BOULDER — JoAnna Hibberd reaches for the inside of her left bicep and kneads the skin until she finds it.

The birth control implant is impossible to see, and the insertion mark is less visible than a freckle. But she calls it a godsend.

Hibberd, 21, received the device through a state program that provides long-acting reversible contraceptives to low-income and uninsured teenagers and women at little to no cost.

If she has a complaint, it’s not knowing about the program sooner.

She tried other birth control methods as a teenager but lapsed at times. She became pregnant at age 18 and gave birth the same year to her daughter, Zoe.

“It was really hard in the beginning ,” she recalled at a recent gathering for Boulder area teen parents at a local park. “I was still going to high school, and it sucked.”

Hibberd, then and now, represents the target population for the Colorado Family Planning Initiative — a much-acclaimed program now fighting to survive.

Over the past seven years, a private foundation donated about $27 million to boost the program, but the grant money expired July 1.

A push to use state taxpayer dollars to continue the program failed in the Republican-led state Senate earlier this year, killed by ideological and fiscal objections.

Now, a month after the money ceased, the county clinics that administer the program are starting to see the effects, as limited federal and state funding fail to meet high demand in some areas.

The long-acting reversible contraceptives, whether intrauterine devices or implants, typically cost from $500 to $1,000 — which makes it hard for counties to keep them in stock and meet clients’ needs.

In Jefferson County, the state’s fourth largest, the public health department had to start a waiting list in July.

In Pueblo County, the clinics are reserving the high-end devices for clients under age 19 and those with Medicaid coverage, which will reimburse the cost.

Problems ahead

At this point, many clinics — including Denver Health Medical Center — are not facing shortages, but more are expected to encounter problems if more money isn’t found soon.

“We are sort of in scramble mode,” said Dr. John Douglas, the executive director of the Tri-County Health Department, the largest local agency in the state covering Adams, Arapahoe and Douglas counties. “We will figure out some way of getting by, but we will have to cut back in some areas because this is so important.”

In the three counties, the teen pregnancy rate decreased the same or more than the statewide average, which fell 39 percent from 2009 through 2013.

The story is the same when it comes to the teen abortion rate, which dropped 42 percent statewide in the five-year period.

Colorado officials and outside experts largely credit the shifts to the grant-funded contraceptive program that covered roughly 70 clinics statewide, and supporters suggest that each dollar spent saved $5.85 in potential costs to the Medicaid system from teen mothers and their children.

Even when taking into account the nation’s overall decline in teen births, researchers from Texas A&M University recently found the Colorado initiative responsible for a 5 percent decline in the state’s rate, according to an unpublished study.

The number is less pronounced than other studies, but “I wouldn’t say that this is a small effect given how many programs have had little or no effect on teen childbearing,” said Jason Lindo, the lead researcher of the study and an associate professor.

For months, and particularly since July 1, Colorado Department of Public Health and Environment officials have met with top philanthropists, hoping to find donors to continue the initiative launched with grant money from the Susan Thompson Buffett Foundation.

In a recent interview, Dr. Larry Wolk, the agency’s director and the state’s chief medical officer, said he is “very confident” the state will get a firm commitment from donors for the current year — possibly within the next two weeks.

“I think they are working really hard to try to help us out this year to get the emergency funding in place so we can keep it going at the level it’s been operating,” he said.

Legislation planned

The bigger question is the initiative’s long-term future, and Wolk said his agency — with Gov. John Hickenlooper’s support — will push the legislature for money again next year.

“We can’t just go after private money when there really is a true public benefit here,” he said.

Back in Boulder County, where Hibberd and other teenage moms meet regularly, officials are taking action on their own.

The county recently agreed to put $52,000 toward subsidized long-acting reversible contraceptives for low-income and uninsured women, backfilling about half the loss in state money, said Susan Levy, the executive director of Boulder Valley Women’s Health Center. The clinic also is looking to provide a new intrauterine device, or IUD, that just arrived on the market for only $50, far less than similar products.

“When you remove the barrier of cost, women and teens are very much interested in having these long-term methods that are fool-proof, that you can put in and forget about,” she said.

In Boulder, Jody Scanlon manages the county’s programs that address teen pregnancy.

She worries about clinics that can’t stock the popular long-acting birth control method.

Since the grant ended, Scanlon said she’s heard a few anecdotal examples of delays in getting young women the contraceptives.

“That can be a big barrier,” she said, citing transportation and schedule issues her clients often face. “And ultimately what that can do is close the door for teens.”

Sitting at the table with Hibberd, 19-year-old Alexia Rojas Martinez said the birth control implant she received is helping give her peace of mind.

When she became pregnant at age 18, she describes a sense of isolation, limited options for her future and a life much different than she imagined.

As she spoke, her 8-month-old son Roberto sat in a diaper and shirt on a park table, mouthing anything he could reach.

“When I had him, I knew I didn’t want any more children for a while,” she said. “Just having that (long-term) option meant … I can move on with my life, I can do something better with myself.”

John Frank: 303-954-2409, jfrank@denverpost.com or twitter.com/ByJohnFrank