REPORT 6 MONTH PROGRESS - COMMUNITY HEALTH IMPROVEMENT PLAN - Healthy by Design
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2020-2023 YELLOWSTONE COUNTY
COMMUNITY HEALTH
IMPROVEMENT PLAN
6 MONTH
PROGRESS
REPORT
1 JULY – 31 DECEMBER 2020 | PUBLISHED JANUARY 29TH 2021
Significant Outcomes at a Glance
Celebrated 4 years of the Healthy Neighborhood Project in Billings’
South Side neighborhood
Healthy Formed a working group of committed leaders and residents to guide
Neighborhoods strategy over the next 3 years
Prepared the launch of the Healthy Neighborhood Partnership
Initiative focused on partnering with a new neighborhood in 2021
Formed a working group of committed leaders and residents to guide
Healthy strategy over the next 3 years
Connections Selected social isolation among seniors due to winter weather as first
project for the strategy working group
Applied for funding from America Walks to support project
Formed a working group of committed leaders and residents to guide
strategy over the next 3 years
Healthy
Investments By design, this group will spend additional time learning about
investing for health, anchor strategies, and community development
before selecting an initial project in spring 2021
Successfully submitted a phase 1 Culture of Health Prize nomination
for Billings, Montana in fall 2020, followed by a phase 2 application in
Strengthening winter 2020 (phase 3 notification: February 16, 2021)
Partnerships Began development of a web-based collaborative platform for HBD
Coalition members, to be launched in spring 2021
Project Spotlight: 10th Annual Gardeners’ Market
The market successfully operated its 10th season at South Park under special COVID-19
precautions. Numbers remained steady with an average of 211 customers attending each week.
Alongside social distancing, 9 out of 10 customers reported 21 vendors sold fruits and vegetables,
sanitizing stations, and mask they were more likely to eat 5 eggs, meat, honey, baked goods, and
requirements, reusable masks daily servings of fruits and more. Many choose this market to help
were given to customers in need. veggies because of the market. people eat more fruits and veggies.
All photos in the document are from Healthy By Design archives. Icon graphics are from flaticon.com.
Published January 2021 | Page 2
2020-2023 Community Health Improvement Plan
Overview
Vision A vibrant Yellowstone County where the healthy choice is the easy choice.
By 2023, increase proportion of Yellowstone County residents who self-report
Overall Goal
good or better overall health from 83.3% to 87.5%.
Mental Health
Priorities Nutrition, Physical Activity, and Weight
Substance Abuse
Strategies
Healthy Neighborhoods Healthy Connections Healthy Investments
Strengthening Partnerships
By 2023, increase the proportion of Yellowstone County residents who self-
report good or better mental health from 79.8% to 83.8%.
Priority-Specific By 2023, increase the proportion of Yellowstone County residents who are at
Objectives a healthy weight from 26.9% to 28.2%.
By 2023, decrease the proportion of Yellowstone County residents whose
lives have been negatively affected by substance abuse (their own or someone
else’s) from 53.8% to 51.1%.
Approach Equity | Policy, Systems, Built Environment | Collective | Community-Informed
Based on Healthy People 2020 guidelines; Healthy People 2030 guidelines are currently in development.
Published January 2021 | Page 3
Strategy 1. Healthy Neighborhoods
Brief Description: Neighborhoods are the fabric of community—providing a sense of place
and identity while also connecting residents to daily needs such as healthy foods, safe parks and
sidewalks, high quality schools, jobs, and opportunities for social connections. Unfortunately, due to a variety
of factors, not all neighborhoods are created equal, resulting in disparities in the health behaviors and
outcomes of residents throughout Yellowstone County.
Objective: By 2023, increase the number of active healthy neighborhood plans within Yellowstone County.
Strategy Working Group Members:
Big Sky Economic Development
Billings Clinic
Billings Parks, Recreation, and Public Lands
City-County Planning and Community Services Vision Statement:
City Public Works
Kathy Aragon (community advocate for active transportation) Vibrant neighborhoods are welcoming,
Northern Plains Resource Council accessible, and foster health for all.
