I/DD Crisis Pilot

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Transitions at West Springs

515 28 ¾ Road, Grand Junction

SummitStone Health Partners Crisis Stabilization Clinic

1217 Riverside Ave. Ft. Collins

Meeting the needs of children and adults with intellectual or developmental disabilities and behavioral health needs

 

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.

  • Rocky Mountain Health Plans (RMHP) is conducting the pilot in partnership on the Western Slope with Strive, a community-based support services organization for individuals with developmental disabilities; Mind Springs Health, a network of community mental health centers; and other organizations that support individuals with developmental disabilities, as well as other community mental health centers.
  • In Larimer County, RMHP is conducting the pilot in partnership with Foothills Gateway, Inc. (FGI), a community-based support services organization for individuals with developmental disabilities and SummitStone Health Partners, a community behavioral health center.  FGI and SummitStone have a history of collaborative work over the past twenty years.

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.
 

Background

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.

The Goal

Ensure timely access to behavioral health supports for those in crisis who also have an intellectual or developmental disability. That means providing crisis intervention, stabilization (for those who need longer-term care) and follow-up for children and adults with I/DD who need mental health services. The partners hope to reduce emergency department visits and psychiatric hospital admissions while improving the quality of life for these individuals and their families.

Why It Matters

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.[1] Data suggest that 43 percent of individuals with I/DD need extensive support to manage self-injurious, disruptive and/or destructive behavior.[2] Too often, these individuals lack access to appropriate mental health services.[3] 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.

How It Works

There are three key components:

  • First, the local 24/7 mental health crisis hotline/walk in locations have professionals who respond to anyone presenting in crisis.  As part of the response, people are screened  for an I/DD and, when appropriate, the professional can jointly assess the individual by using an I/DD professional to assist in determining needs.
  • For those who need site-based therapeutic services, the pilot provides these in homes adapted for those with intellectual and developmental disabilities. For individuals who can safely stay at home, home-based therapeutic services are provided. I/DD and mental health professionals work as part of an interdisciplinary team, providing care management, therapy, medication monitoring and, ultimately, working with the individual and their families on a plan to get him or her integrated back into the community.
  • The program helps individuals connect to needed community services and programs for which they may be eligible, and offers follow-up once the individual is integrated back into the community.

Collaboration

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.

Sustainability

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.


[3] Interview with Sharon Jacksi, The Ascent, July 2016

 

 

What the pilot requires

 
  •   Timely crisis intervention
  •   Stabilization
  •   Evaluation
  •   Treatment
  •   Home-based or Site-based therapeutic support
  •   Follow up services
  •   Access to
    •   intensive psychiatric, behavioral and mental health services;
    •   community-based mobile support; and
    •   education/training and follow-up support.

All efforts complement and expand on the existing Colorado Behavioral Health Crisis Response System.