Last year, Colorado declared a youth mental health state of emergency after record numbers of kids and youth in mental health crises were reported across the pediatric health system. According to the Healthy Kids Colorado Survey, 40% of public middle and high school respondents had experienced feelings of depression in 2021. The Children’s Hospital Colorado said just 22% of youth with severe mental health impairment received the care they need.
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The American Rescue Plan Act provided federal funding to expand home and community-based services (HCBS) under Medicaid through state initiatives focused on addressing the national youth behavioral and mental health crisis.
In response, Gov. Jared Polis signed into law a bipartisan bill devoted to expanding access to HCBS in June and by October, the I Matter program was established. The $9 million statewide program provides anyone 18 years or younger with up to 6 free telehealth sessions in which a licensed therapist provides counseling sessions on a range of mental health issues including substance use disorder. Children 12 and younger need the consent of a parent or legal guardian to receive care.
The Colorado Behavioral Health Administration, which administers the program, said it has served more than 3,300 children from 55 counties utilizing over 180 licensed therapists to administer almost 11,000 virtual sessions through July of this year. Some 1,800 of those children received 3 or more free therapy sessions in that time. The average cost to the state is $144 per session.
Children of all age groups have sought help through I Matter, with the program having served about 1,200 children younger than 12 years old, 950 users between the ages of 12 and 14, and 1,200 users between the ages of 15 and 18. The program has served about 1,900 girls, about 1,300 boys, and 178 children who identify as non-binary.
Meanwhile AccessCare, the telehealth subsidiary of Colorado Access, said its Virtual Care Collaboration and Integration (VCCI) program saw an increase in need and delivery of services in 2021 with more than 1,300 sessions.
“[VCCI is] really designed to increase access to behavioral health in the primary care setting,” said George Roupas, Senior Manager of the telehealth program at Access Care. “We work and partner with primary care providers that work with Colorado Access to increase their access to behavioral health by providing them with a virtual behavioral health team that can assist [patients] with behavioral issues right in the primary care setting.”
In 2020, VCCI partnered with Kids First Health Care, a network of community and school-based health clinics in Adams County, to offer students virtual therapy.
The partnership allows school-based health centers to coordinate physical health care with behavioral health care. Through the program, a student first meets with a physical health provider to identify any physical health needs and discuss needs and options for mental health services.
From there, physical and behavioral health care are integrated to provide a more holistic model of care. Specific conditions that require both physical and mental health treatment, like in the case of an eating disorder, especially benefit from this approach.
“The VCCI program emphasizes collaborative and team-based care. It’s a brief intervention, short term treatment program,” Roupas said. “Generally we have our virtual psychiatrists and counselors see patients for 6 to 8 sessions for things like psychiatric evaluations, diagnostic assessments, medication management, psych evaluation, and short term counseling.
All of our staff is accredited by Triple P America. It’s called the Positive Parenting Program, an evidence-based parent coaching training program that focuses on working with parents surrounding behavioral modification and skill building with children ages 0 to 12.”
VCCI is now fully integrated into 27 primary practice sites throughout metro Denver.
Program administrators said while more work needs to be done to address language, cultural, and legal consent barriers to providing care, they are focused on building out the program’s capacity and improving its equity.
Colorado Access and AccessCare said they intend to collaboratively expand these efforts to meet the growing need and increase access to care throughout Adams, Arapahoe, Broomfield, Clear Creek, Denver, Douglas, Gilpin, and Jefferson counties.