RiverStone Health
Safer Routes to Schools committee
South Side leaders involved in Healthy Neighborhood pilot
St. Vincent Healthcare
Health Priorities Addressed - Mental Health | Substance Abuse | Nutrition, Physical Activity, Weight
Current Initiatives
Healthy Neighborhoods Partnership
Proposed Performance Indicators
% who consume 5+ servings of fruits and vegetables (CHNA)
% of children who are physically active 1+ hours per day (CHNA)
% who feel safe walking alone in neighborhood (CHNA)
% who get the social and emotional support needed (CHNA)
Food Environment Index (10 point index of contributors to healthy food access) (County Health Rankings)
Other initiative-specific performance metrics determined by strategy working group:
- # of neighborhood partnership applications received in 2021 (goal: 3)
- % of work plan deliverables met on time (goal: 80%)
Helpful Resources
CDC Healthy Neighborhood Checklist
Public Health Institute – Fostering Healthy Neighborhoods
South Side – Healthy Neighborhood Project Pilot Website
Published January 2021 | Page 4
Strategy 1. Healthy Neighborhoods
Initiative: Healthy Neighborhoods Partnership
Overview: Yellowstone County residents are invited to apply for this planning partnership, designed to assist
neighborhoods in developing a stronger sense of place while also connecting them to daily needs. The 2021
selected neighborhood will be supported in identifying and prioritizing their unique health issues, creating a
Healthy Neighborhood Plan to outline opportunities for both community- and evidence-based solutions.
Adopted strategies will take an upstream approach, aiming to build long-term, positive changes. Note: A more
detailed workplan is available for this initiative upon request.
Current Performance Metrics:
Metric Goal Current Achieved?
# of neighborhood partnership applications 3 N/A
received in 2021
% of work plan deliverables met on time 80% N/A
“As a resident of a past
neighborhood chosen for
this, I was very pleased
with the results. I’m
involved now to see the
success of others.” Above is a pinto poll used to assess
the top priorities for the South Side
A key priority of the South -- Linda Deavila, South Side resident and Healthy Neighborhood Plan. The
Side’s Healthy Neighborhood community partner for the South Side 2021 Partnering Neighborhood will
Plan was placemaking, using Healthy Neighborhood Plan, Healthy similarly be assisted in finding fun
such initiatives as the Neighborhoods Strategy Working Group ways to gather resident input on how
neighborhood branding a member their neighborhood could be a
signage seen above. Future healthier, more vibrant place to live,
partnering neighborhoods may work, play, learn, pray, and age.
choose similar or different
priorities based on their unique
needs.
Project Spotlight: South Side Stories
As the original initiative which sparked the adoption of the Healthy Neighborhoods Strategy, residents of
the 2021 partnership may find inspiration from the South Side Healthy Neighborhood Plan—that is how
strategies such as placemaking and neighborhood branding can foster identity, or how neighborhood
strengths might be built upon in their work. For South Side Stories, residents participated in an oral history
project, where neighborhood elders shared memories from their childhood and kept recordings for their
families. The local history highlights were made into two walking routes, marked by stickers, with printable
maps to accompany the routes. Using the oral recordings, two podcasts will soon be available to listen to
while walking the routes.
Published January 2021 | Page 5
Strategy 2. Healthy Connections
Brief Description: Social isolation is defined by a lack of social interactions or connections
with family, friends, neighbors, and/or society at large. When someone has a perceived lack of social
connections, he/she/they may experience loneliness. Connections provide social, emotional, physical, and
financial support. Individuals experiencing social isolation are at an increased risk of poor health outcomes
such as increased stress, mental illness, substance abuse, disability, and physical inactivity. Welcoming public
spaces and civic engagement opportunities such as volunteering, mentoring, and community groups that build
social ties or capital improve individual health outcomes and the quality of life within a community.
Objective: By 2023, increase the number of Yellowstone County residents who have the social or emotional
support they need.
Current Strategy Working Group Partners:
Big Sky Economic Development
Big Sky Senior Services
Billings Clinic
City-County Planning Vision Statement:
Dementia Friendly Billings
MET Transit Healthy connections integrate diverse
MSU Extension residents into the community in a way that is
Rehabilitation Hospital of Montana relevant, accessible, and fulfilling across all
RiverStone Health stages of life.
