Outreach and Enrollment through Social Service Case Coordinator

Objective: To continue with the initial implementation and creation of a specific Social Service program to provide and improve Social Service case management to clients, as well as increase enrollment through community activities and outreach.

Description: Missoula Indian Center developed a Social Service program, including the creation of a full time position for a Social Services Coordinator to oversee the Behavioral Health and Health clients to facilitate enrollment. Other community agencies refer clients to Missoula Indian Center to provide Urban Native Americans assistance with advocacy, facilitation and on-site outreach and patient education services. The Social Service Coordinator facilitates enrollment with Medicare, Medicare via Social Security Disability, Medicare/Medicaid and/or Medicaid. The Social Service program also provides client advocacy for other community assistance programs via case management with continued follow‐up. In addition, the program provides in‐house collaboration to meet several needs of the client with a multi‐disciplinary team approach for case management.

Population of Focus: Adolescents, Adults, American Indian or Alaska Native, Children, Elderly, Limited English Proficient, Transition aged, Women

Setting: Primary care facility

Level of Intervention: Community, Family, Individual

Resources/Qualifications Needed: Cultural sensitivity training to community agencies to assist their organizations in addressing Native American client needs and/or facilitating enrollment with their programs. Funding from Indian Health Service (IHS) contracts and grants, along with State contracts and limited donation account.


Troy Wilson-Bird, Data Coordinator
Missoula Indian Center
830 W. Central, Missoula, MT 5980