Lewis and Clark County health leaders map next steps for community plan
County health leaders say Helena's biggest test is access, with mental health, addiction and preventive care still lagging as the next community plan phase starts.
The 2025 Lewis and Clark Community Health Improvement Plan names six areas of highest concern: asthma, cancer, heart disease, housing, mental health and substance use. Helena’s next community health plan is being measured by whether people can actually use it. Lewis and Clark County leaders say the hardest problems are still access, rural reach and follow-through on mental health, substance use, housing and chronic disease, the same pressure points that show up again and again in daily life across the city and the county.
What the county is trying to fix
The plan is built from the 2024 Community Health Assessment. Those six concerns fall under three larger priorities the county is using to organize the work: chronic disease, behavioral health and housing.
The county is treating those priorities as connected, not separate. The plan ties them to access to care, community partnerships and health equity in a health system that serves both Helena neighborhoods and residents living much farther out. The rural nature of the county still makes it harder to reach outlying communities with enough staffing, transportation reach and resources.
How the county keeps the plan from becoming shelfware
Healthy Together was formalized in October 2017 to produce a community health assessment every three years, monitor progress annually and use the health improvement plan to create a common agenda for the community. The 2025 plan is the fourth Community Health Improvement Plan in that sequence.
The current plan covers three years. The CHIP process is designed to support the policies, projects and programs that will do the most to improve population health, and the latest check-in focused leaders on what still has to change next rather than what has already been written down.
Lewis and Clark Public Health and the Healthy Together Steering Committee brought back the original stakeholder group that shaped the plan to stay involved in fixing the problems it identified.
Who is on the hook
This is not a public health department project by itself. The 2025 plan includes leaders from PureView Health Center, St. Peter’s Health, Shodair Children’s Hospital, Helena Indian Alliance, United Way of the Lewis and Clark Area, Rocky Mountain Development Council and Lewis and Clark Public Health.
The planning table also extends into local government and civic life. Participants include the Lewis and Clark County Commission, Helena City Commission, the City of Helena, Housing and Urban Development, the League of Women Voters Helena, Lewis and Clark Community Services, Family Outreach, Helena Food Share, YWCA Helena and criminal justice services.
Public Health Officer Drenda Niemann has stressed the need for agencies to work together, and United Way’s Emily McVey has said the process helps put everyone on the same page. The county is trying to line up clinics, schools, housing partners, nonprofits and elected officials so decisions reflect the same local picture instead of operating in separate lanes.
Why access remains the hardest test
Lewis and Clark County had 70,973 people in the 2020 census. The county portal lists 88.8% of residents as non-Hispanic white, 1.9% as American Indian and Alaska Native and 7.1% as reporting two or more races.
The county’s equity work spans an urban and rural population and communities with different health needs and different levels of access to care. A prevention program that works in Helena proper may still miss residents in outlying parts of the county if staffing, outreach and transportation do not keep up.
A 2023 local health update counted more than 750 people trained in suicide prevention and mental health awareness through a grant, and five school districts were using the Signs of Suicide model. The update also identified a funding gap for outreach and promotion of 988, the national suicide and crisis hotline, showing that behavioral-health communication and staffing were still uneven.
What happens next
Lewis and Clark Public Health held public meetings in February 2025 on chronic disease and behavioral health to gather community and expert input for the new plan, and the county now expects to return to the table in about a year to review how the plan is working and decide what comes next.
County leaders want to improve training, reach more people and help elected officials understand the local health picture so county and city decisions match what is happening on the ground in Helena, East Helena and the county’s rural stretches.
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