SB19-195 Enhancing Children and Youth Behavioral Health Services May-20
Our Mission Improving health care access and outcomes for the people we serve 2 while demonstrating sound stewardship of financial resources
Today’s Agenda • Introduction s and overv iew of SB19-195 • Departmental updates 3 • Single Entry Point: HMA presentation • Discussion and questions
Introductions 4
Tasks Dept of Health Care Policy & Financing Dept of Human Services – Office of Behavioral Health 5
Updates 6
COVID-19 ● HCPF resource webpage https://www.colorado.gov/pacific/hcpf/COVID ● OBH resource webpage 7 https://www.colorado.gov/pacific/cdhs/article/covid-19-behavioral- health-info ● State resource webpage https://covid19.colorado.gov/
Office of Behavioral Health Office of Behavioral Health Population in Need Study: SB-195 Related Findings
Study Findings Will Inform… Statewide behavioral Statewide behavioral health funding health priorities that allocation priorities will assist the State in standardizing and prioritizing services Purpose of the Needs Assessment A comprehensive five- Baseline behavioral year behavioral health health data to use in strategic plan and an evaluation of the annual strategic plan implementation plan implementation
PIN Approach 1. Key informant interviews and focus groups in communities 2. Behavioral health provider survey 3. County government survey 4. Pediatric survey 5. Coordinating with existing efforts Examples of Engagement Focused on Children and Youth • Review of Population Health Data Early Childhood Councils • Schools • Review of Past Reports and Denver Children’s Home • Assessments BHTF Community Conversations • Parents • Pediatric Partners of the Southwest • Young People in Recovery • Children’s Hospital Partners in Mental Health • CCHAP
Children and Youth Themes • Among children and adolescents specifically, CO ranks 48th in the country across several indicators including prevalence of mental illness and access to care . • Nearly one of three high school students (30%) reported feeling so sad for at least two weeks in a row that they stopped engaging in normal activities. • According to school data, resources are lacking, with 29% of elementary schools in Colorado ✓ Access to Care without a school counselor, 11% without a school psychologist, and 47% without access to a school ✓ Psychiatric Services social worker • Lack of trained providers specialized in child ✓ Continuum Needs populations ✓ Sub-Population Needs • Suicide is the leading cause of death among those ages 10-24 years in Colorado.
Survey Data What THREE age groups are LEAST LIKELY TO GET the mental health and substance use services and supports they need in the community in which you live? 10% Newborns and Infants (Birth to 1… 10% 20% Young Children (ages 1 - 5) 22% 31% School Age Children (ages 6 to 12) 31% 51% Adolescents, ages 13 to 19 50% 48% Young adults, ages 20 to 24 52% 29% Women, ages 25 to 64 27% 50% Men, ages 25 to 64 51% 5 … Older Adults, ages 65 and older 47% Providers (n=86) Consumers (n=157) Source: OBH PIN Community Survey, 2020
Age Group Least Likely to Access Behavioral Health Care Frontier (n=15) 67% 67% 61% Rural (n=28) 57% Urban (n=20) 51% 50% 50% 46% 45% 39% 43% All Counties (n=63) 41% 40% 40% 38% 35% 35% 35% 27% 13% Newborns, Infants, School Age Children Adolescents (ages Adults (ages 18 to Older Adults (ages and Young Children (ages 5 to 12) 13 to 17) 65) 65 and older) (Birth to 4 year of Source: OBH PIN County Government Survey, 2020 age)
Populations Who May be Excluded at Time from Intake into Services Percent of Providers with Children and Youth Exclusions at Intake into Services (n=62) Children and youth with fetal alcohol syndrome 60% Children, age 0 to 4 years 51% Youth with serious mental health service and support… 48% Youth with co-occurring Traumatic Brain Injury and MH… 47% Youth with co-occurring I/DD and MH and/or SUD 45% Children, age 5 to 9 years 44% Children, age 10 to 12 years 42% Youth actively engaged within the child welfare system… 39% Youth actively engaged within the juvenile justice system… 37% Youth, age 13 to 18 years 35% Youth with SUD service needs 34% Youth with mild/moderate MH service needs 33% Source: OBH PIN Behavioral Health Provider Survey, 2020
