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A two-year pilot underway in the Western Slope and Larimer County seeks to bridge an important gap in care delivery: Individuals with intellectual or developmental disabilities (I/DD) who too often lack access to necessary mental health services.
This pilot represents an innovative integration of behavioral health and intellectual / developmental disabilities systems to serve people in crisis, and capitalizes on relationships RMHP has cultivated over the years on the Western Slope and in Larimer County.
A 2014 report from the University of Colorado School of Medicine identified the gaps in the delivery of care for individuals with I/DD. In response, Colorado enacted HB 15-1368 in 2015. This established the Cross-System Response for Behavioral Health Crises Pilot Project to help address service gaps for individuals who have both an intellectual or developmental disability and a mental health or behavioral disorder. The Colorado Department of Health Care Policy and Financing issued a Request for Proposals for a Crisis Center Pilot Contractor. RMHP and its partners submitted a proposal and were awarded the contract.
The partners: community mental health centers and community-centered boards--Strive, Mind Springs Health, The Center for Mental Health, Mountain Valley Developmental Services (MDS), Community Options, SummitStone Health Partners and Foothills Gateway, Inc.
The pilot is in five counties representing two Colorado regions: Mesa, Montrose, Delta and Garfield on the Western Slope, and Larimer County on the Front Range.
Nationally, about 1 to 3 percent of the population has an intellectual or developmental disability. Of those, about a third has mental health issues as well. Data suggest that 43 percent of individuals with I/DD need extensive support to manage self-injurious, disruptive and/or destructive behavior. Too often, these individuals lack access to appropriate mental health services. The pilot begins to bridge that gap, setting up a system for mental health professionals to share their expertise with I/DD professionals and I/DD professionals to share theirs with mental health providers.
Oftentimes, fragmented policy and funding contribute to fragmented treatment response resulting in those with intellectual or developmental disabilities not getting their mental health needs addressed beyond medication management. This can result in the patients cycling back and forth between facilities. Often, someone won’t be admitted to a psychiatric hospital because they manifest behaviors that appear more related to developmental disabilities. So the person returns home until the next crisis, and gets bounced around again. The actual mental health issue is often not addressed. This Pilot aims to close that gap in care with a specific focus on those in crisis.
There are three key components:
To provide a truly cross-system response, the partners are leveraging existing cooperative agreements--and, when necessary, developing new ones--with Colorado Crisis Services, various Medicaid services, the capitated mental health system and various other providers and organizations. They are also developing informal agreements with jails, housing authorities, homeless shelters and law enforcement. View the full collaboration plan.
Throughout the pilot, participants will identify funding and service gaps and ways to use existing resources close to them. The partners in this pilot will make specific recommendations regarding policy and funding barriers. Funds from the Cross-System Response for Behavioral Health Crises Pilot Project should be used once existing resources have been exhausted.
 Information on dual diagnoses. The National Association for the Dually Diagnosed. Web Accessed June, 2014.
http://thenadd.org/resources/information-on-dual-diagnosis-2/;Final Report: Analysis of Access to Mental Health Services for Individuals who have Dual Diagnosis of I/DD and Mental and/or Behavioral Health Disorders (11/2014)
 National Core Indicators data brief, May 2014; http://www.nationalcoreindicators.org; Final Report: Analysis of Access to Mental Health Services for Individuals who have Dual Diagnosis of I/DD and Mental and/or Behavioral Health Disorders (11/2014)