Vincent Atchti
Many of us know that Colorado is in deep crisis with mental health, substance use, and homelessness. Every day, we see too many of our friends, family, and neighbors facing hardship. We see that there are not the right supports and safeguards in place to prevent people from experiencing the worst avoidable outcomes. But what most people don’t realize is how outdated and seemingly benign policies perpetuate this cycle that traps so many Coloradans.
We see tragic stories unfold in our communities all the time. People fall into difficult situations, experience mental health or substance use issues, or all of the above. Their health needs go unmet, and before they know it, they end up cycling between prisons, emergency centers, homeless camps, and crisis centers of all kinds. If they are lucky, they may be placed in the hands of a competent mental health provider in a high-quality inpatient setting. But even in those very rare cases, they are often released from that care before they have a chance to stabilize and get back on their feet.
That’s because of a decades-old rule now being revisited by Colorado lawmakers that states psychiatric hospitals cannot reimburse Medicaid patients for more than 15 days in the hospital. Enacted in 1965, the rule is part of a larger effort to establish community-based mental health care capacity in the least restrictive settings and prevent unnecessary institutionalization. Met. Today, because that dreamed capacity was never developed, this policy places vulnerable and unstable patients in supportive care, often before they have access to all the care they need. This has led to patients being discharged from inpatient facilities. go. The result is multiple expendations of effort and resources across the system that fail to meet the needs of critically ill patients and at significant cost.
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In a recently published report, treatment advocacy center This perfectly sums up the consequences of this worsening crisis and the chaotic policies that perpetuate it. Colorado currently has the third-longest waiting list in the country for people found incompetent to face low-level criminal charges and waiting in prison to access mental health treatment centers. Incarcerating people who are presumed innocent despite known unmet health needs is an unacceptable tragedy, a violation of their rights, and a violation of our society. It’s a shame.
Although several factors are at play here, over-incarceration of people with mental health needs is significant, and Medicaid patients are quickly getting the care they need to stabilize themselves in Colorado’s mental health hospitals. It is important to ensure that the This is an important step we must take to break this vicious cycle. Colorado lawmakers must act now to expand Medicaid coverage for mental health care and provide these vulnerable Coloradans with an authentic path to healthier, more productive lives. . Eliminating her 15-day cap on Medicaid coverage for inpatient care would allow health care providers to help improve health outcomes.
Research from other states Research organizations that have already acted to eliminate the 15-day cap on Medicaid coverage for mental health treatment centers are showing promising results. First, by providing institutional care for the most acute patients, the state freed up resources for community-based services for patients with lower needs. In these states, emergency room use has decreased since patients were more responsibly discharged from psychiatric care, saving critical health care resources. And finally, readmission rates are decreasing, he said, and Vermont’s readmission rate is 8%. Hospital readmissions are a major contributor to the capacity issues we face in our treatment centers. From January 2020 to July 2023, 3,171 patients were admitted and readmitted to Colorado psychiatric hospitals, according to UHS Hospital data.
If the state invests now in providing adequate mental health care for people with serious illnesses, it will reduce the drain of resources elsewhere, such as in ERs, prisons, crisis response, and community responses to homeless camps. You could do that. This investment will meaningfully highlight the state’s efforts to address this devastating crisis that has torn families apart and claimed countless lives. It’s time to bring Medicaid policy into the 21st century and break this deadly cycle.
Vincent Achity is president and CEO of Colorado Mental Health. He is a champion of public health and health equity.He has worked statewide and nationally to lead the Equitas Project, which disentangles mental health and criminal justice and promotes care, not handcuffs, and also served as governor of Colorado.’■ Behavioral Health Task Force and Behavioral Health Transformation (ARPA) Task Force.
