20DABE13B8D52A87872587A700592CEE Hearing Summary

Vincent Atchity, Subpanel Chair, discussed the activities of the subpanel and how the subpanel determined its priorities. He discussed ranking the recommendations.

A list of the subpanel's priorities may be found on the task force website at: https://leg.colorado.gov/sites/default/files/images/committees/2017/bh_supanel_recommendation_summary_1.pdf

Jacob Bornstein, Wellstone Strategies, explained expectations and the recommendation list.

Marisol Rodriguez, Wellstone Strategies, also explained the process for reviewing recommendations, including question and answers. 

Committee discussion ensued about the process and how to proceed with the review of the recommendations. 

Senator Pettersen asked the task force members how they would like to proceed with the discussion about the recommendations. Committee discussion followed about how to proceed.

Lesley Brooks, Subpanel Vice-Chair, presented Recommendation A: Southern Ute Behavioral Health Facility: One-time dollars to support the Southern Ute community in renovating an identified existing facility for inpatient services as well as for establishing transitional housing. Should also serve the Ute Mountain Ute tribe if possible.

Committee members discussed the recommendation and focused on other federal funding available to the tribe. Further discussion about whether the recommendations would fall under the federal guidelines for expending the American Rescue Plan Act (ARPA) funds.

The facilitators asked the committee to show their support for this recommendation by using the fist to five process, with a fist being no support and five fingers as full support. 

Dr. Atchity presented Recommendation D: Immediate Life-Saving Activities (including Opioid Response): Invest through the community investment grant in treatment on demand and Medicated-Assisted Treatment in communities with high need, including for those involved with the criminal justice system. Consider focusing on ensuring community MAT providers can service the jails to better ensure smooth transitions. Two direct investments are also requested: Naloxone bulk purchase fund for an additional 5 years, and harm reduction funding through CDPHE ‘s HIV/STI program.

Committee discussion ensued about community investment grants, funding, and the use of current funds allocated for Medication Assisted Treatment for individuals involved in the criminal justice system. The facilitators proceeded with the fist to five for this recommendation. Committee discussion continued about other resources for this recommendation.

Senator Pettersen recessed the meeting.

Senator Pettersen reconvened the meeting.

Dr. Brooks presented recommendation E: Primary and Pediatric Care BH Integrations: Invest in School Based Health Centers.

Committee discussion followed about the implementation of the recommendation. The facilitators proceeded with the fist to five for this recommendation. Committee discussion continued about other resources for this recommendation.

Dr. Atchity presented recommendation F: Children, Youth, and Families Community Services: Through the community investment grant, ensure there is a youth and family oriented care center within a two-hour drive of every community by investing in eight to ten additional centers. These would support children, youth and families in crisis. These centers are envisioned to build out the hub and spoke model beyond beds. Additional grants may be allocated for expanded caregiver interventions and establishing other evidence-based services, including care navigation and coordination.

Committee discussion followed about supporting existing services and infrastructure. The facilitators proceeded with the fist to five for this recommendation. Committee discussion continued about other specifics. 

Dr. Brooks presented recommendation G: Crisis Response, Diversion, and Competency: Through the community investment grant, fund communities to develop or expand pre-arrest diversion programs (e.g., STAR, mobile response, co-responder), post arrest diversion through the judicial branch, and intensive community-based services. In addition, allow for judicial districts to apply to add additional competency courts for high-need areas for up to 3 years of funding.

Committee discussion followed about existing state resources and programs related to pre-arrest diversion. Discussion focused on being too prescriptive on how to utilize these grants. The facilitators proceeded with the fist to five for this recommendation. Committee discussion continued about specifics and community grants that are designed to address community needs. 

Dr. Atchity presented recommendation H: Care Navigation & Coordination: Through the community investment grant, augment existing infrastructure, and develop additional regional centers as needed to support a localized resource navigation system for each region of the state. These should be connected to the navigation hub funded through SB21-137 and an expanded 988 that is also connected to the care navigation database. Separately, enforce current statutes and strengthen language so that anyone who is eligible for Medicaid in the justice system is getting enrolled. Funding for both of these should save money in the long run due to connecting people to care they need.

Committee discussion followed about flexibility for implementation, issues related to care coordination, and limitations related to technology. Concerns were raised that this recommendation may be duplicating efforts. The facilitators proceeded with the fist to five for this recommendation.

The committee took a lunch break. 

The committee reconvened and wished Madam Chair a happy birthday.

Dr. Brooks presented recommendation I: Workforce Expansion and Recruitment: Invest in a tiered and expanded workforce that includes clinicians, peer support professionals and other staff. In addition, ensure reciprocity so that people from other states and countries can come to Colorado and fill behavioral health positions, especially when they can serve and/or identify with high-need populations.

The committee discussed different community needs across the state.

Dr. Atchity presented recommendation J: Workforce Training: Focus on three strategies: 1) Provide funding for established and accredited academic institutions to develop rural behavioral health academic hubs or satellite programs to support virtual licensure-track degree programs, including technology investments. 2) Invest in Crisis Intervention Training for all law enforcement both through funding and policy requirements. 3) Support all safety net providers by 2026 to be a) culturally and linguistically competent and b) serve a set of complex youth needs, including mental health, IDD, autism, SUD, and co-occurring conditions. Incentivize with rating system and consider higher Medicaid rates for certain cases.

Dr. Brooks presented recommendation K: Workforce Retention: Allocate funding for workforce retention for direct service. Strategies include short-term salary increases, bonuses, and telehealth investments.

The committee discussed recommendations J and K. The committee discussed different aspects of community behavioral health aides and peer support services. They talked about the need for training the workforce within Colorado and keeping the workforce in the state.

The members discussed different ways to keep the people providing these services in Colorado, including compensation and benefits.

Dr. Atchity presented recommendation L: Community Investment Grant: Provide funding for the above-mentioned recommendations that can be funded through the grant (totaling about $140m) as well as this additional amount to fund local governments and community-based organizations to address identified behavioral health needs. The Community Investment Grant would provide funding to services along the continuum of behavioral health care that meet regional needs. Specifically, there should be investments in evidence-based programs along the continuum, including prevention, treatment, recovery and diverting people away from the criminal justice system. To effectively implement these investments without further bifurcating the system, there should first be a county or regional level assessment that identifies gaps in the service continuum for that community and areas that need investment should be identified.

The committee spoke about identifying state-wide gaps and needs.