Rocky Mountain College
St. Vincent Healthcare
United Way of Yellowstone County
Health Priorities Addressed - Mental Health | Substance Abuse | Nutrition, Physical Activity, Weight
Current Initiatives
“Be A Good Neighbor” Sidewalk Shoveling Initiative for Seniors
Proposed Performance Indicators
% who feel isolated from others (CHNA)
% who feel they can help make their community a better place to live (CHNA)
% who get the social and emotional support needed (CHNA)
% who have considered suicide (CHNA)
Other initiative-specific performance metrics determined by strategy working group:
- % match between volunteer need and placement (goal: 80%)
- # of Snow Buddies volunteers (goal: increase from 2020)
Key Resources
Hidden Brain Podcast – Episode: A Social Prescription: Why Human Connection is Crucial to Our Health
How Placemaking Drives Community Resilience
Age Friendly Inspiring Communities – AARP Report
City of Billings Snow Buddies Program
Published January 2021 | Page 6
Strategy 2. Healthy Connections
Initiative: “Be a Good Neighbor” Sidewalk Shoveling Initiative
Overview: Accessible sidewalks are essential to maintaining healthy connections, particularly for low-income
families, differently-abled individuals, and older adults, who are especially at risk of social isolation. Sidewalks
connect many local neighborhoods, but keeping them accessible year-round is a challenge for a county which
often experiences winters marked by prolonged cold and snow. Those most impacted by snow-laden
sidewalks may also be least able to safely shovel their own sidewalks. While the City of Billings runs its Snow
Buddies Program each year, demand for help outweighs volunteers. This initiative involves a two-pronged
approach: piloting a hyper-local shoveling program matching volunteers from Rocky Mountain College to
those in need of assistance around the neighborhood; and the “Be a Good Neighbor” campaign, designed to
supplement the city’s Snow Buddies PSA by reminding able-bodied people of the impact shoveling their walk
makes for others. Note: A more detailed workplan is available for this initiative upon request.
Current Performance Metrics:
Metric Goal Current Achieved?
% match between volunteer need and placement 80% N/A
in pilot neighborhood
# of Snow Buddies volunteers Increase from 2020 N/A
“Snow removal is a “This is particularly
critical issue for our important during the
clients. Without pandemic, when other
assistance, our clients forms of transport or
become homebound exercise may not be
or risk injury just to Year-round access to parks was
available, especially
go out the front considered when selecting the for our community’s
shoveling initiative, as places that
door.” encourage physical activity and most vulnerable.”
provide safe ways to connect with
-- Suzanne McKiernan of Big Sky others during the pandemic. Shown -- Holly Basta of Rocky Mountain
Senior Services, Healthy Connections here is the Pioneer Parks Rx map College, Healthy Connections
Strategy Working Group member kiosk. Strategy Working Group member
Project Spotlight: Connecting During COVID
Every fall, the South Side Healthy Neighborhood Plan has included a party, celebrating neighborhood pride
and its healthy accomplishments, but doing so safely during COVID presented a creative challenge.
Community Health Improvement staff and a few strategy and resident partners packaged and distributed
at-home placemaking kits to over 1000 households across the South Side triangle. Kits included items like
crayons, sidewalk chalk, and sticky notes. Residents were invited to share their creations, and were able to
celebrate separately, together.
Published January 2021 | Page 7
Strategy 3. Healthy Investments
Brief Description: Quality of life is an increasingly essential investment for communities as
they compete to recruit new residents and to maintain their existing workforce and residents.
A community’s livability and lovability are inherently tied to access to daily needs such as trails, parks,
walkability, safety, healthy foods, family-friendly destinations, quality schools and jobs.
Objective: By 2023, enhance the ability of Billings and Yellowstone County to respond to the demand for
livability through community investments that directly impact the health and wellbeing of area residents.
Current Strategy Working Group Members:
Big Sky Economic Development
Billings Area Chamber of Commerce
Billings Clinic
Vision Statement:
City-County Planning & Community Services
Living Independently for Today & Tomorrow
(In progress as part of working group
Native American Development Corporation framework development)
RiverStone Health
St. Vincent Healthcare
Western Security Bank
Health Priorities Addressed - Mental Health | Substance Abuse | Nutrition, Physical Activity, Weight
Current Initiatives
Health in All Investments Framework
- Locally-Tailored Framework for Health in All Investments (e.g. toolkit for CDFIs, checklist for community
development projects, etc.)
