Options are few and drives are often long for residents with Medicaid coverage in rural western Colorado communities searching for behavioral health service providers, according to Dr. Patricia Oliver, founder of Oliver Behavioral Consultants, a behavioral health agency based in Thornton.
Most of the state’s diagnostic and treatment options for Medicaid recipients are concentrated on the Front Range, and even those usually have wait lists exceeding a year just to receive diagnostic assessments for complicated neurodevelopmental disorders, Oliver said.
For years Oliver dreamed of remedying that by creating a way to bring providers and diagnosticians to patients, instead of the other way around. However, without a sustainable source of funding, it remained a dream until last year when Oliver partnered with Rocky Mountain Health Plans, a UnitedHealthcare insurance provider and the Regional Accountability Entity for Medicaid members on the Western Slope, which agreed to fund the creation of a “Mobile Diagnostic Unit” to include an Americans with Disabilities Act-accessible bus.
Combining the use of the bus, hotel lodging, skilled staff and long hours, the “Mobile Diagnostic Unit” serves rural Colorado communities by performing neuropsychological diagnostic assessments for conditions like autism and intellectual developmental disabilities.
Meg Taylor, vice president of Behavioral Health at Rocky Mountain Health Plans, said that at the same time as rates of diagnoses for autism spectrum disorder have increased from one in 10,000 children to one in 38 children, three of every four Colorado counties has a shortage of behavioral health service providers.
Additionally, Taylor said that for the 750,000 Coloradans who live in rural counties, accessing behavioral health service providers can be complicated by the need to drive far distances, find alternatives for child care and an inability to get time off from work.
“The nature of the rural setting makes it difficult to access care in general so we have to continue looking for innovative ways to help people overcome those barriers,” Taylor said.
Furthermore, according to Oliver, long wait times to receive behavioral health care can be extremely detrimental, particularly for children who might miss out on invaluable interventions during critical periods of their development.
“The need for diagnostic support for rural Colorado families is not only so they don’t have to drive to the Front Range to find a professional to help their child, but so they don’t need to wait two years for that to happen,” Oliver said.
To illustrate how the Mobile Diagnostic Unit works, meet Amy, who requested that she not be identified by her full name. Amy is the mother of a teenage daughter enrolled at Durango High School who was the first person to receive care from the Mobile Diagnostic Unit.
Amy said she was referred to Oliver Behavioral Consultants through a local service provider whose funding to care for her daughter had run out. Oliver said the Mobile Diagnostic Unit finds most of its patients through referrals from other providers.
After contacting Oliver Behavioral Consultants, Oliver and members of her team came from the Denver area to Durango as the “Mobile Diagnostic Unit” and performed a psychological diagnostic assessment in a private, rented office space in the Durango Public Library. Oliver said they have since found a different rented office space elsewhere in Durango where assessments are performed.
Because of the assessments administered by the Mobile Diagnostic Unit, Amy’s daughter was able to receive diagnoses for generalized anxiety disorder and clinical depression.
Because of her diagnosis, Amy’s daughter was able to update her Individualized Education Program at school to more accurately reflect her needs. Oliver has also continued to play an advocacy role for Amy’s daughter, as she has done for other patients of the Mobile Diagnostic Unit, communicating between Amy and Durango High School to ensure Amy’s daughter's IEP is better supported by the school
“She’s like an angel sent from God,” Amy said. “I don’t know what I would do with my child if I didn’t have them in my life.”
Amy said that before these changes at school, her daughter’s anxiety could be so crippling that she would walk out during the middle of the day, and on some days she was unable to leave the house at all.
“The teachers would judge her. You have to have a relationship with my daughter, you can’t just come in and start yelling at her because she doesn’t do that,” Amy said.
Although she still struggles with her diagnosis, after her IEP change and Oliver’s advocacy, Amy said her daughter has less anxiety about school and has been able to receive her education more consistently.
Since assessing Amy’s daughter last November, the Mobile Diagnostic Unit has fielded assessments for 69 western Coloradans that would likely have had to drive all the way to Denver and stay there multiple days to receive such a complicated service. Nowadays, when the Mobile Diagnostic Unit goes to a community it often evaluates several patients over a matter of days, requiring staff to stay overnight in hotels.
In March, Oliver Behavioral Consultants also established a new office in Delta, and Oliver said she intends to open more offices across western Colorado, even if that means a single room leased to store secure documents and equipment for when the Mobile Diagnostic Unit comes to town.
“The purpose is sustainability,” Oliver said. “In the long term, it's about being able to have providers based in those communities. In the meantime, we have to continue to do work with the Mobile Diagnostic Unit.”
nmetcalf@durangoherald.com
