Building from the Baseline: The Inaugural Cohort of the Colorado Health Access Fund

Behavioral health is a hot topic in Colorado these days – and for good reason.

Suicide rates have reached an all-time high. The rate of opioid overdoses continues to climb. And in 2015, nine percent of Coloradans – or 440,000 residents – said they needed mental health care or counseling but did not get it, according to the Colorado Health Access Survey (CHAS).

For the past year and a half, CHI has been involved in a unique part of this work. We have been the evaluator for a statewide program called the Colorado Health Access Fund, which aims to increase behavioral health access for Coloradans with high health care needs.

This week, in partnership with The Denver Foundation, we are releasing the results from the first annual evaluation report.

Established in 2015 at The Denver Foundation with an anonymous gift of $40 million, the Colorado Health Access Fund aims to expand behavioral health care access to the neediest Coloradans. The foundation retained CHI to independently evaluate its impact.

We’re proud to be involved in this important work. Our approach was to measure how well the fund is increasing access to behavioral health services across the state. We also are measuring how well it adheres to the donor’s intent.

Our report analyzes results from the inaugural cohort of 27 grantees that completed their first year of funding on September 1, 2016.

As you might expect, increasing access to behavioral health care in Colorado is all about the long game. This first cohort provided results for year one of the fund’s eight years. In other words, this is a marathon, not a sprint.

So what did we find?

The fund is generally on track to meet its mission of expanding behavioral health care access to Coloradans with high health care needs.

The number to remember is 32,000. That’s how many Coloradans received services via the first cohort of grantees.

Grantees from this first cohort are diverse and serve a variety of populations. And the work they are doing is wide-ranging. Interventions include counseling services for elderly or homeless Coloradans, integration of behavioral health into primary care, as well as providing telepsychiatry services to bring mental health encounters to rural or underserved areas via videoconferencing. 

As part of the evaluation, we asked grantees about common challenges and success factors they found in rolling out their programs. Despite their diversity, there were some recurring themes. Grantees said that:

  • Adequate staffing and financing were key ingredients to success — both for rolling out programs and ensuring a sustainable future after the Fund’s support ends.
  • Policy barriers do exist. Grantees raised opportunities to shape the way behavioral health providers are reimbursed and certified as Medicaid providers.
  • Strong partnerships in the community and trust in clients were important to program success.
  • Hiring — and retaining — experienced and culturally sensitive staff for programs was a challenge.
  • Being able to adapt to the changing needs of their clients and understanding the social, economic and geographic context for the program was critical to grantee success.

Based on the findings, we made some recommendations. The intent of those recommendations is to help meet the intent of the donor, and to help grantees be successful.

For example, we recommended that future grantmaking should intentionally identify grantees serving rural parts of the state.

As another example, we recommended that grantmaking should work to continue funding programs that are positioned for success. That means grantees need a clear plan for sustaining the program, and strong partnerships with local actors. They also need to be able to deal with challenges as they come, like problems hiring or retaining a behavioral health service provider.

We’re excited to move into year two working with The Denver Foundation. We have partnered closely throughout the design, roll out and analysis of the evaluation. It’s been a pleasure and honor to support them in their philanthropic effort.

This first annual evaluation report marks the beginning of a long road ahead. And here at CHI, we’re thrilled to be along for the ride. Year two of the Fund will bring another cohort of grantees working to increase behavioral health care access across the state.

But we’re not taking a breath yet. We just hosted the first grantee check-in call of 2017 to update the programs on what we’re learning. We’re also working with grantees to find ways they can support each other as evaluators and learning organizations. One idea is a peer-to-peer learning network.

Stay tuned for more to come.

For now, read the full evaluation report here and the executive summary here.  Learn about the Colorado Health Access Fund here

And see all of our work on the Colorado Health Access Fund here.

Alex Caldwell joined the Colorado Health Institute as a Policy Analyst in August 2016. Alex conducts analysis on emerging health policy issues both in Colorado and nationally.