Colorado’s Behavioral Health Task Force Plans to Address the ‘Missing Middle’ in the Care Continuum – State of Reform

The Transformational Task Force on Behavioral Health interim commission works to address the “missing middle” in the behavioral health continuum, according to Rep. Dafna Michaelson Jenet (D-Aurora).

The task force is working to address the “missing middle” in the criminal justice system and in opioid overdose care. They are also working on expanding hospital facilities and expanding the behavioral health workforce in Colorado.

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The task force is made up of lawmakers, board members and community members to put together legislative recommendations around behavioral health. According to Michaelson Jenet, the recommendations should be ready and available around December 10, before the start of the legislative session on January 12. She says:

“We’ve really dug into the community to bring the community into the process.”

Michaelson Jenet says the task force has $450 to $650 million to spend and is trying to make the money go as far as humanly possible.

Michaelson Jenet stressed the need to expand services for those in prison, especially young people. She says that 80% of incarcerated youth have at least one diagnosable mental illness. Of the incarcerated youth in Colorado, 60-70% are expelled from the state – on behalf of the state – to get the right services.

She says the state needs to create a framework to help those incarcerated because of their mental illness receive the right treatment, which requires extensive “missing middle” services such as inpatient facilities.

“[Of those] who are in prison because of their mental illness, [we need to] first bring them to the right level of care, where we can then move them through the system and open up this missing middle to the general public. It’s like the Suez Canal. It’s stuck. We have this massive congestion, and we can clear that congestion as we build out the missing middle and really [transform] our system.”

To do this, Michaelson Jenet plans to utilize the former Ridge View Youth Services Center, which: closed in summer 2021, as a clinical behavioral health facility for adults to cover this “missing middle.” The youth care center used to house young boys with health behavioral problems, so it has the infrastructure to handle the new facility.

However, a stable workforce is needed for this new facility, which is another priority of the task force, says Michaelson Jenet. She says the state needs to find solutions to create a stable workforce of Colorado residents, as well as invest in the workforce that is already there. She says this can be used specifically in rural settings:

“What is the response to our nationwide health care crisis? [We need to] reach the rural communities and see who wants to get paid to go to school. That’s the answer. I hope for recommendations that are very specific about that.”

The task force also focuses on the rise in opioid overdoses in Colorado. According to a recent Colorado Health Institute report, opioid overdoses are up 54% in 2020.

Michaelson Jenet says the task force is working to provide recommendations for increased drug-assisted treatment (MAT) in hospitals, emergency rooms (ED) and prisons. The task force also wants to provide more MAT in acute care settings and potentially create specific emergency rooms for behavioral and mental health crises.

Michaelson Jenet was a featured speaker at our recent Colorado State of Reform Health Policy Conference 2021 last month as part of our Afternoon Keynote presentation. View and read more about the keynote here.

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