Yellowstone City County Health Department

Yellowstone City County Health Department, operating as Riverstone Health, is a U.S. local government entity based in Billings, Montana, that operates as a federal grant recipient delivering behavioral health crisis intervention, primary care, public health, nutrition, and maternal child health services across four states. Riverstone Health functions primarily as a sub-recipient (74% of recent awards) receiving flow-through federal funding from state health departments and universities rather than as a direct federal prime grantee.

Riverstone Health's federal footprint centers on health and human services grant work. The organization acts as prime recipient on a $750,000 SAMHSA Center for Mental Health Services project grant (CFDA 93.532, awarded September 2026) to establish a behavioral health-led mobile crisis response system serving Yellowstone County, Montana, with services launching in Billings within six months, scaling to 24/7/365 coverage by end of year two, and extending into rural county areas by year three through September 2030. The organization also held a prime grant from the U.S. Department of Agriculture's Agricultural Marketing Service (awarded September 2024, completed September 2026) focused on vendor recruitment and marketing expansion for a farmers' market on Billings' South Side, and received prime awards from the Department of Health and Human Services Bureau of Primary Health Care for the FY 2023 Bridge Access Program and FY 2023 COVID-19 vaccination expansion, both delivered through brief award windows in 2022 and 2023.

Sub-recipient activity dominates the organization's federal pipeline. Riverstone Health receives roughly 100 sub-awards flowing through the Montana Department of Health and Human Services (the primary pass-through entity), the University of Washington, the University of Montana, Montana State University, the Montana Board of Crime Control, and the National Children's Alliance. These sub-awards fund public health emergency preparedness (PHEP), maternal and child health block grant (MCHBG), HIV/STD prevention and care, immunization programs, Women Infants and Children (WIC) nutrition services, refugee health services, mental health and substance use treatment, geriatric workforce education, AIDS education and training, and trauma-informed services for child crime victims. The Montana Department of Health and Human Services accounts for the largest share of sub-awards, with recent sub-awards in public health surveillance, epidemiology, immunization, rural health workforce initiatives, and viral hepatitis prevention. Sub-recipient work began in the source data in 1995 and has remained continuous, with activity patterns showing 24 awards in 2023, 15 in 2024, and 13 in 2025, declining to 2 recorded awards year-to-date in 2026.

The organization serves 27 distinct federal customer agencies across two primary funding paths: the Department of Health and Human Services (Health Resources and Services Administration, Centers for Disease Control and Prevention, and Substance Abuse and Mental Health Services Administration collectively account for 51% of recent awards by count) and the Department of Agriculture Food and Nutrition Service. A single award faces recompete in the next twenty-four months. Riverstone Health's federal posture is fundamentally that of a local public health authority executing federally funded programs on behalf of state and regional partners, without a prime contract portfolio or a seat on government-wide vehicles.