Colorado behavioral health task force plans to address the “missing middle” in the care continuum

The Behavioral Health Transformational Task Force interim committee is working to address the “missing middle” in the behavioral health care continuum, according to Rep. Dafna Michaelson Jenet (D-Aurora). 

The task force is working to address this “missing middle” in the criminal justice system and in opioid overdose care. They are also working to expand in-patient facilities and expand the behavioral health workforce within Colorado.

 

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The task force is made up of lawmakers, administration members, and community members to curate legislative recommendations around behavioral health. According to Michaelson Jenet, the recommendations should be ready and available around Dec. 10, before the start of the legislative session on Jan. 12. She says:

“We’ve really dug into the community to bring the community with us in the process.”

Michaelson Jenet says the task force has $450 to $650 million to spend and is trying to make the money go “as far as humanly possible.” 

Michaelson Jenet highlighted the need for expansion of services for those who are incarcerated, especially youth. She says 80% of incarcerated youth have at least one diagnosable mental illness. Of incarcerated youth in Colorado, 60-70% are sent out of state—on the state’s behalf— to get the appropriate services. 

She says the state needs to create a framework to help those incarcerated due to their mental illness receive the proper treatment, which would require expanded “missing middle” services like in-patient facilities. 

“[Of those] who are being incarcerated because of their mental illness, [we need to] get them first into the right level of care, where we can then move them through the system and open up this ‘missing middle’ to the general public. It’s like the Suez Canal. It’s stuck. We have this huge congestion, and we can clear out that congestion while building out the ‘missing middle’ and truly [transform] our system.”

To do this, Michaelson Jenet wants to use the former Ridge View Youth Services Center, which closed in the summer of 2021, as an in-patient behavioral health facility for adults to cover this “missing middle.” The youth services center used to house young boys with behavioral health challenges, so it has the infrastructure to handle the new facility. 

However, a stable workforce would be needed for this new facility, which is another priority of the task force, says Michaelson Jenet. She says the state needs to find solutions to create a stable workforce from residents within the state of Colorado, and to invest in the workforce that is already here. She says this specifically could be used in rural settings:

“What’s the answer to our rural health care provider crisis? [We need to] reach into the rural communities and see who wants to be paid to go to school. That’s the answer. I am hoping to see recommendations that are very specific about that.”

The task force is also focusing on the rise in opioid overdoses in Colorado. According to a recent Colorado Health Institute report, opioid overdoses rose 54% in 2020.

Michaelson Jenet says the task force is working on providing recommendations to include more medication assisted treatment (MAT) in hospitals, emergency departments (ED), and jails. The task force also wants to provide more MAT in acute care settings and potentially create specific EDs for behavioral and mental health crises. 

Michaelson Jenet was a speaker at our recent 2021 Colorado State of Reform Health Policy Conference last month as part of our Afternoon Keynote presentation. You can watch and read more about the keynote here