Harold
Gray, who is with the Indian Stud-


ies Program at U of M in Missoula,
will prepare the published records
and findings in cooperation with
State CHP.

The State CHP Office in a co-
operative agreement with the Inter-
Mountain Regional Medical Pro-
gram secured funding and hired
an Indian Health Planner, Duane
Jeanotte. He will be responsible
for coordinating state-level efforts
to involve more Indians in health
careers and in health planning. He
will also devote time to dealing
with inquiries from Indian students
who are interested in health

State CHP has been in contact
with Montana United Scholarship
Service (MUSS), in Great Falls,
concerning plans for an Urban In-
dian Clinic there. The Indian Edu-
cation Center in Great Falls,
MUSS, and both State and Area-
wide CHP would cooperate in pro-
viding services to landless and off-
reservation Indians.

tinue to improve information hand-
ling and increase efficiency of pub-
lishing functions.

An ongoing responsibility of
State staff and council is refine-
ment of committee membership to
be representative of both a broad
geographical constituency and a
wide variety of health interests,
areas of knowledge and special
ability. With elected officials dis-
allowed as consumers, membership
changes have been necessary to
maintain the 51% consumer ma-
jority. Work continues to coordi-
nate federal, state and areawide
concerns in council and committee
membership policy. Presently, to
incorporate available expertise as
needed, committee members may
often not be members of the gen-
eral Advisory Council. Committee
decisions and recommendations
must be approved or adopted by
the council as a whole.

Acknowledging changing federal
emphasis. State CHP will direct
formal efforts in environmental
health to an essentially coordinat-
ing role for the efforts of other
groups and agencies. With cost
contamment growing to be a cen-
tral federal theme, Montana CHP
will increasingly use cost as an
evaluation factor and as a basis
for establishing priorities and mak-
ing decisions.

Milifary Program —

—continued from page 4
military facility on active duty,
or in a civilian facility (as in Mon-
tana or another state) on inactive
duty status without increasing his
active duty obligation.

Students who fail to complete
the academic portion of the pro-
gram must serve on "active duty
in an appropriate military capacity"
to fulfill their obligation.Those
dropped from the program may be
relieved of military obligation
"when such action would be in the
best interest of the military depart-
ment," and be referred to HEW
"for possible assignment to an area
of health manpower shortage . . ."

Additional information may be
obtained through an armed forces

1 3

Online LibraryMontana. Division of Comprehensive Health PlanningMontana comprehensive health planning news (Volume 1973 VOL 5 NO 1) → online text (page 3 of 3)