By Kim Bimestefer and Michelle Barnes
Ensuring Coloradans have real access to mental and behavioral health care services has been a commitment for the Polis-Primavera administration since day one. Even before the pandemic increased the need for behavioral health services into a crisis, we recognized the need to make significant changes to our behavioral health system in Colorado. We are committed to addressing the problems and gaps in the behavioral health system and to making bold changes to ensure people the mental health and substance abuse treatment and services they deserve.
In April 2019, Governor Polis established the Behavioral Health Task Force, asking for honest input about how the state could make real, impactful change. Hundreds of families, county commissioners, local governments, including clients, providers, and advocates weighed in on how we could improve access to care. The Task Force developed a detailed plan of action and reform that included the establishment of a Behavioral Health Administration (BHA), and expanding the behavioral health safety net.
There are many factors that have contributed to this crisis, including a shortage of providers, lack of transparency and accountability across the system, and flawed payment
models.
However we got here, we are all taking responsibility.
We must change the way we deliver and pay for behavioral health services, and we are working to do that through the BHA. Additionally, the Governor and the General Assembly have directed $550 million to behavioral healthcare. $100 million was allocated during the 2021 legislative session to care coordination, school-based services, treatment for high needs children and youth and a number of other services and programs.
How to spend the other $450 million is being debated by an interim legislative committee, which will finalize its recommendations for the 2022 legislative session. We both sit on that committee and hope its recommendations are transformative, address system gaps and provide us with a strong foundation to build a highly functional behavioral health system.
Coloradans deserve nothing less.
Real investment in behavioral health is long-overdue. We are taking a new approach: one that asks all stakeholders to work together on an unprecedented level to ensure the behavioral health system is highly functional, transparent, and accountable. Cooperation and mutual respect are essential to ensuring that we provide care for Coloradans, especially those with the highest need.
We must hold ourselves and our providers accountable, modernize our data and reporting systems, improve access and technology, change state contracting while setting new standards with providers, and create sustainable funding to programs that serve all Coloradans in need.
Some of these changes are underway already; for example, within the Medicaid program, which covers one in four Coloradans, we have expanded substance use coverage, added 1,500 behavioral health providers to improve care access over the last 18 months, and increased the Medicaid behavioral health budget by $400 million since 2018. As a result, the total Medicaid behavioral health budget will exceed $1 billion next year.
We need systems and supports that prevent people from “falling through the cracks” that acknowledge the whole person so all Coloradans can recover and thrive in their communities. Planned system reforms in progress include a regional approach to care coordination to help people navigate and access behavioral health care in programs that track and measure outcomes.
Through all these reforms, lifting up behavioral health frontline workers is a top priority. Expanding workforce opportunities is an essential pillar of behavioral health transformation and investment. We know that workers need better pay, and we need more of them. Colorado is investing $18 million for workforce development so that we can grow this critically needed workforce. The program will increase the ability and capacity of providers to treat individuals, including youth, with severe behavioral health disorders. Governor Polis has also made a request to the Behavioral Health Transformation Task Force for $20 million in loan forgiveness for behavioral health providers.
For far too long, Coloradans have struggled to get the care they desperately need. We are confident this path, forged shoulder to shoulder with consumers, patients and family members and committed, mission-driven providers and advocates, will create a system that works.
Kim Bimestefer is Executive Director, Colorado Department of Health Care Policy & Financing. Michelle Barnes is Executive Director, Colorado Department of Human Services.