- Coordinated Support for Healthy Investments
Proposed Performance Indicators
% who live in poverty (Census, CHNA)
% who perceive neighborhood as safe (CHNA)
State of workforce metrics (TBD, BillingsWorks)
Other initiative-specific performance metrics determined by strategy working group:
- Successful development of healthy investment criteria (goal: completion)
- % of workplan tasks completed on time (goal: 80%)
Key Resources
Strategies for Strengthening Anchor Institutions’ Community Impact
2016 Billings Growth Policy
2020 Yellowstone County Community Health Needs Assessment
2020/2021 Billings City Council Priorities
Healthy Planning Guide, ChangeLab Solutions
Community Investment: Focusing on the System, Kresge Foundation
Defining Shared Priorities – The Capital Absorption Framework, Kresge Foundation
Published January 2021 | Page 8
Strategy 3. Healthy Investments
Initiative: Health in All Investments Framework
Overview: The Health in All Investments Framework is designed to support businesses and investors
committed to improving local livability and retaining a healthy, talented workforce. By assessing overlapping
priorities from the Community Health Needs Assessment and those named by City Council and the 2016 City
Growth Policy, and collecting national and local examples of impactful, upstream investments, the group is
developing a set of criteria to serve as a local guide. Ultimately, this will be used to create a resource
document and educational workshop to promote Health in All Investments for a healthier, more vibrant
Yellowstone County. Note: A more detailed workplan is available for this initiative upon request.
Current Performance Metrics:
Metric Goal Current Achieved?
Successful development of healthy investment criteria 100% N/A
% of work plan deliverables met on time 80% N/A
“This strategy
contributes to the
health and vibrancy
of our community. It’s
essential to attract
Pictured here are a collection of local the businesses and Investing in community placemaking
poems made into stamps. A healthy
investment in accessibility and workforce necessary since 2018, Big Sky Economic
Development’s Space2Place grant
placemaking, the South Sidewalks
Project is replacing sidewalk segments
for continued funded this local project for Safer
Routes to Schools. These sign
in disrepair and stamping the fresh economic growth.” toppers mark the safest routes for
concrete with these poems celebrating children to follow to Newman and
the neighborhood. Not only increasing -- Thom MacLean of Big Sky Orchard elementary schools.
walkability and access, the project Economic Development, Healthy Corresponding mascot prints were
makes the streets hosts to public art. Investments Strategy Working also painted along the routes by
Group member community volunteers.
Project Spotlight: 2020 Complete Streets Progress Report
A great example of a local healthy investment, and one fitting within Health in All Policies which inspired this
initiative, is the Billings’ Complete Streets policy. Its initial adoption served as a catalyst for collective work
and collaboration in Yellowstone County, and it continues to serve as such in its implementation and
progress reports published every three years. CHI and the City Planning staff helped in putting together
the 2020 report. Recent milestones included inclusive walk audits conducted with LIFTT: Living
Independently For Today and Tomorrow, investments in safer routes to area schools, and the Missing
Sidewalks Project which updated city policy. Find the report at among our resources at www.hbdyc.org.
Published January 2021 | Page 9
Strategy 4. Strengthening Partnerships
Brief Description: Yellowstone County is facing several complex, generational health challenges
including mental health, substance abuse, and the obesity epidemic. These challenges are too large
for one organization or sector to tackle independently, requiring strategic partnerships among professions,
organizations, and local coalitions.
Objective: By 2023, increase Yellowstone County’s collective ability to create a healthier, more vibrant
community through increased collaboration, data sharing, and strategic planning among Coalitions and sectors.
Current Partnerships Across Strategy Area
Best Beginnings Council of Yellowstone County+
Big Sky Economic Development*
Billings Chamber of Commerce+
Billings Clinic+
Billings TrailNet*
City of Billings * Vision Statement:
Continuum of Care Coalition+ Advancing Collective Action to Make
Downtown Billings Alliance* Yellowstone County Healthier and More
Living Independently For Today and Tomorrow Vibrant
RiverStone Health+
St. Vincent Healthcare+
Substance Abuse Connect Coalition+
Suicide Prevention Coalition of Yellowstone County+
United Way of Yellowstone County+
+Collective
Impact Core Leaders Team Member
*Community Builders Working Group Member
Health Priorities Addressed - Mental Health | Substance Abuse | Nutrition, Physical Activity, Weight
Current Initiatives
- Culture of Health Prize application through Robert Wood Johnson Foundation (RWJF)
- Data Across Sectors for Health Mentorship
- Collective Impact Collaborative of Local Coalition Leaders
- Universal Community Planning Tool (UCPT)
- Local Initiatives that Support a Culture of Health/Health in All Policies in Yellowstone County
Proposed Performance Indicators
Retention of local leaders in Collective Impact Collaborative (goal: 100%)
# active UCPT users (launching spring 2021)
% of workplans incorporating lived experience input in 1) planning and 2) evaluation phase of project
Indicators to be determined by strategy working groups
Key Resources
Committing to Collective Impact
Robert Wood Johnson Foundation – Building a Culture of Health
Published January 2021 | Page 10Strategy 4. Strengthening Partnerships
The following initiatives support strengthening partnerships across sectors to improve
community health throughout Yellowstone County. Additional planning and performance metrics will be
developed in spring 2021 following the launch of other CHIP activities.
