I_OpioidSubstance_2023A 08/30/2023 09:06:28 AM Committee Summary

Congresswomen Brittany Pettersen gave an overview of the federal response to the opioid crisis, including the current deaths and the cost of the crisis. Congresswomen Pettersen also gave an overview of the current Colorado response as well as the global landscape of drug trafficking.

Congresswomen Pettersen went over different types of federal responses, including the Patients and Communities Reauthorization Act, the American Rescue Plan Act, and the Infrastructure law. In addition, she went over concerns at the Federal level.

Congresswomen Pettersen said federal responses should include drug trafficking, screening, public awareness, harm reduction, treatment, workforce, housing, continuum of care, and criminal justice, In addition, she went over possible state priorities.

A panel of Steve Holloway, Health Access Branch Director of the Colorado Department of Public Health and Environment and Kristen Igstrup, Associate Director of Workforce Development of the Behavioral Health Administration, went over workforce initiatives.

The panel went over the use of data sources in making workforce decisions. They then went over the summary of the behavioral health workforce. The distribution of care is typically centered around large population centers and access needs to look beyond just a county level into a community level.

The panel also went over initiatives to strengthen the workforce to fill the current provider gap. These include grant making, education, training, and diversifying the workforce.

The committee asked if the identified practitioners work on both substance use and mental health. The panel says the next steps of data analysis is to start to understand the type of work provided.

The committee asked about the provider map. The panel talked about how the map has changed over time, and new levels of precision in the map.

The committee asked about implementing those with lived experience in the workforce. The panel spoke on giving a certified credit to those with lived experience.

A panel of Dr. Lesley Brooks, Chief Medical Officer of SummitStone Health Partners, Dr. Jo Daugherty Bailey, Professor and Associate Dean at the College of Health and Human Sciences at Metropolitan State University (MSU) of Denver, Dr. Dawn Matera Bassett, Professor at MSU Denver, Dr. Tricia Hudson-Matthew, Professor and Chair of Addiction Studies and Mental Health at MSU Denver, and Dr. Allison Kramer, Associate Professor at the Colorado Mountain College Spring Valley and Glenwood Springs, presented to the committee.

The panel went over legislative opportunities in the state including, robust liability coverage, payment models, coverage for stay, and overall administrative burdens.

The panel went over solutions for those through lower income backgrounds to get higher education degrees and join the workforce. Funding from these initiatives often come through grants. They also went over how to collaborate across systems to make sure the best regional care is available.

The panel spoke on the burnout of the field. The goal would be for the system as a whole to have less of a strain so that there are better services and less burnout with the workers. There are also efforts to lower the requirements to begin working in the field for certain students.

The panel went over the success of micro-credentialing and being able to quickly go from education to getting paid for the job as a way to keep people interested in the field. They also spoke on the success of collaborative efforts and how that needs to be part of all funding efforts to create stronger systems.

The committee asked about regulatory barriers to the workforce. The panel stated that funding can be prioritized using a tiered system to see what level of collaboration should receive funding. Outsourcing the licensing process to out of state actors also slows the process.

The committee asked about current solutions in a fee for service model. The panel stated there are mechanisms in current structures that could allow great integration of care.

The committee asked about barriers of lived experience in licenses. The panel stated that there are pathways for lived experience, but the process needs to defined out so there is not additional burnout in the field.

The panel asked about school counselors and high school pathways currently in Colorado. A lot of these programs are not well advertised due to stigma, but they are across the state. There also need to be collaborative approaches and partnerships to better define the programs.

Richard Bottner, Colorado Hospital Association, spoke about the findings from a report by the Colorado Hospital Association regarding caring for patients with substance abuse disorder in acute care hospitals. Dr. Susan Calcaterra, CU School of Medicine, spoke about her experiences treating patients with addiction issues without having addiction treatment structure in place.

Audrey Rich Loy, San Luis Valley Health, spoke about the barriers for their organization to provide treatment in a rural area and the services that they provide. She spoke about the difficulties with funding and the limits on the reimbursement model as well as staffing. Angela Swafford, UC Health, spoke about how UC Health used grant money for addiction treatment and shared statistics about the success of treatment. Members of the panel answered questions about prenatal care while in treatment for substance abuse.

Members of the panel answered questions regarding the barriers for a hospital to be DEA approved to provide methadone treatment. The panel discussed the problems faced with recruiting and retaining workforce. The panel discussed the data behind the different substances being treated.

Jason Hoppe, CU School of Medicine, spoke about the Prescription Drug Monitoring Program (PDMP) and barriers that it faces. He spoke about legislative changes and language around research and public health that creates barriers. Samuel Delp, Department of Regulatory Agencies, spoke about the finding the task force has found through the PDMP. He spoke about PDMP registration rates and requirements in the states.

Diane Matt, Colorado Veterinary Medical Association, spoke about the requirements for veterinarians to have substance abuse training and the connection between veterinary care and substance abuse. She raised concerns for a lack of clarity on how PDMP laws may affect veterinarians. She spoke about the importance of Xylazine still being available for veterinary use.

Representative deGruy Kennedy gave and overview of the process that went into creating the survey sent out regarding potential legislation ideas. Members of the committee shared their thoughts and priorities on different ideas on the survey distributed.

Yelana Love, Office of Legislative Legal Services, gave an overview of the deadlines and requirements for requesting bill drafts in the interim.

Members of the committee discussed drafting a bill authorizing overdose prevention centers in Colorado.

Mrs. Sarah Copeland, representing themself, testified. Ricahrd Woodruff, representing themself, testified.

Christina Johnson, representing the Colorado Cross-Disability Association, testified.