Q&A: Rep. Dafna Michaelson Jenet talks about mental health and systemic reform in Colorado

Rep. Dafna Michaelson Jenet was elected to represent District 30 in the Colorado House in 2016, unseating a Republican incumbent. Serving as Vice Chair of both the Public Health Care & Human Services Committee and the Legislative Audit Committee, she is in the position to influence health policy in more ways than one: how we pay for it and how make it better.

In a recent conversation, Rep. Michaelson Jenet told me more about a bill she’s working on provide coverage for annual mental wellness exams and she offered her perspective on the issues unique to Colorado health reform.   

 

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Michael Goldberg: Can you give me a quick overview of what you’re working on this session?

Rep. Dafna Michaelson Jenet: My biggest bill, HB 20-1086, asks insurance companies to cover an annual mental wellness exam as preventive care; 60 minutes with a qualified mental health provider, and no copay. The idea is to fundamentally rethink the way we do medicine, so that you don’t only have a primary care physician but also a primary mental wellness provider. Imagine a pregnant woman and their partner going out to find a pediatrician may also a primary mental wellness provider so that they can start learning about social and emotional wellness, cues from babies and how to take care of babies and set them up for an emotionally healthy life.

This would would provide us the opportunity to detect mental illness earlier and provide treatment earlier. Also, it would provide an opportunity to stop treating mental health in a crisis management way. Right now that is the only way we manage mental health: on a crisis by crisis basis. We wait for a crisis to happen and either you end up in the emergency department or you have serious depression and you’re missing many days of work. To really set us for success,  believe is the way to go is annual mental wellness exams.”

MG: What is your take on Gov. Polis’s public option proposal?

DMJ: Well, I can tell you that I have UCHealth in my district and I know that they are very, very concerned. We have two members of the house that are working very hard on this. I think for me, I’m going to see what’s rolled out, and let’s see how we can work with the medical community to make this a palatable move.”

MG: One ongoing concern we’ve been hearing in Colorado policy circles is the funding blockade imposed by the TABOR amendment. The concern is that with the TABOR amendment in place, the state is prohibited from raising the revenue that would be necessary to implement a true public option.  Does Colorado have the tax schedule necessary to develop these broad based programs that many polls indicate Coloradans approve of?

DMJ: Yes, our tax system makes it exceptionally challenging to get the amount of revenue we need to adequately take care of our community. I think that’s a fair statement. But I think the idea behind our tax system of allowing the citizens to vote and have this control was an excellent idea. And who’s going to vote to give up their money? Right now, Colorado is seeing economic success but it’s not trickling down to our families, so it’s hard for them to vote give up any more of their money.”

MG: How much are legislators thinking about the intersection between health policy and gun violence? Do you think conversations taking place in the health policy space are influencing conversations surrounding gun legislation?

DMJ: For me the pathway has always been mental health. We live in Colorado. This is a state that was grown with people who were protecting their lands with firearms since the very beginning. It’s in our DNA. The question we have is, how do we keep people safe in homes where there are firearms? How do we make sure our firearms owners are safe in the event they become ill or depressed? My focus has been on how to create that mental health stability, with the hope that it will lessen the completions of suicide. We are ranked 7th in the nation for suicides. Suicide is the number one cause of death for our death. We are seen as an epicenter of school shootings, even though, and I’ve done the research, we don’t have the most school shootings, we’re just the most visible. But it’s something that happens.

We do know that if a firearm is used, the suicide completion rate is significantly higher. Our top population for suicide is middle aged men and they are more likely to have access to firearms than the rest of the population. So, there is a mental health crisis we are facing and it does hand-in-hand with gun violence.” 

MG: At State of Reform, we’re always interested in hearing about about the systemic reforms taking place across different states. Do you see any unique opportunities in Colorado for building a more functional health care system?

DMJ: There are always opportunities to improve upon what we have, I thoroughly believe that. I worked at Denver Health for a number of years and I thought that was a highly functioning organization when I was there and we made amazing things happen with limited funds. I don’t love that this is the situation we’re in, but it is. What can we do with what we have? I think we’re going to see some incredible conversations happen this session that will hopefully move the needle forward for a health system that is serving our community and not chasing out the insurers or the doctors.”     

This conversation was edited for clarity and length.