Initiative: Culture of Health Prize through Robert Wood Johnson Foundation
Overview: The Culture of Health Prize is a national recognition for communities in the United States that are
“working at the forefront of advancing health, opportunity, and equity for all”. Each year, the Robert Wood
Johnson Foundation honors up to 10 communities for their demonstrated commitment to creating a broad-
based culture of health. In fall 2020, Healthy By Design and the United Way of Yellowstone County co-
nominated Billings for this award. Awardees are given a $25,000 prize to support their work.
Initiative: Data Across Sectors for Health Mentorship
Overview: The Data Across Sectors for Health (DASH) mentorship is an opportunity for Coalitions and
partnerships to deepen their multi-sector collaboration to create meaningful change. Each community could
select two representatives to participate in monthly coaching calls with a mentor and peer learning calls with a
peer cohort. HBD, represented by Melissa Henderson from HBD and Thom MacLean from Big Sky Economic
Development, were paired with the Civic Canopy in Denver, Colorado. Participating communities also
received $5,000 to support collaboration, data sharing, and action, which have yet to be designated.
Initiative: Collective Impact Core Leaders Collaborative
Overview: Beginning in winter 2019-2020, backbone staff from HBD and the United Way of Yellowstone
County worked together to co-host a collective impact workshop for local Coalition members and core
leaders across these efforts. Based on this workshop, a collective impact core leaders group was formed to
map and align efforts across Yellowstone County and to apply for the Culture of Health Prize. This group has
met semi-quarterly via email, zoom, and in person. Looking ahead to 2021, our goal is to formalize this group
and to develop a shared vision and further opportunities to share and leverage resources.
Initiative: Universal Community Planning Tool
Overview: The Universal Community Planning Tool or UCPT (now officially the “Garrett County Planning
Tool”), is an open-source, WordPress plugin designed to support CHIP strategy work and to foster
community engagement and input for CHNA data. It provides a digital platform where coalition partners and
advocates can form groups around individual strategies and health priorities for more accessible sharing and
collaboration. Currently, CHI staff is learning how to format and use the tool to create a user-guide. They will
pilot the tool and the guide with strategy working group members in Spring 2021.
Initiative: Local Initiatives that Support a Culture of Health/Health in All Policies
Overview: The following partnerships represent opportunities HBD has taken to support a culture of health
and health in all policies across Yellowstone County over the past 6 months:
- Facilitation of a walkability committee in conjunction with a presentation by Jeff Speck, walkability
advocate and expert in fall 2021
- Ongoing support for the 2020 Complete Streets Progress Report
- Facilitation of a safer routes to schools funding committee, which seeks to identify opportunities to
accelerate safer routes to schools infrastructure within Billings
- Participation in the MET Transit Human Services Transportation Committee
- Letters of support for affordable housing on the South Side of Billings, Project Re:Code’s emphasis on
health outcomes, and the Complete Streets Champions fellowship for Councilmember Joy.
Published January 2021 | Page 11Get involved!
Join a strategy working group
Share your feedback and experiences
Advocate for policies or programs that improve health
Connect with us (@HBDYellowstone on Facebook, join our e-news!)
Make the healthy choice, the easy choice where you live, work, learn and play
The Community Health Needs Assessment, Community Health Improvement Plan, and Healthy By Design
Coalition are sponsored by Billings Clinic, RiverStone Health, and St. Vincent Healthcare.
These initiatives are intended as a resource for Yellowstone County residents, organizations, and leaders. To
learn more or get involved, please contact us.
Contact:
Melissa Henderson, MPH
Community Health Improvement Manager
(406) 651.6569
Published January 2021 | Page 12You can also read
