I_ECR_BH_2021A 09/17/2021 09:08:57 AM Committee Summary

Senator Pettersen made opening remarks.

The agenda can be found at this link:  https://leg.colorado.gov/sites/default/files/images/committees/2017/bh_task_force_-_agenda_sept_17_final_1.pdf

Lauren Snyder, Vice President of Government Affairs, Mental Health Colorado, and Jose Equibel, subpanel member and Director, Colorado Consortium of Prescription Drug Abuse Prevention, discussed the behavioral health survey they developed on behalf of the Task Force. They presented information on the distribution process, response rate, and type of respondent.  Their presentation can be viewed at this link:  https://leg.colorado.gov/sites/default/files/images/committees/2017/bhttf_survey_initial_info_-_sept_17_2021.pdf

Committee members asked questions about a similar survey from Colorado Counties Incorporated.  Inquiries were also raised about the Governor's Behavioral Task Force and priorities identified in that report, as well as the public participation process.  

Jose Equibel, subpanel member, and Director, Colorado Consortium for Prescription Drug Abuse, provided background information about the federal CARES Act. He discussed funding for housing, community centers, opioid treatment, and telehealth. Committee members asked questions about the housing funds.

Mr. Equibel referenced the memorandum on Senate Bill 21-137, the Behavioral Health Recovery Act, prepared by Legislative Council Staff (https://leg.colorado.gov/sites/default/files/images/committees/2017/sb21-137_memo_v5.pdf). He discussed how certain American Rescue Plan Act (ARPA) funds have been expended through the bill. Committee members asked questions about matching grant programs for counties. Further questions were raised about the distribution of funds.

Summer Gathercole, Senior Advisor for Behavioral Health Transformation, Colorado Department of Human Services, provided an overview of the Governor's Behavioral Health Task Force.  She described how the task force prioritized recommendations arranged by subject matter, including access and affordability, workforce and support, accountability, consumer and local guidance, and whole person care. Ms. Gathercole further provided an update on the newly created Behavioral Health Administration (BHA), and the related governance model.  She noted that BHA will be initially housed in Colorado Department of Human Services (CDHS).  Ms. Gathercole continued to share information about BHA and the expected interplay with the Office of Behavioral Health in CDHS. 

Ms. Gathercole's presentation can be found here:  https://leg.colorado.gov/sites/default/files/images/committees/2017/bhtf_bha_overview_for_091721_finalv2.pdf

Committee members asked questions about budgets and enhancing general funds. Further questions were asked about payer sources. Committee members discussed insurance, Medicaid, accountability, and technology integration. The discussion turned to lack of providers and workforce challenges. Committee discussion ensued about the differences between Medicaid and private insurance for mental health coverage. 

The task force took a break. 

The task force recovened. 

The task force and subpanel members received documents from the facilitators, Jacob Bornstein, Marisol Rodriguez, and Erik Arndt.  The members broke into small groups to discuss the identified pillars and priorities. The documents provided by the facilitators can be found here:

• https://leg.colorado.gov/sites/default/files/images/committees/2017/overview_of_guidelines_and_lenses.pdf
• https://leg.colorado.gov/sites/default/files/images/committees/2017/strategic_pillars_-_trello_summary.pdf
• https://leg.colorado.gov/sites/default/files/images/committees/2017/bhttf_presentation_09-17-21.pptx_.pdf
• https://leg.colorado.gov/sites/default/files/images/committees/2017/upcoming_meetings.pdf
• https://leg.colorado.gov/sites/default/files/images/committees/2017/pillar_worksheets.pdf

The task force and subpanel members participating in-person broke into small groups to discuss the pillars. 

Dr. Lena Heilmann, Office of Suicide Prevention, Colorado Department of Public Health and Environment, discussed suicide prevention efforts and guiding principles. She recapped data resources and takeaways.

Dr. Heilmann continued with her presentation about suicide fatalities in Colorado, including by age group and noted various agency roles in suicide prevention. She further discussed suicidal despair, ideation, and attempts. Committee members asked questions about access to care and firearms.

Dr. Heilmann continued her presentation and discussed suicide attempt data. She explained Colorado initiatives, including populations of focus, prevention strategies, and comprehensive suicide prevention approaches.

Dr. Heillmann's presentation can be viewed at this link:  https://leg.colorado.gov/sites/default/files/images/committees/2017/bhtt_presentation_cdphe_suicide_prevention_workforce_9.17.21.pdf

The task force and subpanel breaked for lunch. 

The hearing was called back to order. 

Elizabeth Owens, Director of Policy and Communications, Colorado Department of Human Services, Office of Behavioral Health, provided an update on SB21-137, referenced earilier in the hearing.  She discussed funding, implemention, and distribution.  Committee members asked questions about vouchers.

Ms. Owens' presentation can be found at this link:  https://leg.colorado.gov/sites/default/files/images/committees/2017/senate_bill_21-137_implementation_covid_impacts_vision_-_obh_bhttf_presentation_sept_17_2021.pdf

Robert Werthwein, Task Force member and Director, Office of Behavioral Health in DHS, discussed care coordination and answered questions about technology. 

Committee discussion continued about care coordination and bed space availability.

Ms. Owens and Dr. Werthwein continued their presentation and switched focus to the workforce. Committee discussion ensued about incentives and retention. 

Ms. Owens and Dr. Werthwein presented information about COVID and the impact on community behavioral health. 

Dr. Tracy Johnson, Medicaid Director, Colorado Department of Health Care Policy and Financing, presented information about Medicaid and Child Health Plan (CHP) eligibility.  She discussed telemedic trends and behavioral health outcomes during COVID. 

Cristen Bates, Population Health Division Director, Colorado Department of Health Care Policy and Financing, presented information about culturally responsive care.  She also discussed residential and step-down services and answered questions about it.

Ms. Bates continued her presentation about the implementation of Senate Bill 19-195, the Families First Act. Committee members asked questions about aging out of the system.

Dr. Johnson and Ms. Bates' presentation can be found here: https://leg.colorado.gov/sites/default/files/images/committees/2017/hcpf_leg_and_data_updates_bhttf_sept_17_2021_2.pdf

Further committee discussion ensued about system gaps, respite care, the safety net, and workforce isseus. 

Curt Drennen, CEM Operations and Response Supervisor, Healthcare Operations and Response Branch, Colorado Department of Public Health and Environment, gave a presentation on workforce initiatives.  His presentation can be viewed at this link, starting on page 23: https://leg.colorado.gov/sites/default/files/images/committees/2017/bhtt_presentation_cdphe_suicide_prevention_workforce_9.17.21.pdf 

Task force and subpanel members broke into small groups to discuss pillars. 

The small groups shared major themes and recommendations for additional learning, including but not liited to: diversion, psychiatic facilities for complex needs, and access to care and care coordination in rural communities.

Mr. Bornstein discussed integrating the findings at the upcoming subpanel meeting.

There was no public testimony.

The presentation by Dr. Werthwein was rescheduled to the following week.