CDHS advocates for more support around healthcare workforce before House Committee
The executive director of the Colorado Department of Human Services (CDHS), Michelle Barnes, testified before the House Public and Behavioral Health and Human Services Committee on Wednesday that the department has a critical staffing need.
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In her testimony, Barnes outlined three departmental priorities for the upcoming fiscal year: talent recruitment and retention, compliance with a federal consent decree, and upstream prevention of homelessness.
“We’re not judging people about where they are today,” Barnes testified. “We’re trying to help people to thrive and do what they want in their own community, within their own set of values, within their own family.
We focus on innovative and bold health and human services. We are not Medicaid, but almost all the services we provide are health services. And we think it’s really important to let you all know when we think of health, we don’t just think of physical health, we think of mental health. We think of people dealing with trauma. We think of people that have barriers. So for us health is a very big word.”
CDHS has paid more than $28 million in federal fines under a 2019 consent decree over ongoing failures to provide court-ordered services and competency evaluations for criminal defendants in its custody. The state’s nursing shortage coupled with staff shortages at the department are affecting the department’s ability to comply with the federal consent decree.
CDHS currently has a staff of 4,600 people, 1,400 shy of the 6,000 workers whom Barnes says the department needs to be fully staffed. CDHS staff works with all 64 counties in the state to administer human services to thousands of children, youth, families, and older Coloradans each year.
CDHS is requesting $3.2 billion in general funds in FY 2023-2024, up from last session’s $2.6 billion appropriation.
“We thought we would take three years to get into compliance,” Barnes said. “And then the pandemic happened and then the nursing shortage happened. And so we have not made the progress we thought—not through lack of effort but through exogenous factors outside of our control.
So we are working with a special master to try and figure out how we don’t spend the money paying fines and not have money to actually fix the problem. And so we’re collaborating with [federal officials] on it.”
According to Barnes, inpatient state mental hospitals lack the adequate capacity to timely process and serve these individuals. Barnes said Colorado has 425 people waiting in jails to be assessed. Barnes clarified that the issue stemmed from state mental hospitals lacking the personnel to man the beds and not the beds themselves.
“We do not have staff to fill the beds,” Barnes said. “We have three and a half units open at Pueblo because we can’t hire nurses. We have 22 beds open in Fort Logan because we can’t hire nurses.”
CDHS plans to open 125 group homes over the next year to take in incarcerated individuals and transfer mental health patients who do not need the hospital level of care.
The committee unanimously approved House Bill 1043, which would promote continued and emergency placement of children and youth with relatives or kin over state custody care.
Minna Castillo Cohen, director of the Office of Children, Youth, and Families (OCYF) within CDHS testified before the committee that Colorado had the lowest number of children and youth in the continuum of state care in its history.
As of December, there were 3,958 children and youth in out-of-home care, 89% of whom are with kin, with 227 of these youth in congregate living situations. OCYF has also developed new license types for foster parents and therapeutic professionals who care for young people in a family-like setting.
Yet staffing issues also extend to treatment and services for children and youth under the state’s care, according to Cohen.
Shortages have led to delays in court-ordered assessments and placements of children, as well as the under-utilization of beds at psychiatric residential treatment facilities (PRTF) or qualified residential treatment programs (QRTP), which manage acute and congregate care respectively.
Cohen said her office is working closely with the Behavioral Health Administration and HCPF on expanding treatment options, and developing workforce strategies and data analysis to build a continuum of care that meets the needs of its young people.