Fix archaic medical policy failing Coloradans with mental health needs | OPINION

February 20, 2024

By: Vincent Atchity

Many are aware Colorado is in a dire crisis of mental health, substance use and homelessness. We see every day too many of our friends, family members and neighbors are experiencing difficulties. We see we don’t have the proper supports and safeguards in place to stop people from experiencing preventable worst outcomes. What most are unaware of, however, is how outdated and seemingly benign policies perpetuate this vicious cycle in which so many Coloradans are trapped.

We’re constantly seeing tragic stories play out in our communities. A person falls on hard times, experiences a mental health or substance use issue, or all of the above. Their health needs go unmet, and before they know it, they’re cycling through jails, ERs, homeless encampments and various kinds of crisis centers. With some luck, they may find themselves in the hands of competent mental health providers in a quality in-patient setting. But even in those very rare cases, they are often forced out of that care before they have the chance to stabilize and get back on their feet.

That’s due to a decades-old rule — one Colorado lawmakers are currently reconsidering — preventing mental health hospitals from being reimbursed for Medicaid patients in their care for longer than 15 days. Enacted in 1965, the rule was part of a much bigger effort intended to create community-based capacity for mental health care in the least restrictive settings and prevent unnecessary institutionalization. Today — because that dreamed-of capacity was never developed — this policy leads to the discharging of vulnerable and unstable patients from supportive in-patient settings before they have gotten all the care they need and often before they have a place to go. As a result, we’re misfiring at great cost — spending efforts and resources, over and over again across systems, fail to meet the needs of seriously ill patients.