Depression, anxiety, attention deficit disorder and temper tantrums are among issues that come to doctors at Pediatric Partners of the Southwest. But now they have on-site professional backup available.
Since October, behavioral health counselors Tara Jackson and Mary Gilden have worked part-time in the clinic as part of a new program. Their services are free and fully funded through Rocky Mountain Health Plans, an insurance provider.
Patients may see the doctor and the counselor at the same time, allowing them to address both physical and emotional issues.
“A lot of mental issues can cause physical problems, and a lot of physical problems can cause mental issues,” Gilden said.
The clinic is the only pediatric practice on the Western Slope that was selected to hire counselors. With no appointments of their own to keep, the counselors are free to spend as much time as needed with families and help calm children during shots or other potentially scary procedures, Jackson said. They also follow up with patients to make sure their recommendations are working.
Right now, the insurance company is collecting data from clinics where it has paid for counselors so it can measure the impact those professionals have on long-term health outcomes, said Patrick Gordon, associate vice president of Rocky Mountain Health Plans.
“It really represents a unique model of practice we need to learn about how to support,” he said.
The company would like to expand the program because it believes it will lower future health-care costs. The program also could benefit from a $65 million grant Colorado received from the federal government in December. Part of the funding could be dedicated to fund and hire counselors to work in primary care practices.
The need for counselors within pediatric clinics is widely recognized by professionals, said Heidi McMillan, a pediatrician with the clinic.
About 10 percent of children struggle with a mental-health issue. But far fewer seek care, often because of the stigma surrounding it or the obstacles to get to care, she said. When patients bring mental-health problems to primary care doctors during 20 minute checkups, it often is difficult for the issue to be fully addressed.
At Pediatric Partners, patients’ transition from a doctor’s care to a counselor’s is designed to be smooth and overcome any stigma.
A natural trust is built quickly between the counselor and families because people have a beloved relationship with their pediatrician, Jackson said.
“The pediatrician has a halo ... and we get to stand with them,” she said.
The counselors recommend coping strategies on-site and give referrals to other counselors for ongoing therapy.
The insurance company provides the services free, in part because it has a contract with the state to help Medicaid patients understand and use their benefits. As part of this program, the company is trying to increase access to mental-health care for Medicaid patients, Gordon said.
The insurance company holds the state contract to improve Medicaid services through 2017 but plans to fund the program even if it doesn’t win the contract again, Gordon said.
The doctors have about 25,000 appointments scheduled each year, and a large portion of those appointments are with Medicaid patients. In addition, the clinic draws families from all over the region, making it a good candidate for the funding, McMillan said.
Non-Medicaid patients also get help because services that are available only to a certain group tend to fail, Gordon said.
In addition, making the counselors available to all patients encourages other insurance companies to start covering the service, Gordon said.
Rocky Mountain Health Plans is looking to have complete baseline data collected from the clinic by this time next year, Gordon said. The health data in future years will show whether counselors are improving overall well-being of patients, he said.
But the anecdotes from the doctors already are positive.
“At our physician partner meeting last week, the main sentiment was: ‘What a gift this program has been for patients and families,’ and ‘How did we operate without it?’” said Dr. Cecile Fraley, the practice administrator.