Aurora Mental Health Center to discontinue day treatment programs for youth

AURORA, Colo. — The Aurora Mental Health Center will be discontinuing its regional Hampden Youth Campus programs at the end of the school year, adding additional strain to the already stretched-thin resources for pediatric mental health, local educators say.

Tony Poole, assistant superintendent of special populations for Cherry Creek, said the announcement of Hampden’s closure came as a blow to the district.

“It was a definite shock for us,” he said.

AMHC leaders said that the programs became increasingly financially unviable due to changes in how behavioral health programs receive funding from the state, and are part and parcel of what mental healthcare providers have said is a convoluted and inefficient system.

In an April letter to area school districts, AMHC special education director Kelli Perez said that AMHC had decided to halt the three-day treatment programs offered at the campus “after careful consideration of current operating challenges, including increasing acuity of students, diminishing referrals and enrollments, and decreasing financial viability.”

The programs offered at the campus include Metro Children’s Center, which serves kids in grades kindergarten through eighth grade, and Hampden Academy, which serves youth in eighth through 12th grades. A third program, Intercept Day Treatment, was not in operation this year because the health center was not able to hire enough teachers to staff it, the letter said.

AMHC spokesperson Lori MacKenzie told The Sentinel in an email that Intercept Outpatient Services, ​​a program for children and youth with co-occurring behavioral health and intellectual/developmental disabilities will continue uninterrupted.

Chief Clinical Officer Kirsten Anderson said that there have been decreasing referrals to the program over the past few years. At the same time, the severity of problems individual students are experiencing has increased, she said. That means that to properly staff the program more employees are needed, which is hard for the center to do because it is losing significant amounts of money.

“Last year this program lost over $300,000, which made it very difficult to be able to hire enough staff to work with the level of acuity that we were seeing in the students,” Anderson said.

The program is required to predict how many students it thinks it will serve during the school year, and is funded based on that number, she said. For the past school year it estimated it would serve 26 students across all grade levels but only received 18, which put it in a bad financial position.

In the letter, Perez said that the health center is “saddened” by the decision and is working to help transition students currently in the programs so they do not fall through the cracks.

“This decision was not made without a lot of analysis and consideration of the landscape both current and moving forward with changes due to the Behavioral Health Administration,” Perez said.

The Behavioral Health Administration is a new state agency set to launch in July that will oversee the state’s network of mental health care providers. An investigation from the Colorado News Collaborative published in Sentinel Colorado in December detailed a series of failures in the state’s mental health safety net, including a lack of oversight of the state’s 17 community mental health centers and serious workforce shortages.

CEO Kelly Phillips-Henry said that the decision wasn’t spurred by future changes to the BHA but to changes the state made about three years ago. Previously, it was much easier for the organization to “float” costs across programs that could not pay for themselves. Now, it is largely operating on a fee-for-service model that makes it very difficult to cover programs that come in at a loss year after year, she said.

“Year over year, for at least four years, we have taken a significant loss on this service line, and it’s getting harder to be able to do that in the way we are now paid,” Phillips-Henry said.

AMHC officials also said that the Cherry Creek School District’s plan to open its own day treatment facility was a factor in the closure. The district is one of the largest referrers to the day treatment program, “and with them taking day treatment in-house that would decrease our referrals even more than what we’ve seen recently,” Anderson said.

With the way it is now funded, Phillips-Henry said that AMHC has to prioritize the services it offers and educational programs have never been its primary area of expertise. With CCSD opening its own facility, it made the decision to put its resources into other programs that have a higher level of community demand.

The closure came as a disappointment to Cherry Creek, however.

Poole said that on average, about 3 to 10 district students are in one of the Hampden programs at any given time. With how few local resources there are for young people with mental health issues, the closure of any one program is a challenge.

Nine years ago, Poole said the district had 77 placement options for kids with mental health needs. With Hampden’s closure, there are now fewer than 30.

“It’s bad,” he said.

In response to the shortage, Cherry Creek has plans to build its own $15 million mental health day treatment facility that it will operate in partnership with a local health provider. AMHC is one of the providers that responded to an RFP the district put out, a decision is pending.

Depending on the severity of needs, the facility will be able to serve 60 to 100 students at a time, Poole said. However, it will not be operational for at least several years.

The neighboring Aurora Public Schools district also has partnerships with AMHC. APS spokesperson Corey Christiansen said the district is always concerned when community services are cut.

“We are proud of our partnership with Aurora Mental Health in getting services into our schools which helps to provide services to our youth during the academic day,” he said in an email.

The dearth of mental health resources for children and youth has been a topic of concern throughout the pandemic, with Children’s Hospital Colorado declaring a “state of emergency” for pediatric mental health last year.

Heidi Baskfield, the hospital’s vice president of population health and advocacy, said that since 2007, the state has lost 2,000 beds for youth mental health treatment.

“The central biggest challenge is that there has been a consistent pattern of closing facilities serving youth with mental health needs without a clear plan for how additional capacity gets built somewhere else,” she said.

Many of those facilities closed because they couldn’t make their business model work with the low rates of reimbursement they received from Medicaid and other providers, Baskfield said. She applauded the state for helping increase reimbursement rates, but said that it needs to be more proactive about finding capacity in other places when mental health facilities close.

Meanwhile, the hospital is continuing to see a record number of pediatric mental health patients.

“We have nothing that would indicate it is going to slow down anytime soon,” she said.

Anderson said that AMHC is still committed to serving youth and will be enhancing the services it offers to young people who need more than just outpatient therapy, including piloting a program to get patients who are coming out of the hospital into treatment much quicker than they are currently.

“It does not mean that we want to shirk our responsibility in any way of providing clinical care to this population of students, where necessary,” Phillips-Henry said. “We very much remain at the table as the clinical expert. What we just no longer can sustain is the running of the school.”