In another sign that the state’s approach to behavioral health has left rural counties such as Chaffee County behind, commissioners scheduled a work session with the Colorado Community Behavioral Health Division Director Camille M. Harding. Harding highlighted the steps the state is beginning to take to formulate a behavioral health strategic action plan and the importance of involving rural counties in the process, while county representatives outlined local needs.
“Our big goal for the next two years is the state behavioral health blueprint,” said Harding. “We’ll have a few sub-committees and a couple of state-level task forces – three subcommittees. One is developing the statewide strategic plan, the second will focus on competencies for children’s health services, and the third will concentrate on safety net services.”
The work session included not just the Chaffee County Board of Commissioners, but Chaffee County Sheriff John Spezze, the Chaffee County Department of Public Health, and representatives of Solvista Health. It follows the passage in April of Colorado HB19-1177, the Extreme risk Protection Order, more commonly known as the Red Flag Bill. That bill permits families to request that guns be removed from a family member in the midst of a mental health crisis to prevent injury to that person or family members.
Prior to the bill’s passage, Chaffee commissioners and the sheriff wrote a letter to Gov. Jared Polis outlining 14 areas of concern with the bill, many focused on the lack of behavioral health support services which could prevent a crisis situation from occurring. After the governor signed the bill into law, he announced a statewide Behavioral Health Task Force initiative.
Harding said the Office of Behavioral Health contracts with 17 mental health groups around the state, including Solvista Health, and works with many county jails. It receives federal funding for the state crisis system.
“We get Medicaid service funding, Solvista is a partner in that. We’ve designed [the program] based on funding by the legislature in 2014 by the legislature,” said Harding. “We’re focused on data collection and standardized reporting. We prioritized mobile response in this latest RFP – we designed it for a quick response, and 18 months ago the legislature funded addition resources for co-responder models paired with law enforcement as part of a continuum of services … and mobile responses for mental health emergencies.
“We have a lot of suicides in Chaffee County – way more than I saw in 27 years in Denver,” said Spezze. “We have a high number of people with mental health issues coming here. We’ve got to take a step further. I see a lot of meetings, but we’re saying — let’s get this thing going.”
Harding confirmed that Eagle and Chaffee counties have the highest incidents in the state for mental health needs. While Eagle County just announced their $60 million construction project for mental health, Chaffee County currently has no facility in the works.
“We are about 25,000 people here, but the sheriff’s office averaged eight mental health interactions per month over the last year,” said Commissioner Greg Felt, who noted that population doesn’t count the huge influx of visitors during high tourist season.
“We had two suicides in three days a few weeks ago,” said Spezze. “This is a crisis in this county. We talk about opioids–but it begins as mental health issues.”
“That’s what the crisis response/mobile health response will be – now it’s a priority and it wasn’t in the past,” said Harding.
“But we don’t have any beds – that’s other parts of the state,” said CEO of Solvista Health Brian Turner, about the lack of an in-patient facility in Chaffee County. The situation means that those in mental health crisis must be transported to other areas of the state where patient beds are available.
Harding acknowledged the problem. “We’re thinking about building infrastructure, funding pilots [programs], funding that critical start-up infrastructure. The majority of our services get paid for by Medicaid and we want them flexible – resource-building as Medicaid has expanded and has a larger footprint [in the state].”
She said that the state plans to have their behavioral health blueprint done by next summer so that it has time to create a plan to fund the enhanced effort. “There are funding disparities across the state, but we first have to understand where the gaps are around the state. Next, you’ll see us arranging community meetings and focus groups, with data sets coming from these to direct the funding.”
Regarding the state’s development of a Children’s Safety Net, Harding added “It’s competencies that are in the consent decree, the judgment about getting individuals into a competency bed at a state hospital …so folks are getting the right services, so they can get treatment before they end up in jail or in a state hospital.
Chaffee County representatives made clear the need for local solutions to mental health issues. “Solvista does a great job, and your idea is good – but what’s the timeline here?” asked Spezze. “ We need help now. I have three in my jail right now awaiting [behavioral health] bed space. This is a big problem with a simple solution – funding. But there has never been funding.”
“Here’s what Solvista does, and can do,” said Turner, who has applied to serve on the state’s new Behavioral Health Task Force. “That local conversation – designing the local solutions – is absolutely crucial.”