CO Discretionary Funding Fiscal Year 2023

Children’s Hospital Colorado (CHCO), in partnership with the University of Colorado School of Medicine (CU), will develop and expand two programs that together will enhance access to mental health care and improve linguistic responsiveness in mental health services for children and youth in Aurora, Colorado and the broader Denver metro area. The two programs are an Unlicensed Behavioral Health Clinician Pathway Program (Pathway Program) and a Bilingual Salary and Benefit Enhancement Program (Bilingual Program).

The Pathway Program will provide unlicensed psychotherapists with the professional supervision and training required for them to obtain a license—either Licensed Professional Counselor (LPC) or Licensed Clinical Social Worker (LCSW). CHCO will employ these professionals before they become licensed in the state. Additionally, they will be trained in novel, evidence-based treatments that are specifically designed for children, youth and families. For the six behavioral health clinicians in this proposal, they will each see an average of 25 patients per week; in total, these clinicians will have approximately 7,800 patient encounters in one year.

The second component of the proposal is a Bilingual Program that will provide enhanced salaries and benefits for mental health providers and other staff to attain a clinical level of fluency in a second language, with the goal of helping all staff provide better mental health care services. Funds will be spent paying higher salaries and benefits to providers who have attained fluency requirements as demonstrated by testing and supervisory oversight. Eligible providers would include psychiatrists, psychologists, behavioral health clinicians, advanced practice providers and administrative staff. Annually, this would equate to approximately 9,016 visits for faculty and 2,208 visits for trainees per year.

The 988 State Improvement Project aims to utilize funds for the following objectives: 1) Facilitate effective coordination and collaboration between the 988/911 services across the Crisis Continuum in Colorado. Specific plans will be developed to account for regional differences; 2) Enhance collaboration and understanding with local Public Safety Answering Points (PSAPs); 3) Implement a comprehensive statewide quality assurance and continuous quality improvement plan; 4) Execute a 988/911 Integration Communication Plan and a statewide marketing campaign; 5) Improve Colorado's centralized resource directory, known as Colorado Ownpath; 6) Enhance the Rocky Mountain Crisis Partners (RMCP) Mobile Crisis Response Dispatch Portal to enhance referral tracking and follow-up care. To achieve these objectives, Colorado will establish regional workgroups that will inform statewide efforts and create regional process maps outlining crisis services. Statewide training for Public Safety Answering Points (PSAPs) will be provided to improve coordination between 911 and 988, and PSAP staff will be recruited to participate in regional workgroups. Monthly reports outlining 911 Resource Center and coordination efforts will be developed to increase awareness throughout the state. A state quality assurance plan will be created based on continuous data analysis and trend recognition. Trend data will be presented monthly to the steering committee and made available to the public through a data dashboard. The care directory in Colorado will be enhanced to track information related to individuals using the 988 services. A statewide marketing strategy will be implemented, and the campaign's effectiveness will be measured using industry-standard benchmarks. During the first six months of the calendar year 2022, Colorado's statewide crisis line experienced a significant increase in call volume, with a record high of 18,881 calls in May 2022. Although the volume for 988 remains considerably lower than the statewide crisis line, it has been steadily increasing each month, reaching a total of 52,949 calls from July 2022 to May 2023. Based on the current 988 call volume, this project is expected to serve approximately 63,539 individuals per year and 190,616 individuals over the lifetime of the project. However, the Behavioral Health Administration (BHA) anticipates a significant increase in 988 call volume as the implementation progresses and calls previously handled by the crisis line are transferred to 988. The 988 State Improvement Project will utilize funds to support Colorado's commitment to integrate the statewide crisis line and prioritize 988 as the primary point of access to Colorado Crisis Services. Colorado Crisis Services is the state's 24/7/365 crisis response system, available to anyone in Colorado, regardless of their ability to pay. This project will prioritize statewide behavioral health resource navigation and increase access to Colorado's most vulnerable populations in need of crisis response services and support.