Stakeholder View of Single Entry Point Needs… • A reliable funding stream • To be a place to go for all types of end users, including primary care, social services, hospitals, behavioral health, community organizations, schools, and households • A strong marketing and communications plan • An evaluation plan for continuous quality improvement • Multiple modes of access, including website, phone, email, text. • Accurate and updated information (i.e. waitlists, eligibility, locations, costs, etc.) • Reliable local information and resources
Where do you seek health information or discussion about mental health/substance use issues? (n=144) Community based organizations 58% Health clinics/hospitals 53% Advocacy organizations 43% Word of mouth (from my friends and family) 40% Government agencies (Women, Infants and… 30% Virtual/internet groups 28% Faith based organizations 21% Schools 19% Face-to-face groups 17% Libraries 10% There is no one I feel I can talk to about mental… 8% Ads or brochures at bus stops or other public… 6% 211 6% Other (please specify) 15% Source: OBH PIN Community Survey, 2020
County Led Initiatives for Single Entry Point • Douglas County • Larimer County • Eagle County
Douglas County • In 2014, in relation to a series of tragic events in the community, Douglas County began the Douglas County Mental Health Initiative (DMCHI). • Partnership of over 40 organizations committed to finding solutions to provide effective, coordinated behavioral health and substance use services for all community members. • Developed a model and blueprint for implementing a countywide mental health care delivery system. The model is community- driven and aims to improve services and resources available to all populations across the behavioral health continuum • Overall, the goals of the blueprint are to: (1) create a networked system of care ; (2) rebrand mental health and substance use; (3) develop programs and interventions to address current gaps ; (4) work on policy and systems improvements; and (5) develop the workforce.
Eagle County • Between 2014 and 2018, Eagle County saw local emergency department visits for anxiety and depression increase by 465 percent, suicides rise by 183 percent over three years (2016-18), and the percentages of 7 th and 8 th graders who felt sad or hopeless for two or more weeks rise by 63 percent from 2011 to 2017. The county saw that their behavioral health system was failing its citizens and undertook a mapping process that would inform a collaborative transformation of the behavioral health system. • The main goals of the transformation plan are: (1) build a cross functional behavioral health facility ; (2) expand behavioral health provider access and capacity; (3) develop system coordination /transformation; (4) expand prevention and education efforts; (5) integrate crisis response and transition services ; and (6) expand and enhance school based behavioral health services.
Larimer County • County put out a community master strategic plan that outlines the changes that need to take place over the next 20 years to create a comprehensive behavioral health system. The plan follows a three-pronged approach: • Expand and enrich local behavioral health services across the County; • Facilitate connections between community-based services with service/providers in a centralized facility providing a stronger care coordination system and building transition bridges across providers and services in and outside of the facility; and • Build a regional behavioral health facility to provide coordinated care and crisis ser vices.
SINGLE ENTRY POINT PROGRAMS AND CONCEPTS New Jersey-Unique Feature Family Support Organizations (FSO’s) are family -run, county-based organizations that provide direct family-to-family peer support, education, advocacy and other services to family members of children with emotional and behavioral problems. Maryland MD Think - Child Welfare Module going live this Summer across all counties and Baltimore • Master Client Index • Universal Screening Tool • Confidentiality and Private Rules/Policies for shared Data Considerations • Fluid protocols for stepping up and down • Strong prevention focus • More work up front for educated staff • Enhanced referral or warm referral
Discussion or 22 questions?
Andrew Gabor Director of Child, Youth, and Family Behavioral Health Andrew.Gabor@state.co.us Susanna C. Snyder Child and Youth Behavioral Health Program Manager Maternal Child Health Policy 23 Susanna.Snyder@state.co.us Brett Snyder Child and Youth Behavioral Health Stakeholder Specialist Brett.Snyder@state.co.us
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