According to the 2018 County Health
Rankings, of Colorado's 58 ranked counties, Delta County
ranked 41st for healthcare outcomes. Local county
needs assessment planning had also revealed that
pediatric behavioral healthcare was a pressing issue.
Plus, a nonprofit children's behavioral health
organization in Delta, Colorado, led an effort to
increase behavioral healthcare access to the county's
population age 18 and younger.
Initial strategic community planning created the Delta
Consortium and consortium members established 3 main
objectives: create access to comprehensive healthcare for
underserved children; integrate behavioral health
professionals into physical health clinics; and develop
community-wide collaboration to promote behavioral
healthcare throughout Delta County.
Other county health data was used to identify 3 groups in
most need of care: children with complex physical and
mental health needs living in family environments with
adults with similar needs; children enrolled in clinics
with no behavioral healthcare access; and children with
an anxiety and depression diagnosis needing mental health
therapy in addition to the medication prescribed by the
primary care provider.
Using several evidence-based behavioral health models,
the consortium primarily implemented the
Wraparound Model, a model covered by Colorado
Medicaid that uses a process bringing all key agency and
healthcare providers together to build an integrated
treatment plan. The model also focuses on
person-centric/family-centric care drawn from two
healthcare component, a family/child
unit might select an option for a licensed mental
healthcare professional to follow alongside for an
extended interval. Another choice from this component
might include physical and dental care. From the
community component, choices include
options such as families that mentor, academic tutors, or
enrollment fees for sports programs.
The age of the Families Plus participants were age 3 to
24 and standardized measures tracked progress. Knowing
that age 11 is often when children with early trauma
begin to struggle, program successes were recognized when
youth were able to stay at home and avoid residential
care, remain in school, remain free of addiction, and
need no legal supervision. Program outcomes demonstrated
that 82% of the participating children showed same or
improved scores on the Achenbach Child Behavior Checklist
and similarly, 92% on the Parent Achenbach Child Behavior
Staffing was a key element for the project's launch and
Families Plus was able to hire 2 full-time behavioral
health professionals. To integrate the behavioral health
record into the physical health record, these clinicians
developed an electronic health record (EHR) pathway for
the three different EHRs used by the primary care clinic
consortium members. In addition, these clinicians also
developed pathways for use by the primary care providers
to more easily navigate the new behavioral health
offerings. Due to the clinical language differences
between behavioral/physical healthcare, a common
vocabulary was created. Billing for behavioral health
services — another difference from physical health
workflow — was done by a private billing agency.
The original consortium consisted of 4 partners and in
three years grew to a total of 9. This growth was also
accompanied by a name change to Delta Consortium for
Behavioral Health Access. The new consortium is
positioned to develop new projects for 2018-2021.
Funding for this project came from the Federal Office of
Rural Health Policy's 2015-2018
Rural Health Care Services Outreach Program.
This model was one of 7 Health Resources & Services
Administration's 2018 Rural Health Champions and received
the Champion in Innovation award.