1 week Ago By Vince Bzdek
Three years ago, Gov. Jared Polis said he was going to get serious about Colorado’s mental health care crisis. He established the Behavioral Health Task Force which then created a brand new state agency, the Behavioral Health Administration, to streamline and improve Colorado’s fragmented mental health care system, promising to bring better care to those who could least afford it.
The creation of this new agency seemed like a bright beacon of hope after The Gazette had written a series of stories showing that Colorado was near the bottom of the nation in mental health outcomes. So where are we now? Alas, Colorado had the second-highest prevalence of mental illness in the country in 2024, according to a recent report by the Common Sense Institute. More than 530,000 Coloradan adults are still struggling with depression, costing the state between $1.
16 billion and $2.52 billion annually in lost productivity. Spending on mental health by the state has actually gone down rather than up recently, declining by $7 million between Fiscal Year 2024 and FY 2025.
And the total number of people working in state behavioral health programs dropped from 2,330 in FY 2022 to 2,282 in FY 2025, the report found. The BHA has not centralized and simplified the administration of behavioral health care, which was its primary stated mission. Thirteen different state departments and agencies were allocating funds for behavioral health care before the BHA formed, and 13 are now.
The BHA oversees just 7% of behavioral health staff and receives only 19% of total funding. “This study demonstrates how incredibly challenging the mental health outcomes are here in Colorado,” said Kelly Caufield, executive director of the CSI. “I applaud the governor for his leadership in looking at the stimulus dollars and prioritizing a big chunk of it to go to behavioral health.
So I think the intent was good. I think they set up an agency that could have been really valuable, but it was like a failure to launch. To me they were never given real authority or the ability to actually move dollars in a way to help solve the problem.
” The BHA has little to no say in the allocation of behavioral health funding, the CSI found. "The state budget dictates what amounts go to each department or agency and these entities then appropriate the dollars as they see fit," said Caufield. "While the BHA can consult on how the money is spent, or how much is appropriated, it ultimately does not control the funding flow.
" That means BHA can't allocate dollars to places or people who need it the most. Instead of immediately helping the crisis, the BHA got quickly enmeshed in a crisis of its own. BHA fired its first director, who just this week filed a federal lawsuit seeking financial compensation and the return of her job because she alleges the state fired her because of her race.
Dr. Morgan Medlock, who is Black, lost her job in April 2023, because lawmakers said the BHA was behind on work, and providers and other stakeholders didn’t think the new agency was addressing their needs. The legislature pushed back timelines to complete the BHA’s setup after Medlock’s departure.
A new director was announced in February 2024. On top of all this, the BHA is about to lose $31.5 million in federal grants as the U.
S. Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration cuts costs as part of the DOGE initiative in Washington. Granted, BHA has had some success as a coordinator of care.
The BHA has increased transparency around total behavioral health funding in the state — the very data CSI used in its report comes from BHA's new Performance Hub, a bank of publicly available information about the current state of access to behavioral health care in Colorado. And BHA has also aggregated the licensing process for providers to a one-stop shop. And it has met many of the requirements the state had for it, like creating a statewide behavioral health grievance system.
"Since its inception, the Behavioral Health Administration’s role has always been to coordinate and oversee the entire behavioral health system in Colorado, no matter the source of funding," Alexandra Eliot, chief communications officer for CSI, told me in an email. For example, BHA has coordinated with the Colorado Department of Agriculture, creating new programs for agricultural and farming communities which experience higher rates of suicide. And they partner with the Department of Corrections to make mental health records more accessible, giving clinical staff in prisons and jails a resource to create more appropriate treatment plans.
"There are countless examples of the tangible benefits that interagency work has provided," Eliot said, including the improvement of reimbursement rates for residential treatment programs. BHA is also regulating providers more tightly through the Safety Net System, requiring them to conduct initial screening to ensure that they can meet the care needs of the individual seeking services. If they are not at the appropriate level of care based on the screening, they are required to provide care coordination and a "warm handoff" to other sources, Eliot said.
"With the coming launch of the Behavioral Health Administrative Service Organizations in July, the Safety Net system will be even further streamlined bringing together crisis, substance use, and mental health services into one network, constructed with community input and the unique needs of distinct regions in mind," said Eliot. But with all these achievements, why isn’t the impact greater? “The mission is not equaling reality," said Caufield. “That’s what our data and report is showing.
Whoever has the money, moves the message. Whoever powers the money effects change. And it was quite clear to us that they are not positioned to actually oversee real dollars when it comes to behavioral health care.
” Specifically, the legislature needs to give the BHA control over how the funds and staffing for all the various departments are allocated. It doesn’t have that now. And it may be that the BHA just needs more time to jell.
“It was created just a few years ago,” Caufield points out. “I don't think it's time to give up on the BHA. We just don’t think they were set up for success.
” It may be that local municipalities are going to have to take mental health matters into their own hands in the meantime, tailoring a local and individualized response to the mental health crisis rather than relying on a uniform approach dictated by the state. The coming regional service organizations may help. The brightest spot on the mental health horizon in Colorado right now is Fort Collins, which has dramatically improved its care without much help from the state.
In 2018, the suicide rates in Larimer and El Paso County were nearly identical. But Larimer County reduced its suicide rate per 100,000 people by more than 27% between 2018 and 2023. It now has the lowest suicide rate among Colorado’s largest nine counties.
In contrast, according to the report, the suicide rate in El Paso County, home of Colorado Springs, increased more than 15 % in that same time period and is now 59 % higher than Larimer County’s. What did Fort Collins do right? In 2018, 61% of Larimer residents approved a 20-year, 0.25% countywide sales tax increase ballot measure that funded behavioral health services.
The measure generated an estimated $19 million in its first year to “expand and enrich local behavioral health services.” Thanks to those funds, Larimer opened the state’s first county-owned mental health and addiction treatment facility in 2023. It registered 7,000 acute care visits in its first year of operation.
Larimer also prioritized mental health services in its recent $80 million expansion of the county jail. Larimer County’s Behavioral Health Services director, Amy Martonis, told reporter Hap Fry that she has “a deep appreciation that our community made the forward-thinking decision to make the investment of taxing themselves to invest in critical behavioral health services for our community,” The successes of Larimer’s forward thinking may provide just the blueprint the BHA and the rest of the state need to really make a difference in mental health care..