Douglas County, Colorado is creating an “Enhanced Model of Services” (the Model) to ensure youth and families utilizing crisis and intensive case management services in the County are connected to ongoing, non-crisis, healthcare. The Model is a network of intensive in-home and outpatient treatment, youth peer support, evidence-based treatment, an intensive case management program serving youth and families, and technology enhancement and integration. The target populations are children, youth, families and clients of the intensive case management program, the Youth Care Compact (YCC) (to be developed), who are in crisis, recovering from crisis or who have multiple unmet behavioral health and basic needs. The proposed geographic catchment area is Douglas County, Colorado. The project strategies and interventions, and the estimated individuals/families served during this year of funding are: Youth Care Compact Navigator to develop and lead the YCC: 20 families?? Outpatient Mental Health Treatment: 150 youth?? Intensive in-home treatment: 40 families?? Supportive Parenting for Anxious Childhood Emotions (SPACE) course: 54 caregiver units or individual caregivers Marijuana Treatment Program: 20?youth and families Youth peer support opportunities: 50?youth Integration of web-based case management platform with faith-based portal to fulfill basic needs: N/A?? The primary goal of the Model is to reduce future reliance on and utilization of the crisis system. The Model’s strategy-oriented goals are geared towards increasing connection to ongoing, non-crisis, mental health and substance use treatment, recovery and preventive services, and increasing the capacity of local youth and family serving organizations to provide care coordination. These goals and objectives will be achieved by implementing the above seven strategies. The Model is complimentary to the partnership between Douglas County and community mental health center AllHealth Network who will open a Walk-In Crisis Center (WIC) for all ages and a 16-bed Crisis Stabilization Unit (CSU) for children and adolescents, a first-of-its-kind facility in Douglas County, as part of a proposal for local American Rescue Plan Act (ARPA) funding. The Model supports a larger continuum that includes direct coordination with Co-Responders, coordination of multiple substance use and mental health providers, wrap-around services, partnership with schools and child welfare, and collaboration with the justice system. To avoid boarding at the WIC and CSU, the Model will offer reliable follow-up support to keep youth and families engaged in treatment following a crisis while avoiding cycling through the emergency system. The County and its partners through the Douglas County Mental Health Initiative (DCMHI) are committed to building a mental/behavioral health continuum of care that meets the needs of individuals in Douglas County.?

The Montezuma County Community Intervention Program (CIP) is a mobile crisis prevention and response pilot initiative integrated into the public safety systems of Montezuma County to respond to a growing behavioral health and substance use crisis.

2022 Project AWARE Colorado aims to increase the mental health awareness and literacy of school-aged youth, and individuals who interact with them, and connect youth and families to culturally-responsive, trauma-informed, and equity-based strategies, services, and interventions. The Colorado Department of Education in partnership with Colorado's Behavioral Health Administration along with two identified Local Education Agencies LEAs and a Tribal Education Agency TEA will address systemic barriers to school-aged youth receiving mental and behavioral health interventions through state and local-level infrastructure improvements. Service gaps will be addressed through state and local partnerships and the implementation of evidence-based or informed policies, practices, and or programs EBPs. The LEAs are Poudre School District, the 8th largest in Colorado, with 28 percent minority students and 27 percent of students receiving free reduced lunch and Westminster Public Schools, a suburban district with 84 percent minority students and 76 percent of students receiving free reduced lunch. The TEA is the rural-based Southern Ute Education Department, serving Southern Ute Tribe students and families. Project goals and objectives include: Goal 1 Enhance school-based SB mental and behavioral health infrastructure within Colorado Multi-Tiered Systems of Support for an equity- based, culturally-responsive, and trauma-informed approach including SEA objectives: 1.1.1 Create a SB Mental Health Professionals' Early Career Pathways Strategic Plan; 1.1.2 Convene a SB Mental & Behavioral Health Alignment Advisory Board; 1.1.3 Convene a Trauma Recovery and Resilience Promotion Advisory Board to address effects of COVID-19 and other traumas; and LEA TEA objectives: 1.2.1 Develop a multi-disciplinary mental health leadership team; 1.2.2 Convene local partners to enhance behavioral and mental health infrastructure; and 1.2.3 Conduct a needs assessment of systems that support service delivery. Goal 2 Increase mental health awareness and literacy of school-aged youth and individuals who interact with them to promote wellbeing and detect signs and symptoms of mental illness, substance use or misuse, and co-occurring disorders including SEA objectives: 2.1.1 Train adults to promote wellbeing and detect signs and symptoms for youth, particularly youth who have systematically experienced greater obstacles to health, resulting in behavioral health disparities.; 2.1.2 Partner with the Mental Health Technology Transfer Center to develop training for youth and families; and LEA TEA objectives: 2.2.1 Offer psychological safety and belonging training for LEA TEA school community members; and 2.2.2 Train the school community in mental health literacy or identity-affirming learning. Goal 3 Increase the capacity for and quality of implementation of EBPs, mental health services and suicide prevention efforts that are culturally-responsive and trauma-informed including SEA objectives: 3.1.1 Train SB mental health staff on evidence-based, SB mental health programming, and appropriate supports for marginalized students and 3.1.2 Develop a cross-agency partnership to create a training plan aligned with a Student Suicide Prevention & Awareness Training Policy; and LEA TEA objectives: 3.2.1 Create a Tier 2 or 3 improvement strategy; and 3.2.2 Train building level mental health staff on EBPs. Collectively, TEA LEAs will reach approximately 38,000 per year and 51,600 school-aged youth over the lifetime of the grant. Additionally, the SEA & SMHA will offer approximately 10 training opportunities each year of 2022 Project AWARE Colorado.

To be fully staffed to answer the projected 988 call/chat/text volume, RMCP plans to hire 190 new staff over the next year and a half. Colorado will use these funds to start to build the workforce needed at RMCP (estimated 105 staff). OBH is expecting to collect a surcharge that will fund these activities after this grant funding is spent; however, OBH will continue to collect and report data to SAMHSA throughout the duration of the grant cycle.