Behavioral Health Support
Children in low income families are at higher risk for mental health issues due to a variety of factors:, the many socioeconomic factors that produce stress in the family and also influence the developing child (now referred to as the “toxicity” of poverty), the higher degree of other stresses in the family, the higher incidence of postpartum depression in the mother, the higher incidence of other mental health issues in the family, the higher incidence of developmental delays and the delays in identifying and treating other behavioral issues in the child. Children covered by Medicaid have access to mental health counseling in community mental health centers, but only a small proportion of referred families actually get to the mental health center due to a sense that mental health care carries a stigma or due to the any of the many psycho-socio-economic barriers. CCHAP works to reduce behavioral health disparities in children by assisting medical homes to integrate “primary preventive behavioral health care,” behavioral health screening and early intervention at well child visits, and behavioral health care coordination into the medical home, progressing toward completely integrated behavioral health in the medical home. CCHAP also assists medical homes interested in integrating a behavioral health professional into their medical home.
CCHAP’s Preventive Behavioral Health Program
The CCHAP goals for comprehensive preventive behavioral health care of children parallel the goals of the Colorado State Health Innovation Plan.
- By 2019, 80% of medical homes for children will have an integrated behavioral health care provider.
- By the end of 2016, 75% of medical homes for children will have incorporated evidence-based methods for providing preventive behavioral health care including early screening, early intervention, appropriate care coordination and attention to socioeconomic barriers.
CCHAP is addressing this vision and its supporting goals through its Preventive Behavioral Health Program that promotes and enables medical homes to develop one of two models of care, by providing education, technical assistance and coaching to medical homes serving children:
- Integrated Care Model: CCHAP partners with medical homes for children in Colorado and Project CLIMB (an integrated behavioral health training program at Children’s Hospital Colorado) to integrate behavioral health professionals into the medical home. CCHAP also assists the medical home to code, bill and obtain sufficient reimbursement, determine best practices for providing integrated care, prove the value of this approach; and ultimately to make integrated care sustainable. There are very few behavioral health providers today trained in “true” primary integrated behavioral health for children in medical homes, and only small numbers are being trained each year; so, CCHAP and Project CLIMB will also develop an expanded training program to expand the workforce able to provide primary behavioral health care in medical homes.
- Early Behavioral Health Intervention and Navigation Model: Since so few behavioral health providers are trained today in the Integrated Care Model, CCHAP provides information and coaching for medical homes statewide in ways to improve behavioral health outcomes that do not require a children’s integrated behavioral health provider. CCHAP helps medical homes to provide:
- Appropriate number (and timing) of preventive care visits for all children and teens, at which preventive behavioral health care can be provided
- Postpartum depression screening for mothers of newborns and young infants
- Developmental screening and autism screening at appropriate ages
- Behavioral health screening for infants, toddlers and preschoolers
- Depression screening for children and teens, starting at age 11
- Substance abuse risk screening for teens
- Appropriate referral, navigation and care coordination for behavioral health issues – linking medical home staff with BHOs and mental health center staff to orchestrate an effective “warm handoff”
- Counseling and educational materials for parents, children and teens to promote good mental health
- Assistance to families to access resources to address socioeconomic stressors/barriers
- Culturally responsive care and communication around behavioral health issues
- And the ability to review their health care data to evaluate and improve their success in providing these activities
- CCHAP and partner organizations will also determine the most sustainable payment mechanisms for these services and determine how best to measure and evaluate outcomes.
CCHAP Services For Your Practice
CCHAP provides education, technical assistance and coaching for medical homes that care for children on Medicaid and CHP+ to implement comprehensive preventive behavioral health services to address behavioral health disparities. CCHAP can assist your practice:
- To integrate a behavioral health provider into the medical home, providing “primary preventive behavioral health care”
- Implement behavioral health screening at well child and youth preventive care visits
- Establish early intervention at well child visits
- Institute behavioral health care coordination into the medical home, progressing toward completely integrated behavioral health into the medical home