Mental health isn’t officially part of Colorado’s emergency response. Lawmakers want to change that.

Proposed cash fund would reimburse organizations for mental health, substance use resources

Flowers lean on a fence surrounding the King Soopers supermarket in Boulder where a day earlier, March 22, 2021, a shooter killed 10 people. (Carl Payne for Colorado Newsline)

At the outset of the COVID-19 pandemic, Colorado mobilized its State Emergency Operations Center to respond to the public health emergency.

The SEOC — with the help of Federal Emergency Management Agency funding — worked with the Colorado Department of Public Health and Environment to expand health care capacity, launch dozens of community testing sites and process countless COVID-19 tests, and administer and distribute millions of coronavirus vaccines.

Community mental health centers have also launched programs to help people deal with the psychological effects of the pandemic.

Some lawmakers and advocates took inspiration from those efforts and offered up a novel concept: state-funded public resources, built into local or statewide response to emergencies, that could help address Coloradans’ urgent mental health and substance use-related needs triggered by disease outbreaks, tragedies and natural disasters.

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Sponsored by Reps. Lisa Cutter, D-Dakota Ridge, and Perry Will, R-New Castle, along with Sen. Brittany Pettersen, D-Lakewood, House Bill 21-1281 would create a community behavioral health disaster preparedness and response program.

The bill would appropriate $529,000 of general fund money next year to a new cash fund, which would pay for grants to community organizations providing emergency mental health and substance use response. The fund could accept state money as well as gifts, grants and donations.

Besides disease outbreaks with behavioral health implications, the legislation could help in the wake of tragedies like the mass shootings that recently occurred in Colorado Springs and Boulder, according to advocates.

State Rep. Lisa Cutter
State Rep. Lisa Cutter, a Democrat from Dakota Ridge, represents Colorado House District 25. (Colorado General Assembly photo)

“There is a clear need for a more holistic response to disasters like wildfires, pandemics, floods, and even mass shootings,” Cutter said in an April 30 statement, after HB-1281’s first committee hearing. “This bill will support the great work of our state’s behavioral health organizations striving to meet the needs of communities left reeling in the wake of a disaster or an emergency.”

Other than a general fund appropriation of $529,000 for fiscal year 2021-2022 and $529,000 the following year, the bill’s backers haven’t identified long-term funding streams, but they hope the state will invest more money eventually.

“Maybe once the line item has been created in the budget, then this would give us an opportunity in future years to direct some additional general fund resources in that way,” said Doyle Forrestal, CEO of the Colorado Behavioral Health Council, a statewide advocacy organization that counts behavioral health providers as members. “That’s our long-term hope.”

After a gunman killed 10 people at a King Soopers grocery store in Boulder, community mental health center Mental Health Partners worked quickly to mobilize funding from private donations; from Colorado Community Health Alliance, which coordinates Medicaid services for Boulder, El Paso and other counties; and from the state’s Office of Behavioral Health, Forrestal said. All together, the money allowed the mental health center to offer services to people who needed support following the tragedy.

“It’s usually very, very rare that the state has any additional funds that they can direct for these types of purposes, but I think because of COVID and some of the additional grants and donations that have come in from the federal government, they have dollars that they can direct,” Forrestal noted. “The majority of the funding for that response, however, has been donation-based.”

Different levels of emergency support are needed for people who might have shopped at the store regularly but weren’t there the day of the shooting, employees at the King Soopers store who were working but uninjured, and friends and family of the victims, Forrestal said.

In situations like mass shootings, communities might not be able to use federal emergency funding for mental health response, Forrestal said, but they could potentially get reimbursed through grants from HB-1281’s cash fund.

It can take time before people seek help

Should the bill pass in the Senate and receive Gov. Jared Polis’ signature, CDPHE will solicit feedback and establish new rules to determine the specifics of when and how organizations would qualify for grants. Forrestal believes the fund could help pay for the behavioral health response to situations as diverse as mass shootings, disease outbreaks, or natural disasters such as wildfires or floods.

“Sometimes the need in the community extends beyond the time frame of the official federal emergency declaration, and so additional funds could be necessary” for behavioral health response to disaster emergencies, Forrestal said. “Or in an instance like the King Soopers shooting, where it doesn’t rise to that level (of a federal disaster emergency), you need resources throughout that response process.”

The legislation would also require two full-time staff members within CDPHE to provide technical assistance, oversee contracts with local organizations for behavioral health emergency response, and help communities prepare for, respond to and recover from mental health and substance use issues triggered by disasters.

Currently, the process of setting up mental health and substance use supports is informal, but much of it is led by members of the Colorado Behavioral Health Council, including community mental health centers, managed service organizations treating substance use disorders, and two specialty clinics, the Asian Pacific Development Center and Servicios de La Raza.

The mass shooting in Colorado Springs appeared to be more targeted than the Boulder shooting — and therefore required mobilizing a different kind of behavioral health response. The Colorado Springs Police Department reported that a suspect who didn’t get invited to a birthday party opened fire at party guests before taking his own life. Children present at the party were uninjured and staying with family members, CSPD said after the shooting.

Forrestal said that several behavioral health providers discussed how best to respond to the massacre in Colorado Springs, and that they reached out to the people affected to offer culturally responsive services.

When a tragedy occurs, it can take time before people are ready to seek help, Forrestal added, and different events could trigger needs years after the original tragedy. The emergency behavioral health fund — which wouldn’t necessarily need to comply with a rigid time frame — could help accommodate a flexible response, depending on how CDPHE crafts the rules.

Besides the Colorado Behavioral Health Council, HB-1281’s supporters include Centura Health, Children’s Hospital Colorado, Colorado Hospital Association and Colorado Psychiatric Society. It passed the House on May 20 by a vote of 43 to 20, with two lawmakers excused.

All Democrats present voted yes on the legislation. Most Republicans voted no, with the exception of rural Reps. Will, Richard Holtorf of Akron and Rod Pelton of Cheyenne Wells.

Lawmakers on the Senate State Affairs Committee voted unanimously Tuesday to advance HB-1281, referring it to the Senate Appropriations Committee. The bill’s next hearing could happen as early as Friday.

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