DENVER – Colorado is known as the Mecca for healthy outdoor types. According to federal surveys, however, a higher proportion of citizens than the national average struggle with mental illness, thoughts of suicide, or heavy drug or alcohol consumption.
The COVID-19 pandemic – with the accompanying job losses, school closings and bereavement – has made the situation worse.
Now, Colorado policymakers are preparing to spend huge spending on mental health and addiction services thanks to the federal COVID-19 aid package from March, the Mammut American Rescue Plan Act.
Legislators voted this spring to spend $ 550 million Colorado received under the Behavioral Health Services Act. There are also grants for services the law provides for the state and emergency funds allocated to Colorado schools that can be used for efforts to improve student mental health.
The additional funds and block grants approved by the legislature alone amount to more than a third of what the state spends each year on behavioral health, said Robert Werthwein, director of the State Office for Behavioral Health.
“Very rarely can you make this kind of investment in behavioral health infrastructure,” he said.
Lawmakers in at least seven other states – Illinois, Indiana, Maryland, Ohio, Virginia, Vermont, and Washington – have also allocated billions of dollars to mental health services and drug use, according to the National Academy for State Health Policy, a non-partisan research organization with offices in Washington , DC and Portland, Maine.
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Health officials in these states hope the cash flow will turn things around. They plan to spend it on everything from mental health awareness campaigns to mobile crisis teams and rewards for mental hospital staff.
But there is a catch. After the aid funds have been used up – the money must be spent by the end of 2026 – leaders will have to find other ways to fund programs, services, or staff increases that they are now spending federal funds on.
Heads of state need to make sure they don’t start a successful new program only to get rid of it five years later, said Dr. Brian Hepburn, executive director of the National Association of State Mental Health Program Directors based in Alexandria, Virginia member organization.
“If it’s just a rash – if it’s only one time and we only see improvement over the next few years, it won’t help very much,” said Hepburn.
Policymakers’ approaches to spending the money vary, said Hemi Tewarson, executive director of the National Academy for State Health Policy. In some states, they focus on short-term use of the funds, such as: B. Professional development programs. Other state officials plan to invest in longer-term commitments and work out a sustainable funding plan later, she said.
Colorado lawmakers have taken on the daunting task of devising a plan for how the one-time funds will be spent to transform the state’s behavioral health care system.
“I think everyone is in the place of: We know these are one-time dollars. How can we spend these dollars so that they have a long-term effect? ”Said Colorado State Representative Serena Gonzales-Gutierrez, a Democrat. “And that’s difficult.”
She is the vice chair of a task force that will make recommendations for spending $ 450 million on the behavioral health insurance fund. The task force started the meeting last month but will not make any decisions until the end of the year.
Right now, members are pondering a variety of mental health and drug use challenges in Colorado, such as accessibility, affordability, and labor shortages. “These things are all on the table,” said Gonzales-Gutierrez.
An inflow of cash
The COVID-19 pandemic has exacerbated some worrying behavioral trends.
According to federal surveys, an increasing number of adults in the United States reported having a mental illness in recent years. After the 2020 pandemic, the proportion of US citizens reporting symptoms of anxiety and depression increased and the number of deaths from overdose increased 31% compared to the previous year.
In Colorado, calls and text messages to the state hotline rose 25% last year. Hospitals have been so inundated with mentally ill children that Colorado Children’s Hospital did one in May Emergency for the mental health of young people.
This spring, lawmakers voted to spend $ 550 million of the $ 3.8 billion in flexible funding Colorado received under the American Rescue Plan Act for mental health and drug use services, of which $ 100 million Dollars were allocated immediately (spent on more than a dozen line items, including prison-based services and staff training) and the rest is due to be allocated later.
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While democratic support was unanimous, GOP members were divided. In the Senate, for example, 4 out of 15 Republicans voted against the final bill.
“The majority of our group supported the bill,” said Sage Naumann, Republican communications director in the Colorado Senate. “As for the other four, it was most likely a difference in strategy, especially when it comes to things like substance abuse.”
There is a lot of bipartisan support for mental health services in Colorado, he said. “In 80% of the discussions about mental health, substance abuse, suicide prevention and the like, we usually find common ground with our colleagues on the other side.”
Indiana Democratic lawmakers also made behavioral health a priority this year, defying an initial budget that would have cut behavioral health funds by $ 26 million. “We have repeatedly pushed back these cuts and spoken out against these cuts,” said Senator Shelli Yoder, a Democrat and vice-chairman of the minority group.
The conflict ended after President Joe Biden signed the American Rescue Plan Act, Yoder said. With $ 3 billion in flexible federal funding, the Republican-controlled legislature approved a budget that spent $ 100 million the federal dollar on mental health services.
“We are making record investments in the health and mental health of Hoosier, which is what we need right now,” said Republican Senate President Pro Tempore Rodric Bray during an April press conference on the budget agreement. Bray was unavailable for comment at the time of publication.
Shenetha Shepherd, Indiana Senate Press Secretary for the Democrats, said policymakers at the state’s Mental Health and Addiction Department will decide how the $ 100 million will be spent.
The American Rescue Plan Act also approved block grants of $ 3 billion for all states and territories, hundreds of millions more for everything from youth suicide prevention to community clinics, and $ 112 billion for schools. Districts can use the money in a variety of ways, including hiring counselors and strengthening mental health services.
Away from the funding cliff
A task force of 16 Colorado policymakers – advised by a sub-panel of mental health attorneys, hospital officials, and others with a stake in the behavioral health system – is now discussing how to spend the $ 450 million legislature that is being spent in the set aside last session.
Task force members are generally in favor of four investments of $ 100 million rather than thinly spreading the money across many priorities, said Vincent Atchity, chair of the subcommittee. He is President and CEO of Mental Health Colorado, an organization that works to help people with mental illness or addictions.
Mental Health Colorado plans to spend at least $ 165 million to add hospital and psychiatric treatment beds nationwide and improve recovery services. “We have an acute shortage of resources available to properly manage care in terms of inpatient capacity,” he said.
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Werthwein said that all new editions must be sustainable. “We have to be careful that there is no cliff effect.” The money could perhaps be spent on training staff or on facilities.
Colorado could use Medicaid dollars to pay for new programs over the long term, he suggested. Medicaid is the state health insurance program for low-income and disabled people that is jointly funded by the federal states and the federal government.
Policy makers in other countries could make the same calculation. For example, many states are using their block grants from the American Rescue Plan Act to upgrade and expand behavioral health crisis response teams and call centers, said Hepburn of the National Association of State Mental Health Program Directors. Such increases have been a state priority since the federal government moved to make 988 A nationwide emergency number for suicide and mental health crises from 2022.
States looking to fund crisis services over the long term could learn from Arizona, said Hepburn, which has changed its Medicaid rules in recent years to cover the cost of its expanded crisis services.
It is also possible that state legislators are simply voting to increase spending on services or personnel in the coming years.
In Virginia, for example, Democratic Governor Ralph Northam announced a plan in July to provide $ 485 million – a mix of American Rescue Plan Act funds and state dollars – for rewards for state mental hospital staff, addiction treatment, and supportive care Housing spend Other services.
The Virginia General Assembly urged Northam to commit to adding pay increases for the facility’s staff to its next budget, noted Alison Land, commissioner for the Virginia Department of Behavioral Health and Developmental Services, in a statement emailed.
Yoder, of Indiana, said she hopes the increased spending on mental health and substance use will at least partially pay off by allowing more residents to fully participate in the economy.
“We need every Hoosier who gets involved and participates in business,” she said. “And when people are struggling with an addiction, that’s a big challenge.”